향요법 발반사 마사지가 치매노인의 인지, 불안, 공격행동 및 배회행동에 미치는 효과 The Effects on Aromatherapy and Foot Reflex Massage on the Cognition, Anxiety, Aggressive Behavior and Wandering Behavior of Elderly with Dementia원문보기
본 연구는 치매노인에 대한 간호중재로 향요법 발반사 마사지 프로그램을 적용하여 인지, 불안, 공격행동 및 배회행동에 미치는 효과를 알아보고자 하였다. 연구 설계는 비동등성 대조군 전후 시차 설계의 유사실험설계이다. 연구대상자는 실험군 21명, 대조군 22명으로 실험군에는 향요법 발반사 마사지를 2주간 적용하였고 대조군은 2주간 무처치 하여 전체 실험기간은 총 4주간이었다. 자료의 처리는 SPSSWIN 18.0 프로그램을 이용하였다. 대상자의 일반적 특성과 집단간 동질성 검정은 Chi검정과 t검정, 종속 변수에 대한 검정은 t검정, 대조군과 실험군의 사전, 처치 1주, 처치 2주의 효과 변수의 변화에 대한 분석은 반복측정분산분석(Repeated measure ANOVA), 사후분석은 Bonferroni로 검정하였고 유의수준은 p<.05로 하였다. 향요법 발반사 마사지를 받은 실험군에서 불안, 공격행동 및 배회행동의 감소를 가져와 치매노인 삶의 질 향상에 도움을 줄 수 있는 간호중재로 사료된다.
본 연구는 치매노인에 대한 간호중재로 향요법 발반사 마사지 프로그램을 적용하여 인지, 불안, 공격행동 및 배회행동에 미치는 효과를 알아보고자 하였다. 연구 설계는 비동등성 대조군 전후 시차 설계의 유사실험설계이다. 연구대상자는 실험군 21명, 대조군 22명으로 실험군에는 향요법 발반사 마사지를 2주간 적용하였고 대조군은 2주간 무처치 하여 전체 실험기간은 총 4주간이었다. 자료의 처리는 SPSS WIN 18.0 프로그램을 이용하였다. 대상자의 일반적 특성과 집단간 동질성 검정은 Chi검정과 t검정, 종속 변수에 대한 검정은 t검정, 대조군과 실험군의 사전, 처치 1주, 처치 2주의 효과 변수의 변화에 대한 분석은 반복측정분산분석(Repeated measure ANOVA), 사후분석은 Bonferroni로 검정하였고 유의수준은 p<.05로 하였다. 향요법 발반사 마사지를 받은 실험군에서 불안, 공격행동 및 배회행동의 감소를 가져와 치매노인 삶의 질 향상에 도움을 줄 수 있는 간호중재로 사료된다.
This study aims to evaluate the effects of aromatherapy and a foot reflex massage program on the cognition, anxiety, aggressive behavior, and wandering behavior of elderly with dementia. The research design was a non-equivalent control group, quasi-experimental study where 43 subjects were divided i...
This study aims to evaluate the effects of aromatherapy and a foot reflex massage program on the cognition, anxiety, aggressive behavior, and wandering behavior of elderly with dementia. The research design was a non-equivalent control group, quasi-experimental study where 43 subjects were divided into two groups. Aromatherapy and foot reflex massage was administered to the experimental group (N=21), and no treatment was administered to the control group (N=22). The data was analyzed using the ${\chi}^2$-test, t-test, while the repeated measures of ANOVA were utilized with the SPSS/Win 18.0 program. The experimental group did not show significant differences in cognitive function; however, it showed significant differences in anxiety, aggressive behavior, and wandering behavior in relation to the control group. Thus this research suggests aromatherapy and a foot reflex massage program as nursing intervention to improve the quality of life of elderly with dementia.
