16 research outputs found
Nursing satisfaction of critically ill patients and nurse's recognition and performance with nursing needs
๊ฐํธํ๊ณผ/์์ฌ[ํ๊ธ]์คํ์์ค์ ์๋ช
์ ์ํํ๋ ์ฌ๊ฐํ ๊ธ์ฑ์งํ์ ๊ฐ์ง ํ์๋ค์ ์น๋ฃํ๊ธฐ ์ํ์ฌ ์ฌ๋ฌ ํน์ํ ๊ฐ์ ์ฅ์น์ ์๋ฃ ์ธ๋ ฅ์ ๊ฐ์ถ ์ง์ค์น๋ฃ์ค๋ก ํ์์ ์๋ช
์ ์ ์งํ๋ฉฐ ์ค์ ์ฅ๊ธฐ์ ์์์ ์๋ฐฉ, ์น์ ํน์ ์ต์ํํ๊ธฐ ์ํ ์ง์์ ์ด๊ณ ๋ค์์ ์ธ ์น๋ฃ๊ฐ ์ํ๋๋ ๊ณณ์ผ๋ก, ๊ฐํธ๋์์๋ค์ ์ ์ฒด์ , ์ ์ ์ , ํ๊ฒฝ์ ์ผ๋ก ๋ค์ํ ์คํธ๋ ์ค๋ฅผ ๊ฒฝํํ๊ฒ ๋๋ค. ๋ฐ๋ผ์ ์๋์ ์ผ๋ก ์คํ์์ค ์
์ ๋์์์ ๊ฐํธ ์๊ตฌ๋๊ฐ ๋์ ์ ์์์ ์ง์ํ ์ ์์ผ๋ ์ด์ ๋ํ ์ ํ ์ฐ๊ตฌ๋ ๋ฏธ๋นํ ์ค์ ์ด๋ค.๋ฐ๋ผ์ ๋ณธ ์ฐ๊ตฌ๋ ์คํ์์ ๊ฐํธ์๊ตฌ์ ๋ํด ๋ฌธํ์ ํตํด ํ์
ํ์ฌ ์ด์ ๋ํ ๋ง์กฑ๋๋ฅผ ์กฐ์ฌํ๊ณ ์คํ์์ค ๊ฐํธ์ฌ๊ฐ ์คํ์์ ๊ฐํธ์๊ตฌ์ ๋ํด ์ธ์งํ๋ ์ ๋์ ์ํํ๋ ์ ๋๋ฅผ ์กฐ์ฌํ์ฌ ๋น๊ตํจ์ผ๋ก์ ํ์์ ๊ฐํธ์ฌ์ ์ธ์์ฐจ์ด๋ฅผ ์ขํ๋๋ฐ ์์๊ฐ ์์ผ๋ฉฐ, ์คํ์์ ๊ฐํธ์๊ตฌ์ ๋ํ ์ค์ ์ํ์ ๋๋ฅผ ํ์
ํ์ฌ ๋น๊ตํจ์ผ๋ก์ ๋ณ์์ฐจ์์์ ๊ณ ๊ฐ์ค์ฌ์ ์๋น์ค ์ ๋ต์ ์๋ฆฝํ๊ณ ๊ฐํธ์ ์ง ํฅ์๊ณผ ํจ๊ณผ์ ์ธ ๊ฐํธ์
๋ฌด ์ํ์ ์ํ ๊ฐํธ๊ณํ์ ๊ธฐ์ด ์๋ฃ๋ฅผ ์ ๊ณตํ ์ ์๋ค.๋ณธ ์ฐ๊ตฌ๋ ์์ธ ์๋ด ์ผ ๋ํ ๋ณ์ ์คํ์์ค์ ์
์คํ ์์ ์๋ 18์ธ ์ด์ ์ฑ์ธ ํ์์ ์คํ์์ค ๊ฐํธ์ฌ๋ฅผ ๋์์ผ๋ก ํ๋ ํก๋จ์ ์กฐ์ฌ์ฐ๊ตฌ์ด๋ค.๋ณธ ์ฐ๊ตฌ์์ ์ฌ์ฉ๋ ์คํ์์ค ๊ฐํธ์๊ตฌํญ๋ชฉ์ ๊ธฐ์กด ์ฐ๊ตฌ๋ฅผ ๊ธฐ์ด๋ก ํ์์ผ๋ฉฐ ์ ๋ฌธ๊ฐ ์ง๋จ์ ์๋ฌธ์ ์ป์ด ๊ฐ๋ฐํ ๋๊ตฌ๋ก 43๊ฐ์ ๋ฌธํญ์ผ๋ก ๊ตฌ์ฑ๋์ด ์์ผ๋ฉฐ ์ ์ฒด์ ๊ฐํธ์๊ตฌ 7๋ฌธํญ, ํ๊ฒฝ์ ๊ฐํธ์๊ตฌ 7๋ฌธํญ, ์น๋ฃ์ ๊ฐํธ์๊ตฌ 7๋ฌธํญ, ์ ์์ ๊ฐํธ์๊ตฌ 11๋ฌธํญ, ์ ๋ณด์ ๊ฐํธ์๊ตฌ 11๋ฌธํญ์ด๋ค.์๋ฃ์์ง์ 2006๋
3์ 20์ผ๋ถํฐ 5์ 30์ผ๊น์ง ์์ธ์๋ด ์ผ ๋ํ ๋ถ์๋ณ์์์ ๋ณ์์ฅ์ ์น์ธ์ ๋ฐ์ ์คํ์์ค ํํธ์ฅ์ ํ์กฐ๋ฅผ ์ป์ด ์คํ์๋ ๋ฉด์ ๋ฒ์ ์ฌ์ฉํ์์ผ๋ฉฐ ๊ฐํธ์ฌ๋ ์๊ฐ๋ณด๊ณ ์ ์ง๋ฌธ์ง๋ฒ์ ์ฌ์ฉํ์๋ค. ์๋ฃ๋ถ์ ๋ฐฉ๋ฒ์ SPSS WIN 12.0 program์ ์ฌ์ฉํ์ฌ ๋์์์ ํน์ฑ, ์คํ์์ ๋ง์กฑ๋, ๊ฐํธ์ฌ์ ์ธ์ง๋ ๋ฐ ์ํ๋๋ ๋น๋์ ๋ฐฑ๋ถ์จ, ํ๊ท , ํ์คํธ์ฐจ๋ฅผ ์ธก์ ํ์์ผ๋ฉฐ ๊ฐํธ์ฌ์ ์ํ๋์ ์คํ์์ ๋ง์กฑ๋์ ์ฐจ์ด๋ independent t-test๋ก ๋ถ์ํ๊ณ ๊ฐํธ์ฌ์ ์ธ์ง๋์ ์ํ๋์ ์ฐจ์ด๋ paired t-test๋ก ๋ถ์ํ์๋ค.