Journal of agricultural medicine and community health (농촌의학ㆍ지역보건)

Korean Society for Rural Medicine and Community Health (한국농촌의학지역보건학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of a Health Diary Program on Fall-Related Outcomes in Low-Income Elderly Women with Osteoarthritis

건강다이어리 프로그램이 저소득 관절염 여성노인의 낙상관련 심리적 변수에 미치는 효과

  • 이명숙 (목포 가톨릭대학교 간호학과)
  • Received : 2011.07.07
  • Accepted : 2011.09.19
  • Published : 2011.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study was done to identify the effects of a health diary program on fall related outcomes the low-income elderly women. Methods: The study was carried out with a nonequivalent control group with pretest-posttest design. The study was composed of two groups, each made up of 24 subjects: experimental group and control group. The subjects were low-income women aged over 65 years with osteoarthritis and both the experimental and control groups were made up of subjects with the same age profiles. The independent variable was the health diary program, and the dependent variables were fall related outcomes (fear of falling, fall-efficacy, knowledge of fall) difficulty of performing activity, and mood state. The health diary program was performed for 50 minutes each session and twice a week for 8 weeks. Data were collected before the health diary program 10 weeks after the beginning of the program. Results: The experimental group showed significant differences in knowledge of fall, fear of falling, and mood state compared to the control group. However there was no significant differences in difficulty of performing activity and fall efficacy. Conclusion: The results of this study may be used as part of an education to prevent falls for low-income elderly women with osteoarthritis.

본 연구는 관절염 여성노인을 대상으로 건강다이어리 프로그램을 개발하고 그 효과를 분석하여 낙상위험이 있는 관절염 여성노인을 위한 간호중재 서비스의 기초자료로 활용하고자 수행되었다. 2010년 9월 27일부터 11월 26일까지 대상자의 집을 방문하여 낙상예방을 위한 교육과 자가능력 향상을 위한 교육을 실시하였다. 프로그램 시작전 사전 평가를 하였고 종료 후 실험 후 평가를 실시하였다. 연구대상은 전라남도의 지역사회에 거주하며 의사로부터 관절염 진단을 받은 국민기초생활수급자 혹은 건강보험료 부과 하위 20%에 해당되는 65세 이상의 여성 노인으로서 연구자가 연령대별로 짝지어 실험군에 24명 대조군에 24명을 배정하였다. 중재는 8주 프로그램 이었으며 낙상관련 심리적 변수(낙상두려움, 낙상 효능감, 낙상지식), 일상 활동수행 정도, 기분상태를 측정하였다. 프로그램 1회 소요 시간은 약 50분 정도이며 관절염 질환이해 및 재활, 낙상관련 예방교육 등 2영역 교육내용을 16회로 나누어 제공하였으며, 매회 건강증진을 위한 자가 간호 수행정도점검과 개인별 상담으로 구성하였다. 이해력과 학습력을 높이기 위해 다이어리 전 내용을 그림으로 제작하였으며 매일의 건강증진 활동 실천을 확인하기 위해 자가 간호 수행표를 만들어 해당항목에 스티커를 부치도록 하였다. 프로그램 참여에 따른 낙상관련 심리적 변수, 일상 활동수행정도, 기분상태 변수에 대한 변화를 측정하여 분석한 결과 낙상예방 다이어리 프로그램을 시행한 실험군은 대조군에 비해 낙상 두려움, 낙상 지식, 기분상태는 유의한 차이가 있었으나 낙상효능감, 일상 활동수행 정도는 유의한 차이가 나타나지 않았다. 이상의 결과로 볼 때 본 연구의 낙상예방 프로그램은 저소득층 관절염 여성노인의 낙상예방 지식, 낙상 두려움, 기분상태에도 긍정적인 변화를 나타내어 프로그램 적용의 합리성을 보여주었다. 그러나, 본 연구에서는 낙상위험 정도에 따른 대상자 비교를 하지 않았으므로 낙상예방 프로그램의 구성 타당도를 높이기 위해서는 대상자의 낙상위험요인을 중등도로 분류하고 이를 전기노인과 후기노인 등 연령별로 교육효과를 비교하는 추후연구가 필요하다고 생각된다.

