KCI등재
신장운동을 포함한 자조관리프로그램이 섬유조직염환자의 증상완화에 미치는 효과 = Effects of a Self-Help Program including Stretching Exercise on Reduction of Symptom in Patients with Fibromyalgia
저자
한상숙 (경희대병설간호전문대학)
발행기관
학술지명
권호사항
발행연도
1998
작성언어
Korean
주제어
KDC
513
등재정보
KCI등재
자료형태
학술저널
수록면
39-56(18쪽)
제공처
소장기관
This study was an quasi-experimental study, done to identify factors influencing the reduction of symptoms in patients with fibromyalgia.
The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study included out patient diagnosed with fibromyalgia based on criteria developed by the American College of Rheumatology(1990) and H. University which is a tertiary patient care clinic for Rheumatism.
The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy.
The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise.
Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al.(1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals.
Data were analyzed by SPSS windows and the results are described below.
1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003).
2. The experimental group which participated in the Self-Help Program showed lower scores then the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided (F=9.483, P=.003 ; F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 ; p=.024, F=7.630 ; p=.007, F=15.6512, p=.003 ; F=7.5412, p=.008).
3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043).
4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r=-.500, p=.001)
5. In the exeprimental group , the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r=-.253, p=.027 ; r=-.452, p=.001 ; r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014).
Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms(pain, number of tender points, level physical disability) and psychological symptoms(depressopn, fatigue, sleep disturbance, anxiety) were reduced. Moreover, it was found that higher the self-efficacy, the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise performance influenced the level of physical disability, one of the symptoms of fibromyalgia.
Accordingly, the conslusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotions self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.
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