본태성 고혈압환자를 위한 자기조절 프로그램 관련요인 연구

A Study on the Factors Affecting Self-Regulation Program for Hypertensives

Essential hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Thus the comprehensive self-regulation program was conducted as a nursing intervention on the promotion self-care 'performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi -experimental research with pre and post test design was used. And the whole program was carried out from October, 1993 to February, 1994. Self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The data was analyzed by experimental stages: the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t -test and F-test, and multiple correlation to determine the variables affecting the effect of program. The results were as follows : 1) Subjects in J company were significantly lower diastolic blood pressure than K company after the program (t=2.39, p=.024). Level of cholesterol was significant difference according to position(t=2.23, p=.034), family history (t=-2.66, p=.013), diagnosis duration, and career(t=2.88, p=.055). Perceived self-efficacy was more significantly increased among the group with family history(t=-3.00, p=.013). 2) Before the program, there were significant positive correlation among the variables: internal-LOC and self-efficacy(r=.3952, p=.015), external-LOC and barriers (r=.6515, p=.000), chance-LOC and Barriers(r=.4133, p=.012). However there were significant negative correlation between internal-LOC and barriers (r=-.3236, p=.041, external-LOC and self -efficacy(r=-.3517, p=.028), self-efficacy and barriers(r=-.6654, p=.000). 3) There were significant relationships between changes in self - care performance and self-efficacy at 5th week (r=.5313, p=.001) and changes in self-efficacy at 9th week(r=.4586, p=.005). 4) After the program, internal health locus of control and perceived benefits showed significant correlation(r=.5673, p=.001, but perceived barriers was negative correlation with perceived self-efficacy (t=-4242, p=.01). From the above results, it can be concluded that the self-regulation program is an effective nursing strategy through the change of variables to promote self-care performance of hypertensives and to increase the self-efficacy. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings.