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류마티스 관절염 환자의 지식, 자기효능감 및 치료이행과의 관계연구
김순봉 대한류마티스 건강전문학회 1998 근관절건강학회지 Vol.5 No.2
Reumatic arthritis is a disease with joint pain being one of the key symptoms. The patient suffers from the pain, stiff sensation and edema due to the inflammation taking place in one or more joints. Accompanying these problems are fatigue, unusual exhaustion, fever, tachycardia and weakness. Inaddition, joints are often deformed and muscles shrink along with the progress of edema, coupled with depression arid psychological instability resulting from the loss of the mobile function and limitations on the daily life. Some patients become fed up with the long and hard flight with the disease and just give up, which aggravates the symptoms. Others come to the hospital only when the conditions have become serious. We need to prevent these and guide the patients in the right direction. Against this backdrop, this study-aims to look into the relations between the knowledge on the part of the patients together with their feeling of self-efficacy and the compliance. The results are expected to help the patients improve their life, in addition to providing useful materials for setting up appropriate plan for nursing intervention. The study was conducted by distributing questionnaire to 88 patients selected from the out-patient department of a university hospital in Inchon, from April 6 to 27, 1998. The following tools were used: the yardstick of self-efficacy, developed in 1997 by the Society for the Health of Rheumatism Patients, was used for measuring the levels of knowledge and the feeling of self-efficacy. The degree or compliance was measured by the date collected from documents in addition to the results f the analysis of the interviews with the patients. The reliability of the tools was confirmed. In the analysis, the general characteristics were expressed in figures and percentages. The levels of knowledge, feeling of self-efficacy, and compliance were expressed in the average values and standard deviations. The relations among the following the general characteristics were analysed by the t-test and one-way ANOVA. The Pearson correction coefficient was used for the analysis of factors. Multiple-loop analysis was used to identify the variables effecting the compliance. The following are the results of this study. 1. Among the 88 patients, 18 were men and the remaining 70 were women, with a ratio 1:3.87. Regarding the age groups, 23 were between 50 and 59 years old, with those between 50 and 69 accounting for 51.1% of the total. High school graduates or higher amounted to 58%. Religious patients was 67% or 59 persons. Fifty nine percent were unemployed, and 58.3% (49 persons) had two children or fewer. The period of suffering from rheumatism varied between 2 months and 15 years, with 70% less than years. 2. The average figure in relation to the of knowledge was 17.63 points over 30 or 58. 76%, which means a medium level. 3. The average figure of the feeling of self-efficacy was 60.06 points. 4. The level of compliance was 3.26, which was above average. 5. The relation between the feeling of self-efficacy and compliance showed an value of 0.37, which was significant. It means that the higher the feeling, the greater the compliance points. 6. The analysis of the knowledge level revealed that the difference is found only between the college graduates and junior-high graduates or lower. 7. The feeling of self-efficacy varied along with the age and education level. 8. The general characteristics of patients as discussed above did not show significant difference with the compliance. 9. Regarding the elements influencing the compliance, the number of children, period of suffering, income, age, feering of self-efficacy, knowledge, and compliance had 54% of significance. In conclusion, rheumatism victims can lead a better life if they are appropriately educated, based on efficient training program from the early days of the disease if they become able to manage themselves thanks to the training and if they are helped by a program focusing on the increase of the feeling of self-efficacy aimed at changing patient's behavior.
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Triage tool을 이용한 응급의료센터 내원환자의 중증도 분류 타당성 및 체류시간 결정요인에 관한 연구
심숙희,노진숙,홍선주,김순봉 병원간호사회 2001 임상간호연구 Vol.7 No.2
This study is a descriptive correlation study to investigate the triage and stay time of patients who are visited to emergency medical center(EMC) using emergency triage method(ETM). Also this study aims to examine the degree of ETM and to improve crowding in EMC. The patients were classified three groups by ETM(emergent, urgent, non-emergent). We reviewed prospectively the medical records of EMC from June 1, 2000, to June 19, 2000 and collect above 15-year-old patients using random non biased method. The SAS package was used for statistical analysis. The result of this study are following: 1) The percentages of each group according to the ETM were as follows : emergent group, 8.3%; urgent group, 20.0% ; non-emergent group, 71.7%. 2) According to the criteria of emergency medical administration charge, the emergent group was 52.8% and non-emergent group was 47.2%. 3) The mean time for laboratory and radiologic study according to ETM were as follows : emergent group, 92 minutes ; urgent group, 83 minutes; non-emergent group, 61 minutes. 4) The mean time for doctor visit according to ETM were as follows: emergent group, 13 minutes; urgent group, 27 minutes ; non-emergent group. 17 minutes. 5) The mean time for decision of admission or discharge according to ETM were as follows : emergent group, 2 hours and 58 minutes ; urgent group, 2 hours and 43 minutes;non-emergent group. 1 hour and 50 minutes. 6) The mean time for diagnosis and treatment according to ETM were as follows : emergent group, 4 hours and 43 minutes ; urgent group, 4 hours and 37 minutes ; non-emergent group. 3 hours and 43 minutes. 7) The mean time for stay in EMC was 3 hours and 48 minutes. 8) The time for decision of admission or discharge according to stay time was as follows : 0-3 hours stay in EMC, 56 minutes ; 3-6 hours stay in EMC, 2 hours and 36 minutes ; over 6 hours stay in EMC. 4 hours and 28 minutes. 9) The criterias of emergency medical administration charge according to stay time were as follows : 0-3 hours stay in EMC, emergent group was 36.4%, non-emergent group was 63.6% ; 3-6 hours stay in EMC, emergent group was 54.4%, non-emergent group was 54.6% ; over 6 hours stay in EMC, emergent group was 63.3%, non-emergent group was 36.7%. In summary, there was significant differences of time to treat and stay among three groups in EMC. Therefore this study suggests that activation of emergency triage method will be help to decrease of crowding in EMC because of shortening of treatment and stay time in non-emergent cases.
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