์คํ์์ค ๊ฐํธ์๊ตฌ์ ๋ํ ์คํ์์ ๋ง์กฑ๋์ ๊ฐํธ์ฌ์ ์ธ์ง ๋ฐ ์ํ๋์ ๊ฒฐ๊ณผ๋ ๋ค์๊ณผ ๊ฐ๋ค1) ์คํ์์ ๊ฐํธ์๊ตฌ์ ๋ํ ๋ง์กฑ๋์ ์ด์ ์ ํ๊ท ์ 7.57(1.85)์ ์ผ๋ก ๋ง์กฑ์ ๋๋ ๏ผ๋น๊ต์ ๋์ ์์ค๏ผ์ผ๋ก ๋ํ๋ฌ์ผ๋ฉฐ, ์์ญ ๋ณ๋ก ์ดํด๋ณด๋ฉด ์น๋ฃ์ ๊ฐํธ์๊ตฌ์ ๋ํ ๋ง์กฑ๋(8.28)๊ฐ ๊ฐ์ฅ ๋์์ผ๋ฉฐ, ๊ทธ ๋ค์์ผ๋ก ํ๊ฒฝ์ ๊ฐํธ์๊ตฌ์ ๋ํ ๋ง์กฑ๋(7.75), ์ ์ฒด์ ๊ฐํธ์๊ตฌ์ ๋ํ ๋ง์กฑ๋(7.69), ์ ์์ ๊ฐํธ์๊ตฌ์ ๋ํ ๋ง์กฑ๋(7.50) ์์ผ๋ก ๋ํ๋ฌ์ผ๋ฉฐ, ์ ๋ณด์ ๊ฐํธ์๊ตฌ์ ๋ํ ๋ง์กฑ๋(7.01)๋ ์๋์ ์ผ๋ก ๋ฎ๊ฒ ๋ํ๋ฌ๋ค.2) ์คํ์์ ๊ฐํธ์๊ตฌ์ ๋ํ ๊ฐํธ์ฌ์ ์ธ์ง๋ ์ด ์ ์ ํ๊ท ์ 8.15(0.82)์ ์ผ๋ก ์ธ์ง๋๊ฐ ๋์๋ค. ์์ญ๋ณ๋ก๋ ์น๋ฃ์ ๊ฐํธ์๊ตฌ์ ๋ํ ์ธ์ง๋๊ฐ ๊ฐ์ฅ ๋์์ผ๋ฉฐ(9.04). ๊ทธ ๋ค์์ผ๋ก๋ ์ ์ฒด์ ๊ฐํธ์๊ตฌ์ ๋ํ ์ธ์ง๋(8.32), ํ๊ฒฝ์ ๊ฐํธ์๊ตฌ์ ๋ํ ์ธ์ง๋( 7.88), ์ ๋ณด์ ๊ฐํธ์๊ตฌ์ ๋ํ ๊ฐํธ์ฌ ์ธ์ง๋(7.79)์ , ์ ์์ ๊ฐํธ์๊ตฌ์ ๋ํ ์ธ์ง๋(7.72) ์์ผ๋ก ๋ํ๋ฌ๋ค.3) ์คํ์์ ๊ฐํธ์๊ตฌ์ ๋ํ ๊ฐํธ์ฌ์ ์ํ๋ ์ด์ ์์ ํ๊ท ์ 7.31(1.05)์ ์ผ๋ก ๏ผ๋น๊ต์ ๋์ ์์ค๏ผ์ผ๋ก ๋ํ๋ฌ๋ค. ์์ญ๋ณ๋ก ์ดํด๋ณด๋ฉด ์น๋ฃ์ ๊ฐํธ์๊ตฌ์ ๋ํ ์ํ๋(8.74)๊ฐ ๊ฐ์ฅ ๋์์ผ๋ฉฐ, ๊ทธ ๋ค์์ผ๋ก ์ ์ฒด์ ๊ฐํธ์๊ตฌ์ ๋ํ ์ํ๋(7.71), ์ ์์ ๊ฐํธ์๊ตฌ์ ๋ํ ์ํ๋(7.06)์์ผ๋ก ๋ํ๋ฌ๋ค. ๋ฐ๋ฉด ์ ๋ณด์ ๊ฐํธ์๊ตฌ์ ๋ํ ์ํ๋(6.64)์ ํ๊ฒฝ์ ๊ฐํธ์๊ตฌ์ ๋ํ ๊ฐํธ์ฌ์ ์ํ๋(6.41)๋ ๋ฎ๊ฒ ๋ํ๋ฌ๋ค.4) ์คํ์์ ๊ฐํธ์๊ตฌ์ ๋ํ ๊ฐํธ์ฌ์ ์ํ๋(7.31์ )์ ์คํ์์ ๋ง์กฑ๋(7.57์ )์ ์ฐจ์ด๋ ํต๊ณํ์ ์ผ๋ก ์ ์ํ์ง ์์๋ค(t=-1.01, p>.05). ๊ฐ ์์ญ๋ณ๋ก ์ดํด๋ณด๋ฉด ์น๋ฃ์ ๊ฐํธ์๊ตฌ์ ๋ํ ๊ฐํธ์ฌ์ ์ํ๋(8.74์ )๋ณด๋ค ์คํ์์ ๋ง์กฑ๋(8.28์ )๊ฐ ๋ฎ์์ผ๋ ์ ์ํ ์ฐจ์ด๋ ์์๋ค(t=1.83, p>.05). ๊ทธ๋ฌ๋ ํ๊ฒฝ์ ๊ฐํธ์๊ตฌ์ ๋ํ ๊ฐํธ์ฌ์ ์ํ๋(6.41์ )๋ณด๋ค ์คํ์์ ๋ง์กฑ๋(7.75์ )๊ฐ ๋์ ์ ์ํ ์ฐจ์ด๊ฐ ์์๋ค(t=-4.60. p<.01).๊ตฌ์ฒด์ ์ธ ํญ๋ชฉ์ผ๋ก๋ ์ฒ๋ฐฉ์ ์ ํํ๊ณ ์ ์ํ๊ฒ ์ํ(t=3.10, p<.01), ์์ธ์ ์ง(t=2.57, p<.0.05), ์คํ์์ค์ ๊ตฌ์กฐ์ ๋ฉดํ๊ท์น, ํ์ง์๊ฐ์ ๋ํด ์ค๋ช
ํ๊ธฐ(t=2.97,p<.01)์์ ๊ฐํธ์ฌ์ ์ํ๋์ ํ์์ ๋ง์กฑ๋์๋ ์ ์ํ ์๊ด์ฑ์ด ๋ํ๋ฌ๋ค5) ์คํ์์ ๊ฐํธ์๊ตฌ์ ๋ํ ๊ฐํธ์ฌ์ ์ธ์ง๋์ ์ํ๋ ์ฐจ์ด๋ ๊ฐํธ์ฌ์ ์ธ์ง๋๊ฐ ์ํ๋๋ณด๋ค ๋๊ฒ ๋ํ๋ฌ์ผ๋ฉฐ ํต๊ณ์ ์ผ๋ก ์ ์ํ์๋ค(t=6.75, p<.01). ๊ฐ ์์ญ๋ณ๋ก ์ดํด๋ณด๋ฉด ์น๋ฃ์ ๊ฐํธ์๊ตฌ(t=2.38, p<.05), ์ ์ฒด์ ๊ฐํธ์๊ตฌ(t=4.59, p<.01), ํ๊ฒฝ์ ๊ฐํธ์๊ตฌ (t=7.57, p<.01), ์ ๋ณด์ ๊ฐํธ์๊ตฌ(t=7.20, p<.01), ์ ์์ ๊ฐํธ์๊ตฌ(t=4.43, p<.01)๊ฐ ๋ชจ๋ ๊ฐํธ์ฌ์ ์ธ์ง๋์ ๋นํด ์ํ๋๊ฐ ๋จ์ด์ง๋ ๊ฒ์ผ๋ก ๋ํ๋ฌ๋ค.์ด์๊ณผ ๊ฐ์ ์ฐ๊ตฌ๊ฒฐ๊ณผ๋ฅผ ์ข
ํฉํด ๋ณผ ๋, ๊ฐํธ์๊ตฌ์ ๋ํ ์คํ์์ ๋ง์กฑ๋๋ ๋น๊ต์ ๋๊ฒ ๋ํ๋ฌ์ผ๋ฉฐ ์คํ์์ ๊ฐํธ ์๊ตฌ๋์ ๋ํ ๊ฐํธ์ฌ์ ์ธ์ง๋๋ ๋์์ผ๋, ์ด์ ๋ํ ์ํ๋๊ฐ ์๋์ ์ผ๋ก ๋ฎ์ ๊ฒ์ผ๋ก ๋ํ๋ฌ๋ค. ์ด๋ ์คํ์์ ์ ์ฒด์ , ์ฌํ.์ ์์ ์๊ตฌ์ ๋ํด ์ฐจ๋ณํ๋ ์ ๊ทผ์ด ์๊ตฌ๋จ์ ์์ฌํ ๋ฟ๋ง ์๋๋ผ ํ์ ์ ์ผ๋ก๋ ์คํ์ ๊ฐํธ์๊ตฌ์ ๋ํ ๊ฐํธ์ฌ์ ์ํ์ ์ด์ง์ํฌ ์ ์๋ ๋ค์ํ ์ ๋ต์ ๋ฐฉ์์ ๊ฐ๊ตฌํ๋ ์ถํ ์ฐ๊ตฌ๊ฐ ํ์ํจ์ ์์ฌํ๋ค
