DOI QR코드

DOI QR Code

The Effects of Planned Discharge Nursing in Compliance, Knowledge, and Nursing Service Satisfaction for Patients having Video-Assisted Thoracoscopic Surgery

계획된 퇴원 간호 중재가 기흉 수술 환자의 약물복용 및 치료 지시 이행도, 질병에 대한 지식과 간호 만족도에 미치는 효과

  • Lee, Won Jin (Graduate School, College of Nursing, Ewha Womans University) ;
  • Bang, Yun Yi (Department of Nursing, KyungBok University)
  • 이원진 (이화여자대학교 일반대학원 간호과학과) ;
  • 방윤이 (경복대학교 간호학과)
  • Received : 2019.07.22
  • Accepted : 2019.11.01
  • Published : 2019.11.30

Abstract

This study aimed to develop a planned discharge nursing intervention guideline for patients with pneumothorax, and to examine its influence on drug compliance, knowledge about disease, compliance level with therapeutic regimen, and nursing satisfaction. Methods: The planned discharge nursing intervention guideline was developed based on comprehensive literature reviews and clinical experiences. Patients having video-assisted thoracoscopic surgery at a single general hospital were allocated to either intervention (n=30) or control group (n=29). Participants in the intervention group were administered planned discharge nursing intervention thrice, 30 minutes each, by a cardiovascular nurse. Standard care was provided to patients in the control group. Data were collected from March, 2010 to December, 2010. Results: Participants in the intervention group presented statistically significant improvement in drug compliance (t=-2.05, p=0.044), pill count (t=-2.61, p=0.011), knowledge about disease (t=-4.39, p=0.001), and nursing satisfaction (t=-4.13, p=0.001). No significant difference in compliance levels was observed with standard therapeutic regimen. Conclusion: Planned discharge nursing intervention can be successfully implemented for patients undergoing thoracoscopic surgery. Further research is required to evaluate long-term effects like complication or relapse.

본 연구의 목적은 비디오 흉강경을 이용한 폐기포 절제술을 받은 기흉 환자에게 계획된 퇴원 간호 중재 지침을 개발하여 적용한 후 약물복용 이행도, 치료 지시 이행도, 질병에 대한 지식과 간호 만족도에 미치는 효과를 확인하기 위한 것이다. 서울 소재 K 종합병원에서 비디오 흉강경을 이용한 폐기포 절제술을 받은 기흉 환자를 대상으로 자료수집 기간은 2010년 3월 16일부터 12월 31일까지이며, 실험군 29명, 대조군 30명이 연구 대상자로 참여하였다. 계획된 퇴원 간호 중재 지침은 포괄적인 문헌 고찰과 임상 경험을 바탕으로 개발되었다. 계획된 퇴원 간호 중재는 흉부외과 간호사가 3회 실시하였으며 1회 교육시간은 약 30~40분 정도가 소요되었다. 연구결과 계획된 퇴원 간호 중재 제공 후 치료 지시 이행도는 유의한 차이가 없었다. 그러나 복약순응도(t=-2.05, p=.044), 약알 세기 약물 이행도(t=-2.61, p=.011), 질병에 대한 지식(t=-4.39, p=.001), 간호 만족도(t=-4.13, p=.001)는 유의한 차이가 있었다. 본 연구에서 계획된 퇴원 간호 중재의 제공은 기흉 진단으로 수술을 시행 받은 환자를 위한 임상에서 적용 가능한 효과적인 간호 중재임을 확인하였다. 합병증이나 재발과 같은 장기적 영향을 평가하기 위한 종단적 연구가 필요하다.