This study aims to evaluate the effects of aromatherapy and a foot reflex massage program on the cognition, anxiety, aggressive behavior, and wandering behavior of elderly with dementia. The research design was a non-equivalent control group, quasi-experimental study where 43 subjects were divided into two groups. Aromatherapy and foot reflex massage was administered to the experimental group (N=21), and no treatment was administered to the control group (N=22). The data was analyzed using the ${\chi}^2$-test, t-test, while the repeated measures of ANOVA were utilized with the SPSS/Win 18.0 program. The experimental group did not show significant differences in cognitive function; however, it showed significant differences in anxiety, aggressive behavior, and wandering behavior in relation to the control group. Thus this research suggests aromatherapy and a foot reflex massage program as nursing intervention to improve the quality of life of elderly with dementia.
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문제 정의
The control group was measured in the same way as the experimental group during the no-treatment period. The researcher gave assistance to observers suffering from the diversity of opinions.
This study aims to administer the aromatherapy and foot reflex massage program to the elderly with dementia in nursing homes to determine its effects on cognitive functions, anxiety, and aggressive and wandering behaviors and provide a nursing intervention method to improve the quality of their living. There was no significant difference in the score for cognitive functions between the experimental group to which aromatherapy and foot reflex massage was administered and the control group given no treatment.
This study aims to apply aromatherapy and a foot reflex massage program as a form of nursing intervention for dementia patients residing in nursing homes to test its effects on their cognitive functions, anxiety, and aggressive and wandering behaviors with the objective of contributing to the development of nursing intervention that can improve the quality of their living.
가설 설정
H1: The score for cognitive functions would differ between the experimental group and the control group.
H2: The tendency of the change in the score for anxiety would differ between the experimental group and the control group.
H3: The tendency of the change in the score for wandering behavior would differ between the experimental group and the control group.
H4: The tendency of the change in the score for aggressive behavior would differ between the experimental group and the control group.
제안 방법
The subjects were selected from January 2 to 6, 2012. A pretest was conducted from January 9 to 13, 2012, and the research was conducted for four weeks from January 16 to February 10, 2012.
They were informed that they could cease to participate in the research at any time during their participation and a written consent was only necessary from the subjects or their family. After completing data collection, foot reflex massage was administered to the control group, and there was time to offer a gift to all the subjects as a token of gratitude for their participation in the research.
The treatment was given at 2 to 5 o'clock in the afternoon over two weeks (five sessions per week). After each session of experimental treatment, anxiety and aggressive and wandering behaviors were observed and recorded by four caregivers of the subjects in the nursing home and two ward nurses. Cognitive functions were measured by their doctor in a single session on the final day of treatment.
Slow massage was administered to induce deep relaxation in consideration of the elderly’s physical conditions in a total of 10 sessions, 20 minutes per session, one session a day, five sessions a week, over a span of two weeks. Both the researcher and trained mental health nurses used 10 ml perfumed oil (per session) made of 100 ml jojoba oil with 16 drops of lavender, 16 drops of geranium, and 8 drops of clary sage diluted to a 2% level to administer the aromatherapy and foot reflex massage program to both feet approximately 10 cm above the knees for 20 minutes at 10 minutes for each foot.
For pretest, anxiety and aggressive and wandering behaviors were measured in five sessions, one session a day, for a week (Mon. to Fri.), while cognitive functions were measured on the final day of pretest in the experimental and control groups.
In consideration of the ethical aspect of this study, explanation of the research objective and methods was given to the subjects and their families during their visit or by phone. It was also confirmed that all materials should be used for the sole purpose of the research and confidentiality should be maintained.
Pretest was conducted in both experimental and control groups before the experimental treatment. Since a problem of experimental spread, such as possibility that the experimental effects of perfumed oil for experimental treatment could contaminate the control group, was expected, the control group was first given no treatment and then the experimental group was given the experimental treatment in a total of ten sessions, one session a day, five sessions a week, over two weeks.
Slow massage was administered to induce deep relaxation in consideration of the elderly’s physical conditions in a total of 10 sessions, 20 minutes per session, one session a day, five sessions a week, over a span of two weeks.
The experimental treatment was given in five sessions, one session a day, for two weeks in the experimental group. The treatment was given at 2 to 5 o'clock in the afternoon over two weeks (five sessions per week).
