수지요법이 노인의 견비통, 일상생활활동 및 수면에 미치는 효과

Abstract

The purpose of this study was to identify the effects of hand moxibustion therapy of elders' shoulder pain, ADL and sleep disturbance in order to determine its usability as efficient nursing intervention for community elders suffering from shoulder pain. This is an quasi-experiment with nonequivalent control group pretest-post test design. Data collection and treatment were conducted from February 16 through March 28, 2009. The subjects consisted of 78 elders in Seongseo community welfare center in D city. They are randomized 20 for the experimental group A by using Ceramic Seo Am moxa therapy, 18 for the experimental group B by using Seo Am pellet therapy, 20 for the experimental group C by using combination of Ceramic Seo Am moxa therapy and Seo Am pellet therapy and 20 for the control group. Three different kind of method were used and three times per week for 6 weeks(total of 18 times) interventions were completed. To measure shoulder pain NRS was used, to measure the activities of daily living, modified IADL(7 contents) by researcher was used, which was modified by Song(1991). Cronbach's α was 0.80. To measure sleep disturbance, modified sleep disturbance scale(15 contents) by Shin, Song and Oh(1998) was used. Cronbach's α was 0.90. The collected data was analyzed with descriptive statistics, X²-test, Fisher's Exact test, Repeated measures ANOVA, One-way ANOVA, Cronbach's ɑ, Time contrast test and Scheffe test with SPSS/Win ver 15.0 statistical program. The results of this study was as follows: 1. Hypothesis 1 was supported that "shoulder pain of the experimental group A provided with Ceramic Seo Am moxa therapy, the experimental group B provided with Seo Am pellet therapy and the experimental group C provided with combination of Ceramic Seo Am moxa therapy and Seo Am pellet therapy would be lower than that the control group" (F=33.40, p=0.000). 2. Hypothesis 2 was supported that "ADL of the experimental group A provided with Ceramic Seo Am moxa therapy, the experimental group B provided with Seo Am pellet therapy and the experimental group C provided with combination of Ceramic Seo Am moxa therapy and Seo Am pellet therapy would be higher than that the control group" (F=18.42, p=0.000). 3. Hypothesis 3 was supported that "Level of sleep disturbance of the experimental group A provided with Ceramic Seo Am moxa therapy, the experimental group B provided with Seo Am pellet therapy and the experimental group C provided with combination of Ceramic Seo Am moxa therapy and Seo Am pellet therapy would be lower than that the control group" (F=12.92, p=0.000). 4. Hypothesis 4 was partially supported that " Among the experimental group A provided with Ceramic Seo Am moxa therapy, the experimental group B provided with Seo Am pellet therapy and the experimental group C will have a significantly different score of pain, ADL and sleep pattern. 4-1 : At the point of post 3 weeks, the experimental group A provided with Ceramic Seo Am moxa therapy, the experimental group B provided with Seo Am pellet therapy and the experimental group C showed significant difference in change of ADL(F=4.69, p=0.013) supporting hypothesis 4-1 partially, but showed no significant difference in pain(F=3.06, p=0.055) and level of sleep disturbance(F=0.03, 0.965) was not supported. 4-2 : At the point of post 6 weeks the experimental group A provided with Ceramic Seo Am moxa therapy, the experimental group B provided with Seo Am pellet therapy and the experimental group C showed significant difference in change of ADL(F=9.85, p=0.000) and level of sleep disturbance(F=9.85, p=0.000) supporting hypothesis 4-2 partially, but showed no significant difference in pain(F=2.88 p=0.065) was not supported. Consequently, hand moxibustion therapy was to be effective in relieving shoulder pain and sleep disturbance, improving ADL among elders and it is suggested that the therapy should be used for managing. Only if the elder have the shoulder pain, Ceramic Seo Am moxa therapy and Seo Am pellet therapy can be applied elder's individual preference and character. In this bout the elder have experience of difficulty ADL, it is desired that using Seo Am pellet therapy or combination of Ceramic Seo Am moxa therapy and Seo Am pellet therapy. When the elder complaints of sleep disturbance, Seo Am pellet therapy improving sleep disturbance.

