편도절제술 동영상프로그램이 환아와 어머니의 불안 및 환자 역할행태에 미치는 효과 = Effects of Video-Based Adenotonsillectomy Education on Anxiety in Pediatric Patients and Mothers and on the Sick-role Behavior of Pediatric Patients

다국어 초록 (Multilingual Abstract)

Background: This study analyzed the effects of video-based adenotonsillectomy education program on the anxiety in pediatric patients and their mothers and on the sick-role behaviour of the child.
Methods: A non-equivalent control group, non-synchronized design was applied. Convenient sampling was used. Thirty children who had had adenotonsillectomies and their mothers were assigned to the experimental group and 33 to the control group. General characteristics, anxiety levels of the children and mothers, and child’s sick-role behavior were assessed. Collected data were analysed using SPSS 15.0 program. Homogen- eity between the two groups was verified using χ2-test and t-test. The hypotheses of this study were verified using two-way repeated ANOVA.
Results: The experimental group showed a statistically significant decrease in the level of anxiety (t=-3.60, P<0.001) and an increase in the sick-role behavior (t=8.64, P<0.001) compared with the control group. There was no statistically significant difference in the level of anxiety between the mothers of the two groups.
Conclusions: The results of our study show that video-based adenotonsillectomy education is effective in reducing anxiety in pediatric patients and increasing their sick-role behavior. A wider application may be suggested after further research in various fields of nursing care.

국문 초록 (Abstract)

연구배경: 본 연구는 편도절제수술을 받기 위해 입원한 환아와 어머니를 대상으로 수술과 관련하여 경험하게 될 과정과 간호에 대한 내용을 동영상프로그램으로 개발, 적용하고 그 효과를 확인하고자 시도되었다.
방법: 본 연구는 비동등성 대조군 전후 시차 설계로 연구 대상자는 편도절제수술을 받기 위해 입원한 만 3~7세까지의 학령 전 수술 환아와 어머니로, 본 연구의 참여에 동의한 실험군 30명과 대조군 33명으로부터 환아와 어머니의 불안 및 환아 역할행태에 관한 자료를 얻었다. 환아의 불안은 Beyer와 Beyers의 얼굴그림 척도로, 어머니의 불안은 Spielberger의 State-Trait Anxiety Inventory from Y (STAI-Y)를 Han, Lee와 Jeon이 수정, 개발한 상태-특성 불안검사 Y형을 이용하여 측정하였다. 환아 역할 행태는 Kim이 개발한 8문항의 5점 리커트척도로 측정하였다. 환아 수집된 자료는 SPSS Windows 15.0을 이용하여 대상자의 일반적 특성은 빈도와 백분율로, 두 집단의 동질성 검증은 χ²-test 와 t-test로, 가설검정은 ANOVA로 분석하였다.
결과: 수술 전 동영상프로그램 제공을 받은 환아는 실험 전(M=1.72)보다 실험 후(M=5.32)에 불안이 증가하였으나(t=-3.60, P<0.001), 동영상프로그램 제공을 받지 않은 환아가 실험 전(M=1.71)보다 실험 후(M=9.12)에 불안이 더 큰 폭으로 증가(t=-7.40, P<0.001)하여 실험군에 비해 불안 증가폭이 유의하게 낮았으며(F=34.73, P<0.001), 역할행태 이행정도가 높은 것으로 나타났다(t=8.64, P<0.001). 그러나 어머니의 불안정도는 실험군(M=44.67)과 대조군(M=50.97) 간에 통계적으로 유의한 차이는 없었으나 두 그룹에서 모두 낮아지는 경향을 보였다.
결론: 이와 같은 결과를 통하여 편도절제술 동영상프로그램이 제공된 환아의 수술불안, 역할행태 이행에 효과가 있는 것으로 확인되었으며, 환아와 어머니의 불안을 완화시킬 수 있는 간호중재로 적용될 수 있을 것으로 본다.

