• 제목/요약/키워드: 만성간호

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만성질환 노인에서 임파워먼트 이론에 근거한 다학제적 자기관리 프로그램의 효과 (Effects of a Multi-disciplinary Approached, Empowerment Theory Based Self-management Intervention in Older Adults with Chronic Illness)

  • 박초롱;송미순;조비룡;임재영;송욱;장희경;박연환
    • 대한간호학회지
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    • 제45권2호
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    • pp.192-201
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    • 2015
  • Purpose: The purpose of this study was to develop a multi-disciplinary self-management intervention based on empowerment theory and to evaluate the effectiveness of the intervention for older adults with chronic illness. Methods: A randomized controlled trial design was used with 43 Korean older adults with chronic illness (Experimental group=22, Control group=21). The intervention consisted of two phases: (1) 8-week multi-disciplinary, team guided, group-based health education, exercise session, and individual empowerment counseling, (2) 16-week self-help group activities including weekly exercise and group discussion to maintain acquired self-management skills and problem-solving skills. Baseline, 8-week, and 24-week assessments measured health empowerment, exercise self-efficacy, physical activity, and physical function. Results: Health empowerment, physical activity, and physical function in the experimental group increased significantly compared to the control group over time. Exercise self-efficacy significantly increased in experimental group over time but there was no significant difference between the two groups. Conclusion: The self-management program based on empowerment theory improved health empowerment, physical activity, and physical function in older adults. The study finding suggests that a health empowerment strategy may be an effective approach for older adults with multiple chronic illnesses in terms of achieving a sense of control over their chronic illness and actively engaging self-management.

도시와 농촌노인의 건강생활습관과 만성질환관리 실태비교 (Comparison of Healthy Life Style and Chronic Disease Management between Urban and Rural Older Adults)

  • 이지아;이예나
    • 재활간호학회지
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    • 제15권2호
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    • pp.100-108
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    • 2012
  • Purpose: The purpose of this study was to compare healthy life style and chronic disease management between urban and rural older adults. Methods: The study employed a comparative and descriptive survey design. Data were collected from 154 older adults living independently in communities (79 from urban and 75 from rural areas) using structured questionaries from 24 July, 2010 to 14 August, 2011. Results: Perceived health status was significantly lower in urban older adults than those in rural areas ($x^2$=13.27, p = .001). Frequency of regular health examination was better in the urban group than the rural group ($x^2$=4.71, p = .030). Among older adults with hypertension, medication noncompliance was higher, and participation rate in disease management education was lower in the rural group than the urban group ($x^2$=6.43, p = .040; $x^2$=23.51, p<.001, respectively) and the same as arthritis. Conclusion: Rural older adults had more problems with health and disease management in this study, might be, due to difficulties in access to health care services than urban residents. More tailored programs of disease management as well as health service programs and staffing should be developed in rural areas. For urban older adults, meal preparation program and more opportunities producing income may be needed.

만성 소화기 질환자의 Pender 모형에 근거한 삶의 질 예측 모형 (A Structural Model Based on PenderPs Model for Quality of Life of Chronic Gastric Disease)

  • 박은숙;김소인;이평숙;김순용;이숙자;박영주;유호신;장성옥;한금선
    • 대한간호학회지
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    • 제31권1호
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    • pp.107-125
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    • 2001
  • This study was designed to construct a structural model for quality of life of chronic gastric disease. The hypothetical model was developed based on the literature review and Pender's health promotion model. Data were collected by questionnaires from 459 patients with chronic gastric disease in a General Hospital from July 1999 to August 2000 in Seoul. Data analysis was done with SAS 6.12 for descriptive statistics and PC-LISREL 8.13 Program for Covariance structural analysis. The results are as follows : 1. The fit of the hypothetical model to the data was moderate, thus it was modified by excluding 1 path and including free parameters and 2 path to it. The modified model with path showed a good fitness to the empirical data ($\chi$2=934.87, p<.0001, GFI=0.88, AGFI=0.83, NNFI=0.86, RMSR =0.02, RMSEA=0.07). 2. The perceived barrier, health promoting behavior, self-efficacy, and self-esteem were found to have significant direct effects on the quality of life. 3. The health concept, health perception, emotional state, and social support were found to have indirect effects on quality of life of chronic gastric disease. In conclusion, the derived model in this study is considered appropriate in explaining and predicting quality of life of chronic gastric disease. Therefore it can effectively be used as a reference model for further studies and suggested direction in nursing practice.