본 연구는 수지요법이 노인의 견비통, 일상생활활동 및 수면장애에 미치는 효과를 알아보기 위하여 실시되었다. 연구 설계는 비동등성 대조군 사전․사후 유사 실험연구이며, 자료수집 및 실험처치는 2009년 2월 16일부터 2009년 3월 28일까지 이루어졌다. 연구 대상자는 D광역시 D구에 거주하며 S복지관 노인정에 등록된 견비통을 호소하는 60세 이상 노인 중 대상자 선정기준에 맞고 본 연구 목적과 참여에 동의한 서암뜸 요법을 적용한 실험군 A 20명, 서암봉 요법을 적용한 실험군 B 18명, 서암뜸과 서암봉을 병행하여 적용한 실험군 C 20명, 대조군은 20명으로 총 78명이었다. 실험처치는 주 3회씩 6주간 총 18회를 실시하였다. 연구도구는 견비통은 시각적 상사 척도(Numerical Rating Scales)로, 일상생활활동은 송미순(1991)이 개발한 도구를 수정한 7문항이었으며, 수면장애는 김신미, 송미순, 오진주(1998)가 개발한 15문항의 도구를 사용하였다. 자료분석은 SPSS 15.0 프로그램을 이용하여 빈도, 백분율, 평균, 표준편차, X²-test, Fisher's Exact test, Repeated measure ANOVA, One way ANOVA, sheffe-test, Simple main effect, Time contrast를 이용하여 분석하였다. 연구결과는 다음과 같다 1. 제 1 가설 “실험군 A, 실험군 B, 실험군 C는 처치를 받지 않는 대조 군보다 견비통이 감소될 것이다”는 지지되었다(p=0.000). 2. 제 2 가설 “실험군 A, 실험군 B, 실험군 C는 처치를 받지 않는 대조군보다 일상생활활동 능력이 증가될 것이다”는 지지되었다(p=0.000). 3. 제 3 가설 “실험군 A, 실험군 B, 실험군 C는 처치를 받지 않은 대조군보다 수면장애가 감소될 것이다”는 지지되었다(p=0.011). 3. 제 4 가설 : “실험처치 후 실험군 A, 실험군 B, 실험군 C간에 효과의 차이가 있을 것이다”는 부분적으로 지지되었다. 4-1 가설 : “3주 후 시점에서 실험군 A, 실험군 B, 실험군 C는 통증(p=0.055), 일상생활활동(p=0.013) 및 수면장애(p=0.965)의 변화량에 차이가 있을 것이다”는 부분적으로 지지되었다. 4-2 가설 : “6주 후 시점에서 실험군 A, 실험군 B, 실험군 C는 통증(p=0.065), 일상생활활동(p=0.000) 및 수면장애(p=0.000)의 변화량에 차이가 있을 것이다”는 부분적으로 지지되었다.

이상의 결과로 수지요법 간호중재가 노인의 견비통, 일상생활활동 및 수면장애를 감소시키고, 능력을 향상시키는데 효과적인 중재임이 확인되었으므로 지역사회 노인의 견비통, 일상생활활동 및 수면장애를 위한 중재로 사용할 것을 제안한다. 대상자중 통증의 문제만 있을 경우 서암뜸 요법과 서암봉 요법 중 어느 방법을 사용 할 것인가는 대상자의 선호와 특성에 따라 적용하면 될 것으로 사료된다. 일상생활활동에 어려움을 겪는 경우는 서암봉 요법이나 병행요법을 사용하는 것이 바람직하겠고, 수면장애의 문제를 호소하는 노인의 경우는 서암봉 요법만으로도 수면장애가 경감될 것으로 사료된다.