연구배경
본 연구는 급성 관상동맥 증후군 환자의 증상 발생 후 종합병원 방문까지의 치료추구행위에 대한 의사결정과정을 파악하여 의사결정모형을 구축하고 이를 검증하고자 시행되었다.
방 법
본 연구는 인지적 문화기술학적 의사결정모형 방법론을 적용한 방법론적 트라이앵귤레이션을 이용하였다. 먼저 질적연구방법을 이용하여 29명의 환자를 대상으로 치료추구행위에 대한 의사결정모형을 개발하였고 개발한 모형을 다시 311명의 환자를 대상으로 양적연구방법으로 검증하였다.
결 과
결 론
본 연구결과는 급성 관상동맥 증후군 환자의 증상 발생 후 병원방문을 지연시키는 요인들 중 병원방문의 장애성과 의식장애가 가장 크게 영향을 미치는 것으로 나타났다. 이는 급성 관상동맥 증후군 환자의 치료추구지연을 감소시키기 위한 교육 전략을 세우는데 기초자료로 활용할 수 있을 것이다.Background
Acute coronary syndrome is major cause of death in Korea. The purpose of this study was to develop and test a decision tree model of the treatment-seeking delay among patients with acute coronary syndrome.
Methods
This study used methodological triangulation, applying the cognitive ethnographic decision tree modeling. The model was developed based on qualitative data collected from in-depth interviews with 29 patients. The model was tested using qualitative and quantitative data collected from interviews and a structured questionnaire involving 311 patients. The predictability of the decision tree model was quantified as the proportion of participants who followed the pathway predicted by the model
Results
The model for decision making about when to visit a doctor after detecting symptoms was developed. Decision outcomes for the model were categorized into immediate visit and delayed visit. In the patients with acute coronary syndrome, the model was influenced by lowered consciousness, perceived seriousness of symptoms, presence of bystander, social-group influences, admission route and barriers to visiting a doctor. The predictability of the model was 88%.
Conclusions
This study results will provide basic data of educational strategies for reducing treatment-seeking delay of patients with acute coronary syndrome.