조혈모세포이식 환자용 교육지침서 개발

Abstract

[한글]본 연구는 조혈모세포이식을 시행 받는 환자들의 자가간호 능력을 증진시키고 자가간호 행위가 효율적으로 이루어지도록 하기 위해 치료과정에 필요한 지식과 기술을 습득하도록 하여 치료에 효과적으로 참여하도록 하기 위한 조혈모세포이식 환자용 교육지침서를 개발하는 것이다.예비지침서 개발을 위하여 먼저 국내병원 및 국외 조혈모세포이식기관에서 제공하는 교육 자료를 분석하여 이식 전, 중, 후 각 이식 단계에 필요한 교육항목을 선정하여 예비교육지침서를 개발하였다.예비지침서의 교육 항목에 대한 전문가 집단의 타당도 검증을 실시하기 위하여 조혈모세포이식 분야에 근무하는 12명의 전문가 집단을 구성하여 타당도 검증을 실시하였으며 임상적용 가능성 검증을 위해서는 이식 전, 중, 후 단계에 있는 환자 5명에게 예비지침서를 배부 후 의견을 수렴하여 조혈모세포이식 환자를 위한 최종 교육지침서를 개발하였다.본 연구의 결과는 다음과 같다.1. 예비교육지침서를 개발하기 위하여 국내, 외 조혈모세포이식을 실시하는 10개의 기관에서 환자들에게 제공하고 있는 가이드북의 내용을 검토, 비교 분석하여 교육지침서 교육내용의 구성항목을 도출하였다.교육내용의 구성항목은 이식 전, 이식 중, 이식 후 이식 각 단계별로 나누어 내용을 구성하였다.2. 교육내용 구성항목에 대한 전문가 타당도 검증결과 문항별 CVI는 이식 전, 중, 후, 전체 42문항 중 41개 문항이 전문가 합의률 80%이상의 나타내었으며 1개의 문항만이 77%의 합의률을 나타내었다. 77%의 합의률을 보인 국립장기이식센터 승인에 대한 내용은 전문가의 합의를 거쳐 교육내용에 포함하기로 하였다. 전체 문항에 대한 CVI는 0.92로 높게 나타났다.3. 조혈모세포이식을 시행 받을 예정이거나 받은 5명의 환자를 대상으로 임상 적용가능성에 대한 타당도를 검증을 실시하여 추가적 내용으로 원하는 혈소판 공여자관리 및 영양관리에 대한 좀 더 구체적인 설명과 이식소요비용, 만성합병증관리에 대한 내용을 추가하였다.4. 전문가 타당도 및 임상타당도 검증을 거쳐 최종 조혈모세포이식환자 교육지침서를 개발하였다.

[영문]This study developed and tested an information booklet for the education of patients undergoing Hematopoetic Stem Cell Transplantation. It is envisaged to assist patients in understanding the treatment process for their effective participation and to better prepared them for self-care.Many health organizations and hospitals have information on the treatment of Hematopoetic Stem Cell Transplantation. This thesis gathers information from the many sources for the different periods of care. These periods are categorised as follows: before treatment, during treatment and after treatment. Information was drawn from hospitals in Korea, international hospitals and the Hematopoietic Stem Cell Transplantation Agency. From the information gathered a preliminary booklet was developed which contained pertinent information regarding the treatment for the educational benefit of the patient. The information was grouped into the three categories as mentioned above.A group of twelve specialists who work in the field of Hematopoietic Stem Cell Transplantation conducted a content validity test to assess the relevance of the information in initial research prior to the drafting of the preliminary booklet. Some material was added due to their feelback and the preliminary booklet was drafted.Five patients in the different stages of Hematopoietic Stem Cell Transplantation treatment were given the preliminary booklet as a trial. Feedback from the group of patients was used to compile the final version of the educational booklet.Methodology:1. Treatment guides provided by ten health agencies in the field of Hematopoietic Stem Cell Transplantation were researched and the content analysed. A single preliminary booklet was developed using this information. The information was divided into three sections; before, during and after treatment to reflect the three periods of care.2. Content Validity Testing was conducted by twelve specialists. Forty two topics were selected from the initial research to be included in the preliminary booklet. 80% of the specialists agreed that in the case of forty one topics, the information was of sufficient detail and of relevance to the patient. One topic had 77% of the specialists' agreement as to relevance and detail. As a result of discussions, the topic of the National Internal Organs Center was expanded to incorporate more information. Overall, the Content Validity Test rating was 0.92.3. Patients in the different stages of Hematopoietic Stem Cell Transplantation were given the preliminary booklet and requested to provide feedback as to the relevance, scope and ease of understanding based on their experiences of the treatment. The patients were requested to list any information that they felt should be covered in more detail or added. As a result, information regarding platelet-pheresis donations, chronic complication management and a better outline of the total treatment cost were added.4. The final draft of the educational booklet was developed from the feedback from the patients and experts in the field of Hematopoietic Stem Cell Transplantation as outlined above.