[์๋ฌธ]In the ICU(Intensive Care Unit), a multimodal treatment is performed continuously to sustain the life of patient with a severe acute disease and prevent, cure, or minimize a damage of critical organs, which is equipped with various special monitoring systems and medical treatment. critically ill patients are experienced various physical, emotional, and environmrntal stress. therefore it will be able to guess criticially ill patient's nursing needs is relatively high possibility but the preceding research is deficient.Currently, advanced techniques, changes of medical environment and multimodal heath managers are enhancing treatment intensity and increasing the stress which has been never experienced before. Many case of critical care tend to cope with an intolerable environment of unfamiliar and isolated space. In this context, it is important to understand sufficiently problems and nursing needs in the ICU.This study performed a literature survey to investigate nursing needs of critically ill patients and survey a nursing satisfaction of critically ill patients and compared between the recognition and the performance of nurses in ICU for the purpose of minimize the difference in recognition between the patients and the nurses. In addition, the practical achievement for nursing need of critical care was investigated comparatively to establish a patient-centered service strategy and provide basic informations for improving nursing quality and efficiency in acting the nursing work. A cross sectional research was performed for both the alert adult patients older than 17 and the nurses in the ICU of un university hospital in Seoul City.An interviews and a self-reported questionnaire method were employed to collect data of the patients and the nurses, respectively. The items of nursing needs were developed with the