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허혈성 심질환(Ischemic Heart Disease)환자 재활간호를 위한 지식정도와 교육요구 파악에 관한 일 연구

Other Titles
 (A) study of the level of knowledge & educational need for cardiac rehabilitation of ischemic heart disease patients 
Issue Date
1987
Description
간호학교육/석사
Abstract
[한글] 많은 허혈성 심질환 환자들이 신체적 고통과 제한이외에도 가족문제, 계속 치료에 의한 경제적 부담, 질병에 대한 불확실성, 직업에의 복귀등 많은 문제는 이들 환자에게 심리적 부담을 가중시키고 있고 이로 인해 정상생활에 적응이 지연되고 있다. 그러므로 이들이 빠른 시일내에 정상생활에 복귀하여 최적의 삶을 유지하기 위하여 재활간호가 필요하며 재활의 많은 비중을 차지하는 환자교육은 매우 중요하며 재활에 영향을 주는 환자교육의 필요성이 대두된다. 이에 본 연구는 허혈성 심질환 환자의 재활을 위한 지식정도와 교육요구를 파악하므로써 간호원으로 하여금 허혈성 심질환 환자의 재활간호에 대한 인식을 높이고 개별요구에 입각한 조직적이고 효과적인 환자교육을 계획하고 수행하는데 기초자료를 제공하기 위하 여 시도되었다. 연구대상은 허혈성 심질환 환자로 서울시내에 소재하고 있는 대학부속병원 4개소와 종합병원 1개소에 입원했거나 외래에 통원치료 받는 환자를 포함하여 65명을 임의표출 방법으로 선정했으며, 자료수집 기간은 10월 13일부터 10월 31일까지 하였다. 연구도구는 지식정도를 측정하는 도구는 Rahe등이 UCLA Medical Center에서 허혈성 심질환 환자의 재활교육 평가도구로 사용한 83문항을 번역하여 그중 40문항을 수정보완하여 사용하였는데 7영역에 40문항으로 구성되었고 선다형과 진·위를 가리는 문제로 구성에 되었다. 교육요구의 측정도구는 문헌고찰을 통해 본 연구자에 의하여 개발되었다. 이는 7영역 30문항으로 구성되었으며 5점 Likert 척도를 사용하였다. 수집된 자료의 분석 SPSS 프로그램으로 전산처리하였다. 방법은 실수, 백분율, 평균, 표준편차 t-test , ANOVA와 Pearson correlation Coefficiency를 사용하였다. 본 연구의 결과는 다음과 같다. 1. 허혈성심질환 환자는 연령은 최저 24에서 최고 74세 까지로 평균연령은 55세였다. 남자가 55.4%, 여자가 44.6%를 나타내었다. 경제상태는 81만원이상이 24.6%를 나타내어 대상자는 비교적 안정된 상태를 나타냈다. 환자구분에서는 입원환자가 46.2% 외래환자 42.2%를 차지했다. 2. 대상자의 허혈성심질환에 대한 지식정도를 측정한 결과 42점 만점에 최저 10점 촤고 34점이었고 범위는 24점이었다. 대상자의 평균점수는 24.308 표준편차 4.548이었고, 21점에서 34점까지가 77.1%로 가장 높은비율이고, 총42점을 3집단으로 나누어보면 평균 24. 308은 15-29점 집단에 속하므로 보통수준이라고 할 수 있다. 영역별 평균점수는 위험요인의 확인과 조절에 관한 평균점수가 7점만점에 5.246, 표준편차 1.50O 평균평점 0.749를 나타내어 가장 높은 지식점수를 나타내었고 가장 낮은 지식영역은 질병의 특성에 관한 영역으로 6점만점에 2.815 ± 1.150을 나타내었다. 문항별로 볼때 식이에 관한 영역중 "심장병에는 저염식이가 좋다"에 96.9%의 정답율을 나타내었고 가장 낮은 정답율을 보인 문항은 운동 및 일상생활의 영역에서 "심장병 발병후 2-3주간 안정을취한다"의 문항으로 10.8%의 정답율 나타내었다. 3. 허혈성심질환 환자의 교육요구를 질병에 관한 영역, 심리·사회적영역, 위험요인의 확인과 조절영역, 투약영역, 식이영역, 운동과 일상생활, 추후간호와 치료등 7개영역에 대한 "매우알기원한다"의 최대평점 5점에 대해 평균 4.149 표준편차 .700을 나타내여 비교적 높은 교육요구를 나타내었다. 대상자의 교육요구점수는 최저 43점에서 최고 150점이었으며 평균 124.015 표준편차 16.678로 높은 교육요구를 나타내었다. 가장 높은 교육요구를 보인 영역은 질병에 관한 영역으로 최대평점 5점에 대해 4.345, 표준편차 .550이었다. 또 가장 낮은 교육요구를 보인 영역은 운동과 일상생활에 관한 영역으로 평균 3.859 표준편차 .762의 순으로 나타났다. 가장 높은 교육요구를 나타낸 문항은 "심장의 통증 혹은 발작을 일으키는 요인에 대하여"로 최대평점 5점에 대해 평균 4.585표준편차 .610을 나타내었다. 또 가장 낮은 교육요구를 나타낸 문항은 "성생활을 할 수 있는 시기와 주의사항에 대하여"로 평균 3.508을 나 타내었다. 4.대상자의 허혈성 심질환에 대한 지식정도와 교육요구와의 관계를 파악한 결과 교육요구의 심리·사회적측면의 영역은 지식정도의 위험요인의 확인 및 조절영역과 식이에 관한 영역 추후간호와 치료영역과 통계적으로 유의한 관계가 있는 것으로 나타났다(r=.3031 p<.01 : r=.2154, p<.05 ; r=.2649, p<.05) 교육요구의 위험요인의 확인 및 조절영역은 지식정도의 위험요인의 확인 및 조절영역과는 서로 통계적으로 유의한 관계를 나타내었다.(r=.2425, p<.05) 교육요구의 운동과 일상생활 영역은 지식의 투약에 관한 영역과 통계적으로 유의한 관계를 나타내었다(r=.2397, p<.05) 5 . 대상자의 일반적특성과 허혈성심질환에 대한 지식과의 관계에서는 연령은 심리 ·사회적영역, 투약에 관한 영역과 통계적으로 유의한 역상관 관계를 나타내었다(r=-.2007, p<.05; r=-.3436, p<.01) 지식정도의 총득점은 최종학력과 가족의 심장병 유무와 통계적으로 유의한 차이를 나타내었다(F:4.205, p<.05; t:7.06, p<.05) 6.대상자의 일반적특성과 허혈성심질환에 대한 교육요구와의 관계에서 연령은 심리 ·사회측면에 관한 영역 ,운동과 일상생활에 관한 영역과 통계적으로 유의한 순상관 관계와 역상관 관계를 나타내었다(r=.2176, p<,05; r=-.2147, p<.05) 입원횟수는 교육요구의 심리·사회측면영역과 통계적으로 유의한 관계를 나타내었다(r:.3855, p<.05) 교육요구의 총득점과 환자구분과는 통계적으로 유의한 관계를 나타내었다(t:2.65, d.f:63, p<.05),즉 입원환자가 외래환자보다 교육요구가 높은 것으로 나타났다. 7. 