심장판막 수술환자의 회복기간에 따른 증상클러스터와 삶의 질 변화

Symptom Clusters and Quality of Life Changes according to Recovery Period of Patients with Heart Valve Surgery

  • 황순정 (전주비전대학교 간호학부) ;
  • 강정희 (전북대학교 간호대학, 간호과학연구소)
  • Hwang, Soon Jung (Department of Nursing, VISION College of Jeonju) ;
  • Kang, Jeong Hee (College of Nursing, Research Institute of Nursing Science, Chonbuk National University)
  • 투고 : 2018.08.13
  • 심사 : 2018.11.19
  • 발행 : 2019.02.28

초록

Purpose : It is widely accepted that addressing multiple symptoms together is the preferred approach in assessment and intervention and results in reduced negative patient outcomes. Yet, there are few studies examining symptom clusters and their impacts on quality of life longitudinally in patients after heart valve surgery. Methods: A total of 101 patients were recruited from a tertiary hospital and were administered questionnaires (at 3, 6, and 10 weeks after the surgery) assessing participants' characteristics, cardiac symptoms, and quality of life. Factor analysis was used to identify symptom clusters. Hierarchical multiple linear regression was used to predict quality of life. Results: Participants were predominantly 70-years old or more with a mean age of 64.34. The two symptom clusters at 3 weeks after the surgery with education, gender, and occupation accounted for 76.3% of variance in quality of life. Conclusion: Symptom clusters containing various physical and psychological symptoms in patients after the surgery affected quality of life, and the relationship was significant at 3 weeks after the surgery. Because symptom clusters were identified in all three recovery periods, nurses need to acknowledge these clusters, rather than each symptom separately, and to utilize these in providing care and education and in promoting quality of life in these patients.

