상호목표설정 간호중재가 복부수술환자의 기능회복과 통증에 미치는 효과 = The Effect of Mutual Goal Setting Nursing Intervention for Functional Recovery and Pain of Abdominal Operation Patients.

다국어 초록 (Multilingual Abstract)

As a quasi-experiment, this study, which is based on King's goal attainment theory, tests differences in functional recovery and the degree of pain after abdominal surgery between an experimental group, receiving mutual goal setting nursing intervention and a control group, receiving only routine nursing intervention. So the aim of the study is helping patients' functional recovery and reducing the degree of pain as patients participate in their postoperative recovery in an active way and achieve their goals through patients and nurses interaction.
Data were collected from 27 patients hospitalized at the Department of Surgery of S general hospital in M city from September 15, 2003 to December 23, 2003. The subjects were divided into an experimental and a control group. The experimental and control groups consisted of 13 and 14 respectively.
To measure postoperative recovery and the level of patients' pain, the experimental group received mutual goal setting nursing intervention five times through interaction between patients and nurses from the day before operation to the forth day after operation. The control group, however, received only routine nursing intervention. As recovery indicators, mobility and bowel function recovery were taken. As mobility recovery indicators, the first sitting-up, standing and walking time were measured. Also, as indicators for bowel function recovery, the first carminative, excrementitious and drinking time were measured. In addition, FVC(Forced Vital Capacity) and FEV1(Forced Expiratory Ventilation in One Second) were measured by using Microplus Spirometer MS03(2000) and the level of pain by VAS(Visual Analog Scale) and GRS(Graphic Rating Scale).
For the data analysis, SPSS/WIN 10.0 Program were used for descriptive statistics, independent t-test, chi-square and Repeated measures of ANOVA.
The result were as follows;
1. Hypothesis 1 : ‘Recovery will be faster in abdominal surgery patients who receive the mutual goal setting nursing intervention than those who receive only routine nursing intervention.'
1) Hypothesis 1-1 : ‘Mobility recovery will be faster in the experimental group patients than the control group patients.' This was partly proved.
There were no significant differences in the first sitting-up time and standing time after operation between the two groups in statistics. However, in terms of the first walking time checked, the patients in the experimental group were statistically faster(t=2.149, p=.042).
2) Hypothesis 1-2 : ‘Bowel function recovery will be faster in the experimental group than the other group.' This hypothesis was partly supported.
In terms of the first postoperative carminative time, the experimental group patients were significantly faster than the other group patients(t=2.314, p=.029). And the same result was drawn in the first excrementitious time(t=2.314, p=.006). However, in the first drinking time showed the experimental group tendency that it is faster but the difference was not significant.
3) Hypothesis 1-3 : ‘FVC of the experimental group patients will be higher than that of the other group patients according to the time passed after operation'. It was proved.
Statistically significant difference was not found between two groups and as time passed, FVC showed the statistically meaningful difference(F=2.667, p=.000). Also difference between two groups was found according the time passed(F=2.667, p=.037).
4) Hypothesis 1-4 : ‘FEV1 of the experimental group patients will be higher than that of the other group patients.' The hypothesis has been rejected.
The two groups were not different in statistics and as time passed, meaningful difference in FEV1 was seen(F=60.587, p=.000). However, the interaction between the groups and the time passed has not been found.
2. Hypothesis 2 : ' The pain of the experimental group patients will be lower than that of the control group patients according to the time passed.' This hypothesis has been rejected.
The two groups had meaningful difference in statistics (F=5.887, p=.023) and as time passed, the degree of patients' pain was statistically diffenent(F=76.604, p=.000) but no interaction between the groups and the time measured was found.
As shown in the results of testing above, the mutual goal setting nursing intervention performed on abdominal surgery patients shortens patients' recovery period and reduces their pain. So my suggestion is that to prove the effectiveness of the mutual goal setting nursing intervention, repeated studies should be conducted on more subjects and in various situations.

목차 (Table of Contents)

• Ⅰ. 서론 = 1
• 1. 연구의 필요성 = 1
• 2. 연구의 목적 = 3
• 3. 연구의 가설 = 4
• 4. 용어의 정의 = 5
• 5. 연구의 제한점 = 7
• Ⅱ. 이론적 배경 = 8
• 1. King의 상호목표설정 간호중재 = 8
• 2. 복부수술환자의 기능회복에 영향을 미치는 요인 = 11
• 3. 수술 후 기능회복을 증진시키는 간호중재 = 15
• Ⅲ. 연구방법 = 20
• 1. 연구설계 = 20
• 2. 연구대상 = 21
• 3. 연구도구 = 21
• 4. 연구진행절차 = 23
• 5. 자료분석방법 = 26
• Ⅳ. 연구결과 = 27
• 1. 실험군과 대조군의 동질성 검정 = 27
• 2. 가설 검정 = 30
• Ⅴ. 논의 = 39
• Ⅵ. 결론 및 제언 = 42
• 1. 결론 = 42
• 2. 제언 = 45
• 참고문헌 = 46
• 부록 = 52
• Abstract = 62