Keywords

References

  1. Ge Z, Hu Y, Heng BC, Yang Z, Ouyang H, Lee EH, Cao T. Osteoarthritis and therapy. Arthritis Rheum 2006;55(3):493-500 https://doi.org/10.1002/art.21994
  2. Kim JS. Influencing Factors for Fear of Falling in Degenerative Arthritis Patients. J Korean Acad Nurs 2007;37(7):1184-1192 (Korean) https://doi.org/10.4040/jkan.2007.37.7.1184
  3. Ruchinskas R. Clinical prediction of falls in the elderly. Am J Phys Med Rehabil 2003;82(4):273 -278
  4. Choi GW, Lee IS. Fall Risk in Low-Income Elderly People in One Urban Area. J Korean Acad Nurs 2010;40(4):589-598 (Korean) https://doi.org/10.4040/jkan.2010.40.4.589
  5. Hyeon IS, Park MH, Paek KM, Kim CN. The effects of a fall prevention program on the low-income elderly at risk of falls. J Korean Acad Community health Nurs 2010;21(2):200-209 (Korean) https://doi.org/10.12799/jkachn.2010.21.2.200
  6. Bergland A, Wyller TB. Risk factors for serious fall related injury in elderly women living at home. Inj Prev 2004;10(5):308-313 https://doi.org/10.1136/ip.2003.004721
  7. Hur JY. Knowledge and attitude toward falls among elderly inpatient. Master.Yonsei University, Seoul, 2007 (Korean)
  8. Tinetti ME, Richman D, Powell L. Fall efficacy as measure of fear of falling. J Gerontol 1990;45(6):239-243 https://doi.org/10.1093/geronj/45.6.P239
  9. Lee MS. Quality of life, perceived health status, pain, and difficulty of activity of daily living of degenerative arthritis patient in island residents. J Agri Med & Community Health 2009;34(3):291-302 (Korean) https://doi.org/10.5393/JAMCH.2009.34.3.291
  10. Rubenstein LZ, Josephson KR. Falls and their prevention in elderly people: What does the evidence show?. Med Clin North Am. 2006;90(5):807-824 https://doi.org/10.1016/j.mcna.2006.05.013
  11. Gill TM, Williams CS, Tinetti ME. Environmental hazards and the risk of nonsyncopal falls in the homes of community-living older person. Med Care 2000;38(12):1174-1183 https://doi.org/10.1097/00005650-200012000-00004
  12. Schoenfelder DP. A fall prevention for elderly individuals exercise in long-term care settings. J Gerontol Nurs 2000;26(3):43-51 https://doi.org/10.3928/0098-9134-20000301-09
  13. Shin KR, Shin SJ, Kim JS, Kim JY. The effects of fall prevention program on knowledge, self-efficacy, and preventive activity related to fall, and depression of low-income elderly women. J Korean Acad Nurs 2005;35(1):104-112 (Korean) https://doi.org/10.4040/jkan.2005.35.1.104
  14. Choi JH. The effects of Tai Chi exercise on physiologic, psychological functions and fall in fall prone elderly. Unpublished doctoral dissertation, Catholic University, 2002 (Korean)
  15. Oh HY, Im YM. Functional status and health Care utilization among elders with hip fracture surgery from a fall. Korean J Adult Nurs 2003;15(3):432-440 (Korean)
  16. Liu MR, So HY. Effects of Tai Chi exercise program on physical fitness, fall related perception and health status in institutionalized elders. J Korean Acad Nurs 2008;38(4):620-628 (Korean) https://doi.org/10.4040/jkan.2008.38.4.620
  17. Kwon MS. Effects of a fall prevention program on physical fitness and psychological functions in community dwelling elders. J Korean Acad Nurs 2011;41(2):165-174 (Korean) https://doi.org/10.4040/jkan.2011.41.2.165
  18. Vaapio S, Salminen M, Vahlberg T, Sjoosten N, Isoaho R, Aarnio P, Kivelaa SL. Effects of risk-based multifactorial fall prevention on health related quality of life among the community-dwelling aged: a randomized controlled trial. Health Qual Life Outcomes 2007;5:20doi:10.1186/1477-7525-5-20
