전인간호 개념에 입각한 신경외과 입원환자의 간호요구 조사에 관한 연구

Abstract

[한글]

현대간호의 목표인 인간중심의 개별적 간호를 시행하기 위해서는 각 개개인의 간호요구를 파악하여야 한다.

그러므로 본 연구는 신경외과 입원 환자의 간호요구를 파악하고, 파악된 간호요구와 인구 사회학적 특성과는 어떠한 상관관계가 있는지를 파악하여 간호계획에 필요한 자료를 제공하고자 시행하였다.

연구기간은 5월 14일∼6월 4일까지 3주간 이었고, 연구방법은 질문지를 통한 직접면접법을 사용하였으며, 통계적 분석방법으로는 백분율과 x**2-test를 이용하였다.

연구결과를 요약하면

1. 연구대상자의 일반적 특성은 평균연령이 40.9세, 남 녀 비는 1.2:1이었고, 교육수준과 경제수준이 중 이상인 도시 거주자가 대부분이었다. 또한 54.7%가 입원경험, 34.4%가 수술경험이 있는 응답자 이었다.

2. 진단과 치료 및 입원에 대한 응답자의 지각과 기대

진단에 대하여 알기를 원하는 응답자는 87.5%, 치료나 검사 전에 설명하여 주기 원하는 응답자가 98.4%이었다. 또한 87.5%가 좋은 치료를 받고있다고 응답하였으며, 95.3%가 차도가 없는 경우에도 계속치료를 받겠다고 응답하여 자신의 질병에 대하여 긍정적인 반응을 보였다. 가족과 함께 있기 원하는 응답자가 79.7%, 입원으로 가족에게 큰 영향을 준다가 75.0%이었다. 71.9%가 의료요원과 의사소통이 잘 된다고 하였으며, 의료요원과 이야기하고 나면 마음이 놓인다고 82.8%가 응답하였다.

40.6%에서 빠른 시일내에 퇴원하기를 원하였으며 51.5%가 병원생활이 갑갑하고 지루하며 불편하다고 하였다. 42.2%가 원목을 만나기 원하였고, 51.6%가 어떤 치료를 하는지 모르고 있었다.

이상의 결과로써 질병에 관한 교육적 간호요구, 퇴원을 위한 사회경제적 간호요구, 병원생활에 대한 심리적 간호요구 및 환경적 간호요구를 파악하였다.

3. 간호요구와 인구사회학적 특성

간호요구를 파악하기 위하여 작성한 질문에 대한 반응과 인구사회학적 변수 (연령, 성별, 교육정도, 거주지, 종교, 입원경험, 수술경험)와 진단과의 관계를 x**2-test로 검증한 결과 여자응답자가 더 원목을 만나기 원하였으며, (x**2=4.704, d.f.=1, P〈0.05), 연령이 많을수록 빠른 시일 내에 퇴원하기를 원하였다. (x**2=10.635, d.f.=4, P〈0.05) 도시응답자가 병의 원인을 더 잘 알고 있었으며 (x**2=6.236,, d.f.=2, P〈0.05), 종교인에게서 더 원목 만나기를 원하였고(x**2=9.823, d.f.=2, P〈0.05), 믿음으로 질병의 경과를 극복할 수 있다고 하였으며(x**2=6.382, d.f.=2, P〈0.05)), 병에 걸린 것이 죄의 댓가라고 생각하였다.(x**2=16.842, d.f.=2, P〈0.05)), 척수질환 응답자가 치료계획(x**2=12,421, d.f.=2, P〈0.05), 병의원인(x**2=7.546, d.f.=2, P〈0.05)을 더 잘 알고 있었고, 보행 장애가 많았다. (x**2=7.723, d.f.=2, P〈0.05）입원경험이 없는 응답자가 가족에게 큰 영향을 준다고 응답하였고(x**2=4.729, d.f.=1, P〈0.05), 수술경험이 있는 응답자가

수술경험이 없는 응답자 보다 높게 병에 걸린 것이 죄의 댓가라고 생각하였다. (x**2=7.283, d.f.=1., P〈0.05)

이상의 연구결과로 다음과 같은 제언을 첨부하고져 한다.

a. 일반적으로 입원으로 인하여 관련되는 사회 경제적 문제는 질병 자체보다 더 큰 문제가 되므로 사회보장제도 및 의료보험제도가 하루속히 확립되어야겠다.

b. 환자와 간단한 면접으로 간호요구를 파악할 수 있는 많은 자료를 얻을 수 있었으며 대인관계가 원만히 조성될 수 있었다. 그러므로 보다 표준화된 면접양식을 가지고 전 신경외과 환자를 대표할 만한 표본을 추출하여 보다 높은 수준의 연구를 시행할 것을 제의한다.

