한국융합학회논문지 (Journal of the Korea Convergence Society)

  • 제10권11호
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  • Pages.543-555
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  • 2019
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  • 2233-4890(pISSN)
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  • 2713-6353(eISSN)
한국융합학회 (Korea Convergence Society)
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만성질환자의 공유의사결정 개념분석

Shared decision-making in Patients with Chronic Disease : Concept Analysis

  • 유지연 (가톨릭대학교 대학원 간호학과)
  • Yoo, Ji Yeon (Department of Nursing, Graduate School, The Catholic University)
  • 투고 : 2019.10.10
  • 심사 : 2019.11.20
  • 발행 : 2019.11.28
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초록

본 연구의 목적은 만성질환자의 공유의사결정에 대한 개념의 속성을 명확히 정의하기 위함이다. 개념분석의 절차는 Walker and Avant의 방법에 근거하여 학제간 융합적 분석을 시도하였다. 분석결과, 만성질환자의 공유의사결정의 속성은 자기돌봄 전문가로서 인정, 자기 결정권, 번복 가능한 협상, 환자중심 돌봄으로 정의되었다. 선행요인은 비슷한 치료방법 중 선택해야 할 필요성이 있는 상황, 의사결정 갈등, 환자, 가족, 의료제공자의 참여 의지, 충분한 시간과 기회이다. 만성질환자의 공유의사결정의 결과는 의사결정 갈등 감소, 환자결과와 만족도 및 삶의 질의 향상, 장기적인 환자의 자기관리 및 자기 효능감 향상, 질병을 수용하는 삶의 태도이다. 본 연구는 만성질환자의 공유의사결정에 대한 명확한 개념을 제공하고, 관련 간호중재 개발을 위한 이론적 근거 형성에 기여할 수 있을 것이며 만성질환자를 위한 공유의사결정 측정도구 개발 연구의 수행을 제언한다.

The purpose of this study was to define and clarify the concept of Shared decision-making (SDM) in patients with chronic disease. Walker and Avant's concept analysis process was used to analyze interdisciplinary convergence in SDM. SDM in patients with chronic disease can be defined by the following attributes: acknowledgment patients as 'self-care experts', the rights of self-determination, reversible negotiation, and patient-centered care. The antecedents of SMD consisted of situations where there is a need to make a decision from several treatment options of similar efficacy, decisional conflict, patient, family, and health provider's willingness to participate in the decision-making process, enough time and opportunity for SDM. The consequences occurring as a result of SMD were decrease decisional conflict, improvement health outcome, satisfaction, quality of life, enhancement self-management and self-efficacy with long-term, and living acceptably with the illness. Based on these results, a scale measuring SDM in patients with chronic disease is needed.

키워드

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