Keywords

References

  1. S. W. Kim, D. S. Kim, C. Y. Lim, H. J. Lee, G. Lee, J. H. Kong, "Recurrence analysis after video-assisted thoracic surgery for the treatment of spontaneous pneumothorax", The Korean Journal of Thoracic and Cardiovascular Surgery, Vol.43, No.6, pp.710-715, 2010. DOI: https://doi.org/10.5090/kjtcs.2010.43.6.710
  2. Ingolfsson, I., Gyllstedt, E., Lillo-Gil, R., Pikwer, A., Jönsson, P., Gudbjartsson, T, "Reoperations are common following VATS for spontaneous pneumothorax: study of risk factors", Interactive cardiovascular and thoracic surgery, Vol.5, No.5, pp.602-607, 2006. DOI: https://doi.org/10.1510/icvts.2006.129676
  3. E. B. Kesieme, A. Dongo, N. Ezemba, E. Irekpita, N. Jebbin, C. Kesieme, "Tube thoracostomy: complications and its management", Pulmonary medicine, Vol.2012, pp.1-10, 2012. DOI: https://doi.org/10.1155/2012/256878
  4. J. H. Kim, E. H. Lee, S. R. Kim, S. R. Kim, "Factors affecting discharge delay in lumbar spinal surgery patients who were treated according to a critical pathway", Korean Journal of Adult Nursing, Vol.28, No.1, pp.43-52, 2016. DOI: https://doi.org/10.7475/kjan.2016.28.1.43
  5. S. Y. Kim, "The Standards of Clinical Practice Guideline", J health Tech Assess, Vol.4, No.2, pp.53-57, 2016. DOI: https://doi.org/10.34161/johta.2016.4.2.003
  6. M. K. Kim, S. H. Yu, D. Y. Lee, Y. M. Son, "Development of a Critical Pathway of Bullectomy for Spontaneous Pneumothorax Patients", Journal of Korean Society Quality Assurance Health Care, Vol.9, No.1, pp.34-51. 2002.
  7. M. T. Fox, M. Persaud, I. Maimets, K. O'brien, D. Brooks, D. Tregunno, E. Schraa, "Effectiveness of acute geriatric unit care using acute care for elders components: A systematic review and meta‐analysis", Journal of the American Geriatrics Society, Vol.60, No.12, pp.2237-2245, 2012. DOI: https://doi.org/10.1111/jgs.12028
  8. E. S. Lee, E. S. Lee, S. Y. Shin, M. J. Hwang, M. H. Chae, "Effects of tailored supportive education on physical, emotional status and quality of life in patients with congestive heart failure", Korean Journal of Adult Nursing, Vol.25, No.1, pp.62-73, 2013. DOI: https://doi.org/10.7475/kjan.2013.25.1.62
  9. S. Shepperd, N. A. Lannin, L. M. Clemson, A. McCluskey, I. D. Cameron, S. L Barras, "Discharge planning from hospital to home", Cochrane database of systematic reviews, Vol.1, pp.1-19, 2013. DOI: https://doi.org/10.1002/14651858.cd000313
  10. D. C. Gonçalves‐Bradley, N. A. Lannin, Clemson, L. M., I. D. Cameron, S. Shepperd. "Discharge planning from hospital", Cochrane Database of Systematic Reviews, Vol.1, 2016. DOI: https://doi.org/10.1002/14651858.cd000313.pub5
  11. J. Y. Back, S. E. Jun. "Effects of symptom-based discharge education for stroke patients", J Korean Data Anal Soc, Vol.14, No.5B, pp.2541-2553, 2012.
  12. I. J. Kim, "Sources of anxiety and burden of family caregivers of stroke patients: the role of self-efficacy and knowledge about care", Korean Journal of Adult Nursing, Vol.24, No.1, pp.1-10, 2012. DOI: https://doi.org/10.7475/kjan.2012.24.1.1
  13. Y. H. Hwang, M. Yi, "Evaluation of an individualized education before discharge and follow-up telephone consultation on self-efficacy for kidney transplant patients", J Korean Biol Nurs Sci, Vol.17, No.4, pp.331-340, 2015. DOI: https://doi.org/10.7586/jkbns.2015.17.4.331
  14. O. J. Park, Y. J. Lee, "The Effect of Discharge Education Program on Compliance with Sick-Role Behavior in Cerebrovascular Surgery Patients", Journal of Korean Academy of Adult Nursing, Vol.18, No.3, pp.436-445, 2006.
  15. D. E. Morisky, A. Ang, M. Krousel-Wood, H. J. Ward, "Predictive validity of a medication adherence measure in an outpatient setting", Journal of Clinical Hypertension, Vol.10, No.5, pp.348-354, 2008. DOI: https://doi.org/10.1111/j.1751-7176.2008.07572.x
