DOI QR코드

DOI QR Code

Correlations among Attitude toward Pressure Ulcer Prevention, Knowledge and Non-compliance Risk for Pressure Ulcer Prevention Practice and Degree of Nursing Performance

간호사들의 욕창예방에 대한 태도, 욕창예방실무지식, 욕창예방실무 미준수 위험, 수행도 간의 상관성

  • Received : 2018.06.18
  • Accepted : 2018.09.07
  • Published : 2018.09.30

Abstract

This study was conducted to describe the attitude toward pressure ulcer prevention, knowledge and non-compliance risk for pressure ulcer prevention practice and degrees of nursing performance, as well as to examine the relationship among these variables. To accomplish this, we invited 397 nurses from four hospitals to complete surveys of attitude toward pressure ulcer prevention, knowledge and certainty for pressure ulcer prevention practice, and degrees of nursing performance. Non-compliance risk for pressure ulcer prevention practice was derived from the difference between knowledge and certainty for pressure ulcer prevention. The data were collected from March to June 2017 and analyzed by descriptive statistics, independent t-tests, ANOVA, and partial Pearson's correlation coefficient testing. The correct answer rate regarding the knowledge of pressure ulcer prevention practice was 79%, and the degree of pressure ulcer prevention nursing performance was $2.46{\pm}0.31$. The highest item of the non-compliance risk for pressure ulcer prevention practice was incontinence diapers prevent incontinence-associated dermatitis. There were significant negative correlations between non-compliance risk for pressure ulcer prevention practice and knowledge (r=-0.25, p<0.001), and degree of pressure ulcer prevention nursing performance (r=-0.13, p=0.009). Continuous education and furnishing practical guidelines for pressure ulcer prevention should be implemented to improve knowledge and certainty of pressure ulcer prevention practice.

이 연구의 목적은 욕창예방에 대한 태도와 지식, 욕창예방실무의 미준수 위험과 욕창예방실무 수행도를 파악하고 변수들 간 상관성을 파악하기 위함이다. 4개의 병원에서 3개월 이상의 경력을 가지고 근무중인 397명의 간호사를 대상으로 욕창예방에 대한 태도, 욕창예방실무에 대한 지식과 지식에 대한 확실성, 욕창예방실무 수행도를 조사하였다. 욕창예방실무 지식과 지식에 대한 확실성 간의 차이값을 욕창예방실무의 미준수 위험으로 정의하여 변수로 활용하였다. 자료수집기간은 2017년 3월부터 6월까지 였다. 자료분석을 위해서는 서술적 통계, independent t-test, ANOVA, partial Pearson correlation을 활용하였다. 욕창예방실무지식의 정답율은 79% 이었고, 욕창예방실무수행도는 $2.46{\pm}0.31$점이었다. 욕창예방실무의 미준수 위험이 가장 높은 문항은 (실금기저귀는 실금피부염을 예방한다) 이었다. 욕창예방실무 미준수 위험은 욕창예방실무지식과 유의한 음의 상관관계(r=-.25, p<.001)가 있었고, 욕창예방간호수행도와는 유의한 음의 상관성(r=-.13, p=.009)이 있었다. 욕창예방실무 수행을 향상시키기 위해서는 지속적인 교육과 욕창예방 실무가이드의 비치가 수행되어 욕창예방실무에 대한 지식과 확실성을 향상시켜야 할 것이다.

