본 연구는 혈액투석환자의 신체증상, 불확실성, 극복력, 자가간호역량에 관한 연구를 통하여 혈액투석환자의 자가간호역량을 증진하는데 필요한 기초자료를 제공하기 위해 시도된 서술적 상관관계 연구이다. 본 연구는 혈액투석전문병원에서 혈액투석치료를 받고 있는 환자 133명을 대상으로 2017년 9월 6일부터 9월 19일까지 혈액투석환자의 일반적 특성 및 신체증상, 불확실성, 극복력, 자가간호역량을 파악하고자 구조화된 설문지를 이용하여 자료를 수집하였다. 연구도구로 신체증상은 Weisbord등이 개발하고 Shin이 번안한 도구를 본 연구자가 수정 보완한 Dialysis Symptom Index (...
본 연구는 혈액투석환자의 신체증상, 불확실성, 극복력, 자가간호역량에 관한 연구를 통하여 혈액투석환자의 자가간호역량을 증진하는데 필요한 기초자료를 제공하기 위해 시도된 서술적 상관관계 연구이다. 본 연구는 혈액투석전문병원에서 혈액투석치료를 받고 있는 환자 133명을 대상으로 2017년 9월 6일부터 9월 19일까지 혈액투석환자의 일반적 특성 및 신체증상, 불확실성, 극복력, 자가간호역량을 파악하고자 구조화된 설문지를 이용하여 자료를 수집하였다. 연구도구로 신체증상은 Weisbord등이 개발하고 Shin이 번안한 도구를 본 연구자가 수정 보완한 Dialysis Symptom Index (DSI)를, 불확실성 측정을 위하여 Mishel이 개발하고 Jung이 번안한 Uncertainty in Illness Scale (MUIS), 극복력 측정을 위하여 Conner와 Davidson이 개발하고 Baek이 번안한 Korean Version of Conner-Davidson Resilience Scale (K-CD-RISC)을 사용하였다. 자가간호역량 측정은 Geden과 Taylor가 개발한 도구를 So가 번안한 Self-as-Carer Inventory (S.C.I)를 이용하였다. 수집된 자료는 SPSS 23.0 프로그램을 이용하여 빈도와 백분율, 평균과 표준편차, t-test, ANOVA, 사후검증으로 Scheffé test, Pearson’s correlation coefficient, Multiple regression analysis를 이용하여 분석하였다.
본 연구결과는 다음과 같다.
1. 대상자 중 남성이 87명(65.4%)이며, 평균 연령은 60.41세로 60-69세가 39명(29.3%)로 가장 많았다. 현재 건강상태에 대해서는 ‘보통이다’가 65명(48.9%)이었고, 투석 기간은 5년 이하가 85명(63.9%)으로 가장 많았다.
2. 혈액투석환자의 신체증상 평균은 35.80±11.20점(75점 기준)이며, 나이(F=3.15 p=.027), 최종학력(F=6.52, p<.001), 규칙적인 운동(t=-3.49, p=.003), 월수입(F=4.44, p=.014), 건강상태(F=11.00, p<.001)에 따라 통계적으로 유의한 차이가 있었다.
3. 혈액투석환자의 불확실성 평균은 95.66±9.78점(165점 기준)이며, 나이(F=4.80, p=.003), 최종학력(F=7.58, p<.001), 월수입(F=8.20, p<.001), 혈액투석기간(F=3.24, p=.024)에 따라 통계적으로 유의한 차이를 보였다.
4. 혈액투석환자의 극복력 평균은 55.98±15.47점(100점 기준)이며, 종교(F=3.78, p=.012), 최종학력(F=5.47, p<.001)), 혈액투석기간((F=2.90, p=.037)에 따라 통계적으로 유의한 차이가 있었다.
5. 혈액투석환자의 자가간호역량 평균은 134.83±24.24점(204점 기준)이며, 최종학력(F=7.98, p<.001), 월수입(F=4.87, p=.009), 건강상태(F=3.10, p=.048)에 따라 통계적으로 유의한 차이가 있었다.
