援곕퀝�썝 �눜�썝�솚�옄�쓽 �쟾�솚愿�由� �봽濡쒓렇�옩(transitional care program) 媛쒕컻 諛� �슚怨쇳룊媛� ; Development and evaluation of the transitional care program for discharge patients from military hospital
媛꾪샇�븰怨�/諛뺤궗 ; [�븳湲�] 蹂� �뿰援щ뒗 援곕퀝�썝 �눜�썝�솚�옄�쓽 �쟾�솚愿�由� �봽濡쒓렇�옩 媛쒕컻�떒怨꾩� �슚怨쇳룊媛� �떒怨꾨줈 吏꾪뻾�릺�뿀�쑝硫� �씠濡좎쟻 湲고��� �쟾�솚�씠濡�(Meleis, Sawyer, Im, Hilfinger Messias, & Schumacher, 2000)�쓣 湲곗큹濡� �븯���떎. �봽濡쒓렇�옩 媛쒕컻 �떒怨꾨뒗 �쟾�솚�씠濡좎쓣 湲곕컲�쑝濡� 臾명뿄怨좎같�뿉�꽌 以묒옱�썝由щ�� �룄異쒗븳 �썑 �룷而ㅼ뒪 洹몃9 �씤�꽣酉곕�� �씠�슜�빐 �눜�썝寃쏀뿕 諛� �봽濡쒓렇�옩�쓽 �슂援щ룄瑜� �솗�씤�븯怨� 援곕퀝�썝 �눜�썝�솚�옄�쓽 �눜�썝以�鍮� �젙�룄瑜� 議곗궗�븯�뿬 �봽濡쒓렇�옩�쓽 �궡�슜�쓣 援ъ꽦�븯�뿬 �쟾�솚愿�由� �봽濡쒓렇�옩�쓣 媛쒕컻�븯���떎. �봽濡쒓렇�옩 �슚怨� �룊媛��떒怨꾨뒗 媛쒕컻�맂 �봽濡쒓렇�옩�씠 �눜�썝以�鍮�, 諛섏쓳�뼇�긽, �닚議곕줈�슫 �눜�썝�쟾�솚 寃쏀뿕�뿉 誘몄튂�뒗 �슚怨쇰�� 洹쒕챸�븯湲� �쐞�븳 鍮꾨룞�벑�꽦 ��議곌뎔 �궗�썑�꽕怨꾩쓽 �쑀�궗�떎�뿕�뿰援ъ씠�떎. �뿰援ш린媛꾩� 2007�뀈 9�썡遺��꽣 2008�뀈 4�썡源뚯��씠怨�, �뿰援щ��긽�� 援�援겸뿃�뿃蹂묒썝�뿉�꽌 �엯�썝移섎즺瑜� 諛쏄퀬 �눜�썝�씠 寃곗젙�맂 怨꾧툒�씠 �긽蹂묒씠�븯�씤 蹂묒궗濡� �젙�떊怨쇱뿉 �엯�썝�븯吏� �븡�븯�쑝硫� �뿰援ш린媛� 以묒뿉 援곕퀝�썝�뿉 �옱�엯�썝�븯吏� �븡�븯怨�, �눜�썝�씠 寃곗젙�맂 蹂묒궗�씠�떎. ��議곌뎔 79紐낆쓣 ���긽�쑝濡� �뿰援ъ뿉 ���븳 �룞�쓽瑜� 諛쏆� �썑 2007�뀈 9�썡遺��꽣 2007�뀈 11�썡源뚯� �옄猷뚮�� �닔吏묓뻽�쑝硫�, �떎�뿕援� 56紐낆쓣 ���긽�쑝濡� 2007�뀈 12�썡遺��꽣 2008�뀈 4�썡源뚯� �눜�썝 1二쇱씪 �쟾遺��꽣 �눜�썝 5二쇳썑源뚯� 6二쇰룞�븞 媛쒕컻�맂 �봽濡쒓렇�옩�쓣 �젣怨듯븯怨� �눜�썝�떦�씪�뿉�뒗 �눜�썝以�鍮꾨��, �눜�썝 1二쇳썑�� �눜�썝 5二쇳썑�뿉�뒗 �눜�썝�쟾�솚�쓣 媛곴컖 痢≪젙�뻽�떎. �닔吏묐맂 �옄猷뚮뒗 SPSS 12.0�쓣 �씠�슜�븯�뿬 x2 test, Fisher's exact test, independent t-test, mixed model濡� 遺꾩꽍�븯���떎. 蹂� �뿰援ъ쓽 寃곌낵�뒗 �떎�쓬怨� 媛숇떎. 1) �봽濡쒓렇�옩 媛쒕컻 �떒怨꾩뿉�꽌 �봽濡쒓렇�옩�쓽 以묒옱 �썝由щ뒗 �쟾�솚�씠濡좎쓽 二쇱슂 媛쒕뀗 以묒뿉�꽌 �쟾�솚�쓽 �냽�꽦�씤 �씤�떇怨� 李몄뿬瑜� 利앹쭊�떆�궎怨�, �쟾�솚�쓽 議곌굔�씤 媛쒖씤�쓽 �눜�썝以�鍮꾩� 吏��뿭�궗�쉶�쓽 吏�吏��쟻 �솚寃� 議곗꽦�쓣 �룙�뒗 寃껋쑝濡� 援ъ꽦�릺�뿀�떎. �룷而ㅼ뒪 洹몃9 �씤�꽣酉곕�� �떎�떆�븳 寃곌낵 移섎즺吏꾧낵�쓽 �떊猶고삎�꽦, �눜�썝�젅李⑥뿉 ���븳 �궗�쟾援먯쑁, 怨꾪쉷�맂 移섎즺怨쇱젙�뿉 ���븳 吏��냽�쟻�씤 援먯쑁, �옄�� 媛꾨��뱾�쓣 ���긽�쑝濡� �븳 �눜�썝蹂묒궗 愿�由ш탳�쑁, 援곕퀝�썝 �쓽猷뚯쭊怨� �옄�� 媛꾨�媛꾩쓽 �뿰怨�, 吏��냽�쟻�씤 �눜�썝�솚�옄�쓽 異뷀썑愿�由�, �옄���뿉�꽌 �솢�슜媛��뒫�븳 �눜�썝愿�由ш� �봽濡쒓렇�옩�쓽 �슂援щ룄濡� �솗�씤�릺�뿀�떎. �눜�썝以�鍮꾩젙�룄瑜� 議곗궗�븳 寃곌낵 �눜�썝 �썑 �씠�슜�븷 �닔 �엳�뒗 嫄닿컯愿�由� �꽌鍮꾩뒪 諛� �젙蹂댁� �옄�� 媛꾨��굹 �룞猷뚮뱾濡쒕��꽣 湲곕��릺�뒗 吏�吏� �젏�닔媛� �궙怨�, �뒪�듃�젅�뒪 �씤吏��젙�룄媛� �넂�븘�꽌 援곕퀝�썝 �눜�썝�솚�옄瑜� �쐞�븳 以묒옱媛� �븘�슂�븳 寃껋쑝濡� �굹���궗�떎. �뵲�씪�꽌 援곕퀝�썝 �눜�썝�솚�옄�쓽 �쟾�솚愿�由� �봽濡쒓렇�옩�� �눜�썝�솚�옄 �긽�떞�떎 �슫�쁺, �눜�썝以�鍮꾩젙�룄 �궗�젙, 媛�移섏� 寃쏀뿕怨듭쑀, �눜�썝�젅李� 援먯쑁, �눜�썝�솚�옄�� 媛숈씠 �눜�썝�썑 二쇱쓽�궗�빆 �옉�꽦 諛� �젣怨�, �쓽�궗�냼�넻湲곗닠 援먯쑁, �눜�썝�솚�옄�쓽 嫄닿컯愿�由ъ뿉 ���븳 �긽�떞�쓣 �눜�썝�쟾 1二쇰��꽣 �눜�썝�썑 5二쇨퉴吏� �떎�떆�븯�뒗 寃껋쑝濡� 媛쒕컻�릺�뿀�떎. 