더 알기 원하는 것에 대한 대상자의 의견에서 65명중 23명이 더 알기 원하는 내용에 대해 의견제시를 했으며 심장병에 대한 안내책자나 모범답안지식의 팜플렛을 입원시 주기를 원했다. 결론적으로 허혈성 심질찬 환자의 지식은 대상자간에 차이가 많았고, 영역별 점수차이가 있었으며 교육요구는 모든 영역에서 일반적으로 높은 교육요구를 나타내에 많은 건강정보를 받기를 원하는 것을 알 수 있다. 이는 허혈성 심질환 환자들의 재활에 대한 간호원의 인식을 높이고 조직적이고 체계적인 교육계획이 필요함과 이를 실천해야할 간호역할을 명백히 해 주었다. A STUDY OF THE LEVEL OF KNOWLEDGE & EDUCATIONAL NEED FOR CARDIAC REHABILITATION OF ISCHEMIC HEART DISEASE PATIENTS Hwang, Kyung Ja Department of Nursing Education The Graduate School of Education, Yonsei University (Directed by Professor San Cho Chun, D.Sc) Patients with ischemic heart disease experience delayed adaptation to optimal life because they have many problem which limit physical activity, family problem, economic problem related to long term care, uncertainty of the disease and returning to occupation or work, and so they were affected by psychosocial problem. Therefore, it was apparent that there is a need to identify the level of knowledge and educational need for the patient with ischemic heart disease. This is a fundamental necessity for patients rehabilitation. So the patients education is very important because it affects the cardiac rehabilitation process. Therefore the purpose of this study was : 1 to increase the perception of nurses regarding cardiac rehabilitation 2. to provide a fundamental resource for establishing o norgaraized, effective, formal educational plan for meeting individual needs of ischemic heart disease patients. The study group was defined. Sixty-five patients with ischemic heart disease were selected. They were both inpatients & out patients in four university hospital and one general hospital, each baying over 500 beds. All hospitals were in seoul. Data was collected from October 13 to 31, 1986.The tool 7ed for a Level of knowledge in this study was the questionnaire based on leaching evaluation for ischemic heart disease, developed by Ruhe. et at. at UCLA metrical center. A questionnaire was devised to mesaure the patients' knowledge .It was composed of 40 items in 7 specific areas related to ischemic heart disease . In the above questionnaire two question formals were used; multiple choice and "true or false". Another tool which measured educational need was developed and modified by the researcher from review of literature. The educational need scale included 30 items in 7 areas and the questions used were 5 points Likert type. The data was analyzed by means of the sass program using population, percentile, mean, standard deviation, t-test, husband pearson correlation coefficients . The results of this study was as follows : 1. Demographic characteristics of the sample : The respondents' average age was 54 years, sex ratio (male to female)revealed as 1.24:1 economic back ground was mostly middle high class. Most came from sin히e family units (63.1%). 2. The knowledge of ischemic heart disease. The 42 points of the 40 questions asked, minimum score of patients was 10 points and maximum score was 34 points, and the range was 24. The respondent's mean score of knowledge was 24, 308,standard deviation was 4.548. In measuring the knowledge of risk factor in ischemic heart disease the highest mom scoff was 5.246, standard deviation was 1.500, and the lowest was related to follow-up care and treatment at 1.420, standard deviation was 0.844. 