6. 혈액투석환자에서 신체증상은 불확실성(r=.18 p=.029)과 정적 상관관계, 극복력(r=-.25 p=.003), 자가간호역량(r=-.41, p<.001)과 부적 상관관계가 있었고, 불확실성은 극복력(r=-.34 p<.001), 자가간호역량(r=-.37 p<.001)과 부적 상관관계, 극복력은 자가간호역량(r=.65, p<.001)과 정적 상관관계가 있었다. 7. 혈액투석환자의 가간호역량에 영향을 미치는 요인을 확인하기 위해 다중회귀분석(Multiple Regression Analysis)을 한 결과, 설명력은 51.8%이었다. 극복력(β=.53, p<.001), 신체증상(β=-.23, p<.001), 불확실성(β=-.13, p=.046)이 자가간호역량에 영향을 미치는 것으로 나타났다. 즉, 극복력이 높을수록, 신체증상과 불확실성이 낮을수록 자가간호역량이 증가하는 것으로 나타났다.
혈액투석환자의 자가간호역량은 극복력, 신체증상, 불확실성에 영향을 받는 것으로 나타났다. 이 결과에 근거하여 혈액투석환자의 신체증상을 조기 사정하고 극복력을 향상시키기 위한 간호중재개발과 불확실성을 낮추기 위한 상담 과 교육중재가 필요함을 확인하였다.
본 연구는 혈액투석환자의 신체증상, 불확실성, 극복력, 자가간호역량에 관한 연구를 통하여 혈액투석환자의 자가간호역량을 증진하는데 필요한 기초자료를 제공하기 위해 시도된 서술적 상관관계 연구이다. 본 연구는 혈액투석전문병원에서 혈액투석치료를 받고 있는 환자 133명을 대상으로 2017년 9월 6일부터 9월 19일까지 혈액투석환자의 일반적 특성 및 신체증상, 불확실성, 극복력, 자가간호역량을 파악하고자 구조화된 설문지를 이용하여 자료를 수집하였다. 연구도구로 신체증상은 Weisbord등이 개발하고 Shin이 번안한 도구를 본 연구자가 수정 보완한 Dialysis Symptom Index (DSI)를, 불확실성 측정을 위하여 Mishel이 개발하고 Jung이 번안한 Uncertainty in Illness Scale (MUIS), 극복력 측정을 위하여 Conner와 Davidson이 개발하고 Baek이 번안한 Korean Version of Conner-Davidson Resilience Scale (K-CD-RISC)을 사용하였다. 자가간호역량 측정은 Geden과 Taylor가 개발한 도구를 So가 번안한 Self-as-Carer Inventory (S.C.I)를 이용하였다. 수집된 자료는 SPSS 23.0 프로그램을 이용하여 빈도와 백분율, 평균과 표준편차, t-test, ANOVA, 사후검증으로 Scheffé test, Pearson’s correlation coefficient, Multiple regression analysis를 이용하여 분석하였다.
본 연구결과는 다음과 같다.
1. 대상자 중 남성이 87명(65.4%)이며, 평균 연령은 60.41세로 60-69세가 39명(29.3%)로 가장 많았다. 현재 건강상태에 대해서는 ‘보통이다’가 65명(48.9%)이었고, 투석 기간은 5년 이하가 85명(63.9%)으로 가장 많았다.
2. 혈액투석환자의 신체증상 평균은 35.80±11.20점(75점 기준)이며, 나이(F=3.15 p=.027), 최종학력(F=6.52, p<.001), 규칙적인 운동(t=-3.49, p=.003), 월수입(F=4.44, p=.014), 건강상태(F=11.00, p<.001)에 따라 통계적으로 유의한 차이가 있었다.
3. 혈액투석환자의 불확실성 평균은 95.66±9.78점(165점 기준)이며, 나이(F=4.80, p=.003), 최종학력(F=7.58, p<.001), 월수입(F=8.20, p<.001), 혈액투석기간(F=3.24, p=.024)에 따라 통계적으로 유의한 차이를 보였다.
4. 혈액투석환자의 극복력 평균은 55.98±15.47점(100점 기준)이며, 종교(F=3.78, p=.012), 최종학력(F=5.47, p<.001)), 혈액투석기간((F=2.90, p=.037)에 따라 통계적으로 유의한 차이가 있었다.
5. 혈액투석환자의 자가간호역량 평균은 134.83±24.24점(204점 기준)이며, 최종학력(F=7.98, p<.001), 월수입(F=4.87, p=.009), 건강상태(F=3.10, p=.048)에 따라 통계적으로 유의한 차이가 있었다.