[영문]

It is necessary to understand the nursing needs by individual patient in order to undertake comprehensive nursing care which is a goal of modern nursing service.

Accordingly, this study is conducted to find out the nursing needs by neuro-surgical patients, to analyse co-relations between the number of patients and their sociological characteristics; thus providing necessary information in establishing future plans for improved nursing care.

The study was conducted between May 14, through June 4, 1977. The method used was a direct interview using prepared questionaires. The result was analysed by statistic-analysis method of percentage and x**2-test.

The result of the study revealed:

1. The general characteristics of the subjects of the study were: Average age was 40.9 years old; ratio of male and female was 1.2 to 1; educational and economic levels were upper-middle catagories; the predominent numbers were urban dwellers.

Out of the patients interviewed, 54.7% had had experience of being in-patients and 34.4% had undergone surgical operation.

2. The study on understanding and expectation by patients on diagnosis, treatment and nursing care: It is revealed that 87.5% of those who had been interviewed wanted to know about the diagnoses; 98.4% of them wanted to be informed of the diagnoses before proceeding to laboratory tests and treatment; 87.3% were satisfied with the treatment received at the hospital; 95.3% expressed desire of continued medical care at the hospital even no immediate result is known on the progress of recovery. Out of those who had been interviewed; 79.7% wanted their family members

to stay with them at the hospital, 75.0% thought their being in the hospital was causing difficulty to their family; 71.9% of them thought they were communicating with hospital staff satisfactorily; 82.8% of them felt easier after talking to hospital staff; 40.6% of them expressed hope of early discharge from the hospital, 51.5% of them found the life in hospital depressing, tedious and uncomfortable; 42.2% of them wanted to eet with hospital chaplain; 51.6% of them had no knowledge on the type of treatment he had been recieving. The above findings have provided the information on nursing needs on information of illness, nursing need based on socio-economic factors which make them desirous of early discharge, nursing need based on psycological effect caused by in-patient treatment and environmental nursing need.

3. Nursing need and population-sociological characteristics.

the analysis through x**2-test on the responses to the questionaires on nursing needs provided by patients and their population-sociological variables reveales that more females want to talk to chaplain (x**2=4.704, d.f.-1, p<0.05), higher age bracket wants early discharge (x**2=10.635, d.f.=4, p<0.05), urban dwellers knew more about their illness (x**2=6.263, d.f.=1, p<0.05). Those who have religious faith indicated higher degree of desire of seeing chaplian (x**2=9.823, d.f.=2, p<0.05), they believed that their religious faith could help them overcome sickness (x**2=6.382, d.f.=2, p<0.05) and they thought their want of good health was result of lack of religious faith (x**2=16.842, d.f.=2, p<0.05).

Among the patients interviewed those who had spinal cord disease knew more about the cause of their illness(x**2=7.456, d.f.=2, p<0.05) and larger number of them had difficulty of walking (x**2=7.723, d.f.=2, p<0.05). Those who had no previous

experience of being admitted in ahospital considered that they were causing their family problem(x*82=4.729, d.f.=2, p<0.05). Those who had undergone surgical operation believed that their ailment was a payment of their own sin (x**2=7.283, d.f.=1, p<0.05).

Based on the result of the study and analysis listed above, the following suggestions are made;

a. In general speaking, socio-economic problems arising from being admitted into hospitals are roe serious than the disease itself. It is therefore recommended that the social security system and medical insurance system be established as soon as

possible.

b. Interviews with patients have provided many informations necessary for understanding nursing needs and have helped in promoting better human relations. It is therefore recommended that further study is made with improved questionaires on a broader scope of the subject that might be regarded as representing the entire neurosurgical patients.