3. For educational needs the average mean score was 4.149,standard deviation 0.700, to maximum mean scone 5 point, so it revealed high education needs. We reviewed the result for educational needs ; the hishest mean score was related to the nature of the disease at 4.345, standard deviation was 0.550 and the lowest score was related to excercise and daily activities at 3.859,standard deviation 0.762. 4. The analyze of the results of correlation between knowledge of ischemic heart disease and educational needs revealed the following: There was a positive correlation between psychosocial educational need and identifying & modifying of risk factors (r=.3031 p<.01, area of diet (r=.2154 p<.05) and follow up care and treatment related to knowledge of ischemic heart disease . A significant correlation was revealed in the educational need area of identifying & modifying risk factor to the knowledge of ischemic heart disease . A significant correlation was revealed between excercise and daily activities and medication and the knowledge of ischemic heart disease. (r=.2397, p<.05) 5. The results of the study of the relationship between the level of knowledge and demographic characteristics were as follows. Age was found to be a significant negative statistical difference in relation to the psychosocial area. (r=-.2007,p< ,05) and medication (r=-.3466, p<.05) Significant positive results were noted in the relation-ship between nature of the disease and educational level of patients with ischemic heart disease. (F=3.304, df=4,p<.05) A significant statistical difference 7as found in the area identity and modification of the risk factor in ischeamic heart disease patients according to the patient's marital status (t=2.22,d.f=62, p<.05) , and the area of dirt oE ischeaic heart disease patients acco「din칭 topt's family structure (single of heart family) (t=2.22,d.f=62, p<.05), family history of heart disease, (p<.05)educational level (p< .05) and occupation. 6. The analyzed results of the study of the relationship between educational needs and demographic characteristics were as follows: A significant difference was noted between psychosocial area of educational needs (r=.1076, p<.05), and a negative significant difference according to pl is age(r=-.2147, p< .05) A significant difference was found the psychosocial of educational need of ischemic heart disease patient according to number of admissions and arccording to whether they were inpation or outpatient. (p<.05) 7. The results Of the Questions relation to the opinion regarding the need for more education showed 35.3? ofpatients answered that they wanted a guide book or panplet about heart diease after admission or a visit to outpatient department. In conclusions, the study showed great variation in the level of knowledge of the disease among ischemic heart disease patients, but the educational needs of ischemic heart disease pt's showed the highest mean score. Nurses must be aware that it is necessary to establish an organized systemic educational plan for patient of ischemic heart disease and this is clearly the responsibility of the nurse.
