대한간호학회지 (Journal of Korean Academy of Nursing)

한국간호과학회 (Korean Society of Nursing Science)
권호 표지
DOI QR코드

DOI QR Code

자기결정성 이론 기반 만성폐쇄성폐질환 환자를 위한 동기면담 호흡재활 프로그램의 개발 및 평가

Development and Evaluation of Motivational Interviewing Pulmonary Rehabilitation Program Based on Self-Determination Theory for Patients with Chronic Obstructive Pulmonary Disease

  • 투고 : 2022.08.11
  • 심사 : 2023.03.07
  • 발행 : 2023.04.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: This study aimed to develop a motivational interviewing pulmonary rehabilitation program based on self-determination theory to maintain pulmonary rehabilitation-related health behaviors in patients with chronic obstructive pulmonary disease. The program was developed by reviewing the literature on pulmonary rehabilitation guidelines, drawing on the self-determinism theory to establish its contents, recruiting experts to test its validity, and conducting a preliminary survey. Methods: A quasi-experimental design was used to confirm the effect of the program. The participants were outpatients diagnosed with chronic obstructive pulmonary disease at three general hospitals in Busan. There were 33 subjects: 15 in the experimental group and 18 in the control group. The experimental group performed a motivational interviewing pulmonary rehabilitation program which comprised 11 sessions delivered over 10 weeks. The outcomes were measured using basic psychological needs, dyspnea, 6-minute walking distance, and functional status. Intervention effects were analyzed using repeated-measures ANOVA. Results: The analysis revealed significant differences between the experimental and control groups in competence among the subdomains of basic psychological needs, dyspnea during exercise, and functional status. Conclusion: The developed program affects physical conditions and can be applied as an effective clinical nursing intervention to continuously improve the pulmonary rehabilitation behavior of patients with chronic obstructive pulmonary disease.

