재가 뇌졸중 환자를 위한 건강증진프로그램의 효과

Abstract

The purpose of this study was to find out the effect of the health promotion program administered to the stroke patients. The conceptual framework was derived from Cox's Interaction Model of Client Health Behavior(IMCHB). The research design was nonequivalent control group pretest-posttest design. The data collection was performed from November 20th, 2003 to February 28th, 2004. The subjects were 41 patients(20 for experimental group, 21 for control group) who were selected at three social welfare centers(Bokgiguan), D city, in Korea. The subjects in the experimental group participated in health promotion program(HPP) for 12 weeks. The HPP was consisted of health education, exercise training, experience sharing, health counseling, and telephone counseling. The HPP provided health information, emotional support, decisional control, and professional/technical competencies for subjects. Data were analyzed by descriptive statistics, x^(2)-test, t-test, Kolmogorov-Smirnov test, ANCOVA and Cronbach's α with SPSS/Win 10.0 program. The results of this study were as follows: 1. The first hypothesis, "The experimental group will have a higher score of health promoting behavior than the control group." was supported(F=32.40, p=0.001). 2. The second hypothesis, "The experimental group will have a higher score of perceived health status than the control group," was supported(F=6.86, p=0.013). 3. The third hypothesis, "The experimental group will have a higher level of physical strength than the control group," was partially supported. In subscales, there were significant differences in the strengths of grip, elbow flexor and extensor, wrist flexor and extensor, hip flexor, extensor, adductor and abductor, knee flexor and extensor, the unaffected ankle flexor and extensor, and ten meter-walking time(p<0.05). There were no significant differences in the strengths of the affected ankle flexor and extensor. 4. The fourth hypothesis, "The experimental group will have a higher score of ADL function than the control group," was supported(F=21.29, p=0.001). 5. The fifth hypothesis, "The experimental group will have a higher improvement of physiologic marker than the control group." was partially supported. In subscales, there were significant differences in systolic BP(F=5.92, p=0.020), diastolic BP(F=4.22, p=0.047), total cholesterol(F=4.31, p=0.046), triglyceride(F=4.79, p=0.036), and glucose(F=4.60, p=0.039). There were no significant differences in the level of HDL cholesterol and LDL cholesterol. 6. The sixth hypothesis, "The experimental group will have a higher score of self-efficacy than the control group." was supported(F=5.32, p=0.027). 7. The seventh hypothesis, "The experimental group will have a lower score of depression than the control group" was supported(F=6.91, p=0.012). 8. The eighth hypothesis, "The experimental group will have a higher score of quality of life than the control group." was supported(F=9.02. p=0.005). In conclusion, the health promotion program for stroke patients at home had positive effect on enhancing health promoting behavior, perceived health status, physical strength, ADL function, self-efficacy, quality of life, and improving physiologic marker, and reducing depression. Therefore, nursing strategies that can expand the health promotion program for stroke patients at home to stroke patients in community need to be developed.