교대 근무를 하는 여성 간호사의 과민성 장 증후군과 신체 활동도의 연관성
A Relationship between Irritable Bowel Syndrome and Physical Activity in Women Nurses with Shift Work
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연구배경: 과민성 장 증후군은 삶의 질에 심각한 영향을 미치는 만성 재발성 질환으로, 뚜렷한 치료법이 없이 주로 증상 관리를 위한 약물이나 생활 습관 변화 등이 권고된다. 기존의 연구에서 운동은 다른 질환과 유사하게 과민성 장 증후군의 증상 개선에 효과적이라고 보고하였다. 하지만 한국인에서 그연관성을 평가한 연구는 거의 없어 본 연구에서는 교대 근무여성 간호사에서 과민성 장 증후군과 신체 활동도의 연관성을 평가하였다. 방법: 한 3차 병원에서 교대 근무하는 여성 간호사 706명에서 자기 기입식 설문 조사를 통해 과민성 장 증후군(로마기준III 진단기준), 신체 활동도(단축형 국제 신체 활동 설문), 우울(Zung의 Self-rating Depression Scale), 불안(Goldberg 불안 척도),스트레스(Brief Encounter Psychosocial Instrument), 인구학적 특성, 건강 행태를 평가하였다. 과민성 장 증후군과 신체 활동도간의 연관성은 카이제곱 검정과 다중 로짓 회귀분석으로 평가하였다. 결과: 교대 근무 여성 간호사의 과민성 장 증후군의 유병률은37.5%이었고, 과민성 장 증후군 아형 분포는 혼합형이 70.6%로 가장 흔했다. 단변수 분석과 다중 로짓 회귀분석에서 모두과민성 장 증후군과 규칙적 운동이나 신체 활동도 간에는 유의한 연관성이 없었다. 다중 로짓 회귀분석 결과 높은 불안(Goldberg 불안 척도 5점), 참을만한 생리통, 일상생활에 영향을 미치는 생리통의 과민성 장 증후군에 대한 교차비(95% 신뢰 구간)는 각각 2.10 (1.37-3.22), 2.83 (1.39-5.75), 2.56 (1.21-5.40) 이었다. 결론: 교대 근무 여성 간호사에서 과민성 장 증후군은 신체활동도와는 유의한 연관성이 관찰되지 않았으며 높은 불안 ·생리 전 또는 생리 중 통증과 유의한 연관성이 있었다.
Abstract
Background: Irritable bowel syndrome (IBS) is a chronic recurrent gastrointestinal disorder that may deteriorate life quality significantly. There is no specific way of curing IBS but to rely on symptomatic and supportive treatment as well as changes in lifestyle. Previous studies have suggested that physical exercise might be effective for improving IBS symptoms. However, evidence does not exist for Korean population. This study was performed to evaluate the association of physical activity with IBS. Methods: A total of 706 women nurses with shift work in a university affiliated tertiary hospital were surveyed with a self-administered questionnaire asking IBS symptoms (Rome III criteria), depression (Zung’s Self-rating Depression Scale), anxiety (Goldberg's Short Screening Scale for Anxiety, GAS), stress (Brief Encounter Psychosocial Instrument),demographic characteristics, and health behavior. The association between IBS and physical activity was examined using chi-square test and multiple logistic regression analysis. Results: Prevalence of IBS was 37.5% and the most common subtype of IBS was mixed constipation and diarrhea (70.6%). Neither physical activity nor regular exercise was not associated with IBS. IBS was independently associated with higher level of anxiety (GAS score ≥ 5), tolerable dysmenorrhea, and troublesome dysmenorrhea with odds ratios (95%confidence intervals) of 2.10 (1.37-3.22), 2.83 (1.39-5.75), and 2.56 (1.21-5.40), respectively. Conclusion: In Korean women nurses with shift work, IBS was not associated with physical activity. However, the higher level of anxiety and dysmenorrhea were independently associated with increased risk of IBS.
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