001). The main effect analysis was carried out by Bonferroni to examine the changes in the score for aggressive behavior among time periods for measurement. The experimental group showed a highly significant decrease in the score for aggressive behavior both one week and two weeks after treatment 18.
001). The main effect analysis was carried out by Bonferroni to examine the changes in the score for anxiety among time periods. The experimental group showed a highly significant decrease in the score for anxiety both one week and two weeks after treatment 16.
010). The main effect analysis was carried out by Bonferroni to examine the changes in the score for wandering behavior among time periods for measurement. The experimental group showed a highly significant decrease in the score for wandering behavior both one week and two weeks after treatment 41.
The research design was a quasi-experimental research with a non-equivalent control group, non-synchronized design, and each experimental treatment lasted for two weeks.
This is a quasi-experimental research with a non-equivalent control group and non-synchronized design to determine the effects of aromatherapy and foot reflex massage on the cognitive functions, anxiety, and aggressive and wandering behaviors of elderly with dementia to whom the treatment was administered for two weeks. The experimental group which received aromatherapy and foot reflex massage treatments showed a significant decrease in anxiety and aggressive and wandering behaviors compared with the control group; thus, these treatments’ effectiveness was confirmed.
This study aims to apply aromatherapy and a foot reflex massage program to elderly with dementia for two weeks and identify their effects on the elderly’s cognitive functions, anxiety, and aggressive and wandering behaviors.
Through revision and complementation of the Ryden Aggression Scale[14] for the purpose of this study, a total of 28 items were constructed: 18 about physically aggressive behavior (PAB), 6 about verbally aggressive behavior (VAB), and 4 about sexually aggressive behavior (SAB). Observation was made for the presence of each type of aggressive behavior per day: 1 was given for the presence of aggressive behavior, and for the absence of aggressive behavior.
There were also a total of eight research assistants involved in this study: two mental health nurses who had a professional aromatherapist's certificate, four caregivers, and two hospital nurses. To improve the consistency and validity of the data collected after education concerning the needs and objective of the research and specific data collection time and methods given, five elders with dementia were selected and each pair of nurses and caregivers were asked to observe one elder in terms of anxiety and aggressive and wandering behaviors, to record the observation according to the guidelines for judgement, and to compare the results and make discussions in pursuit of the coincidence of opinions. Cronbach's α was .
대상 데이터
0[10]. One subject in the experimental group was dropped out due to refusal to get a massage in the course of research; consequently, there were a total of 43 participants 21 in the experimental group (10 in S nursing home, 11 in C nursing home) and 22 in the control group (11 in S and C nursing homes, respectively).
The participants in this study were elders aged 65 years or older, who were diagnosed with dementia and who agreed to participate in the research or for whom their family or the head of an institution gave consent for their participation. The study was conducted in hospitals and two nursing homes for the elderly (S and C nursing homes) with similar socio-economic conditions in K City.
The participants in this study were elders aged 65 years or older, who were diagnosed with dementia and who agreed to participate in the research or for whom their family or the head of an institution gave consent for their participation. The study was conducted in hospitals and two nursing homes for the elderly (S and C nursing homes) with similar socio-economic conditions in K City.
There were also a total of eight research assistants involved in this study: two mental health nurses who had a professional aromatherapist's certificate, four caregivers, and two hospital nurses.
데이터처리
3.3.2 To test Hypothesis 2, "the tendency of the change in the score for anxiety would differ between the experimental group and the control group," the scores for anxiety in both groups were analyzed by repeated measures ANOVA before treatment.
3.3.3 To test Hypothesis 3, "the tendency of the change in the score for aggressive behavior would differ between the experimental group and the control group," the scores for aggressive behavior in both groups were analyzed by repeated measures ANOVA before treatment.
3.3.4 To test Hypothesis 4, "the tendency of the change in the score for wandering behavior would differ between the experimental group and the control group," the scores for wandering behavior in both groups were analyzed by repeated measures ANOVA before treatment.
