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뇌졸중 환자의 낙상과 자기 효능감 및 기능적 수행 능력과의 관계

The Relationships among Fall Down, Self-Efficacy and the Functional Performance Ability in Stroke Patients

이병권|안승헌
특수교육재활과학연구소 (The Research Institute for Special Education & Rehabilitation Science)|2011.09|특수교육재활과학연구|제50권 제3호|pp. 269-288

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참고문헌

키워드

뇌졸중Stroke낙상FallFalls related self-efficacy기능적 수행 능력낙상 관련 자기 효능감Functional performance ability
주제분류기타사회과학

초록

본 연구의 목적은 만성 뇌졸중 환자를 대상으로 낙상 여부에 따른 낙상 관련 자기 효능감이 기능적 수행 능력과 어떠한 관련이 있는지 알아보고자 하였다. 뇌졸중으로 인한 편마비 진단을 받은 환자 69명을 대상으로 2009년 9월부터 2010년 6월까지 실시하였다. 피실험자들의 낙상 횟수와 낙상 관련 자기 효능감(Falls Efficacy Scale), 인지(Mini Mental State Examination), 우울증(Geriatric Depression Scale), 기능적 수행 능력 평가인 동적 균형(Berg Balance Scale)과 이동성(Timed Up & Go test), 하지 조절 능력(Sit to Stand), 마비측 상하지 운동 기능(Fugl Meyer-Motor), 체간 조절(Trunk Impairment Scale), 일상생활동작 수행능력(Modified Barthel Index), 보행 능력(Dynamic Gait Index)을 평가하였다. 낙상 경험에 따른 자기 효능감과 기능적 수행 능력과 어떠한 관련이 있는지 알아보기 위해 Mann-Whitney U 검정과 검정을 실시하였다. 연구 결과 낙상 관련 자기 효능감은 낙상의 두려움과 관련한 이전 낙상의 경험과 기능적 수행 능력이 중요한 요소이었고, 기능적 수행 능력의 장애는 낙상 유무와 관계없이 낮은 낙상 관련 자기 효능감과 밀접한 관련이 있었다. 따라서 뇌졸중 환자의 낙상을 예방하고 기능적 수행 능력을 증진시키기 위해서는 낙상 관련 자기 효능감을 강화시키기 위한 심리적인 치료적 중재와 더불어 기능적인 훈련이 병행되어야 한다.

Abstract

The study were to determine the relationship between fear of falling and functional performance ability of patients after stroke as well as to determine what characterizes fallers who score high fall-related self efficacy, and nonfallers who score low fall-related self-efficacy. The subjects used in this study were 69 subjects with hemiparesis being able to walk independently. Fallers were identified and patients answered the question in the Falls Efficacy Scale, Swedish version(FES-S). On the basis of their FES-S score, patients were divided into one group for low fall-related self-efficacy and one for high fall-related self-efficacy. The cognitive function and mood, the Mini-Mental State Examination-Korean(MMSE-K), Geriatric Depression Scale(GDS) were used. Physical performance assessments were used to measure balance(Berg Balance Scale, BBS), and mobility(Timed Up & Go test, TUG; Dynamic Gait Index, DGI), strength of lower limb(Sit to Stand test, SIT), Trunk control(Trunk Impairment Scale, TIS), basic activity daily living(Modified Barthel Index, MBI), limb paresis(Fugl-Meyer Upper/Lower Extremity, FM-U/E, L/E). The most important factors that are associated with fear of falling are earlier falls and physical functions. Impaired physical function is significantly associated with low fall-related self-efficacy, both in patients who had fallen and in patients who had not. Impaired physical function was significantly associated with scoring low fall-related self-efficacy, for both fallers and nonfallers. Fear of falling is significantly associated with poor physical function and fallers. FES-S is that it is a feasible, simple to use and reliable instrument that captures most patients who have a risk of falling.

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만성 뇌졸중 환자의 낙상 관련 자기 효능감을 이용한 낙상 위험 예측에 관한 연구김우기, 박창식, 안승헌특수교육재활과학연구소 · 특수교육재활과학연구2013 · 제52권 제1호아급성 뇌졸중 환자의 낙상경험과 기능적 요인 및 심리적 요인과의 관련성송창호, 여세광, 이경진특수교육재활과학연구소 · 특수교육재활과학연구2012 · 제51권 제2호뇌졸중 환자의 한국판 Falls Efficacy Scale의 신뢰도와 타당도신현희, 안승헌, 이규창, 조휘영특수교육재활과학연구소 · 특수교육재활과학연구2012 · 제51권 제3호뇌졸중 환자의 낙상 예측을 위한 평가도구 비교원종임한국전문물리치료학회 · 한국전문물리치료학회지2014 · 제21권 제2호낙상예방 프로그램이 뇌졸중 환자의 보행, 균형 및 낙상효능감에 미치는 효과이미화, 이상주, 정향미, 황지혜병원간호사회 · 임상간호연구2010 · 제16권 제1호낙상빈도에 따른 뇌졸중 환자의 균형과 체간위치감각의 변화이완희, 조기훈대한임상건강증진학회 · Korean Journal of Health Promotion2011 · 제11권 제1호

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