  16. G. C. Pascoe, C. C. "Attkisson, The evaluation ranking scale: a new methodology for assessing satisfaction", Evaluation and Program Planning, Vol.6, No.3, pp.335-347, 1983. DOI: https://doi.org/10.1016/0149-7189(83)90013-7
  17. H. S. Oh, J. A. Mo, W. S. Seo, "Demographic and Health-related Risk Factors for the Recurrence of Primary Spontaneous Pneumothorax", Journal of The Korean Society of Emergency Medicine, Vol.23, No.6, pp.831-840, 2012.
  18. J. H. Heo, S. J. Kim, J. H. Kim, S. I. Huh, "Effect of Patient's Satisfaction with Pharmacist's Medication Counseling on Medication Compliance Among Outpatients", Korean Journal of Clinical Pharmacy, Vol.19, No.2, pp.110-119, 2009.
  19. J. J. Jang, J. A. Jeun, J. S. Park, E. H. Sung, H. R. Kim. A. R. Jo, "Effects of the Drug Educational Program on Knowledge and Medication Compliance for Kidney Transplantation Patients", Keimyung Journal of Nursing Science, Vol.21, No.1, pp.48-56, 2017.
  20. S. Y. Lin, S. J. Fetzer, P. C. Lee, C. H. Chen, "Predicting adherence to health care recommendations using health promotion behaviours in kidney transplant recipients within 1-5 years post-transplant", Journal of Clinical Nursing, Vol.20, No.23-24, pp.3313-3321, 2011. DOI: https://doi.org/10.1111/j.1365-2702.2011.03757.x
  21. Y. J. Son, E. K. Song, "Impact of health literacy on disease-related knowledge and adherence to self-care in patients with hypertension", Journal of Korean Academy of Fundamentals of Nursing, Vol.19, No.1, pp.6-15, 2012. DOI: https://doi.org/10.7739/jkafn.2012.19.1.006
  22. H. W. Kim, S. M. ChoiKwon, "Study on knowledge levels of pre-dialysis, chronic renal failure patients at glomerular filtration rates (GFRs) and their educational demands", Journal of Korean Biological Nursing Science, Vol.12, No.2, pp.114-126, 2010.
  23. R. Negarandeh, N. D. Nayeri, F. Shirani, L. Janani, "The impact of discharge plan upon re-admission, satisfaction with nursing care and the ability to self-care for coronary artery bypass graft surgery patients", European Journal of Cardiovascular Nursing, Vol.11, No.4, pp.460-465, 2012. DOI: https://doi.org/10.1016/j.ejcnurse.2011.05.001
  24. G. C. Pascoe, C. C. Attkisson, "The evaluation ranking scale: a new methodology for assessing satisfaction", Evaluation and Program Planning, Vol.6, No.3-4, pp.335-347, 1983. https://doi.org/10.1016/0149-7189(83)90013-7
  25. Y. S. Shin, Y. H. Lee, "The Effects of an Early Knee Joint Exercise Education Program on Pain, Knee Range of Motion, and Satisfaction in Patients after Undergoing Total Knee Replacement Arthroplasty", J Korean Clin Nurs Res, Vol.24, No.3, pp.283-292, 2018. DOI: https://doi.org/10.22650/JKCNR.2018.24.3.283
  26. K. Ryu, S. H. Cho, "The effects of visual information on anxiety and uncertainty in elderly patients after the total knee arthroplasty", Journal of muscle and joint health, Vol.22, No.1, pp.48-56, 2015. DOI: https://doi.org/10.5953/jmjh.2015.22.1.48
  27. Y. R. Kim, S. Y. Park, "The Effects of the Systematic Breathing Exercises Program on Recovery of Patients with Pneumothorax", Journal of Korean Critical Care Nursing, Vol.5, No.2, pp.28-36, 2012.
  28. Y. R. Yeun, "Systematic review of research on adherence among hemodialysis patients in Korea", Journal of the Korea Academia-Industrial Cooperation Society, Vol.13, No.12, pp.5993-6000, 2012. DOI: https://doi.org/10.5762/kais.2012.13.12.5993
  29. E. S. Min, M. H. Hur, "Predictors of Compliance in Hypertensive Patients", Journal of Korean Academy of Fundamentals of Nursing, Vol.19, No.4, pp.474-482, 2012. DOI: https://doi.org/10.7739/jkafn.2012.19.4.474
  30. J. R. Yang, "The effect of health literacy and self-efficacy on medication adherence among the elderly patients with chronic disease", Nursing Science, Vol.26, No.1, pp.29-38, 2014.