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Comparison of the Effects of Abdominal Massage and Lower Extremity Exercise using Survival Analysis in Rehabilitation Patients of Brain Injury

생존분석을 이용한 복부마사지와 하지관절운동의 뇌병변 재활환자 배변완화시기 효과 비교

  • Received : 2022.08.22
  • Accepted : 2023.02.20
  • Published : 2023.02.28

Abstract

Constipation is the most common digestive disorder, and it occurs frequently in the early stages and affects the prognosis on rehabilitation stage in the patients with brain injury. The purpose of this study is to evaluate the bowel habits of brain-injured patients undergoing enteral nutrition immediately after admission to rehabilitation and transmission, and to investigate the effects of abdominal massage and lower extremity exercise. The study design is a quasi-experimental study to investigate the effect of a bowel care intervention (abdominal massage and lower extremity exercise) applicable to patients with brain lesions. As a result of the study, the number of bowel movements was significantly higher in the intervention group (p=.030), and the use of suppositories in the control group was statistically significantly higher than that in the intervention group (p=.004). The time of constipation relief was 1.73 days for the experimental group and 4.61 days for the control group, indicating that there was a difference in the time of constipation relief between the two groups (p<.001). Abdominal massage and lower extremity exercise were effective as nursing interventions to relieve constipation and prevent constipation in patients with brain injury from the early stage of rehabilitation.

뇌손상 환자는 초기 재활 단계에서 가장 흔한 소화장애로 변비가 발생하며 예후에 영향을 미친다. 본 연구의 목적은 경관영양하는 뇌손상 환자의 재활 치료 입원, 전동 직후부터 배변 습관을 사정하고 복부 마사지와 하지 관절 운동을 적용하여 효과를 알아보고자 한다. 연구 설계는 뇌손상 환자에게 배변 간호 중재(복부 마사지와 하지 관절 운동)를 적용하여 그 효과를 알아보기 위한 비 동등성 대조군 시차 연구이다. 연구결과, 배변 횟수는 실험군의 배변 횟수가 통계적으로 유의하게 높았으며 (p=.030), 좌약 사용은 대조군이 실험군보다 사용 횟수가 통계적으로 유의하게 높았다(p=.004). 변비 완화 시점은 실험군은 1.73일, 대조군은 4.61일로 두 군간 변비 완화 시점에 차이가 있는 것으로 나타났다(p<.001). 뇌손상 환자에게 재활 초기부터 배변을 완화시키고 변비를 예방을 위한 간호 중재는 복부 마사지와 하지관절 운동이 효과적임을 입증하였다.

Keywords

References

  1. Kim, H. O., & Joung, K. H. (2007). A Study on the needs of health & community services among the disabled at home in rural areas. Journal of Korean Academy of Community Health Nursing, 18(3), 480-491.
  2. Kim, Y. A., & Choi, S. Y. (2013). The Effects of Abdominal Meridian Massage on Constipation to CVA Patients. Journal of the Korean Data Analysis Society, 15(2), 859-872.
  3. Jeong, S. Y., & Jung, H. M. (2005). The effects of abdominal meridian massage on constipation among CVA patients. Journal of Korean Academy of Nursing, 35(1), 135-142.
  4. Otegbayo, J., Talabi, O., Akere, A., Owolabi, M., Owolabi, L., & Oguntoye, O. (2006). Gastrointestinal complications in stroke survivors. Tropical gastroenterology: official journal of the Digestive Diseases Foundation, 27(3), 127-130.
  5. Robain, G., Chennevelle, J., Petit, F., & Piera, J. (2002). Incidence of constipation after recent vascular hemiplegia: a prospective cohort of 152 patients. Revue neurologique, 158(5 Pt 1), 589-592.
  6. Su, Y., Zhang, X., Zeng, J., Pei, Z., Cheung, R. T. F., Zhou, Q., . . . Zhang, Z. (2009). New-onset constipation at acute stage after first stroke: incidence, risk factors, and impact on the stroke outcome. Stroke, 40(4), 1304-1309. https://doi.org/10.1161/strokeaha.108.534776
  7. Phillips, C., Polakoff, D., Maue, S. K., & Mauch, R. (2001). Assessment of constipation management in long-term care patients. Journal of the American Medical Directors Association, 2(4), 149-154. https://doi.org/10.1016/S1525-8610(04)70190-5
  8. Baber, K. F., Anderson, J., Puzanovova, M., & Walker, L. S. (2008). Rome II versus Rome III classification of functional gastrointestinal disorders in pediatric chronic abdominal pain. Journal of pediatric gastroenterology and nutrition, 47(3), 299.
  9. Shin, D., Kim, S., Jang, I., Kim, Y., Han, J., Kim, E., Song, Y. (2017). Occurrence of Constipation during the Rehabilitation Stage in Patient with Cerebral Vascular Disease. Journal of Korean Academy of Fundamentals of Nursing, 24(3), 200-208. https://doi.org/10.7739/jkafn.2017.24.3.200
  10. Nam, G., Bae, S., Lee, H., & Kim, S. A. (2000). study on therapeutic approach of constipation with connective tissue massage. The Journal of Korean Society of Physical Therapy, 12(3), 475-489.
  11. Jae-Hee, M., & Sook, J. S. (2011). Effects of Carbonated Water Intake on Constipation in Elderly Patients Following a Cerebrovascular Accident. Journal of Korean Academy of Nursing, 41(2).
  12. Silva, C. A., & Motta, M. E. (2013). The use of abdominal muscle training, breathing exercises and abdominal massage to treat paediatric chronic functional constipation. Colorectal disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland, 15(5), e250-e255. https://doi.org/10.1111/codi.12160
  13. Richmond, J. P., & Wright, M. E. (2004). Review of the literature on constipation to enable development of a constipation risk assessment scale. Clinical Effectiveness in Nursing, 8(1), 11-25. https://doi.org/10.1016/j.cein.2004.05.001
  14. Yu-Gon Kim (2013). The Effect of Abdominal Massage with Aroma Oils on Constipation in Elderly Stroke Patients. Asian Society of Beauty&Cosmetology (11)5, 883-890
  15. Kim EH, Park JH.(2007). Reliability and validity tests of patient classification system based on nursing intensity. Journal of Korean Nursing Administration.
  16. Song, Y. (2006). The Effects of Abdominal Massage and ROM exercise of lower extremity on the Constipation for Institutionalized Elderly. Unpublished master's thesis, Dankook University, Gyeonggi.
  17. The Korean journal of rehabilitation. (2003). Rehabilitation and health management of stroke patients. Soomoonsa.
  18. Eun, K. S., Eun, S. J., Sup, H. K., Hee, L. T., Eun, L. B., Young, P. S., Chei, C. S. (2015). Local management of Consipation: Enemas, Suppositories. The Korean Journal of Medicine, 88(1), 15-21. https://doi.org/10.3904/kjm.2015.88.1.15