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만성질환 자가간호 중범위이론 검증: 성인 중증고혈압환자를 대상으로

Testing a Middle-Range Theory of Self-Care of Chronic Illness: A Validation for Korean Adult Patients with Severe Hypertension

Abstract

Purpose: The aims of this study are to provide a theoretical framework for improving the self-care of adults with severe hypertension and to examine the practical suitability of a middle-range theory of self-care for chronic illness by validating the structural model. Methods: Data were collected at a university hospital in D metropolitan city from July 1 to August 14, 2015. A total of 224 Korean adult patients with severe hypertension were recruited. Data were analyzed using SPSS 22.0 and AMOS 22.0. Results: The results show that the fit index of the hypothetical model meets the recommended level; 7 out of 8 hypothetical model paths were statistically significant. Motivation, self-efficacy, support from others, and accessibility to care showed statistical significance and explained 67.3% of the self-care process. The self-care process explained 45.3%, 63.6%, and 26.5% of quality of life, health, and illness stability, respectively. Conclusion: This model can be used as a theoretical framework for improving self-care among adult Korean patients with severe hypertension. Moreover, the practical suitability and validity of the middle-range theory of self-care for chronic illness is secured.

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자가간호
자가간호가 필수적인 사람은?
만성질환자가 자신의 질병악화를 방지하고 건강을 유지하기 위해서는 자가간호가 필수적이다

만성질환자가 자신의 질병악화를 방지하고 건강을 유지하기 위해서는 자가간호가 필수적이다. 특히 고혈압환자의 경우 심뇌혈관질환과 같은 합병증 발생으로 삶의 질을 위협받지 않기 위해서 자가간호는 더욱 중요하다.

한국 성인에게 가장 흔한 만성질환
한국 성인에게 가장 흔한 만성질환의 종류는 ?
고혈압[1]으로 인한 뇌혈관과 심혈관질환 발생률은 각각 35%, 21%에 이르며[2] 이는 한국인 사망원인 2, 3위를 차지한다

특히 고혈압환자의 경우 심뇌혈관질환과 같은 합병증 발생으로 삶의 질을 위협받지 않기 위해서 자가간호는 더욱 중요하다. 그러나 한국 성인에게 가장 흔한 만성질환인 고혈압[1]으로 인한 뇌혈관과 심혈관질환 발생률은 각각 35%, 21%에 이르며[2] 이는 한국인 사망원인 2, 3위를 차지한다[3]. 뿐만 아니라 한국 고혈압 유병자의 혈압 조절률은 40% 정도에 그치고 있다[1].

고혈압 치료
고혈압 치료에 있어 환자별 관리 방법은 ?
특히, 중증고혈압환자는 일반 고혈압환자보다 높은 수준의 건강관리가 필요하다. 중증고혈압이란 수축기 160 mmHg 또는 이완기 100mmHg 이상의 2기 고혈압 또는 당뇨병, 만성신장질환과 심뇌혈관질환을 동반한 고혈압[8,9]을 말하며 이들의 심혈관질환 발생률은 일반고혈압보다 2~5배 더 높다[10]. 따라서 중증고혈압환자의 자가간호 증진은 매우 중요하며 이를 위한 중재와 실무가 간호이론에 근거를 두고 있다면 보다 과학적이고 체계적인 간호가 될 수 있다.

특히, 중증고혈압환자는 일반 고혈압환자보다 높은 수준의 건강관리가 필요하다. 중증고혈압이란 수축기 160 mmHg 또는 이완기 100mmHg 이상의 2기 고혈압 또는 당뇨병, 만성신장질환과 심뇌혈관질환을 동반한 고혈압[8,9]을 말하며 이들의 심혈관질환 발생률은 일반고혈압보다 2~5배 더 높다[10]. 따라서 중증고혈압환자의 자가간호 증진은 매우 중요하며 이를 위한 중재와 실무가 간호이론에 근거를 두고 있다면 보다 과학적이고 체계적인 간호가 될 수 있다.

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