Keywords

References

  1. The National Pressure Ulcer Advisory Panel. National Pressure Ulcer Advisory Panel (NPUAP) announces a change in terminology from pressure ulcer to pressure injury and updates the stages of pressure injury. 2016)
  2. Y. J. Jung, Y. H. Chung, S. J. Oh, S. H. Lee, Y. H. Kim, T. H. Kim TH, "Risk factors for pressure ulcer in severe trauma patients", Journal of Acute Care Surgery, Vol.5, No.1 pp.19-27, 2015. DOI: https://dx.doi.org/10.17479/jacs.2015.5.1.19
  3. M. I. Gonzalez-Mendez, M. Lima-Serrano, C. Martin-Castano, I. Alonso-Araujo, J. S. Lima-Rodriguez, "Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit", Journal of Clinical Nursing, Vol.27, No.5-6, pp.1028-1037, 2018. DOI: https://dx.doi.org/10.1111/jocn.14091
  4. Health Insurance Review & Assessment Service. Disease statistics [Internet]. Seoul: Author; 2014 [cited 2018 May 02]. Available from: http://hira.or.kr
  5. B. Chan, L. Ieraci, N. Mitsakakis, B. Pham, M. Krahn, "Net costs of hospital-acquired and pre-admission PUs among older people hospitalised in Ontario", Journal of Wound Care, Vol.22, No.7, pp.341-346, 2013. DOI: https://dx.doi.org/10.12968/jowc.2013.22.7.341
  6. A. J. Kim, I. S. Jeong, "Performance of evidence-based pressure ulcer prevention practices among hospital nurses", Global Health and Nursing, Vol.8, No.1, pp.8-16, 2018
  7. Registered Nurses' Association of Ontario(RNAO). Assessment and management of pressure injuries for the interprofessional team. 3rd ed. [Internet]. Ontario: Author; 2016 [cited 2017 September 11]. Available from: http://rnao.ca
  8. I. S. Jeong, S. M. Kim, J. S. Jeong, E. Y. Hong, E. Y. Lim, H. J. Seo, K. H. Park, Y. E. Hong, J. H. Hwang, "Development of pressure ulcer management guideline by adaptation process", Journal of Korean Clinical Nursing Research, Vol.20, pp.40-52, 2014.
  9. A. L. Barker, J. Kamar, T. J. Tyndall, L. White, A. Hutchinson, N, Klopfer, C. Weller, "Implementation of pressure ulcer prevention best practice recommendations in acute care: an observational study", International Wound Journal, Vol.10, No.3, pp.313-320, 2013. DOI: https://dx.doi.org/10.1111/j.1742-481X.2012.00979.x
  10. S. Park, N. Y. Yang, J. S. Choi, "Factors Affecting Attitudes and Preventive Practice of Pressure Ulcer among Nurses", The Journal of Muscle and Joint Health, Vol.20, No.1, pp.43-51, 2013. DOI: https://dx.doi.org/10.5953/JMJH.2013.20.1.43
  11. E. J. Lee, S. O. Yang, "Clinical knowledge and actual performance of pressure ulcer care by hospital nurses", Journal of Korean Clinical Nursing Research, Vol.17, No.2, pp.251-261, 2011.
  12. K. Usher, C. Woods, J. Brown, T. Power, J. Lea, M. Hutchinson, C. Mather, A. Miller, A. Saunders, J. Mills, L. Zhao, K. Yates, M. Bodak, J. Southern, D. Jackson, "Australian nursing students' knowledge and attitudes towards pressure injury prevention: a cross-sectional study", International Journal of Nursing Studies, Vol.81, pp.14-20, 2018. DOI: https://dx.doi.org/10.1016/j.ijnurstu.2018.01.015
  13. M. Y. N. Saleh, M. Al-Hussami, D. Anthony, "Pressure ulcer prevention and treatment knowledge and Jordanian nurses", Journal of Tissue Viability, Vol.22, No.1, pp.1-11, 2013. DOI: https://dx.doi.org/10.1016/j.jtv.2013.01.003
  14. N. Y. Yang, S. Y. Moon, "Perceived importance, educational needs, knowledge and performance concerning pressure ulcer care by clinical nurses", Korean Journal of Adult Nursing, Vol.21, No.1, pp.95-104, 2009.
  15. B. O. Simonsen, I. Johansson, G. K. Daehlin, L. M. Osvik, P. G. Farup, "Medication knowledge, certainty, and risk of errors in health care: A cross-sectional study", BMC Health Service Research, Vol.11, No.1, Article ID 175, 2011. DOI: https://dx.doi.org/10.1186/1472-6963-11-175
  16. A. Wells, "Meta-Cognition and Worry: A Cognitive Model of Generalized Anxiety Disorder", Behavioural and Cognitive Psychotherapy, Vol.23, No.3, pp.301-320, 1995. DOI: https://dx.doi.org/10.1017/S1352465800015897
  17. J. Y. Lee, "A study on the possibility of implementing confidence-based assessment in elementary mathematics education", Unpublished master's thesis, Pusan National University of Education, Busan, 2017
