DOI QR코드

DOI QR Code

Factors Related Self-Care Behavior among Liver Cirrhosis Patients: Focusing on Disease Knowledge and Family Support

간경변증 환자의 자가간호 행동 관련 요인: 질병 지식과 가족지지를 중심으로

  • Park, HaeJin (Department of Nursing, Ulsan University Hospital) ;
  • Shin, Yeonghee (College of Nursing Keimyung University Research Institute for Nursing)
  • 박해진 (울산대학교병원 간호부) ;
  • 신영희 (계명대학교간호대학.계명간호과학연구소)
  • Received : 2017.02.10
  • Accepted : 2017.05.12
  • Published : 2017.05.31

Abstract

This study examined the associations among the factors related to self-care behavior in patients with liver cirrhosis, focusing on disease knowledge and family support. The subjects were 120 liver cirrhosis patients recruited from the medical out-patient clinic of ageneral hospital in the U metropolitan city during the period of June-August, 2015. The data were analyzed with SPSS(Version 21) program. The results showed that the average scores of disease knowledge was $12.64{\pm}2.16$ out of 18; family support was $23.28{\pm}5.68$ out of 32; and self-care behavior was $35.66{\pm}8.67$ out of 60. The study subjects had moderate levels of disease knowledge and family support, but low levels of self-care behavior. The data showedthat self-care behavior was positively correlated with disease knowledge (r=0.675, p<0.001) and family support (r=0.804, p<0.001) of the subjects. The best predictors for self-care behavior were family support, disease knowledge, frequency of alcohol consumption per week, having liver cirrhosis patients among family or relatives, and educational level, which accounted for 69.7% of the variance. In conclusion, promoting the self-care behavior of liver cirrhosis patients should be planned based on a consideration of the patient's educational level, knowledge of their own disease, and family support.

본 연구의 목적은 간경변증 환자의 자가간호 행동 관련 요인, 특히 질병지식과 가족지지와의 관련성에 대해 조사하기 위함이었다. 연구대상자는 2015년 6월부터 8월까지 2개월 동안 U 광역시 1개 종합병원 내과 외래를 이용하는 120 명의 간경변증 환자를 대상으로 조사하였다. 자료는 SPSS (Version 21) 통계 프로그램을 사용하여 분석하였다. 그 결과, 대상자의 간경변증에 대한 질병 지식 점수는 18점 만점에 평균 $12.64{\pm}2.16$점이었고, 가족 지지는 32점 만점에 평균 $23.28{\pm}5.68$, 자가간호 행동은 60점 만점에 평균 $35.66{\pm}8.67$점이었다. 즉, 대상자들은 질병에 관한 지식과 가족지지 정도는 보통수준이었으나 자가간호 행동은 낮았다. 또한 간경변증 환자의 자가간호 행동은 질병지식 (r=.675, p<.001)과 가족지지(r=.804, p<.001)와 긍정적 상관관계가 있었다, 자가간호 행동의 가장 좋은 예측요인으로는 가족지지, 질병 지식, 음주회수, 친지 중 간경변증이 있는 경우, 대상자의 교육 수준이었으며, 이들 요인들이 자가간호 행동을 69.7% 설명하였다. 결론적으로 간경변증 환자의 자가간호 행동을 향상시키기 위해서는 대상자의 교육수준, 질병지식 수준과 가족지지 수준을 고려하여 계획하여야 할 것이다.

