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항암화학요법 받는 암환자를 위한 감염예방 자가관리 앱 개발 및 효과검증

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Publication Year
2016-06
Abstract
This study was conducted with the aim to develop a smartphone infection prevention self-care application for the cancer patients who have been discharged from the hospital after receiving chemotherapy and to verify the usefulness of the application by verifying its effectiveness. The abovementioned smartphone application was developed through five stages: analysis, design, development, implementation and evaluation. In the analysis stage, a literary review was conducted and the demand for education was survey for cancer patients who were due to receive chemotherapy. In the design stage, data interface and screens, and database were designed through a literary review and a survey of the demand for eduction, and the validity of the application contents was verified. In the development stage, infection prevention self-care application named NoInfec was developed. In the implementation and evaluation stage, experts and users were provided with the master version of the developed infection prevention self-care application, and based on the evaluation by experts and the satisfaction of users, the final version of the application was developed through correction and supplementation. In the usefulness evaluation of the smartphone application conducted with the aim to test the effectiveness of the developed application, the cancer patients who were due to receive chemotherapy were asked to use the developed application. Then in a nonequivalent control group, a no-synchronized design study was conducted for analyzing the effect of the application on the infection prevention self-care management knowledge and self-care performance of the subjects and infection occurrence. The subjects of this study were those who agreed to participate in this study among cancer patients who were due to receive first cycle chemotherapy in K university hospital. Of them, 26 patients were selected for the experimental group and 26 patients for the control group at first. Excluding dropouts, a total of 46 patients (22 patients in the experimental group and 24 patients in the control group) finally participated in this study. The collected data were analyzed using SPSS 21.0, and the homogeneity for the general characteristics and dependent variables of the experimental group and the control group was verified using a chi-squared test, and t-test. Furthermore, differences in infection prevention knowledge and self-care performance between the two groups were analyzed using a independent sample t-test and the differences in infection occurrence between the two groups were analyzed using a chi-square test. The results of the usefulness evaluation in this study can be summarized as follows: 1. The self-care knowledge score increase was statistically meaningful in the experimental group that used the smartphone infection prevention self-care application for cancer patients receiving chemotherapy compared with the control group that did not used the same application (t=6.74, p=<.001) 2. The self-care performance score increase was statistically meaningful in the experimental group that used the smartphone infection prevention self-care application for the cancer patients receiving chemotherapy compared with the control group that did not used the same application (t=13.44, p=<.001). 3. The infection occurrence score increase was not statistically meaningful in the experimental group that used the smartphone infection prevention self-care application for cancer patients receiving chemotherapy compared with the control group that did not used the same application (χ²=1.23, p=.268). The absolute values of fever in the respective experimental group and control group were analyzed additionally using an independent sample t-test. The results showed that an increase in the average score of the fever in the control group was statistically meaningful compared to the experimental group (t=-2.39, p=.021). Based on the above results, the author of this study concluded that the smartphone infection prevention self-care application for the cancer patients receiving chemotherapy increased infection prevention self-care knowledge and self-care performance in cancer patients receiving chemotherapy, indicating that the application of the developed application to the cancer patients receiving chemotherapy can help them enhance their self-care performance without time and space constraints. Thus it is recommended that discharged cancer patients after receiving chemotherapy, use the smartphone application developed for self-care performance.
본 연구는 항암화학요법을 받고 퇴원한 암환자를 대상으로 감염예방 자가관리 앱을 개발하고 개발된 앱의 효과를 검증하여 유용성을 평가하기 위한 연구이다. 감염예방 자가관리 앱 개발은 분석-설계-개발-실행-평가의 5단계로 진행되었다. 분석단계에서는 문헌고찰 및 항암화학요법을 시작하는 환자를 대상으로 감염예방 자가관리 관련 교육 요구도 조사를 시행하였다. 설계단계에서는 문헌고찰과 교육 요구도 조사를 통하여 데이터 인터페이스 및 화면, 데이터베이스를 설계하였고, 앱 내용의 타당도를 검증받았다. 개발단계에서는 NoInfec이라는 이름의 감염예방 자가관리 앱을 개발하였다. 실행 및 평가 단계에서는 개발된 감염예방 자가관리 앱의 마스터 버전을 전문가와 사용자에게 제공하여 전문가 평가와 사용자 만족도를 조사하여 의견을 수렴하여 수정·보완을 거친 후 감염예방 자가관리 앱을 완성하였다. 앱의 유용성 평가에서는 개발된 앱의 효과 검증을 위해 항암화학요법을 시작하는 환자에게 본 연구자가 개발한 감염예방 자가관리 앱을 사용하도록 한 후 대상자의 감염예방 자가관리 지식, 자가관리 행위 및 감염 발생에 미치는 효과를 조사하는 비동등성 대조군 사후 시차설계 연구를 시행하였다. 연구대상은 K대학교병원 암환자 중에서 첫 주기 항암화학요법을 시작하는 환자 중 실험군 26명, 대조군 26명을 목표로 하였으며, 탈락된 대상자를 제외하고 실험군 22명, 대조군 24명인 총 46명이 연구에 참여하였다. 수집된 자료는 SPSS 21.0을 활용해 분석하였으며 실험군과 대조군의 일반적 특성과 종속변수에 대한 동질성 검증은 chi-square test와 t-test를 사용하여 분석하였다. 또한 두 집단의 감염예방 자가관리 지식, 자가관리 행위의 차이는 독립표본 t-test로 분석하였으며 두 집단의 감염 발생 여부의 차이는 chi-square test로 분석하였다. 본 연구의 유용성 평가에서의 결과는 다음과 같다. 1. 항암화학요법을 받는 암환자를 위한 감염예방 자가관리 앱을 사용한 실험군은 사용하지 않은 대조군보다 감염예방 자가관리 지식 점수가 통계적으로 유의하게 높았다(t=6.74, p=<.001). 2. 항암화학요법을 받는 암환자를 위한 감염예방 자가관리 앱을 사용한 실험군은 사용하지 않은 대조군보다 감염예방 자가관리 행위 점수가 통계적으로 유의하게 높았다(t=13.44, p=<.001). 3. 항암화학요법을 받는 암환자를 위한 감염예방 자가관리 앱을 사용한 실험군은 사용하지 않은 대조군과 감염 발생빈도가 통계적으로 유의한 차이가 없었고(χ²=1.23, p =.268), 실험군과 대조군의 발열 수치 각각의 절대값을 독립표본 t-test로 추가로 분석하였을 때 실험군보다 대조군의 발열 수치의 평균 점수가 통계적으로 유의하게 높았다(t=-2.39, p=.021). 이상의 결과를 통해 항암화학요법 받는 암환자를 위한 감염예방 자가관리 앱은 암환자의 감염예방 자가관리 지식을 증진시키고 자가관리 행위를 향상시키는 것으로 확인되었다. 그러므로 개발된 앱을 항암화학요법을 받는 암환자에게 적용한다면 시간과 공간의 제약 없이 자가관리 수행을 높일 수 있을 것이다. 이에 항암화학요법을 받고 퇴원한 암환자의 자가관리 수행을 위한 앱을 환자에게 활용할 것을 제안한다.
Alternative Title
Development and Effectiveness Verification of Infection Prevention Self-care App:With Focus on Cancer Patients Who are Receiving chemotherapy
Awarded
2016
Degree
석사
Type
Thesis
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/12943
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