  19. Ministry of Health and Welfare. Health diary [cited 2010 Aug 09] Available from:URL: http://diary.hp.go.kr /hpDiary/member.dia?method=diary Instruct View
  20. Lee MS. The effect of a health diary program in solitary elderly. J Korean Acad Nurs 2007;37(6):966-975 (Korean) https://doi.org/10.4040/jkan.2007.37.6.966
  21. Johnson F, Wardle J. The association between weight loss and engagement with a web-based food and exercise diary in a commercial weight loss programme: a retrospective analysis. Int J Behav Nutr Phys Act 2011;8;83-85 doi:10.1186/1479-5868-8-83
  22. Calloway M, Bharmal M, Hill-Zabala C, Allen R. Development and validation of a subjective post sleep diary(SPSD) to assess sleep status in subjects with restless legs syndrome. Sleep Med 2011;12(7):704-710 https://doi.org/10.1016/j.sleep.2010.09.020
  23. Gu MO, Jeon MY, Kim HJ, Eun Y. A review of exercise interventions for fall prevention in the elderly. J Korean Acad Nurs 2005;35(6):1101-1112 (Korean) https://doi.org/10.4040/jkan.2005.35.6.1101
  24. Kim CG, Suh MJ. An analysis of fall incidence rate and its related factors of fall in inpatients. J Korean Society of Quality Assurance in Health Care 2002;9(2):210-228 (Korean)
  25. Tideiksaar R. Falling in old age: prevention and management (2nd ed.). New York, NY: Springer Publishing Co, 1997, 266-267
  26. McNair DM, Lorr M, Droppleman LF. Manual for the profile of mood states. San diego: Educational and Industrial Testing Service, 1992.
  27. Shin YH. The effect of walking exercise program on physical function and emotional state in elderly women. Seoul, Unpublished doctoral dissertation, Ewha Womans University, 1996 (Korean)
  28. Kim SN. Development and evaluation of multifactorial fall prevention program for community dwelling low-income elderly people. Unpublished doctoral dissertation, Seoul, Korea University, 2011 (Korean)
  29. Zijlstra GA, van Haastregt JC, van Eijk JT, van Rossum E, Stalenhoef PA, Kempen GI. Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age Ageing 2007;36(3):304-309 https://doi.org/10.1093/ageing/afm021
  30. Kim SH, Chun YJ. The effect of level of physical strength, depression, and daily lives on falling of the elders using senior center. J Sport and Leisure Studies 2011;39(2):755-762 (Korean)
  31. Rivard V, Cappeliez P. Perceived control and coping in woman faced with activity restriction due to osteoarthritis: Relations to anxious and depressive symptom. Can J Aging 2007;26:241-253 https://doi.org/10.3138/cja.26.3.241

Cited by

  1. A meta-analysis of intervention studies on the effects of self-management in knee osteoarthritis vol.16, pp.3, 2015, https://doi.org/10.5762/KAIS.2015.16.3.1946
  2. Effects of a Thera-Band Exercise Program on Pain, Knee Flexion ROM, and Psychological Parameters Following Total Knee Arthroplasty vol.45, pp.6, 2015, https://doi.org/10.4040/jkan.2015.45.6.823
  3. Strategies on fall prevention for older people living in the community: A report from a round-table meeting in IAGG 2013 vol.6, pp.2, 2015, https://doi.org/10.1016/j.jcgg.2015.02.004
  4. Factors Influencing the Fear of Falling in Elderly in Rural Communities vol.36, pp.4, 2011, https://doi.org/10.5393/JAMCH.2011.36.4.251
  5. Fear of Falling and Related Factors in Elderly Living Alone Based on Fall Experience vol.38, pp.4, 2013, https://doi.org/10.5393/JAMCH.2013.38.4.243