요추수술 환자의 조기 운동프로그램 개발 및 효과

Abstract

This study was attempted to develop an early exercise program for lumbar spine surgery patients and verify it's effect on the patients' pain, sleep disorder, daily living activity disorder, and the strength of lower extremity. The early exercise program was developed through a validation by an expert group based on the exercise guidelines of spine hospitals in D as well as literature review. The study subjects were lumbar surgery patients in the neurosurgery wards of B spine hospital located in D city and were divided into 27 patients of experiment group and 26 patients of control group. In this study, the early exercise program was provided to the experiment group for 7 days and not provided to the control group. For the program effects, the patients' pain, sleep disorder, and daily living activity disorder were measured through a survey questionnaire while the lower extremity strength was measured by the left and right thigh circumference (using a cm-unit measuring tape) as well as the number of sitting down and standing up from a chair within 30 seconds (30-second chair test). The analysis of date is done by SPSS version 21.0 program, and Chi-square test, Independent t-test for verification of prior homogeneity, Independent t-test for hypothesis testing for verification of maintenance of the effect. The hypothesis test showed that after the early exercise program, the experiment group had significant lower scores in back pain (t=2.07, p=.004) and daily living activity disorder (t=-2.14, p=.037) than the control group. Also, the experiment group's number of standing up from a chair increased significantly (t=4.50, p=<.001). In conclusion, this study proved that the early exercise program is an effective intervention for decreasing the back pain and daily living activity disorder of lumbar surgery patients as well as for increasing the strength of lower extremity. Therefore, an active use of early exercise program is demanded as a nursing intervention in clinical settings for lumbar surgery patients. The program will be much more effective if it reflects patients' various characteristics and is provided through an appropriate educational method and medium.

본 연구는 요추수술 환자를 대상으로 조기 운동프로그램을 개발하여 적용함으로써 요추수술 후 환자의 통증, 수면장애, 일상생활 활동장애 및 하지근력에 미치는 효과를 검증하기 위한 목적으로 시도되었다. 조기 운동프로그램은 문헌고찰, D소재지 척추전문병원 운동안내서를 바탕으로 전문가 집단의 검증을 받아 개발하였다. 연구대상은 D시에 위치한 B척추전문병원 신경외과 병동의 요추수술 환자를 대상으로 적용하였으며, 실험군 27명, 대조군 26명이었다. 본 연구에서 실험군에게는 조기 운동프로그램을 7일간 제공하였고, 대조군에게는 제공하지 않았다. 프로그램의 효과는 통증, 수면장애, 일상생활 활동장애는 설문지를 통해 측정하였고, 하지근력은 좌․우 대퇴둘레 (cm 단위의 줄자로 측정)와 의자에서 앉아 일어서기(30-second chair test)로 30초 내에 앉았다 일어서는 횟수로 측정하였다. 자료분석은 SPSS version 21.0 통계프로그램을 이용하여 사전 동질성 검증은 Chi-square test, Independent t-test, 가설 검증은 Independent t-test를 이용하여 실시하였다. 가설 검증 결과, 조기 운동프로그램을 받은 실험군은 대조군보다 허리통증(t=2.07, p=.004), 일상생활 활동장애 정도(t=-2.14, p=.037)가 유의하게 낮게 나타났으며, 의자에서 앉아 일어서기 (t=4.50, p=<.001)의 횟수가 유의하게 증가하였다. 따라서 조기 운동프로그램은 요추수술 환자의 허리통증과 일상생활 활동장애를 감소시키고 하지근력 증가에 효과적인 중재임을 확인하였다. 그러므로 임상에서 요추수술 환자를 대상으로 간호중재로서 조기 운동프로그램의 적극적인 활용이 요구되며, 특히 환자들의 다양한 특성을 반영하여 적절한 교육방법과 매체를 통해 제공한다면 더욱 효과적일 것이다.