대사증후군을 동반한 고혈압 환자를 위한 자가간호 역량 강화 프로그램의 효과 평가

국문 초록 (Abstract)

대표적인 만성질환인 고혈압과 대사증후군은 심혈관계 질환 발생의 위험을 증가시키는 요인으로 널리 알려져 있으며 특히 단순 만성질환에 비해서 복합 만성질환에서의 심혈관계 질환 발생 위험은 더욱 증가할 것이다. 이에 복합 만성질환 관리의 지속성을 유지하기 위한 대상자의 자가간호 역량을 최대로 이끌어 내기 위한 병원 중심 간호사 주도의 중재 프로그램을 개발하였다. 본 연구는 기존에 개발된 자가간호 역량 강화 프로그램의 효과를 평가하기 위한 비동등성 대조군 사전사후 설계에 의한 유사실험 연구이다. 본 연구는 경기도 소재 1개 대학 병원에 내원하고 있는 대사증후군을 동반한 고혈압 환자를 대상으로 하였고 중재 제공 및 자료 수집 기간은 2015년 3월 2일부터 2015년 11월 23일까지였다. 본 연구결과 실험군의 자가간호 행위 중 신체활동과 약물 이행도는 증가한 것으로 나타났지만 자가간호 역량과 간호사-환자 상호작용 점수는 실험군과 대조군에서 모두 증가하여 통계적으로 유의한 차이가 없었다. 생리적 지표 중 수축기 및 이완기 혈압, 맥박, 체중, 복부둘레, 체질량 지수의 감소는 중재 제공 3개월 시점에 대조군에 비해 실험 군에서 더 뚜렷하게 나타났다. 본 중재 프로그램은 대상자들의 신체 활동 지속성을 높였다는 점에서 타 연구와의 차별성을 가지며 이를 통해 대상자의 일상생활 능력을 최대로 유지하고자 한다. 그리고 약물 이행도 증가는 장기적으로 심혈관계 질환 합병증 예방과 이로 인한 의료비용 지출감소 효과를 가져올 수 있을 것이다. 병원을 토대로 한 간호사 중심의 중재 프로그램은 대상자의 생활양식 변화를 지속할 수 있도록 도울 뿐만 아니라 국가차원에서의 보건의료 자원의 효율적 사용을 가능하게 할 것으로 기대한다.

다국어 초록 (Multilingual Abstract)

Hypertension (HTN) and metabolic syndrome (MetS), which are representative chronic diseases, are known to increase the risk of cardiovascular disease (CVD). In particular, the risk of CVD in complex chronic disease is expected to increased more than that of simple chronic disease. Accordingly, a hospital-centered nurse-led intervention program was developed to maximize the self-care capacity of the subject to maintain the continuity of complex chronic disease management. This study is a quasi experimental study based on the nonequivalent control-group pretest-posttest design to evaluate the effect of the previously developed self-care capacity building program. It was conducted for hypertensive patients with MetS who visited one university hospital in Gyeonggi-do. The data collection period was from March 2, 2015 to November 23, 2015. As a result of the study, physical activity and medication adherence increased in experimental group However, there was no statistically significant difference in self-care capacity and nurse-patient interaction in both control and experimental group. Among the physiological indexes, systolic and diastolic blood pressure, pulse, body weight, abdomen circumference, and body mass index decreased more clearly in the experimental group than in the control group at 3 months of intervention. This intervention program is differentiated from other studies in that it enhances the subjects’continuity of physical activity, and through this, the subject’s activity of daily living is to be maintained to the maximum. In addition, the increase in medication adherence may lead to a long-term effect of preventing CVD complications and thereby reducing medical expenses. It is expected that a hospital-based nurse-led intervention program will not only help the subject’s lifestyle changes, but also enable efficient use of health care resources at the national level.

목차 (Table of Contents)

• Abstract
• Ⅰ. 서론
• Ⅱ. 연구방법
• Ⅲ. 연구결과
• Ⅳ. 논의
• Ⅴ. 결론
• 참고문헌
• 요약

참고문헌 (Reference)

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