6. 혈액투석환자에서 신체증상은 불확실성(r=.18 p=.029)과 정적 상관관계, 극복력(r=-.25 p=.003), 자가간호역량(r=-.41, p<.001)과 부적 상관관계가 있었고, 불확실성은 극복력(r=-.34 p<.001), 자가간호역량(r=-.37 p<.001)과 부적 상관관계, 극복력은 자가간호역량(r=.65, p<.001)과 정적 상관관계가 있었다. 7. 혈액투석환자의 가간호역량에 영향을 미치는 요인을 확인하기 위해 다중회귀분석(Multiple Regression Analysis)을 한 결과, 설명력은 51.8%이었다. 극복력(β=.53, p<.001), 신체증상(β=-.23, p<.001), 불확실성(β=-.13, p=.046)이 자가간호역량에 영향을 미치는 것으로 나타났다. 즉, 극복력이 높을수록, 신체증상과 불확실성이 낮을수록 자가간호역량이 증가하는 것으로 나타났다.
혈액투석환자의 자가간호역량은 극복력, 신체증상, 불확실성에 영향을 받는 것으로 나타났다. 이 결과에 근거하여 혈액투석환자의 신체증상을 조기 사정하고 극복력을 향상시키기 위한 간호중재개발과 불확실성을 낮추기 위한 상담 과 교육중재가 필요함을 확인하였다.
This descriptive correlation study investigates the physical symptoms, uncertainty, resilience, and self-care competency of hemodialysis to provide data for improving self-care competency.
Survey data was collected for 133 patients undergoing hemodialysis treatment at a hemodialysis hospita...
This descriptive correlation study investigates the physical symptoms, uncertainty, resilience, and self-care competency of hemodialysis to provide data for improving self-care competency.
Survey data was collected for 133 patients undergoing hemodialysis treatment at a hemodialysis hospital during September 6-19, 2017 using a questionnaire comprised of questions relating to general characteristics, physical symptoms, uncertainty, resilience, and self-care competency.
In terms of research instruments, physical symptoms were measured by the Dialysis Symptom Index (DSI), developed by Weisbord et al. adapted by Shin, and modified by this author; uncertainty was measured using the Uncertainty in Illness Scale (MUIS), developed by Mishel for the measurement of uncertainty, resilience was measured by the Korean version of the Conner-Davidson Resilience Scale (K-CD-RISC), an Baek’s adaptation of CD-RISC was developed by Conner and Davidson. Lastly, self-care competency was measured using the Self-as-Carer Inventory (S.C.I) developed by Geden and Taylor and adapted by So.
The collected data was analyzed using SPSS 23.0 frequencies, percentages, means and standard deviations and perform t-tests, analysis of variance (ANOVA), correlation analyses for Pearson correlation coefficient, and multiple regression analyses and Scheffé as post-hoc tests.
The study results were as follows:
1. The majority of participating hemodialysis patients were male (65.4%) and aged 60-69 (39.3%), with the average age being 60 years old. In terms of current health, 65 patients (48.9%) were reported as average, and 85 patients (63.9%) had received dialysis for less than 5 years.
2. The mean score of physical symptom among hemodialysis patients was 35.80 ± 11.20 (out of 75 points). The patients showed statistically significant differences in the mean score depending on age (F=3.15 p=.027), education level (F=6.52, p<.001), status of regular exercise (t=-3.49, p=.003), monthly income (F=4.44, p=.014), and health (F=11.00, p<.001).
3. The mean score of uncertainty among hemodialysis patients was 95.66 ± 9.78 points (out of 165 points). The patients showed statistically significant differences in the mean score depending on age (F=4.80, p=.003), level (F= 7.58, p<.001), monthly income (F=8.20, p<.001 ) and hemodialysis period (F= 3.24, p=.024).
4. The mean score of resilience among hemodialysis patients was 55.98 ± 15.47 points (out of 100 points). The patients showed statistically significant differences in the mean score depending on religion (F=3.78, p=.012), education level (F=5.47, p<.001), and hemodialysis period (F=2.90, p=.037).
5. The mean score of self-care competency among hemodialysis patients was 134.83 ± 24.24 (out of 204 points). The patients showed statistically significant differences in the mean score depending on education level (F=7.98, p<.001), monthly income (F=4.87, p=.009) and health (F=3.10, p=.048).
6. In hemodialysis patients, physical symptoms were positively correlated with uncertainty (r=.18, p=.029), and negatively correlated with resilience (r=-.25, p=.003) and self-care competency (r=-.41, p<.001); uncertainty was negatively correlated with resilience (r=-.34, p<.001) and self-care competency (r=-.37, p <.001); resilience was positively correlated with self-care competency (r=.65, p <.001).