Keywords

References

  1. Statistics Korea, Statistical Information Report: Cause of Death [Internet]. Daejeon: Statistics Korea, c2016 [cited 2016 December], Available from: http://meta.narastat.kr/metasvc/svc/SvcMetaDcDtaPopup.do?orgId=101&confmNo=101054&kosisYn=Y.(accessed Jan. 17, 2017)
  2. S. L. Friedman, "Molecular Regulation of Hepatic Fibrosis, an Integrated Cellular Response to Tissue Injury", Journal of Biological Chemistry, vol. 275, no. 4, pp. 2247-2250, 2000. DOI: https://doi.org/10.1074/jbc.275.4.2247
  3. M. Pinzani, M. Rosselli, M. Zuckermann, "Liver Cirrhosis", Best Practice & Research Clinical Gastroenterology, vol. 25, no. 2, pp. 281-290, 2011. DOI: https://doi.org/10.1016/j.bpg.2011.02.009
  4. Korean Association for Study of the Liver, "Liver Cirrhosis Clinical Research Center, Update", Korean Association for Study of the Liver, 2011.
  5. D. W. Jeon, "Bacterial Infection in Cirrhosis: Pathogenesis", Korean Association for Study of the Liver. Single Topic Symposium, vol. 2012, no. 2, pp. 13-20, 2012.
  6. K. A. Son, Y. S. Kim, M. H. Hong, M. A. Jeong, "Analysis of the Medication Compliance of Hypertensives and its Influential Factors", Journal of the Korea Academia-Industrial Cooperation Society, vol. 17, no. 9, pp. 141-155, 2016. DOI: http://dx.doi.org/10.5762/KAIS.2016.17.9.141
  7. Y. J. Jeong, J. H. Park, "The Effects of the Stroke on the Health Knowledge, Optimistic Bias and Health-Promoting Lifestyle in Middle-Aged Adults", Journal of the Korea Academia-Industrial Cooperation Society, vol. 17, no. 9, pp. 141-155, 2016. DOI: http://doi.org/10.5762/kais.2016.17.9.141
  8. K. S. Jung, H. S. Min, "The Relations among Self-Care, Symptom Experiences, and Disease Status of the Patient with Liver Cirrhosis", Journal of Korean Academy of Adult Nursing, vol. 19, no. 2, pp. 318-328, 2007.
  9. S. H. Im, K. S. Choi, "Study of Experiences of Patients with Liver Cirrhosis and Spouses", Journal of Korean Academy of Adult Nursing, vol. 8, no. 2, pp. 309-323, 1996.
  10. M. L. Volk, N. Fisher, R. J. Fontana, "Patient Knowledge about Disease Self-Management in Cirrhosis", American Journal of Gastroenterology, vol. 108, no. 3, pp. 302-305, 2013. DOI: http://doi.org/10.1038/ajg.2012.214
  11. C. J. Ryan, J. J. Zerwic, "Knowledge of Symptom Clusters among Adults at Risk for Acute Myocardial Infarction", Nursing Research, vol. 53, no. 6, pp. 363-369, 2004. DOI: https://doi.org/10.1097/00006199-200411000-00004
  12. B. S. Hulka, L. L. Kupper, J. C. Cassel, R. L. Efird, "Medication Use and Misuse: Physician-Patient Discrepancies", Journal of Chronic Diseases, vol. 28, no. 1, pp. 7-21, 1975. DOI: https://doi.org/10.1016/0021-9681(75)90045-4
  13. B. H. Kaplan, J. C. Cassel, S. Gore, "Social Support and Health", Medical Care, vol. 15, no. 5, pp. 47-58, 1977. DOI: https://doi.org/10.1097/00005650-197705001-00006
  14. Y. O. Kim, "A Study of Factors Predicting Self-Care Behavior in Diabetics", Journal of Korean Academy of Nursing, vol. 28, no. 3, pp. 625-637, 1998. DOI: https://doi.org/10.4040/jkan.1998.28.3.625
  15. H. M. Son, "The Relationships of Illness Intrusiveness and Quality of Life in Chronic Liver Disease Patients", Journal of Korean Academy of Adult Nursing, vol. 14, no. 4, pp. 501-509, 2002.
  16. S. H. Kim, "Factors Influencing Symptom Experience in Patients with Liver Cirrhosis", Journal of Korean Academy of Adult Nursing, vol. 17, no. 2, pp. 248-258, 2005.
  17. N. Y. Kim, "The Influence of Family Support on Self-Care and Disease Status of the Patient with Liver Cirrhosis", Ewha Woman's University, Master's Thesis, 2003.
  18. E. H. Kil, "Differences in Adherence to Self - Care, Drug Compliance, and Knowledge of Heart Failure Based on Rehospitalization of Heart Failure Patients", Eulji University, Master's Thesis, 2013.
