농촌거주 여성노인의 요실금 증상과 요실금 관련 삶의 질에 관한 연구

Abstract

The purpose of this study was to examine the relationship between the severity of the symptoms of urinary incontinence and their urinary incontinence related quality of life, as well as the influence of the severity on the quality of life among the female elders in rural areas. A descriptive correlation study design was adopted. A convenient sampling method was used to recruit 194 female elders from seven Public Health Centers in four 'gun's in Jeonnam province. Data were collected from April 30, 2015 to June 30, 2015, In order to measure the severity of the urinary incontinence, the 15-item questionnaire, which was originally developed by Hendrickson (1981) and modified by Youngsook Lee (1994) was used. To evaluate the urinary incontinence related quality of life, the 22-item questionnaire, which was originally developed by Wagner et al. (1996) and translated ․ reverse-translated by Seungjoon Oh et al. (2002) was used. Gathered data were processed using SPSS Win 21.0. Frequency, percentage, mean, standard deviation, t-test, ANOVA, Scheffe test, Pearson's Correlation Analysis and Multiple Regression Analysis was use to analyze data. The finding of the study are described below. 1. The average age of the participants was 71.0±3.5. Majority of them (45.4%) were not educated at all (n=88). Most of the participants were married (99.5%) and only one of the entire participants was not married at the time. The survey on the life style showed that the majority of them (n=101), answered they exercised regularly (at least three times a week, 52.1%). The number of people who have been drinking since the past was 66 (34.0%), and 10 answered they have been smoking since the past (5.2%). As for the OBGY characteristics, the average number of births given was 4.6±1.4, and 44 (22.7%) answered they received an OBGY surgery. 2. The average score severity of the urinary incontinence symptoms was 15.79±12.59 points. The item with the highest point was ‘I experienced a leak when I coughed.’The item with the lowest point was ‘I soiled my clothes with urine while I was sleeping.’The urinary incontinence related quality of life concerning urinary incontinence was, in average score, 81.27 ± 21.00. The item with the highest point was ‘I am concerned about having a sexual relationship because of urinary incontinence or urination issues.’The item with the lowest point was ‘I am worried about if my urinary incontinence or urination issues would worsen as I age further.’ 3. The difference in the quality of life based on the severity of urinary incontinence and the general characteristics of the participants, the severity of urinary incontinence showed statistically significant differences by the age (F=6.206, p<.001), income level (F=3.173, p=.044), exercise (t=-3.271, p=.001), number of life-time births (F=3.646, p=.014), and smoking habits (t=-3.677, p=.001). And, the urinary incontinence related quality of life differed significantly by the age (F=14.464, p<.001), income level (F=5.631, p=.004), exercise (t=3.238, p=.001), and smoking (t=3.337, p=.003). 4. Therefore, the urinary incontinence related quality of life and the severity of urinary incontinence showed a negative correlation (r=-.745, p<.001), meaning that the severer the urinary incontinence was, the lower the quality of life became. 5. The urinary incontinence related quality of life was most significantly and negatively influenced by the severity of urinary incontinence (β=-.674, p<.001), followed by age (β=-.159, p=002). The age level had negatively significant influences. And, this had the power of 61.5% over the entire variance. The result of this study indicated that the urinary incontinence related quality of life decreased as the severity of urinary incontinence increased among the female participants who lived in rural areas. The severity of urinary incontinence was reported to significantly affect the quality of life. This result suggest the necessity of developing the supportive-educational system in cooperation with the legal health care organizations in rural areas, which suffer from the shortage of health care professional and health education and the health promotion programs centered on the local public health centers which may increase the self-nursing capabilities of the participants so that they could manage their urinary incontinence by themselves.;본 연구는 농촌거주 여성노인을 대상으로 요실금 증상정도와 삶의 질 간의 관련성을 파악하고 요실금 증상정도와 요실금 관련 삶의 질에 미치는 영향요인을 규명하고자 하였다. 본 연구는 서술적 상관관계 연구로, 연구 대상자는 전라남도 4개 군의 7개 보건진료소에 내소한 65세 이상의 여성노인 194명을 편의 표집하였다. 자료 수집은 2015년 4월 30일부터 6월 30일까지 시행하였다. 대상자의 요실금 증상정도를 측정하기 위해 Hendrickson (1981)이 개발하고 이영숙(1994)이 수정· 보완한 15문항의 도구를 사용하였고, 요실금 관련 삶의 질을 측정하기 위해 Wagner 등(1996)이 개발하고 오승준 등(2002)이 번안한 22문항의 도구를 사용하였다. 수집된 자료는 SPSS WIN 21.0 프로그램을 사용하여 빈도, 백분율, 평균, 표준편차, t-test, ANOVA, Scheffe test, Pearson's correlation analysis 및 Multiple regression analysis 방법을 이용하여 분석하였다. 본 연구의 결과는 다음과 같다. 1. 대상자의 요실금 증상정도의 총점 평균은 15.79±12.59점, 5점 척도 평균은 1.05±.84점이었으며,‘기침을 했을 때 소변이 흐른 적 있다’가 1.62±.90점으로 가장 높게 나타났다. 요실금 관련 삶의 질은 총점 평균 81.27±21.00점, 5점 척도 평균은 3.69±.95점이었으며, ‘요실금이나 소변문제로 인하여 성관계를 갖는 것을 걱정 한다’가 4.20점으로 가장 높았다. 2. 대상자의 일반적 특성에 따른 요실금 증상정도는 연령(F=6.206, p<.001), 주관적 경제상태(F=3.173, p=.044), 운동여부(t=-3.271, p=.001), 분만횟수(F=3.646, p=.014), 흡연여부(t=-3.677, p=.001)에 따라 통계적으로 유의한 차이를 보였고, 일반적 특성에 따른 요실금 관련 삶의 질은 연령(F=14.464, p<.001), 주관적 경제상태(F=5.631, p=.004), 운동여부(t=3.238, p=.001), 흡연여부(t=3.337, p=.003)에 따라 유의한 차이를 보였다. 3. 대상자의 요실금 증상정도와 요실금 관련 삶의 질은 통계적으로 유의한 부적 상관관계(r=-.745, p<.001)를 나타냈다. 4. 대상자의 요실금 관련 삶의 질에 미치는 영향은 요실금 증상(β=-.674, p<.001)이 가장 큰 영향을 미쳤고, 다음으로 연령(β=-.159, p=.002)이 부적 유의한 영향을 미치는 것으로 나타났다. 본 연구의 결과, 농촌거주 여성노인의 요실금 증상은 삶의 질에 영향을 미치는 가장 높은 요인으로 보고되었다. 이러한 결과는 의료진과 보건교육이 부족한 농촌지역에서 지역보건의료기관과 연계된 보건진료소 중심의 건강증진프로그램의 필요성을 시사한다.