[영문] Patients with ischemic heart disease experience delayed adaptation to optimal life because they have many problem which limit physical activity, family problem, economic problem related to long term care, uncertainty of the disease and returning to occupation or work, and so they were affected by psychosocial problem. Therefore, it was apparent that there is a need to identify the level of knowledge and educational need for the patient with ischemic heart disease. This is a fundamental necessity for patients rehabilitation. So the patients education is very important because it affects the cardiac rehabilitation process. Therefore the purpose of this study was : 1 to increase the perception of nurses regarding cardiac rehabilitation 2. to provide a fundamental resource for establishing o norgaraized, effective, formal educational plan for meeting individual needs of ischemic heart disease patients. The study group was defined. Sixty-five patients with ischemic heart disease were selected. They were both inpatients & out patients in four university hospital and one general hospital, each baying over 500 beds. All hospitals were in seoul. Data was collected from October 13 to 31, 1986.The tool 7ed for a Level of knowledge in this study was the questionnaire based on leaching evaluation for ischemic heart disease, developed by Ruhe. et at. at UCLA metrical center. A questionnaire was devised to mesaure the patients' knowledge .It was composed of 40 items in 7 specific areas related to ischemic heart disease . In the above questionnaire two question formals were used; multiple choice and "true or false". Another tool which measured educational need was developed and modified by the researcher from review of literature. The educational need scale included 30 items in 7 areas and the questions used were 5 points Likert type. The data was analyzed by means of the sass program using population, percentile, mean, standard deviation, t-test, husband pearson correlation coefficients . The results of this study was as follows : 1. Demographic characteristics of the sample : The respondents' average age was 54 years, sex ratio (male to female)revealed as 1.24:1 economic back ground was mostly middle high class. Most came from sin히e family units (63.1%). 2. The knowledge of ischemic heart disease. The 42 points of the 40 questions asked, minimum score of patients was 10 points and maximum score was 34 points, and the range was 24. The respondent's mean score of knowledge was 24, 308,standard deviation was 4.548. In measuring the knowledge of risk factor in ischemic heart disease the highest mom scoff was 5.246, standard deviation was 1.500, and the lowest was related to follow-up care and treatment at 1.420, standard deviation was 0.844. 3. For educational needs the average mean score was 4.149,standard deviation 0.700, to maximum mean scone 5 point, so it revealed high education needs. We reviewed the result for educational needs ; the hishest mean score was related to the nature of the disease at 4.345, standard deviation was 0.550 and the lowest score was related to excercise and daily activities at 3.859,standard deviation 0.762. 4. The analyze of the results of correlation between knowledge of ischemic heart disease and educational needs revealed the following: There was a positive correlation between psychosocial educational need and identifying & modifying of risk factors (r=.3031 p<.01, area of diet (r=.2154 p<.05) and follow up care and treatment related to knowledge of ischemic heart disease . A significant correlation was revealed in the educational need area of identifying & modifying risk factor to the knowledge of ischemic heart disease . A significant correlation was revealed between excercise and daily activities and medication and the knowledge of ischemic heart disease. (r=.2397, p<.05) 5. The results of the study of the relationship between the level of knowledge and demographic characteristics were as follows. Age was found to be a significant negative statistical difference in relation to the psychosocial area. (r=-.2007,p< ,05) and medication (r=-.3466, p<.05) Significant positive results were noted in the relation-ship between nature of the disease and educational level of patients with ischemic heart disease. (F=3.304, df=4,p<.05) A significant statistical difference 7as found in the area identity and modification of the risk factor in ischeamic heart disease patients according to the patient's marital status (t=2.22,d.f=62, p<.05) , and the area of dirt oE ischeaic heart disease patients acco「din칭 topt's family structure (single of heart family) (t=2.22,d.f=62, p<.05), family history of heart disease, (p<.05)educational level (p< .05) and occupation. 6. The analyzed results of the study of the relationship between educational needs and demographic characteristics were as follows: A significant difference was noted between psychosocial area of educational needs (r=.1076, p<.05), and a negative significant difference according to pl is age(r=-.2147, p< .05) A significant difference was found the psychosocial of educational need of ischemic heart disease patient according to number of admissions and arccording to whether they were inpation or outpatient. (p<.05) 7. The results Of the Questions relation to the opinion regarding the need for more education showed 35.3? ofpatients answered that they wanted a guide book or panplet about heart diease after admission or a visit to outpatient department. In conclusions, the study showed great variation in the level of knowledge of the disease among ischemic heart disease patients, but the educational needs of ischemic heart disease pt's showed the highest mean score. Nurses must be aware that it is necessary to establish an organized systemic educational plan for patient of ischemic heart disease and this is clearly the responsibility of the nurse.
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2. 학위논문 > 3. College of Nursing (간호대학) > 석사
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