초기 혈액투석 환자의 질병인식, 자가간호수행 및 혈액투석 불이행의 관계*

Relationships between Illness Perception, Performance of Self-care, and Noncompliance of Hemodialysis in Early Hemodialysis Patients*

본 연구는 초기 혈액투석 환자의 질병인식, 자가간호 수행 및 혈액투석 불이행 정도를 확인하고 이들 요인 간의 관련성을 확인한 것이다. 자료 수집은 2020년 7월 1일부터 8월 31일까지 자가보고형 설문지를 이용하여 144명의 혈액투석 환자를 대상으로 이루어졌다. 자료 분석은 SPSS/WIN 21.0을 이용하여 t 검정, F 검정 및 피어슨 상관계수를 구하였다. 연구결과 초기 혈액투석환자들의 질병인식은 7.56±1.52점, 자가간호 수행정도는 3.61±0.46점, 혈액투석 불이행은 3.31±1.14점이었다. 대상자들의 질병인식은 교육수준, 주관적 건강상태 및 혈액투석에 대한 희망에 따라 차이가 있었으며 자가간호 수행정도는 만성신부전 교육경험, 가족 및 의료인 지지에 따라 차이가 있었고 혈액투석 불이행도는 연령과 교육수준에 따라 차이가 있었다. 초기 혈액투석 환자의 질병인식이 위협적일수록 자가간호를 잘 하였고 혈액투석 불이행도는 낮았으며 자가간호를 잘 할수록 불이행 정도는 낮아 합병증 예방을 위한 자가간호 수행 증가와 혈액투석 불이행을 예방하기 위해서는 혈액투석 초기 단계의 질병인식을 높이기 위한 간호전략이 필요함을 알 수 있었다.

The study aimed to investigate the illness perception, performance of self-care, and noncompliance of hemodialysis in early hemodialysis patients, and to examine the correlations between them. A descriptive correlational study design was utilized. Data were collected from July 1 to August 31, 2020 using a self-reported questionnaire by 144 early hemodialysis patients. Statistical analysis was conducted using t-test, F-test, Pearson correlation coefficients with the SPSS/WIN 21.0. The mean score of illness perception, performance of self-care and noncompliance of the subjects were 7.56±1.52 out of 10, 3.61±0.46 out of 5 and 3.31±1.14 out of 10 in order. There were significant differences in illness perception according to education level, subjective health status, and hope in patient receiving early hemodialysis. Performance of self-care depends on the education experience, family support, and medical personnel support. There were significant differences in noncompliance of hemodialysis by age and education level. The subjects’ illness perception had a significant correlation with self-care, and a significant correlation with noncompliance with hemodialysis. Performance of self-care had a significant correlation with noncompliance with hemodialysis. In order to increase the self-care and compliance with hemodialysis in early stage with hemodialysis patients. it was found that a nursing strategy was needed to raise illness perception in early stage of hemodialysis.