Factors Influencing the Hospital Presentation Time of Stroke Patients

(1)

주요용어 뇌졸중 내원시간 건강지각 신체적 자각증상 자기효능: , , , ,

서 론 I.

연구의 필요성 1.

. 2005

2 ,

(Korea National Statistical Office, 2006).

24 (An, 2002).

,

, ,

뇌졸중 환자의 병원 내원시간에 영향을 미치는 요인

이상현

¹

․ 이영휘

²

․ 김화순

²

․ 임지영

²

Factors Influencing the Hospital Presentation Time of Stroke Patients

Lee, Sang Hyun

¹

Lee, Young Whee

²

Kim, Hwa Soon

²

Lim, Ji Young

²

1

RN, BupyungSaerim Hospital,

²

Professor, Nursing Department, Inha University, Inchon, Korea

Purpose: This cross-sectional survey research was undertaken to identify the factors influencing time from onset

to hospital arrival of stroke patients and to provide basic information for the development of intervention programs for stroke patients. Methods: The data were collected using a convenient sampling method from three hospitals in Inchon. The subjects were 78 patients who were diagnosed as stroke by doctor and they voluntarily participated in the study. Results: On the average, subjects arrived at the hospitals by 16.72 hours after the onset of stroke events with the range from 0.17 hours to 72 hours. Thirty-four(43.6%) subjects arrived within 3 hours which can maximize treatment effects. There was significant difference in hospital presentation time according to the level of knowledge(χ²=18.629, p=.0003). A negative correlation was found between the hospital presentation time and self-efficacy (r= -.320, p=.004). Stepwise multiple regression analysis revealed that the most powerful predictor was self-efficacy. Self-efficacy, the level of knowledge and physical symptoms were significant factors and accounted for 21.7% of the variance of hospital presentation time in stroke patients. Conclusion: According to the results, self-efficacy is a useful concept for reducing the hospital presentation time from onset of attack in stroke patients.

Therefore, nurses should consider educational programs which include not only a knowledge of stroke and recurrence prevention but also the concept of self-efficacy.

Key Words : Cerebrovascular accident, Self-efficacy, Hospital Presentation time, Health perception, Physical symptoms

Corresponding address: Lee, Young Whee, Nursing Department, Inha University, 253 Yonghyun-dong, Nam-gu, Inchon 402-751, Korea. Tel:

82-32-860-8202, Fax: 82-32-874-5880, E-mail: [email protected]

투고일 2006 10 18 심사의뢰일 2006 10 18 심사완료일 2007 3 23

(2)

.

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(Dirksen, Lewis, & Heikemper, 2000; Song

& Lee, 2002).

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(Adams, Victor, & Ropper, 1997; Kim et al., 2001).

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(16%) .

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(Hong & Park, 1999; Jung et al., 1995; Song & Lee, 2002).

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. Kim(2002)

Cronbach's alpha coefficient=.84 ,

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Pearson Product Moment

Correlation .

(Stepwise Multiple Regression) .

연구결과

III.

뇌졸중 환자의 병원 내원시간 1.

Table 1 . ,

16.72 ,

0.17 72

.

3 43.6%(34 ) , 6

56.4% (44 ) .

43.5% (34 ) 6

.

뇌졸중 환자의 일반적 특성 및 병원 내원시간의 2.

차이

Table 2 .

65.4%(51 ) . 58.8

(18.36) 60 33.3% ,

70.5%(55 )

Table 1. Hospital presentation time of stroke patients (N=78)

Hospital presentation

time (hours) N(%) Mean(SD) Range

0- 3 3- 6 over 6

34(43.6) 10(12.8) 34(43.5)

16.72(22.14) 0.17-72

(5)

. 34.6%(27 )

, 200 300

33.4%(26 )

. 47.5%(37 )

35.9%(28

) ,

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62.8%(49 ) .

.

뇌졸중 환자의 질병관련 특성 및 병원 내원시간의 3.

차이

Table 3 .

33.3%(26 ) .

(χ

²

=18.629, p=.0003).

44.9%

Table 2. Differences in hospital presentation time by general characteristics (N=78)

Characteristics Categories N(%) M(SD) z

^*

or χ

^2*

p

Gender Male

Female

51(65.4) 27(34.6)

16.18(22.44)

17.74(21.94) 0.031 .487

Age (years)

50 50-59 60-69 70-79

16(20.6) 22(28.2) 26(33.3) 14(17.9)

11.17(19.91) 11.70(17.84) 19.09(20.65) 26.54(30.25)

5.838 .119

Marital status

Married Currently single

55(70.5) 23(29.5)

14.20(20.33)

22.73(25.43) 1.213 .112

Educational level

Elementary school Middle school High school Above college

20(25.6) 27(34.6) 18(23.1) 13(16.7)

22.43(27.23) 19.84(21.72) 10.39(18.98) 7.14(12.55)

4.219 .238

Monthly family income (10,000won)

Less than 100 100- 200

200- 300 more than 300

19(24.3) 21(26.9) 26(33.4) 12(15.4)

22.72(26.48) 22.22(23.38) 13.19(19.79) 5.24(10.31)

