결핵 환자의 건강신념과 가족지지 및 자가간호 수행과의 관계

Abstract

The purpose of this research is to investigate retrospectively the relationship between self-care performance, family support and health-belief in tuberculosis patients. The research subjects were selected from patients who were treated with TB chemotherapy as outpatients at “M” national TB hospital located in “C” city in the GyungNam province of South Korea. Both the informed consent form and the self-reporting questionnaire were distributed to the study subjects and the were collected from September 17th to October 10th, 2012. To investigate the relationship between health-belief, support, and self-care performance in the tuberculosis patients, 3 tools were used in this study The health-belief evaluation tool, developed by Choi,Younghee (1983) was used. Based on Choi,Younghee’s (1983) tool, Kang,Hyeonsuk (1984) developed a family support evaluation tool and the researcher modified the tool to make it applicable to tuberculosis patient. Based on Choi,Younghee’s (1983) sick-role behavior tool, the researcher modified the self-care performance tool, to fit with the study subject, Statistical analysis was performed by using t-test, One-way ANOVA, Pearson's correlation, simple regression analysis for errors, percent (%), average, and standard deviation, using SPSS/WIN 19.0 program. The results of this research are shown as below. 1. Points for health-belief, family support, and self-care were 3.32, 3.51, and 3.73, respectively, when the highest score was 5.0. 2. The health-belief of the study subjects, when considered both generally and in relation to TB-associated characteristics, was significantly different in accordance with the subjedt’s level of education (F=3.87, p=.005), religion (F=2.50, p=.044), occupation before having the disease (F=2.17, p=.047), smoking state (t=-2.61, p=.010), drinking state (t=-2.34, p=.020), period of symptom relief after primary TB treatment (F=3.18, p=.025), and the existence of diseases except TB in the patient (t=2.91, p=.029). 3. Family support for the study subjects, when considered both generally and an in terms of TB-associated characteristics, was significantly different in relation to the subject’s marriage status (F=7.46, p<.001), whether the subject lived alone or with family (F=5.92, p<.001), average monthly income (F=4.34, p=.005), current employment (t=3.22, p=.001), and the presence of diseases except TB in the patient (t=-3.50, p=.001). 4. The fulfillment of self care among the study subjects, when considered both generally and in terms of TB-associated characteristics, was significantly different in relation to the subject’s marriage status (F=4.05, p=.003), whether the subject lived alone or with family (F=2.57, p<.001), average monthly income (F=4.00, p=.008), smoking state (t=-6.23, p<.001), drinking state (t=-3.04, p=.003), period of taking TB drugs (F=5.79, p=.001), period of symptom relief after primary TB treatment (F=3.45, p=.018), and reason for stopping TB treatment (F=2.49, p=.024). 5. There was a static correlation between(r=.40, p<.001) fulfillment of self care and health-belief among the study subjects. However, the statistical significance was located in lower areas such as susceptibility and severity (r=.16, p=.006), instructiveness (r=.36, p<.001), and disability (r=.37, p<.001). In addition, there was a static correlation between(r=.39, p<.001) the study subjects’s fulfillment of self care and family support. 6. Variable factors affecting TB patients fulfillment of self care were family support, health-belief, smoking state, average monthly family income, drinking state, and the period of taking TB drugs. Among the variables, TB patient fulfillment of self care was mostly affected by family support, which was 24%, demonstrating that it is the explanatory variable. In conclusions, the results of this research, showed that family support, health-belief, smoking state, and average monthly family income were the key explanatory variables. These results should be, utilized as fundamental consideration factors in the future to improve self-care development programs for TB patients.

본 연구는 결핵 환자의 건강신념과 가족지지 및 자가간호 수행과의 관계를 파악하기 위한 서술적 조사연구이다. 본 연구의 대상자는 경상남도 C시 M국립 결핵전문병원 외래로 방문하여 결핵치료를 받고 있는 결핵 환자를 대상으로 하였다. 자료수집은 2012년 9월 17일부터 10월 10일까지 하였으며, 대상자에게 연구 참여 동의서를 포함한 자가보고형 설문지를 배부하였다. 본 연구의 도구에는 3가지를 사용하였는데 먼저 건강신념 척도는 최영희 (1983)가 개발한 도구를 사용하였다. 그리고 가족지지는 최영희 (1983)가 작성한 것을 기초로 강현숙 (1984)이 개발한 것을 본 연구자가 결핵환자에 적합하게 수정하였으며 자가간호 수행척도는 최영희 (1983)의 환자역할행위를 바탕으로 본연구자가 수정, 보완하여 작성하였다. 자료 분석은 SPSS/WIN 19.0 프로그램을 이용하여 실수, 백분율, 평균과 표준편차, t-test, One-way ANOVA, Pearson's correlation, Simple regression analysis의 통계방법으로 분석하였다. 본 연구의 결과는 다음과 같다. 1. 대상자의 5점 만점에 건강신념 3.32점, 가족지지 3.51점, 자가간호 수행 3.73점으로 나타났다. 2. 대상자의 일반적 및 결핵관련 특성에 따른 건강신념은 육정도(F=3.87, p=.005), 종교(F=2.50, p=.044), 발병 전 직업(F=2.17, p=.047), 흡연 상태(t=-2.61, p=.010), 음주 상태(t=-2.34, p=.020), 초 치료 후 증상 호전 시기(F=3.18, p=.025), 결핵 이외의 질환 유무(t=2.19, p=.029)에서 유의한 차이가 있는 것으로 나타났다. 3. 대상자의 일반적 및 결핵관련 특성에 따른 가족지지는 결혼상태(F=7.46, p<.001), 동거가족(F=5.92, p<.001), 월평균 수입(F=4.34, p=.005), 현재 직업 유무(t=3.22, p=.001), 결핵 이외의 질환(t=-3.50, p=.001)에서 유의한 차이가 있는 것으로 나타났다. 4. 대상자의 일반적 및 결핵관련 특성에 따른 자가간호 수행은 결혼상태(F=4.05, p=.003), 동거가족(F=2.57, p<.001), 월평균 수입(F=4.00, p=.008), 흡연 상태(t=-6.23, p<.001), 음주 상태(t=-3.04, p=.003), 결핵약 복용 기간(F=5.79, p=.001), 초 치료 후 증상 호전 시기(F=3.45, p=.018), 치료 중단 이유(F=2.49, p=.024)에서 유의한 차이가 있는 것으로 나타났다. 5. 대상자의 자가간호 수행과 건강신념은 정적 상관관계(r=.40, p<.001)가 있었으며, 하위영역인 민감성․심각성(r=.16, p=.006), 유익성(r=.36, p<.001), 장애성(r=.37, p<.001)과 상관관계가 있었다. 또한 자가간호 수행과 가족지지는 정적 상관관계(r=.39, p<.001)가 있었다. 6. 결핵환자의 자가간호 수행에 영향을 미치는 요인은 가족지지, 건강신념, 흡연 상태, 가족 월평균 수입, 음주 상태, 결핵약 복용 기간으로 나타났으며, 이러한 변수 중 결핵환자의 자가간호 수행을 가장 높게 설명하는 것은 가족지지 변수로 24% 설명하였다 결론적으로 본 연구에서 가족지지, 건강신념, 흡연 상태, 가족 월평균 수입이 설명변수로 나타난 결과는 결핵환자의 자가간호 수행 향상을 위한 프로그램 개발 및 적용 시 기초자료로 활용될 수 있는 고려요인을 찾은 것에서 의의가 있다고 볼 수 있다.