키워드

참고문헌

  1. Korean Academy of Tuberculosis and Respiratory Diseases (KATRD). Chronic obstructive pulmonary disease [Internet]. Seoul: KATRD; c2018 [cited 2018 Feb 8]. Available from: http://www.lungkorea.org/bbs/index.html?code=guide&page=1
  2. Janssen DJ, Spruit MA, Wouters EF, Schols JM. Daily symptom burden in end-stage chronic organ failure: A systematic review. Palliative Medicine. 2008;22(8):938-948. https://doi.org/10.1177/0269216308096906
  3. Willgoss TG, Yohannes AM. Anxiety disorders in patients with COPD: A systematic review. Respiratory Care. 2013; 58(5):858-866. https://doi.org/10.4187/respcare.01862
  4. Miravitlles M, Ribera A. Understanding the impact of symptoms on the burden of COPD. Respiratory Research. 2017;18(1):67. https://doi.org/10.1186/s12931-017-0548-3
  5. McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2015;2015(2):CD003793. https://doi.org/10.1002/14651858.CD003793.pub3
  6. Griffiths TL, Phillips CJ, Davies S, Burr ML, Campbell IA. Cost effectiveness of an outpatient multidisciplinary pulmonary rehabilitation programme. Thorax. 2001;56(10):779-784. https://doi.org/10.1136/thorax.56.10.779
  7. Fischer MJ, Scharloo M, Abbink JJ, van 't Hul AJ, van Ranst D, Rudolphus A, et al. Drop-out and attendance in pulmonary rehabilitation: The role of clinical and psychosocial variables. Respiratory Medicine. 2009;103(10):1564-1571. https://doi.org/10.1016/j.rmed.2008.11.020
  8. Garrod R, Marshall J, Barley E, Jones PW. Predictors of success and failure in pulmonary rehabilitation. The European Respiratory Journal. 2006;27(4):788-794. https://doi.org/10.1183/09031936.06.00130605
  9. Arnold E, Bruton A, Ellis-Hill C. Adherence to pulmonary rehabilitation: A qualitative study. Respiratory Medicine. 2006;100(10):1716-1723. https://doi.org/10.1016/j.rmed.2006.02.007
  10. Wang HC, Tsai JC, Chao YF, Chung MH, Yu YH, Chiu KL, et al. An exploration of beliefs regarding exercise among Taiwanese patients with chronic obstructive pulmonary disease. Heart & Lung: The Journal of Critical Care. 2013;42(2):133-138. https://doi.org/10.1016/j.hrtlng.2012.12.004
  11. Meis JJ, Bosma CB, Spruit MA, Franssen FM, Janssen DJ, Teixeira PJ, et al. A qualitative assessment of COPD patients' experiences of pulmonary rehabilitation and guidance by healthcare professionals. Respiratory Medicine. 2014;108(3):500-510. https://doi.org/10.1016/j.rmed.2013.11.001
  12. Deci EL, Ryan RM. The "what" and "why" of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry. 2000;11(4):227-268. https://doi.org/10.1207/S15327965PLI1104_01
  13. Ryan RM, Deci EL. A self-determination theory approach to psychotherapy: The motivational basis for effective change. Canadian Psychology/Psychologie Canadienne. 2008;49(3):186-193. https://doi.org/10.1037/a0012753
  14. Deci EL, Flaste R. Why we do what we do: The dynamics of personal autonomy. 1st Engl. Ed. Lee SW, translator. Seoul: Eco's Library; c2011. p. 36-136.
  15. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist. 2000;55(1):68-78. https://doi.org/10.1037//0003-066x.55.1.68
  16. Lee E, Park JW. A structural equation model on health behavior adherence for elders with prehypertension: Based on self-determination theory. Journal of Korean Academy of Fundamentals of Nursing. 2012;19(3):343-352. https://doi.org/10.7739/jkafn.2012.19.3.343
  17. Ha YS, Choi YH. Effectiveness of the self-determination theory based a motivational interviewing YOU-TURN program for smoking cessation among adolescents. Journal of Korean Academy of Nursing. 2015;45(3):347-356. https://doi.org/10.4040/jkan.2015.45.3.347
  18. Fortier MS, Sweet SN, O'Sullivan TL, Williams GC. A self-determination process model of physical activity adoption in the context of a randomized controlled trial. Psychology of Sport and Exercise. 2007;8(5):741-757. https://doi.org/10.1016/j.psychsport.2006.10.006
  19. Silva MN, Markland D, Minderico CS, Vieira PN, Castro MM, Coutinho SR, et al. A randomized controlled trial to evaluate self-determination theory for exercise adherence and weight control: Rationale and intervention description. BMC Public Health. 2008;8:234. https://doi.org/10.1186/1471-2458-8-234
  20. Williams GC, McGregor HA, Sharp D, Levesque C, Kouides RW, Ryan RM, et al. Testing a self-determination theory intervention for motivating tobacco cessation: Supporting autonomy and competence in a clinical trial. Health Psychology. 2006;25(1):91-101. https://doi.org/10.1037/0278-6133.25.1.91
  21. Miller WR, Rollnick S. Motivational interviewing: Helping people change. 2nd Engl. Ed. Shin SM, Kwon JO, Lee SH, translator. Seoul: SigmaPress; c2016. p. 13-83.
  22. Markland D, Ryan RM, Tobin VJ, Rollnick S. Motivational interviewing and self-determination theory. Journal of Social and Clinical Psychology. 2005;24(6):811-831. https://doi.org/10.1521/jscp.2005.24.6.811
  23. Mahmoodabad SSM, Tonekaboni NR, Farmanbar R, Fallahzadeh H, Kamalikhah T. The effect of motivational interviewing-based intervention using self-determination theory on promotion of physical activity among women in reproductive age: A randomized clinical trial. Electronic Physician. 2017;9(5):4461-4472. https://doi.org/10.19082/4461
  24. Kang HY, Gu MO. Development and effects of a motivational interviewing self-management program for elderly patients with diabetes mellitus. Journal of Korean Academy of Nursing. 2015;45(4):533-543. https://doi.org/10.4040/jkan.2015.45.4.533
