뇌졸중 환자의 우울 유무에 따른 재활동기, 가족지지 및 재활이행 간의 비교

다국어 초록 (Multilingual Abstract)

Purpose: The purpose of this study was to compare motivation for rehabilitation, family support and adherence to rehabilitation and identify factors predicting adherence to rehabilitation between depressive and non-depressive stroke patients. Methods: Stroke patients admitted to rehabilitation hospitals (n=159) participated in the study. Data were collected through self-reported questionnaires including general characteristics, depression, motivation for rehabilitation, family support and adherence to rehabilitation. The data were analyzed by descriptive statistics, t-test, x2 test, Pearson correlation coefficients and logistic regression using the SPSS/WIN 21.0 program. Results: 62.9% of the subjects were identified as depressive patients. Motivation for rehabilitation (F=48.18, p=.020) and adherence to rehabilitation (F=9.68, p=.002) in depressive stroke patients were significantly lower than non-depressive stroke patients. Family support also in depressive group was lower than non-depressive group but there was no statistical significance (F=2.35, p=.127). Motivation for rehabilitation (OR=11.46), family support (OR=1.05) and onset period (less than 2 year)(OR=3.61) predicted the good adherence to rehabilitation in depressive stroke patients. Conclusion: The results of this study indicate that health professionals need to identify factors affecting adherence to rehabilitation and provide a nursing intervention considering the depression especially when caring for stroke patients.

참고문헌 (Reference)

1 박은영, "한국 뇌졸중 환자의 우울관련 변인에 관한 메타분석" 한국간호과학회 42 (42): 537-548, 2012

2 김애리, "척추손상 환자의 재활 치료 지속이행 설형모형" 성인간호학회 22 (22): 90-102, 2010

3 여형남, "집단재활체조 프로그램이 뇌졸중 환자의 우울과 재활동기에 미치는 효과" 병원간호사회 18 (18): 424-434, 2012

4 김영택, "지역사회 뇌졸중 환자들의 이차 예방을 위한 치료 지속률과 약물 순응도 관련 요인" 한국농촌의학.지역보건학회 40 (40): 9-20, 2015

5 김은주, "뇌졸중 후 우울의 장기적 변화 및 연관 요인 - 전향적 추적 연구 -" 한국장애인재활협회 19 (19): 225-240, 2015

6 김대용, "뇌졸중 환자의 우울증에 영향을 미치는 요인" 고신대학교 의과대학 학술지 24 (24): 69-75, 2009

7 정은정, "뇌졸중 환자의 우울증 유무에 따른 균형, 일상생활동작, 삶의 질의 비교" 한국운동재활학회 8 (8): 61-69, 2012

8 최은실, "뇌졸중 환자의 우울이 재활동기에 미치는 영향에 대한 극복력의 매개효과" 대한근관절건강학회 23 (23): 19-27, 2016

9 임지혜, "뇌졸중 환자의 사망 추적연구" 대한의사협회 54 (54): 1199-1208, 2011

10 조숙희, "뇌졸중 환자의 불확실성, 생리적 위험지표, 자기효능감이 자기관리에 미치는 영향" 대한근관절건강학회 23 (23): 114-124, 2016

11 김민경, "뇌졸중 환자의 건강행위에 대한 영향요인 및 매개요인" 성인간호학회 25 (25): 610-621, 2013

12 박민경, "뇌졸중 환자를 위한 G-AP 기반 목표설정 자기관리프로그램의 효과" 한국간호과학회 44 (44): 581-591, 2014

13 문지영, "뇌졸중 환자가 지각한 스트레스, 사회적 지지 및 재활 동기와의 관계" 한국재활간호학회 14 (14): 24-31, 2011

14 Lee, Y., "Study of the reliability and the validity of the BDI, SDS, and MMPI-D scales" 10 (10): 98-113, 1991

15 National Evidence-based Healthcare Collaborating Agency, "Stroke rehabilitation treatment status and medical user needs analysis" National Evidence-based Healthcare Collaborating Agency 2012

16 Bushnell, C. D., "Secondary preventive medication persistence and adherence 1 year after stroke" 77 (77): 1182-1905, 2011

17 Moon, H. H., "Relationship among depression, family support, and rehabilitation motive in patient with acute or subacute hemorrhagic stroke" Yonsei University 2010

18 Robinson, R. G., "Poststroke depression : A review" 55 : 341-349, 2010

19 Whyte, E., "Post-stroke depression : Epidemiology, pathophysiology and biological treatment" 52 (52): 253-264, 2002

20 Carter, A. C., "Post stroke depression" 56 : 634-, 2004

21 Ruijun Ji, "Persistence of secondary prevention medications after acute ischemic stroke or transient ischemic attack in Chinese population: data from China National Stroke Registry" Informa UK Limited 35 (35): 29-36, 2013

22 Intercollegiate Stroke Working Party, "National clinical guideline for stroke" Royal College of Physicians 2012

23 Sandeep Kumar, "Medical complications after stroke" Elsevier BV 9 (9): 105-118, 2010

24 Park, A. S., "Influencing factors on rehabilitation treatment adherence in stroke patients" Nambu University 2014

25 Park, Y. S., "Factors affecting stroke patients’rehabilitation-motivation" 28 (28): 21-30, 2002

26 Ali Yavuz Karahan, "EFFECTS OF REHABILITATION SERVICES ON ANXIETY, DEPRESSION, CARE-GIVING BURDEN AND PERCEIVED SOCIAL SUPPORT OF STROKE CAREGIVERS" Charles University in Prague, Karolinum Press 57 (57): 68-72, 2014

27 Hafen, K., "Development of a patient questionnaire for assessment of rehabilitation motivation(PAREMO)" 40 : 3-11, 2001

28 Statistics Korea, "Cause of death statistics"

29 Leyes, D., "Atherothrombosis: A major health burden" 11 (11): 1-4, 2001

30 Kang, H. S., "An experimental study of the effects of reinforcement education for rehabilitation on hemiplegia patients' self-care activities" Yonsei University 1984