키워드

참고문헌

  1. Abbott, A. A., Barnason, S., & Zimmerman, L. (2010). Symptom burden clusters and their impact on psychosocial functioning following coronary artery bypass surgery. Journal of Cardiovascular Nursing, 25(4), 301-310. https://doi.org/10.1097/JCN.0b013e3181cfbb46
  2. Bae, J. M., & Shim, M. S. (2011). A study on self-care agency and quality of life in patients with heart valve surgery. Journal of the Korea Academia-Industrial Cooperation Society, 12(9), 3975-3983. https://doi.org/10.5762/KAIS.2011.12.9.3975
  3. DeVon, H. A., Vuckovic, K., Ryan, C. J., Barnason, S., Zerwic, J. J., Pozehl, B., . . . Zimmerman, L. (2017). Systematic review of symptom clusters in cardiovascular disease. European Journal of Cardiovascular Nursing, 16 (1), 6-17. https://doi.org/10.1177/1474515116642594
  4. Dodd, M. J., Miaskowski, C., & Paul, S. M. (2001). Symptom clusters and their effect on the functional status of patients with cancer. Oncology Nursing Forum, 28 (3), 465-470.
  5. Herr, J. K., Salyer, J., Flattery, M., Goodloe, L., Lyon, D. E., Kabban, C. S., & Clement, D. G. (2015). Heart failure symptom clusters and functional status: A cross-sectional study. Journal of Advanced Nursing, 71 (6), 1274-1287. https://doi.org/10.1111/jan.12596
  6. Jurgens, C. Y., Moser, D. K., Armola, R., Carlson, B., Sethares, K., & Riegel, B. (2009). Symptom clusters of heart failure. Research in Nursing & Health, 32 (5), 551-560. https://doi.org/10.1002/nur.20343
  7. Kim, H. J., McGuire, D. B., Tulman, L., & Barsevick, A. M. (2005). Symptom clusters: Concept analysis and clinical implications for cancer nursing. Cancer Nursing, 28 (4), 270-282.
  8. Kim, K. S., Kim, Y. S., Choi, K. O., Hyun, K. S., Yoon, E. J., Kim, S. Y., . . . So, H. S. (2012). Adult health nursing (7th ed.). Seoul, Korea: Hyunmoon Co.
  9. Kim, S. Y. (2014). Predictors of quality of recovery after cardiac surgery (Unpublished doctoral dissertation). Hanyang University, Seoul, Korea.
  10. Kimble, L. P., Dunbar, S. B., Weintraub, W. S., McGuire, D. B., Manzo, S. F., & Strickand, O. L. (2011). Symptom clusters and health-related quality of life in people with chronic stable angina. Journal of Advanced Nursing, 67 (5), 1000-1011. https://doi.org/10.1111/j.1365-2648.2010.05564.x
  11. Korean Statistical Information Service. (2017). Cause of death by topic. Retrieved December 5, 2017, from http://kosis.kr/statisticsList/statistics
  12. Lee, K. H. (2000). Needs assessment in open-heart surgery patients (Unpublished master's thesis). Hanyang University, Seoul, Korea.
  13. Lenz, E. R., Pugh, L. C., Milligan, R., Gift, A., & Suppe, F. (1997). The middle-range theory of unpleasant symptoms: An update. Advances in Nursing Science, 19 (3), 14-27. https://doi.org/10.1097/00012272-199703000-00003
  14. Liao, W. C., Huang, C. Y., Huang, T. Y., & Hwang, S. L. (2011). A systematic review of sleep patterns and factors that disturb sleep after heart surgery. Journal of Nursing Research, 19 (4), 275-288. https://doi.org/10.1097/JNR.0b013e318236cf68
  15. Nam, B. H. (2003). Testing the validity of the Korean SF-36 health survey (Unpublished doctoral dissertation). Seoul National University, Seoul, Korea.
  16. Nieveen, J. L., Zimmerman, L. M., Barnason, S. A., & Yates, B. C. (2008). Development and content validity testing of the cardiac symptom survey in patients after coronary artery bypass grafting. Heart & Lung: The Journal of Critical Care, 37 (1), 17-27. https://doi.org/10.1016/j.hrtlng.2006.12.002
  17. Panagopoulou, E., Montgomery, A. J., Benos, A., & Maes, S. (2006). Are people emotionally predisposed to experience lower quality of life? The impact of negative affectivity on quality of life in patients recovering from cardiac surgery. Social Indicators Research, 76 (1), 55-69. https://doi.org/10.1007/s11205-005-4856-5
  18. Park, K. Y., Kang, W. C., Kim, K. J., Kim, E. Y., Park, C. H., Shin, M. H., . . . Choi, C. H. (2018). Perioperative intensive care of cardiac surgery (3rd ed.). Seoul, Korea: Korea Medical Book Publishing Company.
  19. Schulz, P. S., Zimmerman, L., Pozehl, B., Barnason, S., & Nieveen, J. (2011). Symptom management strategies used by elderly patients after coronary artery bypass surgery. Applied Nursing Research, 24 (2), 65-73. https://doi.org/10.1016/j.apnr.2009.03.001
  20. Skerman, H. M., Yates, P. M., & Battistutta, D. (2009). Multivariate methods to identify cancer-related symptom clusters. Research in Nursing & Health, 32 (3), 345-360. https://doi.org/10.1002/nur.20323
  21. Song, E. K., Moser, D. K., Rayens, M. K., & Lennie, T. A. (2010). Symptom clusters predict event-free survival in patients with heart failure. Journal of Cardiovascular Nursing, 25 (4), 284-291. https://doi.org/10.1097/JCN.0b013e3181cfbcbb
  22. The Criteria Committee for the New York Heart Association. (1994). Nomenclature and criteria for diagnosis of diseases of the heart and great vessels (9th ed.). Boston, MA: Little, Brown & Co.
  23. The Korea Heart Foundation. (2016). Annual status of cardiac surgery 2016. Retrieved November 11, 2016, from http://heart.or.kr./korean/board/board_renew.php
  24. Ware, J. E., Kosinski, M., Bjorner, J. B., Turner-Bowker, D. M., Gandek, B., & Maruish, M. E. (2008). SF-36v2$^{(R)}$ Health survey: Administration guide for clinical trial investigator. Lincoln, NE: Quality Metric Incorporation.
  25. Won, S. J. (2010). Health related quality of life in patients with cardiac surgery (Unpublished master's thesis). Konkuk University, Seoul, Korea.
  26. Yun, I. H. (2005). A study on the relationship among quality of life, self-efficacy and self care of open heart surgery patients after hospital discharge (Unpublished master's thesis). Kwandong University, Gangneung, Korea.