  19. J. S. Ross, J. Chen, Z. Q. Lin, H. Bueno, J. P. Curtis, P. S. Keenan, et al., "Recent National Trends in Readmission Rates After Heart Failure Hospitalization", Circulation. Heart Failure, vol. 3, no. 1, pp. 97-103, 2010. DOI: http://doi.org/10.1161/circheartfailure.109.885210
  20. S. J. Eum, "Effect of The Structured Education for Knowledge of Hepatitis B Type and Self Care Behavior in Chronic Hepatitis B Patients", Journal of Korean Academy of Fundamentals of Nursing, vol. 5, no. 1, pp. 65-79, 1998.
  21. J. E. Heo, "Influences of Family-Participating Patient-Education on Liver Cirrhosis Patients Disease-Knowledge and Self-Care Behavior", Ewha Woman's University, Master's Thesis, 2003.
  22. Educational Assessment Corporation, KR(20) [Internet], Available from: http://edassess.net/eacs/kr20.aspx[accessed201703-04].
  23. C. F. Waltz, O. Strickland, E. R. Lenz, "Measurement in Nursing and Health Research", Springer Pub., 2010.
  24. Y. S. Tae, "A study on The Correlation Between Perceived Social Support and Depression of The Cancer Patients", Ewha Woman's University, Master's Thesis, 1985.
  25. J. Raubenheimer, "An Item Selection Procedure to Maximize Scale Reliability and Validity", Journal of Industrial Psychology, vol. 30, no. 4, pp. 59-64, 2004. DOI: https://doi.org/10.4102/sajip.v30i4.168
  26. D. E. Orem, "Nursing:Concepts of Practice", Mosby, 2001.
  27. S. H. Kim, "Hepatitis B Therapeutic Relationship with the Knowledge and Implementation of the Family Support and to Recognize Hepatitis", Yeonsei University, Master's Thesis, 1989.
  28. H. O. Bae, S. L. Seo, "Effect of Structured Information Provided on Knowledge and Self Care Behavior of Liver Cirrhosis Patients", Journal of Korean Academy of Adult Nursing, vol. 13, no. 3, pp. 476-485, 2001.
  29. H. N. Park, M. H. Kim, J. H. Park, "The Relationships between Self-Care Knowledge and Compliance of Ischemic Stroke Patients with Diabetics", Journal of the Korea Academia-Industrial Cooperation Society, vol. 16, no. 11, pp. 7513-7523, 2015. DOI: http://doi.org/10.5762/kais.2015.16.11.7513
  30. C. Bunchorntavakul, N. Chamroonkul, D. Chavalitdhamrong, "Bacterial Infections in Cirrhosis: A Critical Review and Practical Guidance", World Journal of Hepatology, vol. 8, no. 6, pp. 307, 2016. DOI: https://doi.org/10.4254/wjh.v8.i6.307
  31. L. Groenkjaer, "Oral Care in Hepatology Nursing: Nurses' Knowledge and Education", Gastroenterology Nursing, vol. 38, no. 1, pp. 22-30, 2015. DOI: https://doi.org/10.1097/SGA.0000000000000086
  32. J. S. Lim, D. G. Oh, Y. J. Lee, H. K. Kim, J. H. Yoon, "Developing the Policy Guidance for Psychosocial Support Services in Long Term Chronic Disease Patients", Report of Ministry of Health and Welfare, pp. 2, 2011.
  33. N. Y. Kim, O. S. Kim, "Family Support, Alcohol Consumption and Drinking Motives in Patients with Liver Cirrhosis", Journal of Korean Academic Society Adult Nursing, vol. 19, no. 2, pp. 295-304, 2007.
  34. S. Cobb, "Social Support as a Moderator of Life Stress", Psychosomatic Medicine, vol. 38, no. 5, pp. 300-314, 1976. DOI: https://doi.org/10.1097/00006842-197609000-00003
  35. A. Fengler, N. Goodrich, "Wives of Elderly Disabled Men: The Hidden Patients", The Gerontologist, vol. 19, no. 2, pp. 175-183, 1979. DOI: https://doi.org/10.1093/geront/19.2.175
  36. E. J. Lee, E. Park, "Predictors of Self-Care Behaviors among Elderly with Hypertension using Quantile Regression Method", Korean Journal of Adult Nursing, vol. 27, no. 3, pp. 273-282, 2015. DOI: https://doi.org/10.7475/kjan.2015.27.3.273
  37. H. A. Surucu, D. B. Besen, E. Y. Erbil, "Empowerment and Social Support as Predictors of Self-Care Behaviors and Glycemic Control in Individuals With Type 2 Diabetes", Clinical Nursing Research, Jan 1, 2017. DOI: http://doi.org/10.1177/1054773816688940