폐 절제술 후 걷기 운동을 경험한 폐암 환자의 수술 후 회복 관련 요인 = Factors Associated with Postoperative Recovery among Lung Cancer Patients with Walking Exercise after Lung Resection

다국어 초록 (Multilingual Abstract)

Background: Treatment for lung cancer, which has high incidence and mortality rates, involves lung resection; however, the risk of postoperative pulmonary complications is high. Early walking exercise is a core strategy for preventing complications and promoting postoperative recovery, which is essential for returning to everyday life. This study aims to identify the factors associated with the postoperative recovery of patients who performed walking exercises in an intensive care unit after having a lung resection.
Methods: This cross-sectional study collected data from 90 patients on the day before discharge at a tertiary hospital in Seoul between April and June 2019. Patients’ postoperative recovery was measured using the Postoperative Recovery Profile.
Results: The mean score for postoperative recovery was 0.70±0.41 out of 3, 0 being none of the problems.
Among the five subcategories, the psychological dimension had the highest recovery level at 0.57±0.58, while physical symptoms were rated lowest at 0.89±0.50. As a result of regression analysis, employment status (β=4.353, P=0.005), symptoms of nausea and vomiting during walking (β=0.596, P=0.043), and perceived exertion during walking (β=1.105, P=0.007) were associated with postoperative recovery.
Conclusions: The study indicated unemployed patients, those with more nausea and vomiting, and those who perceived severe exertion during walking showed lower perceived postoperative recovery levels. Not only multidisciplinary, patient-tailored interventions to facilitate return to work after surgery but also interventions to control physical symptoms actively should be developed and implemented to achieve higher postoperative recovery levels. Patients also need to exercise at an appropriate subjective level of perceived exertion.

국문 초록 (Abstract)

연구배경: 발생률과 사망률이 높은 폐암을 치료하기 위해폐 절제술을 실시하지만, 수술 후 폐 합병증의 위험이 높다.
조기 걷기 운동은 합병증을 예방하고, 일상생활 복귀를 위해 필수적인 수술 후 회복을 향상시키기 위해 중요한 요소이다. 본 연구는 중환자실 내 걷기 운동을 실시한 폐 절제술환자가 퇴원 전 인식하는 수술 후 회복에 영향을 미치는 요인에 대해 살펴보고자 한다.
방법: 본 연구는 조사 연구로, 서울의 일 상급종합병원에서 폐 절제술을 시행하고 중환자실 내 걷기 운동을 실시한후 퇴원을 앞둔 폐암 환자 90명을 대상으로 2019년 4월부터6월까지 자료를 수집하였다. 일반적 특성, 임상적 특성, 중환자실 내 걷기 운동 특성 및 수술 후 회복(역문항)을 조사하였다.
결과: 환자가 인식하는 수술 후 회복의 평균 점수는 3점 만점 중 0.70±0.41점이었고, 심리적 영역이 회복 정도가 가장높았으며 신체적 증상이 가장 낮았다. 또한 통증, 식욕의 변화, 소화기계 장애 순으로 회복이 부족하다고 나타났다. 수술후 회복은 직업이 없는 환자인 경우(β=4.353, P=0.005), 걷기운동 중 오심 및 구토 증상이 심할수록(β=0.596, P=0.043), 주관적 운동자각도가 심각할수록(β=1.105, P=0.007) 수술 후회복 정도가 낮은 것으로 나타났다.
결론: 폐 절제술 환자의 수술 후 회복을 향상시키기 위해신체적 증상을 조절하고 직장 복귀를 촉진시킬 수 있는 다학제적, 환자 맞춤형 중재 개발 및 적용이 필요하다. 또한이들의 수술 후 회복을 위해 적절한 강도로 운동을 실시하는 것이 동반될 필요가 있다.

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