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Analysis of Unmet needs by Elapsed Time in Kidney Transplantation Patients

신장이식 환자의 수술 후 경과기간에 따른 미충족요구 분석

  • 노세희 (계명대학교 대학원 간호학과) ;
  • 박정숙 (계명대학교 간호대학)
  • Received : 2020.11.09
  • Accepted : 2020.12.20
  • Published : 2020.12.28

Abstract

This study was conducted to for the development of nursing education programs suitable for the period by identifying the unmet needs of kidney transplant surgery patients who need continuous self-care according to the elapsed period. The subjects of the study consisted of 84 inpatients and outpatients for up to 1 year after kidney transplant surgery. The data collection period was from February 17 to May 31, 2020, and the collected data were analyzed by Chi-square, independent t-test, one-way ANOVA, and post-test by Scheffé using the IBM SPSS 21.0 program. As a measurement tool, the Comprehensive Needs Assessment Tool in Cancer(CNAT), a tool to assess unmet needs of cancer patients, was modified and supplemented to receive expert validity, and then self-report through a questionnaire consisting of a total of 57 questions. As a result of the study, the average of the total score out of 171points for the unmet needs of kidney transplant patients was 68.28(±38.88), and information and education accounted for the highest score of 17.92(±8.36) out of the eight sub-areas. The unmet needs according to the elapsed period were significantly higher in the 6 months ~1 year group(F=7.57, p=.001) compared to the 3-6 months group. Based on this, it is necessary to develop a nursing intervention program that can provide appropriate information and support at a time when the unmet needs of patients up to increase from 6 months to one year after kidney transplantation increase.

본 연구는 지속적인 자가간호가 필요한 신장이식 수술환자의 경과 기간에 따른 미충족 요구를 파악하여, 시기에 맞는 통합적인 간호중재 프로그램 개발에 필요한 기초자료를 제공하고자 시도되었다. 연구대상은 신장이식 수술 후 1년까지 입원 및 외래환자 84명으로 구성되었다. 자료수집 기간은 2020년 2월 17일부터 5월 31일까지로, Comprehensive Needs Assessment Tool in Cancer(CNAT)를 신장이식 환자에 맞게 수정·보완, 전문가 타당도 검증을 거쳐 사용하였다. 자료분석은 Chi-square, 독립 t-test, one-way ANOVA, ANCOVA, 사후검정은 Scheffé로 하였다. 연구결과 신장이식 수술 환자의 미충족 요구는 171점 만점 중 총점 평균 68.28(±38.88)점, 하부영역 8개 중 정보 및 교육이 17.92(±8.36)점으로 가장 높았다. 경과 기간에 따른 미충족 요구는 3-6개월에 비해 6개월-1년까지가 유의하게 높았다(F=7.57, p=.001). 이를 토대로 신이식 후 회복이 되어 관심이 줄어들 수 있는 6개월-1년 사이 환자의 미충족 요구는 증가하였으므로 적절한 정보와 도움을 융합하여 제공하는 간호중재 프로그램이 필요하다.