7. The results of multiple regression analysis showed that resilience (β=.53, p<.001), physical symptoms (β=-.23, p<.001) and uncertainty (β=-.13, p=.460) influenced self-care competency. In other words, self-care competency increased when resilience increased and physical symptoms and uncertainty decreased. Explanatory power of the variables was 51.8%.
In conclusion, in order to increase the self-care competency of hemodialysis patients, it is necessary to increase patients’ resilience and reduce their physical symptoms and uncertainty. Nursing interventions that decrease physical symptoms by helping patients comply with special instructions in long, challenging hemodialysis treatment and increase resilience by helping them cope with crises needs to be developed to improve patients’ self-care competency. In particular, the socioeconomic support system is needed to improve the self-care competency of service recipients with low education level and monthly income.
This descriptive correlation study investigates the physical symptoms, uncertainty, resilience, and self-care competency of hemodialysis to provide data for improving self-care competency.
Survey data was collected for 133 patients undergoing hemodialysis treatment at a hemodialysis hospital during September 6-19, 2017 using a questionnaire comprised of questions relating to general characteristics, physical symptoms, uncertainty, resilience, and self-care competency.
In terms of research instruments, physical symptoms were measured by the Dialysis Symptom Index (DSI), developed by Weisbord et al. adapted by Shin, and modified by this author; uncertainty was measured using the Uncertainty in Illness Scale (MUIS), developed by Mishel for the measurement of uncertainty, resilience was measured by the Korean version of the Conner-Davidson Resilience Scale (K-CD-RISC), an Baek’s adaptation of CD-RISC was developed by Conner and Davidson. Lastly, self-care competency was measured using the Self-as-Carer Inventory (S.C.I) developed by Geden and Taylor and adapted by So.
The collected data was analyzed using SPSS 23.0 frequencies, percentages, means and standard deviations and perform t-tests, analysis of variance (ANOVA), correlation analyses for Pearson correlation coefficient, and multiple regression analyses and Scheffé as post-hoc tests.
The study results were as follows:
1. The majority of participating hemodialysis patients were male (65.4%) and aged 60-69 (39.3%), with the average age being 60 years old. In terms of current health, 65 patients (48.9%) were reported as average, and 85 patients (63.9%) had received dialysis for less than 5 years.
2. The mean score of physical symptom among hemodialysis patients was 35.80 ± 11.20 (out of 75 points). The patients showed statistically significant differences in the mean score depending on age (F=3.15 p=.027), education level (F=6.52, p<.001), status of regular exercise (t=-3.49, p=.003), monthly income (F=4.44, p=.014), and health (F=11.00, p<.001).
3. The mean score of uncertainty among hemodialysis patients was 95.66 ± 9.78 points (out of 165 points). The patients showed statistically significant differences in the mean score depending on age (F=4.80, p=.003), level (F= 7.58, p<.001), monthly income (F=8.20, p<.001 ) and hemodialysis period (F= 3.24, p=.024).
4. The mean score of resilience among hemodialysis patients was 55.98 ± 15.47 points (out of 100 points). The patients showed statistically significant differences in the mean score depending on religion (F=3.78, p=.012), education level (F=5.47, p<.001), and hemodialysis period (F=2.90, p=.037).
5. The mean score of self-care competency among hemodialysis patients was 134.83 ± 24.24 (out of 204 points). The patients showed statistically significant differences in the mean score depending on education level (F=7.98, p<.001), monthly income (F=4.87, p=.009) and health (F=3.10, p=.048).
6. In hemodialysis patients, physical symptoms were positively correlated with uncertainty (r=.18, p=.029), and negatively correlated with resilience (r=-.25, p=.003) and self-care competency (r=-.41, p<.001); uncertainty was negatively correlated with resilience (r=-.34, p<.001) and self-care competency (r=-.37, p <.001); resilience was positively correlated with self-care competency (r=.65, p <.001).
7. The results of multiple regression analysis showed that resilience (β=.53, p<.001), physical symptoms (β=-.23, p<.001) and uncertainty (β=-.13, p=.460) influenced self-care competency. In other words, self-care competency increased when resilience increased and physical symptoms and uncertainty decreased. Explanatory power of the variables was 51.8%.
In conclusion, in order to increase the self-care competency of hemodialysis patients, it is necessary to increase patients’ resilience and reduce their physical symptoms and uncertainty. Nursing interventions that decrease physical symptoms by helping patients comply with special instructions in long, challenging hemodialysis treatment and increase resilience by helping them cope with crises needs to be developed to improve patients’ self-care competency. In particular, the socioeconomic support system is needed to improve the self-care competency of service recipients with low education level and monthly income.
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