Studies on psychology of longterm in-patients and their satisfaction after nursing care of psychological treatment

간호학과/석사[한글] 간호는 그 시대와 사회의 요구에 따라 변천하고 있다. 인간은 자기가 소속된 사회와 일 상화된 환경을 떠나 병원 사회에 입원하게되면 여러 가지 이유로 불만이 생기며 불만의 표현이 여러형태의 양상으로 표현되어 왔다. 본 연구자는 이제 그 심리적 불만의 원인과 장기 입원 환자의 심리 문제의 정도를 파악 하고 분석함으로써 현대 간호의 개념인 전인 간호를 시행하는 데의 요소인 높은 수준의 간호를 함으로써 인간에대한 이해에 기본을 둔 간호 문제 해결에 기여하고져 하는 목적과 장기 입원으로 인해 느끼는 불만도의 원인이 될 수 있다고 추정되는 사항을 다음 여덟게 영역으로 나누어 보았다. 1) 신체적인 것 2) 병원 환경 3) 치료 및 간호 4) 대인 관계 5) 의사 소통 6) 가정 및 경제 문제 7) 정신적 및 영적인 것 8) 성적 연구 이상 여덟 개 항목에 대하여 30개의 설문을 작성하였고 이 설문지를 통해 본 연구자가 직접 면접법을 사용하여 자료를 수집하였다. 다음 여덟 개 항목의 조사 내용에 관한 것을 살펴보면 성적 요구에 관련된 만족도만 제 외하곤 전체적으로 심리간호 전보다 심리간호 후의 만족도가 높아진 것을 알 수 있다. 특히 정신적 및 영적인 것에 관련된 만족도는 높은 만족도를 보인 것으로 이것은 얼마 나 많은 환자들이 정신적으로 외로움과 고통을 당하고 있다는 것의 좋은 입증이 된다. 장기 환자의 연령, 성별, 교육 정도 및 입원과 관련된 특성별로 볼 때 특히 교통사고 장기환자의 교육 정도나 생활 수준이 낮은 분포를 보였다. 이상과 같은 사실로 미루어 보아 일반적으로 만족도가 높다고는 하나 환자가 장기적인 병원 생활로 인하여 가지는 불만도가 많은 것을 알 수 있다. 고로 그 불만을 해소해 가는 방향에서 전인 간호계획이 세워지고 이에 따른 평가가 이루어지도록 시도하이 가장 근본 적인 임상 간호의 요소라고 생각된다. [영문] It is quite natural that one could express his discontentment when he is put into a hospital which is very much different from what he is familliar to. This study was therefore attempted to analyze the causitives of longterm in-patients' discontentment and their psychology so that the results of the study could be utilized in solving the nursing care problems, basically by understanding patients as a whole being. Thirty grown-up orthopedic patients who were hospitalized more than thirty days in Seoul Adventist Hospital were chosen and their possible dissatisfying causitives were studied by questionnairs containing eight items such as 1) physical 2) hospital environment 3) treatment nursing care 4) public relationship 5) communication 6) householding and economic problems 7) mental and spiritual problems 8) sexual desire. These items were formulated into thirty questions and the data were colected by interviewing each patients. The results on a items were as follows. 1. Physical : Before psychological nursing care 60% of the patients expressed their physical discontentment, but after in the treatment by psychological nursing care 80% showed their satisfaction. The item of "longterm hospitalization is discouraging", got 92% of discontentment for the most. 2. Hospital environment : The psychological nursing care did not show any significant important to patients as far as hospital environment was concerned. It should be considered attentively that both before and even after the psychological nursing care treatment, more than 98% of the patients expressed discontentment. Specially 98% of the patients showed their discontentment to the item on were "appropriate diets served". 3. Contentment on nursing and treatment : 49% of satisfaction before P.N.C. was increased to 82% after the P.N.C. The items on "they change the sheets in every case of need", and "they have them shampoo and take a bath regularly" were showed more than 90% of contentment. 4. Public relationships : There was not any significant difference before and after P.N.C. treatment. But 0.67% of the patients responded to the item on "nurse's unkindness." 5. Contentment on Communication : Contentment was raised from 40% to 75% after the psychological nursing care treatment, specially the item "it makes them to have good relation with the other department of the hospital" got the highest rate of contentment (96%) 6. Content on patients' householding and economic problem : They did not show any significant response even after the P.N.C. Remarkably higher contentment (98%) on the item "economic situation" was probably due to the fact that they were all traffic accidents." Patients and they were paid by medical insurance company. 7. Contentment on mentality and spirituality : Increment in contentment from 30% to 90% after P.N.C. could be a proof that PNC could play a role on mental and spiritual health. 8. Sexual desire : Despite of PNC, contentment of sexual desire was low (20%) before and after the PNC. Except sexual desire PNC treatment did raise the overall contentment. Specially it helped to raise the contentment on physical aspects, nursing and treatment and markedly on mentality and spirituality. But it did not much influence the contentment on hospital environment, public relationships, communications, and householding and economic problems. Most of the study patients were low class educationaly and socially. From this study even overall results turned out higher contentment we should bear in mind that almost of all longterm in-patients feel uncomfortable but do not express their discontentment openly. Therefore planning an Comprehensive nursing care in such a way that all the discontentment should be solved and its evaluation hould be followed appropriately is a basic factor in clinical nursing care.restrictio