For the sample size, 22 participants were selected per group through random sampling since 18 were required per group when estimated with the effect size of 0.40, the significance level of 0.05, and power of 0.80 for three sessions of repeated measures ANOVA in both groups by using Gpower 3.0[10]. One subject in the experimental group was dropped out due to refusal to get a massage in the course of research; consequently, there were a total of 43 participants 21 in the experimental group (10 in S nursing home, 11 in C nursing home) and 22 in the control group (11 in S and C nursing homes, respectively).
The subjects' general characteristics and inter-group homogeneity were tested by Chi-test and t-test, while the dependent variables were tested by t-test. In the control and experimental groups, the analysis of the changes of the effect variables in the pretest and one week and two weeks after treatment were tested by t-test and repeated measures ANOVA. Meanwhile, follow-up analysis was tested by Bonferroni at the p<.
The subjects' general characteristics and inter-group homogeneity were tested by Chi-test and t-test, while the dependent variables were tested by t-test.
성능/효과
After t-test was carried out to determine homogeneity in cognitive functions, anxiety, and aggressive and wandering behaviors between experimental and control groups before administering aromatherapy and foot reflex massage, all of them were found to be homogeneous before intervention (Table 2).
As for the effects of aromatherapy and foot reflex massage on anxiety, the experimental group showed a significant decrease in the score for anxiety both one week and two weeks after treatment compared to prior treatment, with no difference in results between one week and two weeks after treatment. While direct comparison can hardly be made with this result because there was no prior research in aromatherapy and foot reflex massage to examine the cognitive functions of the elderly with dementia, it was reported that aromatherapy and hand massage administered to the elderly with dementia led to psychological relaxation and comfort[18] and reduced their anxiety or sense of irritation[19], thus supporting this result, though it may have different subjects and application methods.
Here, perfumed oil effectively controls actions in the hypothalamus to give balance and harmony to mental functions, stabilizes the adrenal cortex to give calm and relaxation[5], and stimulates the foot reflex zone in the middle of metatarsal bones, which is the center of the sole and corresponds to emotions in foot reflex massage[6], controlling the excitement and estriction of the sympathetic nervous system to create synergy effects by reducing physiological awakening and giving nervous relaxation along with psychological and physical relaxation caused by massage contact. Regarding the effects on aggressive and wandering behaviors, the experimental group showed a significant decrease in the score for aggressive and wandering behaviors both one week and two weeks after treatment compared to prior treatment, with no difference between one week and two weeks after treatment. While direct comparison can hardly be made with this result because there was no prior research on the effects of aromatherapy and foot reflex massage on the aggressive and wandering behaviors of the elderly with dementia, it was reported that hand massage using perfumed oil administered to dementia patients delayed, reduced, or prevented restless behavior[18], that lavender aromatherapy administered to long-term inpatients with dementia controlled their impulsive behavior during the administration[21], that inhalation and hand massage administered to the elderly with dementia reduced nighttime wandering behavior[22], and inhalation administered to the elderly with dementia relieved irritative and wandering behavior[23].
The main effect analysis was carried out by Bonferroni to examine the changes in the score for aggressive behavior among time periods for measurement. The experimental group showed a highly significant decrease in the score for aggressive behavior both one week and two weeks after treatment 18.57 before treatment, 13.53 one week after treatment, and 14.12 two weeks after treatment. Therefore, Hypothesis 3 was supported (Table 3).
The main effect analysis was carried out by Bonferroni to examine the changes in the score for anxiety among time periods. The experimental group showed a highly significant decrease in the score for anxiety both one week and two weeks after treatment 16.68 before treatment, 11.13 one week after treatment, and 11.22 two weeks after treatment. Therefore, Hypothesis 2 was supported (Table 3).
The main effect analysis was carried out by Bonferroni to examine the changes in the score for wandering behavior among time periods for measurement. The experimental group showed a highly significant decrease in the score for wandering behavior both one week and two weeks after treatment 41.84 before treatment, 33.20 one week after treatment, and 34.08 two weeks after treatment. Therefore, Hypothesis 4 was supported (Table 3).
The experimental group which received aromatherapy and foot reflex massage treatments showed a significant decrease in anxiety and aggressive and wandering behaviors compared with the control group; thus, these treatments’ effectiveness was confirmed.
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