자궁적출술 환자의 간호요구에 관한 조사연구

Abstract

[한글]

본 연구는 자궁적출술 환자의 수술후 1일 부터 8일간 병원입원시 간호요구를 파악하여 보다 효과적인 간호업무를 위해 기초자료를 제공하기 위한 목적으로 시도되었다.

자궁적출술 환자의 간호요구도를 측정하기 위해 연구도구로는 Abdellah의 21가지 간호문제 중 자궁적출술 환자에게 해당하는 18가지 간호문제와 Henderson의 14가지 간호문제 중 13가지 간호문제를 근거로 하여 신체·생리적 간호요구 15문항, 정서·심리적 간호요구 14문항, 교육적 간호요구 14문항등 총43개의 문항으로서 본 연구자에 의해 작성된 질문지를 사용하였다.

자료수집 기간은 1985년 2월 24일부터 3월 23일까지였다.

수집된 자료는 SPSS프로그램을 이용하여 백분율, 평균, t-검정, 분산분석, pearson상관계수의 통계방법으로 분석하였다. 본 연구의 결과는 다음과 같다.

1. 대상자의 신체·생리적 간호요구도는 평균평점 3.88, 정서·심리적 간호요구도는 4.23, 그리고 교육적 간호요구도는 4.22로 정서 ·심리적 간호요구도 평균평점이 가장 높게 나타났다

2. 대상자의 간호요구도가 일반적 특성 및 부인과적 특성에 따라 차이가 있는지를 확인하기 위한 관계분석에서 본인직업에 따른 신체·생리적 간호요구도 평균평점 간에는 통계적으로 유의한 차이가 나타났으며, 수술에 관해 의사로 부터 설명을 들은 환자가 듣지 않은 환자보다 신체·생리적 간호요구도 평균평점이 낮았으며, 이는 P<.05 수준에서 통계적으로 유의하계 나타났다. 수술후 경과시기에 따라서는 수술후 3일이전 환자보다 4일에서 8일 사이의 환자가 신체·생리적 간호요구 평균평점이 낮았으며 이는 통계적으로 P<.05 수준에서 유의하게 나타났다.

정서·심리적 간호요구도는 의사로 부터 수술에 관한 설명을 받은 군이 받지않은 군보다 낮게 나타났고, 수술을 권한 사람이 누군가에 따라서도 정서·심리적 간호요구도 평균평점이 통계적으로 유의한 차이가 있는 것으로 나타났다.( P<.05 )

교육적 간호요구도는 연령, 학력, 월평균수입, 남편직업, 수술을 권한 사람에 따라 통계적으로 유의하게 나타났다.( P<.05 )

3. 자궁적출술 환자의 걱정은 전체문항 평균평점이 2.808로 나타났고. ‘후유증 없는 정상적 회복’ 4.348로서 가장 높은 평균평점을 보여 주었고, ‘피로하고 기운이 없는 것’ ( 4.326). ‘아내나 어머니 역할 상실’ (4.079)에 관한 문항 순으로 높게 나타났다.

수술에 관해 의사로 부터 설명을 들은 군이 듣지않은 군보다 걱정정도 점수가 통계적으로 유의하게 낮은 것으로 나타났다.( P<.05)

4. 대상자들은 수술후 성교육과 상담을 누구에게 받길 원하는가에 대한 질문에 간호원 47.2%, 의사 47.2%. 성교육 전문요원 5.6%의 순으로 나타났다.

결론적으로 수술에 대해 설명을 받은 환자가 걱정정도가 낮게 나타났고, 이러한 걱정정도는 간호요구와 밀접한 상관관계를 나타냈다. 또한 환자들은 퇴원후 대처방법과 남편의 태도등에 높은 관심도를 나타냈고 거의 과반수의 환자들이 간호원으로 부터 수술 후 성교육과 상담을 받기를 원하고 있으므로 보호자교육과 성교육 및 퇴원교육등 보다 전문적이고 다양한 임상교육프로그램이 개발되어야 할 것이며, 수술 경과 시기에 따라서도 구체적인 간호중재와 계획이 요구될 것으로 사료된다.

[영문]

The purpose of this study was to determine the nursing needs of the hysterectomy patient during the post-operative period, from surgery through the while the patient was on the Gynecologic unit, in order to provide a foundation for more effective nursing care.

The instrument used for this study was the hysterectomy patient needs scale developed by the researcher. The questionnaire was composed of 43 items; including 15 physical and biological nursing needs, 14 emotional and psychologioal nursing needs and 14 educational nursing needs which were selected from nursing needs given by Abdellah and Henderson.

The subjects of this study were 89 patients who received hysterectomies in the Gynecologic units of five hospitals in Seoul and six hospitals located outside of Seoul.

The data was collected during a 28-day period from February 24, 1985 to March 23, 1985.

The data were analyzed by means of the SPSS program using percentile, mean, standard deviation, t-test, ANOVA, and pearson correlation coefficient.

The findings or this study were as follows;

1. In nursing needs of subjects the mean score of the physical and biological nursing needs was 3.88, the mean score of the emotional and psychological nursing needs was 4.23, and the mean score of the educational nursing needs was 4.22. So the emotional and psychological nursing needs score was the highest.

2. The analysis results of the relationship between nursing needs and general and gynecological charateristics were as follows. There was a significant difference found to exist between the scores of physical and biological nursing needs

according to the patient's occupation and the mean scores of physical and biological nursing needs of patients who were given an explanation about a hysterectomy by a doctor were significantly lower than those of patients who were given an explanation about a hysterectjomy by a doctor were significantly lower than those of patients who were not given an explanation.

The mean score of the physical and biological nursing needs of patients up to and including the 3rd post operative day was significantly higer than the score of patients 4 to 8 days after surgery with a statistically significance at p<.05 level.

In regard to emotional and psychological nursing needs, the score of patients who were given an explanation about the operation by the doctor was significantly lower than that of the patients who were not given an explanation. (p<.05)

And there was found to be a significant difference in the emotional and psychological needs of the patient, according to who recomended the operation.

The educational needs mean score, varied according to age, educational level, regular family income per month, husband's occupation and the person who recommended the operation.

3. The mean score of the total items of the hysterectomy patients' anxiety was 2.808. The item that received the highest score(4.348) was "normal recovery without complication". The item that was next in froquency (4.326) was "fatigue and loss of strength" and the item that was third in frequency (4.079) was the "Change in role of mother and wife" The anxiety level of patients who were given an explanation about hysterectomy was significantly lower than that of patients who were not given an explanation.

4. In regard to sex education, 47.2% of the hysterectomy patients wanted to receive sox education from the nurse after a hysterectomy, 47.2% of the subj ects wanted this information from the doctor, and the other 5.6% of subjects wanted to receive it from a person specializing in sex education.

In conclusion, the anxiety level of the patients who were given an explanation about a hysterectomy was significantly lower than that of patients who were not given an explanation. And the hysterectomy patients were concerned about coping after their discharge and about their husband's attitude and almost half the

patients wanted to receive sex education from the nurse after a hysterectomy. So, Nurses need to develop more professional nursing inservice education; family education, discharge education and a sex education program for patients who have had a hysterectomy. And I think nurses should carefully prepare nursing plans and carry out nursing intervention according to the patient's postoperative needs.