간경화 환자의 응급실 내원 예측요인

Other Titles
Predictors of Liver Cirrhosis Patients Visiting Emergency Room
Authors
김은경
Abstract
The purpose of a prospective descriptive study was primarily to identify the predictors of liver cirrhosis patients visiting emergency rooms. To achieve this goal, the predictors for liver cirrhosis patients having an emergency were investigated. The result of which will provide basic structural information that could reduce the number liver cirrhosis patients visiting the emergency room. Data from 215 liver cirrhosis patients were collected from January 1, to January 14, 2017, at Y University hospital located in Daegu. Measurement scales were designed based on liver function test, POMS, self-care and family support. Liver cirrhosis diseases, their related characteristics and the hematologic examination were reviewed by OCS (Order Communication System). The analysis for this study was generated using SPSS 22.0 to calculate frequency, percentile, average, standard deviation, t-test, chi-square test, and logistic regression. The results are as follows: 1. Of the 215 liver cirrhosis patients who visited the emergency room, 49 (21.8%) patients had visited the emergency room before while 168 (78.1%) patients had no previous emergency room visit experience. 2. The variables that were statistically significant for the emergency room visiting group were the cause of liver cirrhosis (p<.001), discomfort (p=.015), drinking (p<.001), hospitalization (p<.001), number of complications (p<.001), bilirubin (p<.001), albumin (p<.001), prothrombin time (p<.001), total cholesterol (p<.001), ALT (p=.014), AST (p<.001), ALP (p<.001), anxiety and depression (p<.001), self-care (p<.001) and family support (p=.001). 3. The result of running a logistics regression shows that there were three significant predictors: Two or more complications (95% CI=1.60-71.81, OR=10.73), Bilirubin (95% CI=1.19-12.01, OR=3.79), self-care (95% CI=0.81-0.97, OR=0.89). The results showed that liver cirrhosis patients are more likely to visit an emergency room under the following conditions; more complications; higher bilirubin level. Liver cirrhosis patients are less likely to visit an emergency room under the following conditions; higher the self-care. Therefore, it is important that liver cirrhosis patients and health care staff be attentive, according to the results of this study. The conclusion drawn from this research could be used to develop further nursing interventional strategies for liver cirrhosis patients visiting emergency rooms. Furthermore, it is necessary to measure the effect of nursing interventional strategies.
본 연구는 간경화 환자를 대상으로 응급실 내원율과 응급실 내원 예측요인을 파악하는 전향적 서술적 조사연구이다. 이를 바탕으로 간경화 환자의 응급실 내원 예측요인을 조사하고, 간경화 환자의 응급실 내원을 줄이기 위한 간호중재개발의 기초자료를 제공하기 위함이다. 연구대상자는 대구소재 Y대학병원에서 간경화 진단을 받고 외래 치료 중으로 2017년 1월부터 1일부터 1월 14일까지 소화기 내과 외래를 방문하고 본 연구의 선정기준을 만족한 215명을 대상으로 하였다. 측정도구는 간기능 검사, POMS, 자가간호, 가족지지 도구를 사용하였고 간경화 환자의 질병 관련 특성, 혈액학적 검사 결과는 전자의무기록을 조회하였다. 자료분석은 SPSS/WIN 22.0 이용하여 빈도, 백분율, 표준편자, t-test, x2-test, 로지스틱 회귀분석을 사용하였고, 본 연구의 결과를 요약하면 다음과 같다. 1. 간경화 환자의 215명 중 응급실 내원군 21.8%(47명), 응급실 비내원군 78.1%(168명)으로 나타났다. 2. 응급실 내원군에서 통계적으로 유의하게 나타난 변수들은 간경화 원인 (p<.001), 평소 불편감(p=.015), 주 평균음주 횟수(p<.001), 간경화 진단 후 입원 횟수(p<.001), 과거 합병증 개수(p<.001), 혈청 빌리루빈(p<.001), 알부민(p<.001), 프로트롬빈 시간(p<.001), 총 콜레스테롤(p<.001), ALT (p=.014), AST(p<.001), ALP(p<.001), 불안 및 우울(p<.001), 자가간호 (p<.001), 가족지지(p=.001)이었다. 3. 로지스틱 회귀분석 결과 삽입한 15개의 예측 변수 중 과거 합병증 개수 (95% CI=1.60-71.81, OR=10.73), 혈청 빌리루빈(95% CI=1.19-12.01, OR=3.79), 자가간호(95% CI=0.81-0.97, OR=0.89)가 유의한 예측요인으로 확인되었다. 결론적으로 과거 합병증 개수가 많을수록, 혈청 빌리루빈이 높을수록 응급실 내원 가능성이 높고 자가간호 이행이 높을수록 응급실 내원할 가능이 줄었다. 따라서 간경화 환자의 응급실 내원율을 낮추기 위해서는 간경화 환자의 응급실 내원 예측요인에 대한 환자와 의료인의 관리가 중요하며, 예측요인을 포함한 응급실 내원에 대한 간호중재 개발과 그 효과 측정이 필요하다.
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/28325
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3. Thesis (학위논문) > 2. College of Nursing (간호대학) > 석사
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http://dcollection.kmu.ac.kr/jsp/common/DcLoOrgPer.jsp?sItemId=000000103690
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