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이소우 ( Lee So-Woo ) - Yonsei University
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Abstract
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The main purpose of this study was to test the effect of the structured information, on the sleep amount of the patients. undergoing open heart surgery. This study has specifically addressed to the following two basic research questions: (1) Would the structured information influence in the reduction of sleep disturbance related to anxiety and physical stress before and after the operation? and (2) What would be the effects of the structured information on the level of preoperative state anxiety, the hormonal change, and the degree of behavioral changes in the patients undergoing open heart surgery?
A quasi-experimental research was designed to answer these questions with one experimental group and one control group. Subjects in both groups were matched as closely as possible to avoid the effect of the differences inherent to the group characteristics, baseline data were also collected en both groups for 7 days prior to the experiment and found those subjects in both groups had been compared sleep patterns, trait anxiety, hormonal levels and behavioral level.
A structured information as an experimental input was given to the subjects in. the experimental group only. Data were collected and compared between the experimental group and the control group on the sleep amount of the consecutive pre and post operative days, on preoperative state anxiety level, and on hormonal and behavioral changes.
To test the effectiveness of the structured in-formation, two main hypotheses and three sub-hypotheses were formulated as follows:
Main hypothesis 1: The experimental group with structured information will have more sleep amount than the control group without structured information in the night before the open heart surgery.
Main hypothesis 2: Experimental group with structured information will have more sleep amount than control group without structured
information during the week following the open heart surgery.
Sub-hypothesis 1: The Experimental group with structured information will be lower in the level of state anxiety than control group without structured information in the night before the open heart surgery.
Sub-hypothesis 2: Experimental group with structured information will have lower hormonal level than control group without structured information on the 5th day after the open heart surgery.
Sub-hypothesis 3: Experimental group with structured information will be lower in the level of behavioral changes than control group without structured information during the week after the open heart surgery. The research was conducted in a national university hospital in Seoul, Korea. The 53 Subjects who participated in the study were systematically divided into experimental group and control group which were decided by randogi sampling method. Among 53 subjects, 26 were placed in the experimental
group and 27 in the control group. a
Instruments:
(1) Structured information: Structured information as an independent variable was constructed by the researcher oil the basis of Roy´s adaptation model consisting of physiologic needs, self-concept, role function, and interdependence needs as related to the sleep and operational procedures.
(2) Sleep amount measurement: Sleep amount as main dependent variable was measured by trained nurses through observation on the basis of the established criteria, such as closed or open eyes, regular or irregular respiration, body movement, posture, responses to the light and question, facial expressions and self-report after sleep.
(3) State anxiety measurement: State Anxiety
as a sub-dependent variable was measured by Spielberger´s STAL
(4) Hormonal change measurement: Hormone as a sub-dependent variable was measured by the cortisol level in. plasma.
(5) Behavior change measurement: Behavior as a sub-dependent variable was measured by the Behavior and Mood Rating Scale by Wyatt. The data were collected over a period of four months, from June to October 1981, after the pretest period of two months. For the analysis of the data and test for the hypotheses, the t-test with mean differences and analysis -of covariance were used.
The results of the test ,for instruments show as follows:
(1) STAI measurement for trait and state anxiety as analyzed. by Cronbach´s alpha coefficient analysis for item analysis and reliability showed the reliability level at r=.90 r=.91 respectively.
(2) Behavior and Mood Rating Scale measurement was analyzed by means of Principal Component Analysis technique. Seven retained factors were anger, anxiety, hyperactivity, depression, bizarre behavior, suspicious behavior and emotinal withdrawal. Cumulative percentage of each factor was 71.3%.
The results of the test for hypotheses show as f ollows:
(1) Main hypothesis was not supported. The experimental group has 282 minutes of sleep as compared to the 255 minutes of sleep by the control group. Thus the sleep amount was higher in experimental group than in control group, however, the difference was not statistically significant at .05 level.
(2) Main hypothesis 2 was not supported. The mean sleep amount of the experimental group and control group were 297 minutes and 278 minutes respectively. Therefore, the experimental group had more sleep amount as compared to the control group, however, the difference was not statistically significant at .05 level. Thus, the main hypothesis 2 was not supported.
(3) Sub-hypothesis 1 was not supported. The mean state anxiety of the experimental group and control group were 42. 3, 43.9 in scores. Thus, the experimental group had slightly lower state anxiety level than control group, however, the difference was not statistically significant at 05 level.
(4) Sub-hypothesis 2 was not supported. The mean hormonal level of the experimental group and control group were 338 mg and 440 mg respectively. Thus, the experimental group showed decreased hormonal level than the control group, however, the difference was not statistically significant at .05 level.
(5) Sub-hypothesis 3 was supported. The mean behavioral level of the experimental group and control group were 29.60 and 31. 00 respectively in score. Thus, the experimental group showed lower level of behavioral change than the control group. The difference was statistically significant at . 05 level.
In summary, the structured information did not influence the sleep amount, state anxiety or hormonal level of the subjects undergoing open heart surgery at a statistically significant level, however, it showed a definite trends in their relationships, not least to mention its significant effect shown on level of behavioral change.
It can further be speculated that a great degree of individual differences in the variables such as sleep amount, state anxiety and fluctuation in hormonal level may partly be responsible for the statistical insensitivity to the experimentation.
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KeyWords
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원문 및 링크아웃 정보
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등재저널 정보
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