Keywords

References

  1. KJT. (2008). Kidney transplantation and a new life. [Brochure]. Seoul : Medical culture.
  2. Korea Disease Control and Prevention Agency. (2019.03.13.). Naver. Chronic kidney disease increases the risk of complications and death as it progresses. https://www.cdc.go.kr/board.es?mid=a20501000000&bid=0015&act=view&list_no=143249
  3. Korea Network for Organ Sharing. (2020. 2.7). Naver. Organ transplant status. https://www.konos.go.kr/konosis/sub4/sub04_03_01_pop.jsp
  4. Kim et al. (2010). A Renal Transplantation and Hemodialysis Cost-Utility Analysis in Patients with End-Stage Renal Disease. Journal of the Korean Society for Transplantation, 24(3), 173-181. DOI : 10.4285/jkstn.2010.24.3.173
  5. H. C. Kim, W. H. Cho. (2000). Kidney transplantation. Seoul : Koonja.
  6. E. J. Gordon, M. Gallant. A. R. Sehgal. D. Conti, L. A. Siminoff. (2009). Medication-taking among adult renal transplant recipients: barriers and strategies. Transplant International, 22(5), 534-545. DOI : 10.1111/j.1432-2277.2008.00827.x
  7. J. H. Lee, M. S. Kim, K. O. Jeon & Y. S. Kim. (2001). Perioperative Care for Kidney Transplantation. The Korean Society of Critical Care Medicine, 16(1), 11-16.
  8. S. H. Yoo. (2004). The degree of educational needs of kidney transplanted patients and the degree of nurses' educational performances perceived by patients. Doctoral dissertation. Kyunghee University, Seoul.
  9. M. K. Sim & S. Y. Son. (2012). The effects of an individual educational program on self-care knowledge and self-care behavior in kidney transplantation patients, Journal of East-West Nursing Research, 18(1), 9-17. https://doi.org/10.14370/JEWNR.2012.18.1.009
  10. P. Patterson, E. Moylan, S. Bannon & F. Salih. (2000). Needs analysis of a cancer education program in south western Sydney. Cancer nursing, 23(3), 186-192. https://doi.org/10.1097/00002820-200006000-00005
  11. H. Y. Lee. (2013). Current Status and Development Plan of the Health Insurance Fee System: Focusing on diagnosis-related group. Doctoral dissertation. Korea University, Seoul.
  12. S. J. Altfeld, G. E. Shier, M. Rooney, T. J. Johnson, R. L. Golden, L. Karavolos & A. J. Perry. (2013). Effects of an enhanced discharge planning intervention for hospitalized older adults: a randomized trial. The Gerontologist, 53(3), 430-440 https://doi.org/10.1093/geront/gns109
  13. J. Harrison, J. Young, M. Price, P. Butow & M. Solomon. (2009). What are the unmet supportive care needs of people with cancer? A systematic review. Supportive Care In Cancer, 17(8), 1117-1128. https://doi.org/10.1007/s00520-009-0615-5
  14. D. E. Holland, P. Mistiaen & K. H. Bowles (2011). Problems and unmet needs of patients discharged "home to self-care". Professional Case Management, 16(5), 240-250. https://doi.org/10.1097/NCM.0b013e31822361d8
  15. D. O. Case. (2007). Looking for information: A survey of research on information seeking. Amsterdam, The Netherlands : Academic Press.
  16. D. M. Ko. (2012). Liver transplant recipients' information according to the time elapsed since liver transplant. Doctoral dissertation. Seoul National University, Seoul.
  17. R. J. Baker, P. B. Mark, R. K. Patel, K. K. Stevens & N. Palmer. (2017). Renal association clinical practice guideline in post-operative care in the kidney transplant recipient. BMC nephrology, 18(1), 1-41. https://doi.org/10.1186/s12882-016-0417-1
  18. H. J. Kim. (2016). Relationship between unmet needs and quality of life of family caregivers of cancer patients in Korea. Doctoral dissertation. Seoul National University, Seoul.
  19. E. G. Oh, J. H. Sung, Y. S. Park, H. J. Lee & Y. K. Kim. (2016). Physiological Functional Status and the Levels of Unmet Care Needs after Discharge in Patients with Chronic Pulmonary Disease, Colorectal Cancer, and Strokes. Journal of Korean Clinical Nursing Research, 22(2), 194-204. https://doi.org/10.22650/JKCNR.2016.22.2.194
  20. J. M. KIm & J. S. Park.. (2018). Comparison of unmet need and quality of life between permanent ostomates and temporary ostomates. Journal of the Korea Academia-Industrial cooperation Society, 19(9), 374-383. https://doi.org/10.5762/KAIS.2018.19.9.374
  21. M. Y. Jang. (2016). Unmet needs and Quality of life of Cancer patients treated with chemotherapy and their family caregivers. Doctoral dissertation. Chung-ang University, Seoul.
  22. D. W. Shin et al. (2011). The development of a comprehensive needs assessment tool for cancer caregivers in patient‐caregiver dyads. Psychooncology, 20(12), 1342-1352. https://doi.org/10.1002/pon.1857
  23. E. H. Mo. (2017). Unmet needs of couples with colorectal cancer, Symptom experience and activation of patients. Doctoral dissertation. Chung-Ang University, Seoul.
  24. Y. R. Noh. (2019). Unmet Supportive Care Needs and Their Influencing Factors in Primary Brain Tumor Patients Receiving Postoperative Radiation Therapy. Doctoral dissertation. Yon-Sei University, Seoul..
  25. H. S. Ha et al. (2007). Psychosocial Adjustment of the Organ Transplantation Recipients in Korea. The Korean Society for Transplantation, 21(2), 269-281