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최영희 ( Choi Young-Hee ) - 이화여자대학교 간호대학
원종순 ( Won Song-Soon ) - 이화여자대학교 간호과학과
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Abstract
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최근 간호의 대상인 인간을 통합된 총체로 보는 견해와 함께, 인간이 접하는 가장 근본적인 환경인 가족이 체제로서의 인간의 건강에 직접적인 영향을 미치는 중요한 일차적인 환경이라는 것이 여러학자를 통해 확인되면서 부터 가족이 간호의 큰 관심의 대상이 되었다. 이에 간호사가 임상에서 실제 환자에게 간호를 제공할 때 효율적인 가족중심 간호전략을 마련하는데 실제적인 기초자료를 제공하고자, 급성질병을 가진 가족과 만성질병을 가진 가족의 가족기능 비교 연구를 시도하였다.
연구대상으로 급성환자군 가족은 서울시내에 위치한 2개 대학부속병원에서 치료후 질병발생이전의 상태로 거의 혹은 완전히 회복될 수 있는 급성질병(심근경색, 위염, 폐렴, 방광염, 맹장염, 췌장염, 담낭염, 담도폐색, 복막염, 신우신염등)의 진단하에 내과, 일반외과 및 중환자실에 입원하여 치료받고 있는 60세 이상의 노인환자가 있는 가족중에서 노인이 생각하는 의미있는 가족구성원 42명을 대상으로 하였고, 만성환자군 가족은 동병원에서 치유가 지연되거나 완치될 수 없으며 상당기간 또는 평생 조절하며 살아야 할 만성질병(고혈압, 당뇨병, 관절염, 만성 폐색성 폐질환, 만성 신증후군, 만성 위궤양 등)의 진단하에 내과, 정형외과에서 통원치료를 받거나 입원치료를 받고 있는 60세 이상된 노인이 있는 가족중에서 노인이 생각하는 의미있는 가족구성원 44명을 대상으로 하였다. 자료수집 기간은 1989년 4월부터 8월까지 5개월간이었다. 연구도구는 Olson, Russell, Sprenkle이 고안한 FACE scale을 번역·수정보완한 것으로 선행연구에서 Cronbach α=0.8902의 신뢰도를 보인 가족결속력 도구를 사용하였다.
설문지를 이용하여 수집된 자료는 S.P.S.S. 전산체제를 이용하여 빈도, χ²-test, t-test, ANOVA 등의 통계방법으로 분석하였다.
본 연구를 통하여 얻은 결과는 다음과 같다.
1. 급성환자군 가족의 가족기능 평균점수는 3.6220이고 만성환자군 가족의 가족기능 평균점수는 3.4219이었다.
2. 가설검정 "급성환자군 가족의 가족기능 정도와 만성환자군 가족의 가족기능 정도간에는 차이가 있을 것이다."라는 가설은 지지되지 못하여(t=1.51, p=0.135), 급만성 환자가 있을 때 다같이 가족기능이 높게 유지되는 현상을 보였다.
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Family has emerged as a key concept in nursing. Family has been identified as a the most important primary environment having a direct effect on human development. Nursing views the client as unitary whole being. This research problem was to compare the degree of family functioning in families with an acutely ill older member (acute patient family group) with that of families with a chronically ill older meinber (chronic patient family group) in order to provide theoretical understanding to contribute to effective family--focused nursing interventions in the clinical setting.
Subjects were 42 families with a acutely ill older member who had an acute illness (myocardiac infarction, gastritis, pneumonia, cystitis, appendicitis, pancreatitis, cholecystitis, gall bladder obstruction, panperitonitis, pyelonephritis, etc.), but was expected to be restored to the previous state of health. The patients were hospitalized at two university hospitals in Seoul. As a comparative group, 44 families with a chronically ill older member who had a chronic illness(hypertension, diabetes mellitus, arthritis, COPD, chronic nephrotic syndromes, etc.) not expected to be restored to the previous state of health but controlled throughout the rest of their life. The chronic older patients were hospitalized or were being treated through the out patient clinics at the same University hospitals.
Date collection was done from April to August, 1989. The instrument used was the Family Adaptability and Cohesion Evaluation scale, developed by Olson, Russell and Sprenkle and modified by the investigator.
Data analysis included frequency, x2-test, t-test and. ANOVA.
The results of the analysis follows.
1. The mean score of the family functioning in the acute patient group was 3,6220, and in the chronic patient group 3,4219 in a range of 0 to 5 where a higher score suggests a higher level of family functioning.
2. Test of hypothesis.
The main hypothesis, That the degree of family functioning families with an acutely ill older person (acute patient family group) would be different from that of families with a chronically ill older person (chronic patient family group), was not supported(t=1.51, p=0.135). Only in the category, spending time together was the degree of family functioning in. acute patient family group different from that of the chronic patient family group (t=3.70, p=0.00 0). More time together as a family was spentin the acute patient family group.
3. There was no significant relationship between family structure and the degree rf family functioning.
4. Relationship between general characteristic variables and the degree of family functioning. The only variable related to the degree of family functioning in acute patient family group was the presence or absence of the patients spouse (t=r 2.51, p=0.016). Family functioning was higher where the spouse was absent. The variables related to the degree of family functioning in the chronic patient family group was the older persons role in the family group and the family´s attitude toward the medical treatment (p=0.0048: P=0.0041). Family functioning was higher when the patients role were many and when the attitude toward treatment was positive.
The degree of family functioning was relatively high in both the acute and chronic patient family groups. But whether the illness is acute or chronic, may have an effect on the perceptions of the family towards the patient´s roles and towards the treatment. When nurses care for chronic patients, they should assess the degree of family functioning and plan interventions to strengthen family focused nursing care.
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KeyWords
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원문 및 링크아웃 정보
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등재저널 정보
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