2) �봽濡쒓렇�옩 �슚怨� �룊媛��떒怨꾩뿉�꽌 '援곕퀝�썝 �눜�썝�솚�옄 �쟾�솚愿�由� �봽濡쒓렇�옩�뿉 李몄뿬�븳 �떎�뿕援곗� ��議곌뎔蹂대떎 �눜�썝�쟾�솚�쓽 媛쒖씤�쟻 議곌굔�씠 珥됱쭊�맆 寃껋씠�떎'�쓽 媛��꽕�쓣 寃��젙�븳 寃곌낵 �넻怨꾩쟻�쑝濡� �쑀�쓽�븳 李⑥씠媛� �엳�뼱 媛��꽕�씠 吏�吏��릺�뿀�떎. '援곕퀝�썝 �눜�썝�솚�옄 �쟾�솚愿�由� �봽濡쒓렇�옩�뿉 李몄뿬�븳 �떎�뿕援곗� ��議곌뎔蹂대떎 �눜�썝 1二쇳썑 嫄닿컯�븳 �눜�썝�쟾�솚 諛섏쓳�뼇�긽�쓣 �굹���궪 寃껋씠�떎'�쓽 媛��꽕�쓣 寃��젙�븳 寃곌낵 �넻怨꾩쟻�쑝濡� �쑀�쓽�븳 李⑥씠媛� �엳�뼱 媛��꽕�씠 吏�吏��릺�뿀�떎. '援곕퀝�썝 �눜�썝�솚�옄 �쟾�솚愿�由� �봽濡쒓렇�옩�뿉 李몄뿬�븳 �떎�뿕援곗� ��議곌뎔蹂대떎 �눜�썝 5二쇳썑 嫄닿컯�븳 �눜�썝�쟾�솚 諛섏쓳�뼇�긽�쓣 �굹���궪 寃껋씠�떎'�쓽 媛��꽕�쓣 寃��젙�븳 寃곌낵 �넻怨꾩쟻�쑝濡� �쑀�쓽�븳 李⑥씠媛� �뾾�뼱 媛��꽕�씠 湲곌컖�릺�뿀�쑝�굹, �떎�뿕援곗쓽 �눜�썝 5二쇳썑 怨쇱젙吏��몴�뒗 �넻怨꾩쟻�쑝濡� �쑀�쓽�븳 李⑥씠媛� �엳�뿀�떎. '援곕퀝�썝 �눜�썝�솚�옄 �쟾�솚愿�由� �봽濡쒓렇�옩�뿉 李몄뿬�븳 �떎�뿕援곗� ��議곌뎔蹂대떎 �닚議곕∼寃� �눜�썝�쟾�솚�쓣 寃쏀뿕�븷 寃껋씠�떎'�쓽 媛��꽕�쓣 寃��젙�븳 寃곌낵 洹몃9�슂�씤�뿉 �뵲�씪 �넻怨꾩쟻�쑝濡� �쑀�쓽�븳 李⑥씠媛� �엳�뼱 媛��꽕�씠 吏�吏��릺�뿀�떎. 寃곕줎�쟻�쑝濡� 蹂� �뿰援ъ뿉�꽌 媛쒕컻�맂 援곕퀝�썝 �눜�썝�솚�옄 �쟾�솚愿�由� �봽濡쒓렇�옩�� 援곕퀝�썝 �눜�썝�솚�옄�쓽 �눜�썝以�鍮꾨�� 珥됱쭊�떆�궎怨� �눜�썝�썑 �쟾�솚寃곌낵蹂대떎�뒗 怨쇱젙�뿉 �뜑 �슚怨쇱쟻�씠硫�, �뿰寃곌컧怨� �긽�샇�옉�슜�쓣 �뼢�긽�떆耳� �눜�썝�솚�옄�쓽 �닚議곕줈�슫 �눜�썝�쟾�솚�쓣 珥됱쭊�븯���떎. [�쁺臾�] The purpose of this study was to develop and evaluate the transitional care program for discharge patients from military hospital. The study consisted of two phases developing the program and evaluating its effectiveness. The conceptual framework guided to develop the program was the transition theory(Meleis, Sawyer, Im, Hilfinger Messias, & Schumacher, 2000). In the phase of program development, intervention principles were drawn from the literature review on transition theory and contents were determined by focus group interview and survey of discharge readiness. For the phase of program evaluation, non-equivalent control group quasi-experimental research design was used to investigate the effectiveness of transitional care program on discharge readiness, response patterns, and smooth transition experience. The participants were 135 discharge patients recruited from a military hospital. Seventy nine patients were assigned to the control group and 56 to the experiment group. The experimental group was given the developed transitional care program for 6 weeks, whereas only usual care was given to the control group. For data collection, discharge readiness was measured on the discharge day, and response pattern was measured in the 1 week and 5 weeks after discharge. The