척수손상환자의 사회적 지지와 재활동기와의 관계

Abstract

본 연구는 척수손상환자의 사회적 지지와 재활동기와의 관계를 파악하여, 척수손상환자의 재활동기를 높이기 위한 간호전략을 개발하는데 활용하도록 기초자료를 제공하고자 한다. 2008년 9월 2일부터 10월 24일까지 서울지역에 소재한 K재활원에 입원하고 있거나 퇴원 후 외래로 내원한 척수손상환자 중에서 83명을 대상으로 설문지를 배포하여 자료수집 하였고, SPSS/PC WIN 12.0을 이용하여 분석하였다. 본 연구의 결과를 요약하면 다음과 같다. 1. 대상자의 일반적 특성은 입원환자(56.6)가 많았다. 평균연령은 39.87세(±15.19)로 21~ 30세(30.1%)가 많았고, 남자(83.1%)가 대부분이었으며, 미혼(53.0%)이 많았고, 대졸이상(43.4%)이 많았다. 종교는 있다(59.0%)가 많았고, 직업은 없다(83.1%)가 대부분이었으며, 경제상태는 보통(37.3%)이 많았고, 가족 수는 3~4명(48.2%)이 많았으며, 주 수입원은 가족보조(36.1%)가 많았다. 질병관련 특성은 평균 유병기간이 3.10(±3.42)년으로 1년 미만(42.2%)이 많았고, 교통사고(48.2%)가 많았으며, 경수손상(48.2%)이 많았고, 완전손상(46%)이 많았다. 2. 대상자의 사회적 지지는 직접지지가 총점 5점 중 평균 3.51점이었고, 하위영역의 유대감이 평균 3.57점으로 가장 높았으며, 문항에서는 부정문으로 '내 주위에는 더 이상 의지할 만한 곳이 없다'가 평균 4.09점으로 가장 높았고, '나는 내 자신에 대해 만족 한다'가 평균 3.05점으로 가장 낮게 나타났다. 간접지지는 평균 3.71점이었고, 정서적 지지가 평균 3.77점으로 가장 높았다. 문항에서는 '그들은 모두 나를 인격적으로 존중해 준다'가 평균 4.00점으로 가장 높았고, '그들은 모두 내가 필요하다고 하면 아무리 큰돈이라고 해도 마련해 준다'는 평균 3.04점으로 가장 낮게 나타났다. 대상자의 재활 동기는 최대평점 4점 중 평균 2.93점이었고, 변화 지향적 동기가 3.27점으로 가장 높았으며, 문항에서는 '나는 지금보다 더 나은 상태로 변화되기를 원한다'가 평균 3.54점으로 가장 높았고, '가족의 압력 때문이다'는 1.71점으로 가장 낮게 나타났다. 3. 대상자의 일반적 · 질병관련 특성에 따른 사회적지지, 재활동기와의 차이는 직접지지가 기혼인 경우, 종교가 있는 경우에 높았고, 유병 기간에 따라서 유의한 차이가 있었으며, 간접지지는 교육정도에 따라서 유의한 차이가 있었다. 재활 동기는 입원환자와 직업이 있는 경우에 높았고, 유병기간과 손상원인에 따라서 유의한 차이가 있었다. 4. 대상자의 사회적 지지와 재활동기와의 관계에서는 직접지지가 높을수록 간접지지가 유의하게 높았으며(r=.663, p=.000), 직접지지가 높을수록 재활동기가 높았고(r=.282, p=.010), 간접지지가 높을수록 재활동기도 높은 것(r=.397, p=.000)으로 나타났다. 직접지지의 하위영역은 재활동기의 과제 지향적 동기와 변화 지향적 동기 및 무동기에서, 간접지지의 하위영역은 재활동기의 과제 지향적 동기와 변화 지향적 동기에서 정 상관관계를 나타냈으며, 모두 통계적으로 유의한 차이가 있었다. 이상의 연구결과에서 사회적 지지는 재활동기와 유의한 상관관계가 있는 것으로 나타났고, 사회적 지지는 재활동기를 강화시킬 수 있는 좋은 사회 심리적 요인임이 확인되었다. 따라서 척수손상환자들에게 사회적 지지를 높여줄 수 있는 다양한 간호중재를 개발할 필요가 있다.; The purpose of this descriptive correlation study was to analyze the relationship between the rehabilitation motive and social support perceived by spinal cord injury patients, provide for the basic methodology which can be used to develop the nursing strategy for enhancing the rehabilitation motive of the spinal cord injury patients. For this purpose, the researcher sampled 83 patients among the spinal cord injury patients being or left of the K-Hospital located in Seoul for a questionnaire survey conducted for the period from September 2 through October 24, 2008. The data collected from the survey were analyzed using the SPSS/PC WIN 12.0 program. The results of this study can be summarized as follows; First, survey objects were composed of 56.6%(n=47) patients in being Hospital and 83.1%(n=69) male. Average age was 39.87(±15.19). 21~30 age was the large percentage age part as 30.1%(n=25). 53.%(n=44) was single and 43.4%(n=36) was graduated of University. 59.0% had religion. 83.1% (n=69) was in state of non-occupation and the object of the middle classed economic state was the greatest portion as 37.3%. And the number of family was 3~4 in average. The major income was come from the family support as 36.1%. According to injury state, the average year of sick-sustenance was 3.10(±3.42) and under 1 year sustenance was the largest part as 42.2%. The major cause was a traffic accident as 48.2% and they are mainly the cervical injury-48.2%- and the complete injury-46%. Second, the social support score was average 3.51 of 5. The connectedness of subordinate portion was the highest as 3.57. Among the questionnaire the negative question “No exist leaning place in my circumstances” was the highest as 4.09. The lowest score is 3.05 as “I am satisfied myself”. The questionnaire “They are respected with me as the morality” was 4.00. The questionnaire “They will support even though being needed a considerable sum of money to sustain.” was the lowest score as 3.04. The rehabilitation motive was 2.93 of maximum 4.00. On the way, the changing oriented motivation was 3.27 of the highest. Between questionnaires, “I want to change as a better state by myself” was 3.54 and “On the pressure of family” is the lowest score as 1.71. Third, the difference between the social support and the motivation of rehabilitation by the generalized and disease-related characteristic of objects was higher in case of objects of the direct support being married and having religion. There was a small difference depending on the period of sick-sustenance. The indirect support was influenced by the level of education. The motivation of rehabilitation was higher when the patient was on the hospital and had an occupation. And the sick sustenance and the cause of injury was affected the difference. Fourth, in the relationship between the social support and the motivation of rehabilitation of objects, the higher the direct support the higher the indirect support a little bits(r=.663, p=000). The motivation of rehabilitation was higher on r=.282(p=.010), as the direct support and on r=.397(p=.000), as the indirect support. The subordinate portion of the direct support had the correlation with the subject oriented motivation and the changing oriented motivation and non-motivation. The subordinate portion of the indirect support had the correlation with the subject oriented motivation of the rehabilitation and the changing oriented motivation and non-motivation. Statistically, they had a little bits difference. According to this study, the social support had the significant mutual relation with the motivation of rehabilitation. The social support was the key factor to enhance the motivation of rehabilitation psychologically. Finally, it is need to develop the nursing methodology which can improve the social support for the spinal cord injury patients.