참고문헌 (Reference)

1 홍희정, "수술대기실 환자현황판을 이용한 수술진행 정보제공이 환아 어머니의 불안에 미치는 효과" 성인간호학회 16 (16): 388-397, 2004

2 한정일, "수술 전 정보제공이 슬관절 전치환술 환자의 수술 후 불안, 코티졸 및 통증에 미치는 효과" 성인간호학회 19 (19): 208-218, 2007

3 구현영, "사진을 이용한 정보 제공이 아동과 부모의 수술 전 불안에 미치는 효과" 아동간호학회 13 (13): 273-281, 2007

4 Wong DL, "Whaley & Wong’s nursing care of infants and children" Mosby 1999

5 Zahr LK, "Therapeutic play for hospitalized preschoolers in Lebanon" 23 (23): 449-454, 1998

6 Braden R, "The use of the essential oil lavandin to reduce preoperative anxiety in surgical patients" 24 (24): 348-355, 2009

7 Shim CJ, "The effects of preoperative nursing instruction on the physical and emotional recovery of pediatric surgical patients-an experimental study" 4 (4): 44-56, 1974

8 Kim Y H, "The effects of play education on preoperative anxiety and patient role behavior of children following tonsillectomy [dissertation]" Samyook University 2000

9 Ji HS, "The effect of visual information program on the easing of anxiety of pediatric patients and their parents [dissertation]" Kongju National University 2004

10 Park SN, "The effect of information by using cartoon on preoperative anxiety of children following tonsillectomy" 28 (28): 490-497, 1998

11 Lee DS, "The effect of hospital playing education with anxiety before operating and after operating patient role behavior of children following tonsillectomy" 7 (7): 160-167, 2004

12 Kim JM, "The effect of hand massage on the anxiety of the hysterectomy patients in immediately prior to surgery" 30 (30): 476-487, 2000

13 Murphy-Taylor C, "The benefits of preparing children and parents for day surgery" 8 (8): 801-804, 1999

14 Cohen J, "Statistical power analysis for behavioral sciences" Academic Press 1988

15 Justus R, "Preparing children and families for surgery: Mount Sinai’s multidisciplinary perspective" 32 (32): 35-43, 2006

16 Graumuller S, "Postoperative pain after tonsillectomy- comparison of children and adults" 254 : 469-472, 2003

17 Hahn DW, "Korean adaptation of Spielberger’s STAI (K-STAI)" 1 (1): 1-14, 1996

18 Beyer JE, "Knowledge of pediatric pain: the state of the art" 13 (13): 150-159, 1986

19 Kasl SV, "Health behavior, illness behavior and sick role behavior" 12 : 26-33, 1966

20 Kang MS, "Deducing coronary artery disease anxiety through musical therapy and providing information" 30 (30): 380-390, 2000

21 Kanerva M, "Day-case tonsillectomy in children: parental attitudes and consultation rates" 67 (67): 777-784, 2003

22 Hamers JPH, "Children’s pain at home following (adeno) tonsillectomy" 6 (6): 213-219, 2002

23 Smith L, "Children’s accounts of their preoperative information needs" 14 (14): 230-238, 2005

24 Spielberger CD, "Anxiety on emotional state. In: Spielberger CD,editor. Anxiety: current trends in theory and research" Academic Press 1972

25 Wollin SR, "Anxiety in children having elective surgery" 19 (19): 128-132, 2004

26 Neylan MP, "Anxiety" 62 : 110-111, 1962

27 Shin HS, "A study on the preliminary validation of a postoperative pain measure for parents for children’s pain assessment after surgery" 30 (30): 847-856, 2000

28 Joo MK, "A study of postoperative pain perception by effects of the video program as preoperative nursing intervention" Korean Acad Nurs 25 (25): 210-221, 1995

29 Kim SY, "A study based on the educational program developed before operating for the children following tonsillectomy" Ehwa Dongdaemun Hosp Nurs 154-179, 1999