6.224 .101

Religion None

Buddhism Catholic Protestant

37(47.5) 13(16.6) 7( 9.0) 21(26.9)

14.15(21.08) 12.38(16.11) 28.38(28.14) 20.04(24.69)

1.499 .682

Occupation Unemployed

Housewife Office worker/

Technician Service worker

23(29.5) 14(17.9) 13(16.7) 28(35.9)

24.45(28.63) 19.39(21.81) 8.58(19.23) 12.82(15.30)

1.201 .752

Main supporter

Spouse Children Others

49(62.8) 21(26.9) 8(10.3)

15.73(21.04) 15.00(19.21) 27.29(34.01)

0.260 .878

* Wilcoxon test for 2 category variable, Kruskal-Wallis test for more than 3 category variable.

(6)

(35 ) 6.4%(5 ) .

(χ

²

=8.847, p=.059).

71.8%(56 )

, ‘ ’

73.9%(57 ) , , ,

. (91.0%)

69.2% .

, , ,

.

병원 내원시간과 자기효능감 신체적 자각증상

4. , ,

건강지각과의 상관관계

, ,

Table 4 .

(r=-.320 p=

.004)

.

. Table 3. Differences in hospital presentation time by disease related characteristics (N=78)

Characteristics

related to stroke Categories N(%) M(SD) z or χ

^2*

p

Previous stroke attack

First Second More than third

56(71.8) 12(15.4) 10(12.8)

15.88(21.91) 21.48(21.05) 4.50(24.93)

2.029 .362

Past disease history

Yes No

57(73.1) 21(26.9)

17.89(21.52) 13.54(23.99)

-1.755 .079

Level of knowledge on stroke

Very well Moderate Few Not at all

4( 5.1) 24(30.8) 24(30.8) 26(33.3)

40.75(36.14) 7.30(13.68) 11.38(17.03) 26.64(24. 6)

18.629 .000

Experience of education related to stroke

No Yes

71(91.0) 7( 9.0)

16.05(21.52) 33.50(28.77)

0.262 .396

Means of transportation

119 Ambulance Own car

Public transportation By foot

27(34.6) 6( 7.7) 35(44.9) 5( 6.4) 5( 6.4)

8.20(14.28) 33.47(25.79) 16.78(21.59) 29.70(29.08) 29.20(33.94)

8.847 .065

Consciousness Yes

No

24(30.8) 54(69.2)

10.91(19.62) 19.30(22.86)

-1.882 .059

* Wilcoxon test for 2 category variable, Kruskal-Wallis test for more that 3 category variable

Table 4. Correlations among hospital presentation time, self-efficacy, physical symptoms and health perception (N=78)

Variables Self-Efficacy Physical symptoms Health perception

Time of hospital presentation

r=-.320 (p=.004)

r=-.180 (p=.116)

r=-.193

(p=.091)

(7)

자기효능 신체적 자각증상 건강지각 점수

5. , ,

,

Table 5 .

4 2. 29

2.50 2.98

3.00 1.50 0.55 .

6. 뇌졸중 환자의 병원 내원시간에 영향을 미치는 요인

,

Table 6 .

‘ ’

‘ ’ 1, ‘ ’ 2,

‘ ’ 3 .

10%

,

22% .

논 의 IV.

.

16.72 William,

Rosamond Morris(2000) 4.3

Song Lee(2002)

17 .

3 43.6% Hong Park(1999)

22% Schroeder,

Rosammond, Morris, Evenson Hinn(2000)

47.3% .

, 6

.

Table 5. Self-efficacy, health perception and physical symptoms of stroke patients (N=78)

Variables Mean (SD) Range

Self efficacy 2.29(.276) 1.53-3.06

Health perception 2.98(.428) 2.00-4.40

Physical symptoms 0.55(.305) 0.07-1.43

Table 6. Predictors of hospital presentation time (N=78)

Variables β R

²

F p

Self-efficacy -.344 .102 8.658 .001

Knowing very well .260 .166 7.451 .014

Physical symptoms -.228 .217 6.836 .031

(8)

6 56.4% . 1995

Cho(1996) Hong Park(1999) 39.9%, 33.2%

10 ,

, 119

. Cho(1996)

22.2%, 21.1%,

19.9%, 119 9.2% ,

44.9%

119 34.6% . 10

119 119

.

65.4%, 34.6%

. An(2002)

50.7%, 49.3% ․

.

Youn (2003) 1.74:1

.

60 33.3%, 50 28.2%

Cho, Choi, Lee Ha(1998) 60 30.5%. 50 30.5%

50 , 60 .

30 . 50, 60

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. Kim(1992)

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28.2%

.

‘ ’ , ‘

’ 33.3%

.

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9% ,

. Yu (2002) 3

.

Cho(1996) 119

, Williams (1993)

.

(p=.065) 119 8.20

, 16.78 ,

33.47 . 119

119 119

.

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. Jung (1995) Cho(1996)

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(Cho, Lee, & Kim, 2002; Choi, 2004; Kim & So, 2001).

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결론 및 제언 VI.

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(11)

22% .

.

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