주요용어 수술 전 정보제공 불안 통증 슬관절 전치환술: , , ,
서 론 .
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. 10,000
(Kim, Fitzgerald, & Lotke, 2002)
수술 전 정보제공이 슬관절 전치환술 환자의 수술 후 불안 코티졸 , 및 통증에 미치는 효과
한정일1․ 윤혜상2
1, 2
The Effect of Preoperative Information on Post-Operative Anxiety, Cortisol and Pain of Patients Undergoing Total Knee Arthroplasty
Han, Jung Il1 Yoon, Hae Sang2
1RN, MS, Gachon University Gil Medical Center
2RN, PhD, Department of Nursing, Gachon University of Medicine & Science
Purpose: The purpose of this study was to ascertain the effects of preoperative information on postoperative state anxiety, plasma cortisol, and pain for patients under total knee arthroplasty, and to provide generic data with nursing intervention for total knee arthroplasty. Methods: Data were collected from 34 patients who had total knee arthroplasty from January 3, 2003 to January 15, 2004. An experiment group of 17 patients was provided with pre-operative information prepared by the researchers; a control group of another 17 patients was provided with general information. Data were analyzed through Chi-squared test, t-test, paired t-test and ANCOVA using SPSS WIN 11.0. Results: There was no significant differences between the experiment group and the control group in post operative state anxiety(p=.612). However, there was statistically a significant difference between the above two groups in post operative plasma cortisol(p=.012). There was a statistically significant difference between the above two groups in post operative pain(p=.041). Conclusion: According to the results of the study, the authors concluded that the preoperative information for patients under total knee arthroplasty had the effect on the decrease of postoperative plasma cortisol and pain.
Key Words : Anxiety, Plasma cortisol, Pain, Preoperative information, Knee arthroplasty
Corresponding address: Yoon, Haesang, Department of Nursing, Gachon University of Medicine & Science, 534-2 Younsoo-dong, Younsoo-gu, Incheon 406-812, Korea. Tel: 82-32-820-4212, Fax: 82-32-820-4201, E-mail: [email protected]
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(p=0.768),
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(p=0.001).
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Table 1. Homogeneity of demographic and physiologic variables between experimental and control group (N=34)
Variable Exp(n=17)
Mean±SD or N(%)
Con(n=17) Mean±SD or N(%)
Total (N=34)
N(%) χ² or t p
Age 68.7±4.7 66.0±8.3 -1.15 .260
Gender Female
Male
17(100) 0( 0)
14(82.4) 3( 17.6)
29(91.2) 3( 8.8)
3.29 .227
Education None
Elementary Above middle
11(64.7) 5(29.4) 1( 2.9)
7( 41.2) 8( 47.1) 2( 5.9)
18(52.9) 13(38.2) 3( 8.8)
1.92 .384
Religion Yes
No
9(52.9) 8(47.1)
12( 70.6) 5( 29.4)
21(61.8) 13(38.2)
1.12 .481
Economic
status Middle
Low 14(82.4)
3(17.6) 10( 58.8)
7( 41.2) 24(70.6)
10(29.4) 2.27 .259
Alcohol Yes
No
2(11.8) 15(88.2)
6( 35.3) 11( 64.7)
8(23.5) 26(76.5)
2.62 .225
Anesthesia Spinal General
13(76.5) 4(23.5)
17(100.0) 0
30(88.2) 4(11.8)
4.53 .103
Trait anxiety (score) 43.8± 8.6 48.5± 8.6 1.54 .133
State anxiety (score) 41.2±13.0 6.3±11.1 1.25 .219
Cortisol ( / ) 12.8± 4.7 11.2± 4.6 -1.01 .324
Pain by VAS (score) 80.6±14.8 70.0±22.0 -1.64 .111
Exp: experimental group, Con: control group, SD: standard deviation
(p=0.041),
. 논 의 .
Ⅸ
1
Giraudet-Le Quintrec (2003), Manyande (1995) Asilioglu Celik(2004)
. Giraudet-Le Quintrec (2003), Asilioglu Celik(2004)
3
. Manyande (1995)
. Salmon (1986) 1-3
. 1
Salmon (1986) Yang Lee(1997)
1-3 .
Yang(1998) Doering (2000) 1-2
. Yang(1998)
.
(Christman, 1990), Yang(1998)
. Yang(1998)
1-2
. Doering (2000)
.
. 62.1 54.1,
53.7 48.3,
42.5 44.8 (Seong & Hong, 1995;
Yang, 1998)
41.2 46.3 .
Table 2. State anxiety, cortisol and pain (N=34)
Variable Group Pre Op
Mean ± SD
Post Op
Mean ± SD paired t p Pre Op-Post Op
Mean ± SD Student's t p State anxiety
(score)
Exp(n=17) Con(n=17)
41.2 ± 13.0 46.3 ± 11.1
40.2 ± 17.3 42.7 ± 13.5
0.29 1.04
.768 .314
-3.59 ± 3.45 -1.06 ± 14.6
-0.51 .612
Cortisol( / ) Exp(n=17) Con(n=17)
12.8 ± 4.7 11.2 ± 4.6
14.6 ± 5.2 20.3 ± 9.0
-1.09 -4.26
.288 .001
9.09 ± 8.81 1.85 ± 6.82
2.67 .012
Pain by VAS (score)
Exp(n=17) Con(n=17)
80.6 ± 14.8 70.0 ± 22.0
60.0 ± 23.7 73.0 ± 19.0
3.17 -0.55
.006 .592
4.56 .041
Exp: experimental group, Con: control group, SD: standard deviation, Pre Op: pre operative 1 day, Post Op: post operative 1 day
.
Salmon (1986) 1
2-3
. Bergmann
(2001) 429.5
nmol/L 1 743.7 nmol/L
, 401.7 nmol/L,
1 566.0 nmol/L .
24
, Bergmann (2001) Salmon (1986)
. 1
1
Manyande (1995) Doering (2000) .
Doering (2000), Manyande (1995) Salmon (1986)
.
, Bergmann (2001), Lee Suh(1995)
. Bergmann (2001) 1
. Bergmann (2001)
. Lee Suh(1995)
.
Salmon (1986)
. 1
. Giraudet-Le Quintrec (2003)
1 ,
Manyande (1995) 1
. Manyande (1995)
. Doering (2000)
, Kim(1985)
. Kim(1985)
. Kim(1985)
.
.
, , ,
,
. 결론 및 제언
.
Ⅹ
,
.
2003 1 3 2004 1 15
1 34 .
18 18
1 .
17 ,
. 30
Spielberger STAI
VAS .
SPSS (version 10.0)
Chi-squa- red test t-test,
,
. ,
(p=.612).
,
(p=.012).
,
(p=.041).
.
. ,
. ,
PCA
. ,
.
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