행동수정요법이 만성정신질환자의 자기간호 수행 및 대인관계 지각에 미치는 효과

Abstract

This study was conducted to test the effects of a behavior modification program on self-care and perception of interpersonal relationships of psychiatric patients. It was also performed to help the psychiatric nursing profession improve and develop more reliable rehabilitation program for chronic psychiatric patents. A nonequivalent control group and non-synchronized research design with pre and post test results was used in this study. The subjects of this study were 27 hospitalized chronic psychiatric patients in two university hospitals and two local clinics in Taegu. An experimental group of 16 and a control group of 11 patients participated. The ages of the patients were from 18 to 50 years old. They lacked the universal self-care. The patients also showed no signs or acute symptoms of risks for violence. This study was carried out from July 3, 2000 to November 4, 2000. The behavior modification program of this study was a 7 week long program. It reinforced chronic psychiatric patients` self-care by applying a token economy reward system with self-care teachings one time a week. The self-care teaching method involved 23 items on the basis of Orem(1985)`s universal self-care demands: personal hygiene, cleaning, eating, sleeping, elimination, dressing, and leisure time and social interaction activities. This was accomplished with the aid of 25 pictures. Whenever patients carried out self-care activities, verbal reinforcements and tokens were given. Primary reinforcements were then used where patients exchanged the tokens for a variety of items after 1 week. The instrument for the changes of chronic psychiatric patients` self-care in this study was a self-care activity scale for the observer, which was composed of the same 23 items noted above. Cronbach`s alpha of the scale was .95. The instrument for the perception of interpersonal relationships was made by Schlein and Guerney. It was translated by Moon, Seon Mo(1998) and modified by Cheon. Suk Kyun(1994). Data was analyzed by SPSS/PC+ 10.0 program with descriptive statistics, χ^2-test, t-test, Repeated measure ANOVA, simple main effect, and Time contrast. The results were as follows : 1. The first hypothesis, "The experimental group which received the behavior modification program would score higher from the self-care activity scale throughout this process", was supported(F=9.101, p=.006). 2. The second hypothesis, "The experimental group which received the behavior modification program would score higher from the perception of interpersonal relationships scale", was not supported(F=.523, P=.476)/ From the above results, it can be concluded that the behavior modification program is an effective intervention tool to improve the self-care of chronic psychiatric patients. This suggests that the psychiatric nursing profession need to develop and carry out rehabilitation programs for chronic psychiatric patients. It also makes a contribution to improving the quality of psychiatric nursing with systematic and identifiable procedures.