data were analyzed by chi-square, Fisher's exact test, independent t-test, and mixed model with SPSS win 12.0 program. The results of this study were as follows; 1. In the phase of program development, intervention principles consisted of the promotion of transition awareness and engagement, and the facilitation of personal readiness and supportive community. The focus group interview showed that the contents of the program would include construction of the trust between medical staffs and soldiers, advanced education about discharge protocol, discharged soldier's management education for unit, connection between medical staffs and unit officers, continuous follow-up for discharge patient, and appropriate discharge management for military personnel. Also, as the result of the discharge readiness's survey, the expected support and stress management were added to the contents. Finally, transitional care program for military hospital discharge patients was developed and consisted of management of discharge counseling room, assessment of discharge readiness, sharing values and experience, education of discharge protocol, making and provision the follow-up brochure individually with patient, education of communication skill and the counseling about health management and military daily activity after discharge. The program was provided from 1 week before discharge to 5 weeks after discharge. 2. In the phase of program evaluation, the hypothesis 'the personal condition of experimental group will be promoted more than control group' was supported. The hypothesis �쁢xperimental group will show more healthy patterns of response in the 1 week after discharge than control group�� was supported. The hypothesis 'experimental group will show more healthy patterns of response in the 5 week after discharge than control group' was rejected. The hypothesis 'experimental group will experience smoother discharge transition than control group' was supported. In conclusion, the transitional care program developed for discharge patients from military hospital promoted discharge readiness, influenced more on discharge process than discharge outcome, and promoted smooth discharge transition through improving the feeling of connection and interaction. ; prohibition