  18. L. W. Schuwirth, C. P. M. Van Der Vleuten, "Different written assessment methods: What can be said about their strengths and weaknesses?", Medical Education, Vol.38, No.9, pp.974-979, 2004. DOI: https://dx.doi.org/10.1111/j.1365-2929.2004.01916.x
  19. D. Bruttomesso, S. Costa, M. Dal Pos, D. Crazzolara, G. Realdi, A. Tiengo, A. Baritussio, R. Gagnayre, "Educating diabetic patients about insulin use: changes over time in certainty and correctness of knowledge", Diabetes & Metabolism, Vol.32, No.3, pp.256-261, 2006. DOI: https://dx.doi.org/10.1016/S1262-3636(07)70277-X
  20. D. F. Polit, "Data analysis and statistics for nursing research, 2nd edition", Humanalysis Incorporation, New York, 2010.
  21. Z. Moore, P. Price, "Nurses' attitudes, behaviours and perceived barriers towards pressure ulcer prevention", Journal of Clinical Nurse, Vol.13, No.8, pp.942-951, 2004. DOI: https://dx.doi.org/10.1111/j.1365-2702.2004.00972.x
  22. K. S. Seo, "Nurses' knowledge, attitudes, and preventive care for pressure ulcers in nursing homes", Unpublished master's thesis, Ewha Womans University, Seoul, 2010.
  23. A. J. Kim. "Knowledge and practice of pressure ulcer care among hospital nurses", Unpublished master's thesis, Pusan National University, Busan, 2016.
  24. Z. Tulek, C. Polat, I. Ozkan, D. Theofanidis, R. E. Togrol, "Validity and reliability of the Turkish version of the pressure ulcer prevention knowledge assessment instrument", Journal of Tissue Viability, Vol.25, No.4, pp.201-208, 2016. DOI: https://dx.doi.org/10.1016/j.jtv.2016.09.001
  25. M. Gray, K. K. Giuliano, "Incontinence-Associated Dermatitis, Characteristics and Relationship to Pressure Injury: A Multisite Epidemiologic Analysis", Journal of Wound, Ostomy and Continence Nursing, Vol.45, No.1, pp.63-67, 2018. DOI: https://dx.doi.org/10.1097/WON.0000000000000390
  26. A. Jo, "Prevalence, incidence and affecting factors of pressure ulcer for elderly patients admitted through emergency department of one tertiary hospital", Unpublished master's thesis, Seoul National University, Seoul, 2017.
  27. N. Tayyib, F. Coyer, P. Lewis, "Pressure injury prevention in a Saudi Arabian intensive care unit: registered nurse attitudes toward prevention strategies and perceived facilitators and barriers to evidence implementation", Journal of Wound, Ostomy and Continence Nursing, Vol.43, No.4, pp.369-374, 2016. DOI: https://dx.doi.org/10.1097/WON.0000000000000245
  28. K. R. Shin, M. Kim, Y. Kang, D. Jung, C. Cha, E. Lee, Y. J. Kim, Y. R. Kweon, "Facility and Nursing Factors Influence on Pressure Ulcer Occurrence among Patients at Risk for Pressure Ulcer in Long-term Care Hospitals", Journal of Korean Gerontological Nursing, Vol.14, No.1, pp.29-38, 2012.
  29. S. Graham, "A Study of Students' Metacognitive Beliefs About Foreign Language Study and Their Impact on Learning", Foreign Language Annals, Vol.39, No.2, pp.296-309, 2006. DOI: https://dx.doi.org/10.1111/j.1944-9720.2006.tb02267.x
  30. J. Park, M. Park, "Knowledge, Attitude, and Confidence on Patient Safety of Undergraduate Nursing Students", The Journal of Korean Academic Society of Nursing Education, Vol.20, No.1, pp.5-14, 2014. DOI: https://dx.doi.org/10.5977/jkasne.2014.20.1.5
  31. M. Barakat-Johnson, C. Barnett, T. Wand, K. White, "Knowledge and Attitudes of Nurses Toward Pressure Injury Prevention: A Cross-Sectional Multisite Study", Journal of Wound, Osteotomy and Continence Nursing, Vol.45, No.3, pp.233-237. DOI: https://dx.doi.org/10.1097/WON.0000000000000430
  32. R. Grol, M. Wensing, "What drives change? Barriers to and incentives for achieving evidence-based practice", Medical Journal of Australia, Vol.180, No.6, pp.S57-S60, 2004.
  33. J. F. Lavallee, T. A. Gray, J. Dumville, N. Cullum, "Barriers and facilitators to preventing pressure ulcers in nursing home residents: A qualitative analysis informed by the Theoretical Domains Framework", International Journal of Nursing Studies, Vol.82, pp.79-89, 2018. DOI: https://dx.doi.org/10.1016/j.ijnurstu.2017.12.015
  34. T. C. Liu, Y. C. Lin, M. J. Tsai, F. Paas, "Split-attention and redundancy effects on mobile learning in physical environments", Computers & Education, Vol.56, No.1, pp.172-180, 2011. DOI: https://dx.doi.org/10.1016/j.compedu.2011.08.007