대학생의 과민대장증후군 중증도 예측모형
Prediction Model of Irritable Bowel Syndrome Severity in University Students
초록/요약 도움말
본 연구는 생물정신사회 모델과 선행 문헌 고찰을 통해 대학생의 과민대장증후군 중증도를 예측할 수 있는 모형을 구축하고 이를 검증하는 구조모형 연구이다. 본 연구에서는 과민대장증후군 중증도에 영향을 미치는 요인으로 확인된 가족력, 완벽주의, 사회적지지, 식이는 외생변수로, 대처, 스트레스, 불안, 수면, 과민대장증후군 중증도를 내생변수로 설정하여 가설적 모형을 구축하였다. 연구 대상은 대학교에 재학 중으로 ROME Ⅳ Adult Questionnaire의 IBS Module에 의해 과민대장증후군으로 분류된 학생 205명을 대상으로 하였다. 자료수집기간은 2019년 4월∼5월까지 구조화된 설문지를 이용하여 자료를 수집하였다. 수집된 자료는 SPSS WIN 25.0 program 과 AMOS 20.0 program을 이용하여 분석하였다. 본 연구의 연구 결과는 다음과 같다. 1) 대상자의 과민대장증후군 중증도는 경증이 30명(14.6%), 중등도가 93명(45.4%), 중증이 82명(40%)로 중등도가 가장 많았으며, 대부분의 대상자가 중등도 이상의 과민대장증후군 증상을 경험하는 것으로 나타났다. 2) 가설적 모형의 적합도 지수는 χ2=264.96(df=70, p<.001)과 χ2/df= 3.79, RMSEA= .12, RMR =1.78, GFI =.86, AGFI=.77, NFI=.82, CFI=.86, TLI=.79로 권장수준에 미치지 못해 가설적 모형을 수정하였다. 확인적 요인 분석에서 요인부하량이 .7이하인 측정변수를 제거하였으며 가설적 모형에서 유의하지 않은 경로를 제거하여 모형을 수정한 결과 χ²=79.66(df=52, p=.009), χ²/df=1.50, CFI=.94, TLI=.96, RMSEA=.05, RMR=1.59, GFI=.94, TLI=.96로 적합도 지수가 향상되었으며 수정한 모형을 최종 모형으로 채택하였다. 3) 과민대장증후군 중증도에 영향을 미치는 요인 중 불안과 수면은 과민대장증후군 중증도에 직접적으로 영향을 미친다. 가족력은 불안을 통해 과민대장증후군 중증도에 간접적으로 영향을 미치며, 완벽주의는 스트레스, 불안, 수면을 통해 과민대장증후군 중증도에 간접적으로 영향을 미친다. 사회적지지는 대처, 스트레스, 불안, 수면을 통해 과민대장증후군 중증도에 간접적으로 영향을 미치는 것으로 나타났다. 스트레스는 불안, 수면을 통해 간접적으로 영향을 미치며, 대처는 스트레스, 불안을 통해 간접적으로 영향을 미치는 것으로 나타났다. 이상의 연구 결과에서 과민대장증후군 중증도는 불안과 수면에 직접적인 영향을 받으며, 가족력, 완벽주의, 사회적지지, 대처, 스트레스의 간접적인 영향을 받는 것으로 확인되었다.그러므로 본 연구 결과를 토대로 과민대장증후군 대학생의 건강 증진과 증상의 자가 관리를 돕기 위해 중증도에 직접적인 영향 요인인 불안을 감소시키고 수면의 질을 향상시킬 수 있는 간호 중재가 요구되며, 간접적인 영향요인으로 확인된 가족력, 완벽주의, 대처, 사회적지지, 스트레스에 대한 간호중재의 개발과 적용은 증상을 경감시키는데 도움이 될 수 있을 것이다.
more목차 도움말
Ⅰ. 서 론 ··································································································1
1. 연구의 필요성 ··································································································1
2. 연구 목적 ·········································································································4
3. 용어 정의 ·········································································································5
Ⅱ. 문헌고찰 ···························································································11
1. 과민대장증후군 ······························································································11
2. 과민대장증후군 중증도의 영향 요인 ···························································16
3. 대학생의 과민대장증후군 ··············································································32
Ⅲ. 개념적 기틀 ·····················································································35
1. 연구의 개념적 기틀 ·······················································································35
2. 가설적 모형 ····································································································38
3. 연구 가설 ·······································································································40
Ⅳ. 연구방법 ···························································································42
1. 연구 설계 ·······································································································42
2. 연구 대상 ·······································································································42
3. 윤리적 고려 ····································································································43
4. 연구도구 ·········································································································44
5. 자료수집 방법 ································································································49
6. 자료분석 방법 ································································································50
7. 연구의 제한점 ································································································52
Ⅴ. 연구결과 ···························································································53
1. 대상자의 일반적 특성 ···················································································53
2. 대상자의 과민대장증후군 특성 ·····································································55
3. 대상자의 특성에 따른 과민대장증후군 중증도 ···········································57
4. 변수의 서술적 통계 ·······················································································59
5. 변수 간의 상관관계 ·······················································································61
6. 가설적 구조 모형의 검증 ··············································································63
7. 가설적 모형의 검증 ·······················································································67
8. 수정 모형의 검증 ··························································································76
9. 수정 모형의 효과 분석 ·················································································80
Ⅵ. 논 의 ································································································83
1. 대상자의 과민대장증후군 특성 ·····································································83
2. 대학생의 과민대장증후군 중증도에 대한 구조모형의 타당성 ···················85
3. 대학생의 과민대장증후군 중증도에 영향을 미치는 요인 ···························87
4. 간호학적 적용 및 의의 ·················································································91
Ⅶ. 결론 및 제언 ···················································································93
참고문헌 ··································································································95
부 록 ·································································································114
Abstract ·································································································133
