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여대생의 골밀도 감소 예방을 위한 소셜네트워크서비스 기반 골건강증진 프로그램 개발 및 효과 검증

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Author(s)
신경숙
Issued Date
2022-02
Abstract
This study was conducted to develop a Social Network Service-based bone health promition program and verified its effectiveness to prevent bone density reduction on female college students. When it comes to bone density, a rapid decrease after menopause can be prevented in advance by women reaching their maximum bone density during their 20s. However, the recent decline in bone density among female college students in their 20s is on the rise, and health experts advise that education on risk factors and preventive measures should be provided to improve the problem of bone density reduction. It is necessary for female college students to practice and manage bone health behavior by acquiring appropriate knowledge related to bone health.

This program was implemented based on the ADDIE model to develop a Social Network Service-based bone health promotion program. The contents of and methods for education were constructed based on analysis of previous studies and educational needs survey through focus group interviews, and content validity was also verified through expert groups. Regarding the theoretical basis, this program was based on the Information-Motivation-Behavioral skill model (IMB) of Fisher, Fisher, Amico, and Harman (2006), and consisted of four weeks of training regarding bone density reduction concepts and definitions, bone health exercise, bone health essential nutrients, and bone health-related lifestyle. This study provided education using YouTube and KakaoTalk, which allow subjects to repeatedly acquire information without time and space constraints, enable information exchange and interactive communication between subjects for motivation, and improve self-efficacy through self-monitoring.

The contents of and methods for education were constructed based on analysis of previous studies and educational needs survey through focus group interviews, and content validity was also verified through expert groups. This program was based on the Information-Motivation- Behavioral skill model (IMB) of Fisher, Fisher, Amico, and Harman (2006), and consisted of four weeks of training regarding bone density reduction concepts and definitions, bone health exercise, bone health essential nutrients, and bone health-related lifestyle. This study provided education using YouTube and KakaoTalk, which allow subjects to repeatedly acquire information without time and space constraints, enable information exchange and interactive communication between subjects for motivation, and improve self-efficacy through self-monitoring.

A pre-post control experimental study was conducted to verify the effectiveness of the bone health promotion program to prevent bone density reduction in female college students. Data were collection between June to September 2021. The research subjects were enlisted from four universities in Daegu and Gyeongbuk Province through bone density screening for female students, and 20 in the experimental group and 18 in the control group were the final analysis subjects.

With respect to data analysis, this study conducted homogeneity verification based on Chi-square test, Fisher’s exact test, t-test, and the Mann Whitney U-test for bone health-related characteristics and dependent variables with the use of the SPSS statistical program (ver. 27.0), and with repeated measures ANOVA, generalized estimating equations (GEE).

The experimental group to which the SNS-based bone health promotion program was applied had a more significant increase compared to the control group in terms of knowledge of decreased bone density (F=12.56, p<.001), a health belief with reduced bone density (F=4.41, p=.036), decreased bone density self-efficacy (F=14.56, p<.001), bone health promotion behavior (F=27.26, p<.001), and bone density (F=5.65, p=.023), and there was no significant difference between the two groups in terms of osteocalcin, the bone formation index, (F=1.44, p=.237), CTX, the bone absorption index (F=0.03, p=.861), calcium in the blood (F=0.01, p=.898), and Vitamin D (F=0.01, p=.912).

