뇌졸중 환자의 사회적 지지, 자아존중감 및 재활동기가 일상생활 수행능력에 미치는 영향
Influences of Social Support, Self-esteem and Motivation for Rehabilitation on the Activities of Daily Living in Stroke Patients
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목적: 본 연구는 뇌졸중 환자의 사회적 지지, 자아존중감, 재활동기 및 일상생활 수행능력 정도를 파악하고 일상생활 수행능력에 영향을 미치는 요인을 규명하기 위해 수행된 서술적 상관관계 연구이다. 방법: 연구대상은 M시에 소재한 2개의 종합병원과 2개의 재활전문병원에 입원치료 중인 뇌졸중 환자 192명을 대상으로 실시하였다. 자료수집은 2013년 7월 11일부터 9월 30일까지 구조화된 설문지를 이용하여 편의표집 하였다. 결과: 사회적 지지와 자아존중감 및 재활동기 정도가 높을수록 일상생활 수행능력 정도가 높아지는 것으로 나타났다. 대상자의 일상생활 수행능력에 미치는 영향 요인은 재활동기(β=.323, p<.001), 사회적 지지(β=.308, p<.001) 순으로 나타났으며, 수정된 R2값은 0.459로 설명력은 45.9%이었다. 결론: 이상의 결과에서 뇌졸중 환자 스스로 변화하려는 내적 동기 및 재활을 통하여 사회로 복귀하려는 강한 의지와 같은 긍정적인 재활동기와 사회적 지지는 일상생활수행에 긍정적 영향을 미치는 밀접한 영향 요인이므로, 뇌졸중 환자의 재활을 돕는 가족들과 의료인들은 긍정적인 사회적 지지를 통해 재활동기를 높여 뇌졸중 환자의 일상생활 수행능력을 향상시키는 체계적 간호중재 개발이 필요하리라 사료된다.
Abstract
Purpose: The purposes of this study were to evaluate the degree of social support, self-esteem, and motivation for rehabilitation in stroke patients and examine correlations between activities of daily living and study variables. Furthermore, this study explored factors that influence on activities of daily living. Methods: The study population was 192 stroke patients admitted in two general hospitals and two rehabilitation hospitals in M city. We collected the data using the structured questionnaires from July 11 to September 30, 2013. Results: The higher degree of social support, self-esteem, motivation for rehabilitation, the higher performance level for activities of daily living. Influencing factors of activities of daily living in the participants were motivation for rehabilitation(β=.32, p<.001) and social support(β=.31, p<.001). The model explained 45.9% of the variance. Conclusion: This study shows that intrinsic motivation of change in stroke patients themselves, a strong will to return to society and social supports are important factors on activities of daily living. Therefore, it is needed to develop a systemic nursing intervention improving activities of daily living in stroke patients through positive social support from patients’ family members and health care providers.
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