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만성 B형 간염환자의 건강행위 수준 및 영향요인 (Factors Influencing Health Behavior of Patients with Chronic Hepatitis B)

  • 이정은;김소선;김선아;한광협;김수현;지은주;오의금
    • 성인간호학회지
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    • 제23권1호
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    • pp.20-30
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    • 2011
  • Purpose: The aim of this study was to examine patients with Chronic Hepatitis B (CHB) and their level of knowledge of their disease, uncertainty, stress and health behaviors and to identify factors influencing their health behavior. Methods: A cross-sectional, descriptive design was used. The sample included 136 patients in a gastroenterology outpatient department at one hospital located in Seoul. The mean age of the subjects was 41 and 77.2% were male. Data were collected using a structured questionnaire from April to June 2009. The collected data were analyzed using SPSS/WIN 15.0. Results: The reported scores for knowledge of the disease, uncertainty, stress, and health behaviors were 14.43, 81.50, 26.50, 52.11, respectively. There were statistically difference between health behaviors and gender, age, marital status and antivirus treatment. A positive correlation existed between knowledge of disease and health behaviors (r=.199, p=.020). In contrast, there was a negative correlation between uncertainty and health behaviors (r=-.250, p=.003). The factors influencing health behaviors were knowledge of disease, gender, age, uncertainty, antivirus treatment, and marital status ($R^2$=.267, p<.001). Conclusion: These findings support that strategies for enhancing knowledge of disease and reducing uncertainty are needed to promote health behavior in patients with CHB.

제4기 국민건강영양조사에 기초한 만성 폐쇄성폐질환자의 성별에 따른 삶의 질 분석 (The Quality of Life in COPD Patients according to Gender: Based on the 4th Korea National Health and Nutrition Examination Survey)

  • 강경숙;나순옥;유영법;신준호
    • 지역사회간호학회지
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    • 제26권2호
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    • pp.61-68
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    • 2015
  • Purpose: In this study, we performed a comparative analysis on the quality of life (QoL) in male and female chronic obstructive pulmonary disease (COPD) patients based on the 4th Korea National Health and Nutrition Examination Survey (KNHANES IV) from 2007 to 2010. Methods: We extracted the socio-demographic and clinical data of 1,218 COPD patients including 874 men and 344 women from the KNHANES IV database. Descriptive statistics and correlation test were used to analyze the data. In order to find factors associated with QoL of COPD patients, we conducted multivariate linear regression analysis. Results: Infrequency analysis, the educational level and income were lower in the female COPD patients than in the male ones. The QoL indexes including mobility, self-care, activities of daily living, discomfort, anxiety, and depression were significantly worse in the female of COPD patients than in the male ones (p<.01).Conclusion: Our study indicates that QoL of female COPD patients should be improved on the educational, economic, and healthcare aspects.

만성 폐쇄성 폐질환 환자에 있어서 호흡근육 훈련의 효과에 관한 실험적 연구 (The Effect of Respiratory Muscle Training in Patients with Chronic Obstructive Pulmonary Disease - Preliminary Study -)