assistance of consults of experts. It consists of 43 items; 7 items of physical nursing needs, 7 items of environmental nursing needs, 7 items of treatment nursing needs, 11 items of emotional nursing needs, and 11 items of information nursing needs.Data was collected from the 20th March 2006 to the 30th May with the aids of the Presidents and the Chief Nurse of the hospital. For data analyses, SPSS WIN 12.0 was used. The satisfaction of patients, the recognition and performance of nurses are measured in terms of frequency, percentage, average and standard deviation. The difference between the patient's satisfaction and the nurse's performance were analyzed by 'independent t-test'. 'Paired t-test' was employed to analyze the difference between the recognition and the performance of nurse.The obtained results are summarized as follows:1) Considering the satisfaction with nursing needs of critical care, the average was 7.57 and indicated the high level of satisfaction relatively. For more details based on the classification into subcategories, the treatment nursing needs scored the highest satisfaction(8.28) and was followed by in the order of the environmental nursing(7.75), the physical nursing(7.69), the emotional nursing(7.50), and the information nursing scored relatively lowly(7.01). 2) The recognition of nurse scored the high level with the average of 8.15(0.82). Out of the classified subcategories, the recognition of treatment nursing needs was the highest(8.28) and was followed by in the order of the physical nursing(8.32), the environmental nursing(7.88), the information nursing (7.79) and the emotional nursing(7.72).3) The performance of nurse also scored the high level relatively with the average of 7.31. Considering the classified subcategories, the ecognition was the highest in the case of treatment nursing needs(8.74). The physical nursing (7.71) was the second to the treatment nursing and was followed by the