슬관절 전치술 노인 환자의 수술 전 자가통증조절기 사용 교육이 수술 후 환자에게 미치는 효과

심주희; 최스미

서지반출

국문초록

우리나라는 다른 선진국에 비해 급속하게 인구의 고령화가 진행되고 있으며, 65세 이상 노인은 전체인구의 11.5%를 차지하는 것으로 나타났다(Health Insurance Review & Assessment Service, 2013). 노인인구가 증가함에 따라 만성 질환 또한 증가하고 있으며, 65세 이상의 24%가 골관절염을 앓고 있다(Korea National Health & Nutrition Examination Survey, 2013). 만성 퇴행성관절염은 모든 관절에 나타날 수 있으나 슬관절 부위에 가장 많이 나타나며 무릎의 퇴행성 질환이 유발되면 관절기능, 근력, 유산소성 능력 등이 저하된다(Lee & Park, 2013). 그러나 최근 슬관절 전치술을 통해 노인 환자들은 통증 경감, 운동범위 향상, 일상 생활 능력 증진의 효과가 나타나 삶의 질이 향상되었다(Park, 2011). Health Insurance Review & Assessment Service (2013)에 따르면 인공 관절 치환술을 받은 환자는 10만 4,112명으로 최근 4년 새 31%가 증가했고, 그 중 슬관절 전치술은 7만 8,940건(76%)으로 가장 많았다. 슬관절 전치술은 수술 자체가 중간 이상의 통증을 유발하며 수술 후 진통제 사용량이 많고, 통증이 극심한 것으로 보고되었다(Hwang et al., 2004). 그러나 환자들은 수술 후 통증관리 및 진통제에 대한 지식부족으로 통증관리가 적절히 이루어지지 못하고 있다(Ko, 2002). 수술 후 부적절한 통증관리는 내분비계, 호흡기계, 위장관계, 면역학적 반응, 응고체계, 인지기능에 영향을 주어 합병증 발생 빈도를 증가시키고 환자의 기동력을 제한할 수 있다(Lee, 2002). 그러나, 효과적인 통증관리는 관절 섬유증 발생과 관절운동 범위의 제한을 줄여주고, 정상 보행으로 빠르게 회복하도록 도와주는 것으로 나타났다(Choi, Kim, Gwak, Kim, & Min, 2010).

영문초록

Purpose: The purpose of this study was to investigate the effects of preoperative patient controlled analgesia (PCA) education on total knee replacement arthroplasty (TKRA) patients’ PCA usage, level of pain, the frequency of pro re nata (prn) administrations, number of ambulations/day and continuous passive motion (CPM) angle after TKRA. Methods: This research used the non-equivalent control group pre-test and post-test design. Forty-five TKRA patients at a hospital in Seoul, Korea were included for in the study. For the experimental group, a 20-minute education session was provided a day before surgery. Data were analyzed using Windows SPSS Statistics 21.0 program. Results: Knowledge was higher in the experimental group than in the control group (p<.001). Incidence of nausea was lower in the experimental group (p=.01). No significant differences were found in post-operative pain scores, the frequency of prn analgesics administrations, dizziness, number of ambulations/day and CPM angle. Conclusion: This study showed that pre-operative PCA education could be an effective nursing intervention for increasing patient knowledge on PCA and nausea reduction after TKRA.

키워드

Arthroplasty Replacement Knee Analgesia Patient-Controlled Patient education Knowledge Aged 슬관절 전치술 통증자가조절기 교육 지식 노인

참고문헌 (29건)

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