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배영숙 ( ) - 계명대학교 동산병원
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Abstract
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This research was done for the improvement of practical appliance of Ng diagnosis and for the elevation of nursing quality(level). Ng students of the fourth grade of K university which is in Taegu cared for patients who were addmitted for open heart surgery in the ICU. They practiced from March 5, 1992 to July 2,1993, each for 3 weeks. After their practice, they reported on 31 cases which had a total of 204 Ng diagnoses. I analized the Ng diagnoses with 170 diagnoses used by NANDA and 34 diagnosis by nonNANDA through comparison diagnoses from NANDA
The general characteristics of the patients are as follows : by sex, men were 6 cases (19.4%) and women were 25 cases (80.6%). In age, 16-39 were 9 cases (29.0%), 4049 were 11 cases (35.5%), and over 50 were 11 cases (35.5%). In diagnosis of the patients, AR & MR were 7 cases (22.6%), ASD were 2 cases (6.5%), MR were 17 cases (54.8%), PS was 1 case (3.26%), Angina Pectoris (CABG) were 4 cases (12.9%).
Ng students used all 204 Ng diagnoses. They used 170 NANDA in them, which means that one person used about 5.5 of NANDA´s diagnoses. The diagnoses other than NANDA were 34(16.7%), which means one person used about 1.1 of nonNANDA´s diagnoses. We think from this that nonNANDA´s students do not have enough knowledge and experience in using diagnoses, and they tend to use their own diagnoses. All used NANDA´s was 25 diagnoses in which the most popular diagnoses were ineffective air way clearance (48. 4%), mobility, physical impairment, ineffective bleeding patterns, knowledge deficit, all of them were 41.9% in 31 cases. Kang showed self care deficit (27.7%), skin integrity (23.4%), tissue per-fusion, alteration in cerebral area (16.4%), and high risk for infection (0.6%), in her diagnosis analysis research of brain disease patients. Park(1987) showed the representative diagnosis of high risk for injury, altered nutrition less than body requairements, knowledge deficit, sleep pattern disturbance, and fluid volume excess, in her evaluations, of the original and revelational research rate of five diagnosis in patients with CAAH or CAVH. When we consider the specifics of each patient we can determine how the Ng assessment reveals that patients problems differ according to their disease. Signs and symptoms are one thing, and nursing requests are another. The nursing diagnosis of 170 NANDAs according to age has 7.2 diagnoses per person in 40 through 49 years old. 5.5
diagnoses in those over 50. It is much more than 3.3 diagnoses in 16 through 39.
The number of nursing diagnoses as medical diagnoses didn´t have difference, in those 5.0 through 7.0. Nursing diagnoses as of the day of ad-mission in the ICU was 6.6 diagnoses of NANDA per person for 3 through 5 days. 31 patients were in the ICU after having open heart surgery, and it seems that nursing problems and requirements of patients were not different. The specific responseformal analysis in exchanging (52.0%), moving (12.0%), feeling (12.061o), knowing (8.0%) in 25 diagnoses, is similar with the research of Park, Lee(1989) who showed exchanging (43.7%), feeling (23.5%), moving (19.3%), perceiving (4.0%), knowing (3.8%).
The related factors of ineffective air way clearance were painkillers or sedatives (53.3%), and secretion(40.0%). Using painkillers and sedatives Ithink must result in energy decrease or fatigue. The related factors of impaired physical mobility were due to pain and discomfort in NANDA. And attachment of instrument (30.8%) cannot be used as the related factor. The related factors of ineffective breathing pattern, heart failure (23.1%) can´t be used as medical diagnoses, so it must be changed to energy decrease or fatigue. As the related factor of knowledge deficit, there was a perceiving deficit (53.8%) which is represented as a knowledge deficit in NANDA and which I think is more familiar using the word confusion. The relation of anxiety was in connection with the change of health situation (81. 8%), and economical problem (9.1%). Another related factor is operation (9.1%) which doesn´t be-long to NANDA. Operation itself is the change of health situation which must be the related factor.
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KeyWords
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간호진단분석, 개심술환자
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원문 및 링크아웃 정보
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등재저널 정보
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