  25. Bjoernshave B, Korsgaard J, Nielsen CV. Does pulmonary rehabilitation work in clinical practice? A review on selection and dropout in randomized controlled trials on pulmonary rehabilitation. Clinical Epidemiology. 2010;2:73-83. https://doi.org/10.2147/clep.s9483
  26. Borg GA. Psychophysical bases of perceived exertion. Medicine and Science in Sports and Exercise. 1982;14(5):377-381. https://doi.org/10.1249/00005768-198205000-00012
  27. Kim YO. The development and effects of pulmonary rehabilitation empowerment program (PREP) for chronic obstructive pulmonary disease (COPD) [dissertation]. Seoul: Korea University; 2013. p. 1-151.
  28. Vogelmeier CF, Criner GJ, Martinez FJ, Anzueto A, Barnes PJ, Bourbeau J, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary. American Journal of Respiratory and Critical Care Medicine. 2017;195(5):557-582. https://doi.org/10.1164/rccm.201701-0218PP
  29. Kim K, Kang DH, Koo HM, Kook JS, Kim GJ, Kim NJ, et al. Cardiovascular and pulmonary physical therapy. Seoul: Jungdam Media; 2013. p. 407-441.
  30. Ries AL, Bauldoff GS, Carlin BW, Casaburi R, Emery CF, Mahler DA, et al. Pulmonary rehabilitation: Joint ACCP/AACVPR evidence-based clinical practice guidelines. Chest. 2007;131(5 Suppl):4S-42S. https://doi.org/10.1378/chest.06-2418
  31. Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, et al. An official American Thoracic Society/European Respiratory Society statement: Key concepts and advances in pulmonary rehabilitation. American Journal of Respiratory and Critical Care Medicine. 2013;188(8):e13-e64. https://doi.org/10.1164/rccm.201309-1634ST
  32. Cleveland Clinic. Positions to reduce shortness of breath [Internet]. Cleveland: Cleveland Clinic; c2018 [cited 2018 Sep 14]. Available from: https://my.clevelandclinic.org/health/articles/9446-positions-to-reduce-shortness-of-breath
  33. Lung Foundation Australia. Better living with chronic obstructive pulmonary disease: A patient guide. [Internet]. 3rd ed. Milton: Lung Foundation Australia; c2016 [cited 2018 Apr 26]. Available from: https://lungfoundation.com.au/wp-content/uploads/2018/09/Book-Better-Living-with-COPDDec2016.pdf
  34. Effing T, Monninkhof EM, van der Valk PD, van der Palen J, van Herwaarden CL, Partidge MR, et al. Self-management education for patients with chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2007;(4):CD002990. https://doi.org/10.1002/14651858.CD002990.pub2
  35. Lee CK. Effects of an inpatient pulmonary rehabilitation program on dyspnea, exercise capacity, and health related quality of life for patients with chronic lung disease. Journal of Korean Academy of Nursing. 2007;37(3):343-352. https://doi.org/10.4040/jkan.2007.37.3.343
  36. Jung JH, Kim JY. The effects of self-efficacy promoting pulmonary rehabilitation program in out-patients with chronic obstructive pulmonary disease. Tuberculosis and Respiratory Diseases. 2006;61(6):533-546. https://doi.org/10.4046/trd.2006.61.6.533
  37. Casey M, Mulkerns A, O'Donnell C, McDonnell T. Pulmonary rehabilitation in COPD: Current practice and future directions. In: McCarthy C, editor. COPD - An Update in Pathogenesis and Clinical Management. London: IntechOpen; 2018. p. 103-129.
  38. Rausch-Osthoff AK, Greco N, Schwank A, Beyer S, Gisi D, Scheermesser M, et al. Effect of counselling during pulmonary rehabilitation on self-determined motivation towards physical activity in people with chronic obstructive pulmonary disease - protocol of a mixed methods study. BMC Pulmonary Medicine. 2017;17(1):115. https://doi.org/10.1186/s12890-017-0457-8
  39. Korean Academy of Tuberculosis and Respiratory Diseases (KATPD); Korean Academy of Cardio-Pulmonary Rehabilitation; Korean Academy of Cardiorespiratory Physical Therapy (KACRPT); Korean Society of Exercise Physiology (KSEP); Korean Society of Clinical Nutrition (KSCN); Korean NeuroPsychiatric Association, et al. Consensus document on pulmonary rehabilitation in Korea 2015 [Internet]. Seoul: KATPD; c2015 [cited 2018 May 16]. Available from: http://www.lungkorea.org/bbs/index.html?code=guide&page=2
  40. Kang KH. Development and evaluation of tailored motivational enhancement program for problem drinkers [dissertation]. Seoul: Seoul National University; 2016. p. 1-177.
  41. Vorrink SN, Kort HS, Troosters T, Lammers JW. Level of daily physical activity in individuals with COPD compared with healthy controls. Respiratory Research. 2011;12(1):33. https://doi.org/10.1186/1465-9921-12-33
  42. Kim YH, Park YK, Seo JY, Son HM, An MS, Oh JA, et al. Health promotion throughout the life span. Paju: Soomunsa; 2017. p. 268-271.
  43. Seo YM, Choi WH. A predictive model on self care behavior for patients with type 2 diabetes: Based on self-determination theory. Journal of Korean Academy of Nursing. 2011;41(4):491-499. https://doi.org/10.4040/jkan.2011.41.4.491
  44. Ng JY, Ntoumanis N, Thogersen-Ntoumani C, Deci EL, Ryan RM, Duda JL, et al. Self-determination theory applied to health contexts: A meta-analysis. Perspectives on Psychological Science. 2012;7(4):325-340. https://doi.org/10.1177/1745691612447309
  45. Casanova C, Cote C, Marin JM, Pinto-Plata V, de Torres JP, Aguirre-Jaime A, et al. Distance and oxygen desaturation during the 6-min walk test as predictors of long-term mortality in patients with COPD. Chest. 2008;134(4):746-752. https://doi.org/10.1378/chest.08-0520