  • Kim Mae-Ja
    • 대한간호학회지
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    • 제16권1호
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    • pp.55-66
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    • 1986
  • 내과외래를 내방한 만성폐쇄성 호흡기질환환자를 대상으로 호흡근육훈련이 호흡근육에 미치는 효과를 조사하기 위해서 자료수집을 하였다. 근력+지구력훈련과 근력훈련을 각각 두군에게 6-주 동안 실시하였다. 근력훈련은 DHD Medical Products사 제품의 흡기근육훈련도구로 매일 30분씩 대상자의 가정에서 실시하였고, 근지구력훈련은 일정한 기온이 유지되는 서울대학교병원복도를 12분 동안 걷게하는 운동을 주 2회 시행하였다. 이 훈련들의 효과를 평가하기 위하여 매주 최대흡기력(PImax), 참을 수 있는 흡기력(SIP), 최대환기량(MW) 및 기관지염-폐기종 증상 체크목록(BESC)과 환자의 건강상태와 계속 훈련여부를 결정하기 위해서 폐기능 검사와 vital signs을 매주 검사하였다. 그리하여 다음과 같은 성적을 얻었다. 근력+근지구력훈련군은 훈련전에 비해서 훈련후에 유의한 차이가 없었으나 근력훈련군은 SIP가 증가되고 BESC는 감소되었으며 , 두 군간의 비교에서는 BESC에서 훈련후에 유의한 차이가 있었다. 호흡근육훈련은 가정에서 간단하게 시행할 수 있는 근력훈련이 근력+근지구력훈련보다 효과가 좋았다. 그러나 측정도구들의 타당도 신뢰도의 평가, 더 많은 수의 연구대상자, 더 효과적인 근지구력훈련의 개발에 관한 연구가 이루어져야겠다.

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만성 호흡기 질환자의 건강증진행위 구조 모형 (A Structural Model for Health Promoting Behaviors in Patients with Chronic Respiratory Disease)

  • 박영주;김소인;이평숙;김순용;이숙자;박은숙;유호신;장성옥;한금선
    • 대한간호학회지
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    • 제31권3호
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    • pp.477-491
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    • 2001
  • Purpose: This study was designed to construct a structural model for health promoting behavior in patients with chronic respiratory disease. A hypothetical model was developed based on the literature review. Method: Data was collected by questionnaires from 235 patients with chronic respiratory disease in a General Hospital in Seoul. Data analysis was done using SAS 6.12 for descriptive statistics and the PC-LISREL 8.13 Program for Covariance Structural Analysis. Result: The results are as follows : 1. The fit of the hypothetical model to the data was moderate. It was modified by excluding 2 path and including free parameters and 3 path to it. The modified model with path showed a good fitness to the empirical data($\chi$2=80.20, P=0.05, GFI=0.95, AGFI=0.88, NNFI=0.95, NFI=0.96, RMSR=0.01, RMSEA =0.06). 2. The perceived benefits, self-efficacy, and a plan of action were found to have significant direct effects on the health promoting behavior in patients with chronic respiratory disease. 3. The health perception, self-esteem, and activity related to affect were found to have indirect effects on the health promoting behavior in patients with chronic respiratory disease. Conclusion: The modified model of this study is considered appropriate in explaining and predicting health promoting behavior in patients with chronic respiratory disease. Therefore, it can effectively be used as a reference model for further studies and suggested direction in nursing practice.

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당뇨병 환자의 치료지시 이행군과 비이행군의 혈당과 만성 합병증 발생비교 (A Study on the Glucose Level Control and Chronic Complication Rate in Diabetic Compliance Groups with Health Care Regimen)

