뇌졸중 환자의 구강인두 기능회복을 위한 감각 자극의 효과 = (The) effects of a sensory stimulation for ingestion in dysphgic patients with stroke

다국어 초록 (Multilingual Abstract)

Dysphagia is a common and serious problem after stroke involving both cerebral hemispheres or brainstem.
When dysphagia is continued for a long time, it can lead to malnutrition, inadequate hydration, aspiration pneumonia and air way obstruction.
To prevent and solve these problems, nurses need to be able to facilitate deglutition for patients who have dysphagia to improve oropharyngeal function as soon as possible after the damage to the brain.
A sensory stimulation method ie quick stretch, vibration or themal stimulation technique will stimulate the neuron through extroceptor and proprioceptor, provoking skin and muscle contraction as well as antagonic muscle suppression.
As a result in influences on oropharyngeal function reregulation and the prognosis of the stroke patients ultimately.
Thus, it is important to develop effective nursing intervention methods.
The purpose of this study is to identify the effect of a nursing intervention using sensory stimulation technique in dysphagic patients.
The design utilized for this study was quasi-experimental with a nonequivalent control group pretest-posttest design.
This study was done between December 20, 2000 and March 10, 2001 and the subjects of the study were 30 patients who were hospitalized in the oriental medicine hospital of K. University.To prevent the diffusion of the experiment, the control and experimented group were selected, 15 each, from seperated wards.
A specific stimulation plan was devised based on a dysfunctional area of the subjects.
For each modality, subjects were systemically sitmulated for 30 minutes, prior to each meal and 3 times per day.Treatment was implemented for a week.
The data were analyzed by SPSS PC program using x2-test, Wilcoxon Signed Rank test and Mann-Whitney U test.
The results of this study are as follows :
1. The experimental group which were implemented with sensory stimulation showed increased tongue control score than the control group which indicated statistically significant difference.
2. While the experimental group which were implemented with sensory stimulation showed increased chewing ability and lip movement score, it was not statistically significant.
The reason not to support the hypothesis seems that the treatment for language disturbance accompanished with the stroke patients, mainly stimulate the articulation and tongue movement, so that it influenced the result of this study, as being similar to my sensory stimulation program.
Therefore, one can infer from this study that sensory stumulation using ice, quick stretch, etc., was effective in improving oropharyngeal function in patient with dysphagia.

목차 (Table of Contents)

• Ⅰ. 서론 = 1
• 1. 연구의 필요성 = 1
• 2. 연구의 목적 = 3
• 3. 가설 = 3
• 4. 용어의 정의 = 4
• Ⅱ. 문헌고찰 = 5
• 1. 뇌졸중환자의 구강인두기능 = 5
• 2. 감각 자극의 효과 = 12
• Ⅲ. 연구방법 = 18
• 1. 연구 설계 = 18
• 2. 연구대상 및 표집방법 = 18
• 3. 실험처치 = 19
• 4. 측정도구 = 21
• 5. 연구진행 및 자료수집 = 21
• 6. 자료분석 방법 = 22
• 7. 연구의 제한점 = 22
• Ⅳ. 연구결과 = 23
• 1. 제 변수에 대한 실험군과 대조군의 유사성 비교 = 23
• 2. 감각자극의 효과 = 24
• Ⅴ. 논의 = 28
• Ⅵ. 결론 및 제언 = 30
• 1. 결론 = 30
• 2. 제언 = 31
• 참고문헌 = 32
• 부록 = 37
• 영문초록 = 41