emotional nursing(7.06) in order, However the information nursing(6.64) and the environmental nursing(6.41) scored relatively lowly4) The difference between the nurses' performance and the patients' satisfaction for nursing needs was not significant (t=-1.01, p>.05). Considering the subcategory of treatment nursing needs, the patients' satisfaction kept the average score of 8.82 lower than the nurses' performance (average score of 8.74) but there was no significant difference (t=1.83, p>.05). However, a significant difference was noticed in terms of environmental nursing(t=-4.6, p<.01); the average score of patients' satisfaction, 7.75 was higher than that of nurses'performance, 6.41.For most of concrete items, the patients' satisfaction and nurses' performance was significant difference such as rapid and exact implementation of prescription (t=3.10, p<.01), keeping position (t=2.57, p<.05), and explanation about the internal structure of ICU, meeting rule, and time table for doctor's round(t=2.97, p<.01)..5) The comparison between the recognition and the performance of nurse showed that the former was high than the latter and the difference was significant statistically (t=6.75, p<.01). For all the subcategories, the performance was lower compared with the recognition (treatment nursing; t=2.38, p<.05, physical nursing; t=4.59, p<.01, environmental nursing; t=7.57, p<.01, information nursing; t=7.20, p<.01, emotional nursing; t=4.43, p<.01).To sum up the results above, it can be noticed that the patients' satisfaction with nursing needs were high relatively and the performance of nurses were lower than the recognition. This result indicates physical, social․emotional needs of critically ill patients are required approach to differentiate each patient, as well as A further study is necessary to build various strategy that be able to promote nurses' performance with nursing needs of critically ill patient administratively.ope