Therefore, the Social Network Service-based bone health promotion program was verified as an effective intervention in improving bone health promotion behavior and bone density of female college students for the reduction in bone density. In years to come, there is a need for school health authorities and local communities to implement effective bone health promotion programs for college students in their 20s to obtain their maximum bone density.
본 연구는 여대생의 골밀도 감소를 예방하기 위해 골건강을 스스로 관리할 수 있는 SNS 기반 골건강증진 프로그램을 개발하고 적용하여 그 효과를 검증하기 위한 못적으로 실시되었다. 골밀도는 20대 부터 최대골밀도에 도달함으로써 폐경기 이후 골밀도가 급격하게 감소하는 것을 예방할 수 있다. 그러나 최근 20대 여대생의 골밀도 감소가 증가하고 있는 실정이며, 건강 전문가는 골밀도 감소 문제를 개선하기 위해 위험인자 및 예방법에 대한 교육을 제공해야 한다. 여대생이 골건강과 관련된 적절한 지식을 습득함으로써 스스로 골건강 행위를 실천하고 관리하는 것이 필요하다. 본 프로그램은 SNS 기반 골건강증진 프로그램 개발을 위해 ADDIE 모형을 기초하여 분석, 설계, 개발, 수행, 평가과정으로 진행하였다. 교육내용과 방법은 선행연구분석, 포커스 그룹 인터뷰를 통한 교육요구도 조사를 통해 내용을 구성하였으며 전문가 집단을 통하여 내용타당도를 검증하였다. 본 프로그램은 이론적 기틀로 J. Fisher, W. Fisher, Amico와 Harman (2006)의 정보-동기-행동기술모델 Information-Motivation-Behavioral skil (IMB)을 근거로 하였으며, 골밀도 감소 개념 및 정의, 골건강 운동, 골건강 필수 영양소, 골건강 관련 생활습관 및 기호식품 등에 대한 주제로 4주간 주 2회 교육으로 구성하였다. 대상자가 시공간 제약 없이 반복적으로 정보를 습득하고 대상자 간의 상호작용이 가능한 유튜브, 카카오톡을 이용하여 교육을 제공하였으며, 동기 유발을 위해 대상자 간의 정보교환 및 쌍방향 의사소통이 가능하도록 하였고, 개인 역량을 확인하는 자가 모니터링을 통해 자기효능감이 증진되어 스스로 행동실천을 개선하도록 개발하였다.

본 연구는 여대생의 골밀도 감소 예방을 위한 골건강증진 프로그램의 효과를 검증하기 위하여 대조군 사전-사후 실험연구를 수행하였다. 자료수집은 2021년 6월부터 2021년 9월까지 이루어졌다. 연구대상은 대구시와 경북지역의 4개의 대학에서 여학생을 대상으로 골밀도 스크리닝을 통해 모집하였으며, 실험군 20명, 대조군 18명을 최종분석 대상으로 하였다.

자료 분석은 SPSS ver. 27.0 통계 프로그램을 이용하여, 골건강 관련 특성과 종속변수에 대한 동질성 검정 Chi-square test, Fisher’s exact test, t-test, Mann Whitney U-test를 실시하였고, Repeated measures ANOVA, Generlized Estimating Equations (GEE)으로 분석하였다.

그 결과 SNS 기반 골건강증진 프로그램을 적용한 실험군은 대조군보다 골밀도 감소 지식(F=12.56, p<.001), 골밀도 감소 건강신념(F=4.41, p=.036), 골밀도 감소 자기효능감(F=14.56, p<.001), 골건강증진행위(F=27.26, p<.001), 골밀도(F=5.65, p=.023)는 두 그룹 간 유의하게 증가하였고, 골형성 지표 Osteocalcin (F=1.44, p=.237), 골흡수 지표 CTX (F=0.03, p=.861), 혈중 칼슘(F=0.01, p=.898), 비타민 D (F=0.01, p=.912)는 두 그룹 간 유의한 차이가 없었다.

따라서 본 연구에서 SNS 기반 골건강증진 프로그램은 골밀도 감소 예방을 위한 여대생의 골건강증진행위와 골밀도를 개선시키는데 효과적인 중재로 검증되었다. 추후 학교 보건현장과 지역사회에서 대학생들의 최대골밀도를 획득하는데 효과적인 골건강증진 프로그램을 시행할 필요가 있다.
Alternative Title
Development and Effect of Social Network Service-based Bone Health Promotion Program for The Prevention of Low Bone Mineral Density in Female College Students
Awarded Date
2022-02
Degree
박사
Type
Thesis
Source
http://www.dcollection.net/handler/kmu/000000119813
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44599
Appears in Collections:
2. College of Nursing (간호대학) > 박사
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