  • 송민선;유양숙;김희승
    • 한국보건간호학회지
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    • 제15권2호
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    • pp.334-341
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    • 2001
  • The purpose of this study is to examine to control of glucose level and the occurrence of chronic complications of diabetes by compliance groups with health care regimen The subjects were consisted of 300 out patients with type 2 diabetes mellitus from beginning of March through the end of April in 2001, who visited at the endocrinology department at Kangnam St. Mary's Hospital of Catholic University in Seoul. The patient's compliance level with health care regimen was assessed at questionnaire. However, the blood glucose level and the occurrence of chronic complications of diabetes were assessed at medical record review. The data were analyzed by SAS program for chi square test and t-test. The results were as follows. 1. Significant differences were found among the factors such as duration of diabetes, the number of participation of diabetes educational program, job, smoking, self monitoring of blood glucose and the methods of diabetes therapy between high and low compliance groups. High compliance group patients had a diabetes longer than low compliance group patients. High compliance group patients more frequently attended the educational program and checked themselves monitoring blood glucose than low compliance group patients. Also, they did not work recently, smoked less and got more insulin injection therapy compared to low compliance group patients. 2. No significant differences were found among the result of fasting blood glucose. 2-hour postprandial blood glucose, and $HbA_{l}c}$ between high and low compliance groups. 3. The occurrence rate of macrovascular complications of chronic complications of diabetes were lower, however, the occurrence rate of microvascular complications were higher in high compliance group than in low compliance group with health care regimen.

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만성폐쇄성 폐질환 환자의 호흡재활 프로그램 관련 논문분석 (Analysis of Research about Pulmonary Rehabilitation of Patients with COPD)

  • 박경민;장희정
    • 지역사회간호학회지
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    • 제14권2호
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    • pp.312-322
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    • 2003
  • Purpose: This study is aimed to analyze the trend of research on pulmonary rehabilitation of patients with COPD (Chronic Obstructive Pulmonary Disease), and to suggest a direction for future research of pulmonary rehabilitation of COPD. Method: A total of 39 studies published from 1991 to 2002 were examined according to the year of publication, type of journal, characteristics of patients, rehabilitation program, research design, and instruments and research findings. Results: 1) The number of studies related to pulmonary rehabilitation of COPD patients has rapidly increased since 1996's (87.18%) 2) There were 10 studies published in the chest. There were 6 studies published in domestic journals and 33 studies published in international journals. 3) The samples in the studies were mostly outpatients whose lung function was moderate. 4) The total period of the pulmonary rehabilitation program shown in the literature was 5 to 12 weeks. The programs included exercise interventions, educational interventions and psychosocial interventions. 5) The outcomes of the pulmonary rehabilitation were measured with lung function, 6-minute walk test, dyspnea, and chronic respiratory disease questionnaire. Research findings were found to be effective on 6-minute walk test, dyspnea, and chronic respiratory disease questionnaire but not on lung function. Conclusion: Based on these findings, pulmonary rehabilitation should be further emphasized, and standardized protocols and community based pulmonary rehabilitation programs need to be provided. More qualitative research should also be conducted in the future to describe the experiences of the pulmonary rehabilitation of patients with COPD.

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노인 만성질환에 대한 기(氣) 시술의 효과 (The effects of Ki on the Elderly with Chronic Illness)

  • 양경희;장혜숙;이명수;허화정
    • 지역사회간호학회지
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    • 제10권2호
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    • pp.412-421
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    • 1999
  • The purpose of current study was to investigate the effects of Ki-therapy which improves mood state and relieves pain on the elderly with chronic illness. The subjects were 42 elderly and convenience sampling(incidental sampling) was used to prevent contamination to the control group. Frequency, %, $X^2$, t-test, and repeated measure ANOVA by SPSS PC + program were used to analyze the data. The mean age of subjects was 72.95(Control group), 73.10(experimental group). Number of complains was 2.45(control group), 2.65 (experimental group). All of demographic characteristics of subjects. that is, age, weight. number of complains. educational background. family type. economic state, perceived health state were homogeneous. There are many difficulties in ADL & IADL. 14.2% in shopping, mode of transportation, ability to handle finances. 11.9% in ability to use telephone. continence, 7.1% in bathing, food preparation, transfer, and housekeeping. As the result of this study. slight improvement of mood state and pain relief were found. Although 3 improved items of 'clear-headed', 'lively', and 'nervous' were statistically significant. the pain relief was not statistically significant. It requires repeated treatment and measurement. And suggested case study or qualitative study in further studies because manufacturing of environment(i. e. rain) is very difficult in community people.

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