환경적 간호중재가 개심술 환자의 중환자실섬망증, 환경적 스트레스 및 수면에 미치는 효과
The Effect of the Environmental Nursing Intervention on ICU Delirium, Environmental Stress and Sleep in Patients Underwent Cardiac Surgical Procedures
1
조회
0
다운로드
11
인용
0
참고문헌
키워드
초록
Abstract
Purpose: To examine the effects of the environmental nursing intervention using eye-shields and earplugs on the incidence of delirium, environmental stress and sleep among the patients with open-heart surgery in the post-cardiac ICU(intensive care units). Method: This study was a non-equivalent control group non-synchronized design. The subjects consisted of 93 patients who received ICU care after the cardiac surgery. Among those, 32 subjects was assigned in one experimental group with eye-shields, 31 in the other experimental group with earplugs, and 30 in the control group. ICU delirium was measured by CAM-ICU, environmental stress by ICUESS, and sleep by two sleep scales developed by Oh, et al. and Kim. The data were analyzed by the SPSS 13.0 program including frequency, percentage, t-test, test, ANOVA and ANCOVA. Results: There are no statistically significant differences in the incidence of delirium among three groups (p=.139). The ICU environmental stress scores from the subjects of two experimental groups demonstrated lower (F=6.731, p=.002) than the control group. Also, the degrees of sleep pattern (p=.000, p=.000) and sleep satisfaction (p=.000, p=.000) were greater than those of the control group. Conclusion: Although the environmental nursing intervention using eye-shields and earplugs did not demonstrate the effects in decreasing the incidence of ICU delirium, it has affirmative effects in decreasing environmental stress and improving the quality sleep among the patients with open-heart surgery while they stay in ICU. Further nursing implications are discussed.
참고문헌 (29)
- 구윤정, "수면안대와 귀마개 적용이 중환자실 관상동맥질환자의 수면양상에 미치는 효과", 석사, pp.2005
- 김경희, "중환자실 관상동맥질환자의 수면에 관한 연구", 석사, pp.2001
- 김명애, "중환자실 환자의 수면량과 수면량에 영향을 미치는 환경적 요인에 관한 연구", 석사, pp.1986
- 김묘진, "귀마개의 적용이 중환자실 입원환자의 소음으로 인한 수면장애에 미치는 효과", 석사, pp.2003
- 김미영, "노인환자의 입원 전․후 수면양상과 관련 요인에 관한 연구", 대한간호학회지, 29(1), pp.61~71 (1997)
- 김영하, "중환자실 간호사의 중환자실정신증 경험", 석사, pp.2005
- 복희, "중환자실 환자와 간호사가 지각한 환경적 스트레스요인에 관한 연구", 석사, pp.1999
- 손연정, "소음과 수면양상에 관한 연구(중환자실을 중심으로)", 석사, pp.1999
- 신영옥, "개심술 후 섬망증 후에 관한 탐색적 연구", 석사, pp.1986
- 오진주, "수면측정도구의 개발을 위한 연구", 대한간호학회지, 28(3), pp.563~572 (1988)
- 이선희, "스트레스 요인에 대한 환자와 간호사의 인식 비교연구", 석사, pp.2003
- 조남옥, "개심술환자에 있어서 수술 후 섬망에 영향을 미치는 요인에 관한 연구", 석사, pp.1985
- American Psychiatric Association, "Diagnotic and Statistical Manual of Mental Disorders(4th ed.)(DSM-Ⅳ)", Washington DC, 123~133 (1994)
- Ballard,K., "Identification of environmental stressor for patients in a surgical intensive care unit", Issues in Mental Health Nursing, 3, pp.89~108 (1981)
- Bross,H.M., "Delirium in the elderly patients", American Family Physician, 50(6), pp.1325~1332 (1994)
- Cochran,J., "A comparison of nurses' patients' perception of intensive care unit stressors", Journal of Advanced Nursing, 14, pp.1038~1043 (1989)
- Freedman,N.S., "Patient perception of sleep quality and etiology of sleep disruption in the intensive care unit", American Journal of Respiratory Care Medicine, 159, pp.1155~1162 (1999)
- Geary,S.M., "Intensive care unit psychosis revisited: Under- standing and managing delirium in the critical care setting", Critical Care Nursing Quarterly, 17(1), pp.51~63 (1994)
- Granberg,A., "Intensive care syndrome : A literature review", Intensive and Critical Care Nursing, 12, pp.173~182 (1996)
- Holland,C., "Patients' recollections of critical care", Dimensions of Critical Care Nursing, 16(3), pp.132~141 (1997)
- Justic,M., "Does “ICU psychosis” really exist?", Critical Care Nurse, 20, pp.28~37 (2000)
- Margaret,C.M., "Delirium in the intensive care unit", Critical Care Nursing Quarterly, 26(3), pp.172~178 (2003)
- McGuire,B.E., "Intensive care unit syndrome: a dangerous misnomer", Archives of Internal Medicine, 160, pp.906~909 (2000)
- Pilcher,J.J., "Sleep quality versus sleep quantity: Relationships between sleep and measures of health well being and sleepiness in college students", Journal of Psychosomatic Research, 42(6), pp.583~596 (1997)
- Simpson,T., "Relationships among sleep dimensions and factors that impair sleep after cardiac surgery", Research in Nursing & Health, 19, pp.213~223 (1996)
- Sorehren,P., "Stressors perceived by cardiac surgical patients in the intensive care unit", American Journal of Critical Care, 4(1), pp.71~76 (1995)
- Wesley,E.E., "Delirium in mechanically ventilated patients validity and reliability of the confusion assessment method for the intensive Care unit(CAM-ICU)", Journal of the American Medical Association, 286(21), pp.2703~2710 (2001)
- Wesley,E.E., "Monitoring delirium in critically ill patients: Using the confusion assessment method for the intensive care unit", Critical Care Nurse, 23(2), pp.25~38 (2003)
- William,L.L., "Delirium in postacute and long-term care", Journal of the American Medical Directors Association, 7, pp.254~261 (2006)