대한간호학회지 (Journal of Korean Academy of Nursing)

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

DOI QR Code

슬관절염 비만노인을 위한 IMB 모델 기반 신체활동 증진 프로그램의 효과

Effect of a Physical Activity Promoting Program Based on the IMB Model on Obese-Metabolic Health Outcomes among Obese Older Adults with Knee Osteoarthritis

  • 김정숙 (아주대학교 간호대학.간호과학연구소) ;
  • 김춘자 (아주대학교 간호대학.간호과학연구소)
  • Kim, Jung-Suk (College of Nursing.The Research Institute of Nursing Science, Ajou University) ;
  • Kim, Chun-Ja (College of Nursing.The Research Institute of Nursing Science, Ajou University)
  • 투고 : 2019.08.21
  • 심사 : 2020.01.19
  • 발행 : 2020.04.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: This study examined the effects of a physical activity promoting program based on the Information-Motivation-Behavioral Skills (IMB) model on physical activity and health outcomes among obese older adults with knee osteoarthritis. Methods: This study utilized a randomized controlled trial with a convenience sample of 75 obese older adults with knee osteoarthritis in a university hospital. The older adults in the intervention group participated in a 12-week program involving weekly group sessions and monitoring calls with education booklets and video clips for exercise dances, while those in the control group received an usual care. Outcomes were measured using self-report questionnaires, anthropometrics, and blood analyses. The intervention effects were analyzed using Mann-Whitney U test and ANCOVA. Results: The mean age of participants was 74.9 years with 84.0% women. The intervention group at 12 weeks showed significantly greater improvements in self-efficacy for physical activity (F=81.92, p<.001), physical activity amounts (Z=-2.21, p=.044), knee joint function (F=15.88, p<.001), and health-related quality of life (F=14.89, p<.001) compared to the control group. Among obese-metabolic outcomes, the intervention group at 12 weeks showed a significant decrease in visceral fat mass (F=7.57, p=.008) and improvement in high-density level cholesterol (F=9.51, p=.003) compared to the control group. Conclusion: Study findings support the need for an IMB based physical activity program for promoting physical activity, knee function and health outcomes in obese older adults with knee osteoarthritis. Longitudinal studies are warranted to confirm the persistence of obese-metabolic effects in clinical settings.

키워드

참고문헌

  1. United Nations Population Fund (UNPF). State of world population 2019 [Internet]. New York: UNPF; c2019 [cited 2019 Jun 14]. Available from: https://www.unfpa.org/sites/default/files/pub-pdf/UNFPA_PUB_2019_EN_State_of_World_Population.pdf.
  2. Statistics Korea. Social indicators of Korea in 2018 [Internet]. Daejeon: Statistics Korea; c2019 [cited 2019 Jun 14]. Available from: http://kostat.go.kr/portal/korea/kor_nw/1/6/5/index.board?bmode=read&bSeq=&aSeq=373801&pageNo=1&rowNum=10&navCount=10&currPg=&searchInfo=&sTarget=title&sTxt.
  3. World Health Organization (WHO). World health report 1997 press kit: 50 facts from the report [Internet]. Geneva: WHO; c2015 [cited 2018 Oct 14]. Available from: https://www.who.int/whr/1997/media_centre/50facts/en/.
  4. Jung KH. Diagnosis and treatment of arthritis. Journal of the Korean Neurological Association. 2017;35(4 Suppl):25-30. https://doi.org/10.17340/jkna.2017.4.28
  5. Kulkarni K, Karssiens T, Kumar V, Pandit H. Obesity and osteoarthritis. Maturitas. 2016;89:22-28. https://doi.org/10.1016/j.maturitas.2016.04.006
  6. Specchia ML, Veneziano MA, Cadeddu C, Ferriero AM, Mancuso A, Ianuale C, et al. Economic impact of adult obesity on health systems: A systematic review. European Journal of Public Health. 2015;25(2):255-262. https://doi.org/10.1093/eurpub/cku170
  7. Haroon M, Gallagher P, Heffernan E, FitzGerald O. High prevalence of metabolic syndrome and of insulin resistance in psoriatic arthritis is associated with the severity of underlying disease. The Journal of Rheumatology. 2014;41(7):1357-1365. https://doi.org/10.3899/jrheum.140021
  8. Hamer M, Bell JA, Sabia S, Batty GD, Kivimaki M. Stability of metabolically healthy obesity over 8 years: The English longitudinal study of ageing. European Journal of Endocrinology. 2015;173(5):703-708. https://doi.org/10.1530/EJE-15-0449
  9. Lee HS. Prevalence of osteoarthritis and related risk factors in the elderly: Data from the fifth Korea national health and nutrition examination survey (KNHANES V), 2010-2012. Journal of the Korean Dietetic Association. 2014;20(2):99-109. https://doi.org/10.14373/JKDA.2014.20.2.99
  10. Wellsandt E, Golightly Y. Exercise in the management of knee and hip osteoarthritis. Current Opinion in Rheumatology. 2018;30(2):151-159. https://doi.org/10.1097/BOR.0000000000000478
  11. Korean Knee Society Subcommittee on Osteoarthritis Guidelines. Guidelines for the treatment of osteoarthritis of the knee. Knee Surgery and Related Research. 2010;22(1):69-74.
  12. Pescatello LS, Arena R, Riebe D, Thompson PD. ACSM's guidelines for exercise testing and prescription. 9th ed. Philadelphia (PA): Wolters Kluwer/Lippincott Williams & Wilkins Health; 2014. p. 1-456.
  13. American College of Rheumatology. Clinical practice guidelines-osteoarthritis [Internet]. Atlanta (GA): American College of Rheumatology; c1985 [cited 2019 Oct 14]. Available from:https://www.rheumatology.org/Practice-Quality/Clinical-Support/Clinical-Practice-Guidelines/Osteoarthritis.
  14. Lee KS, Lee I, Lee EN, Bak WS, Choi HK, Cho KS. Arthritis self-management. Seoul: Korean Society of Muscle and Joint Health; 2014. p. 1-45.
  15. Olanrewaju O, Kelly S, Cowan A, Brayne C, Lafortune L. Physical activity in community dwelling older people: A systematic review of reviews of interventions and context. PLoS One. 2016;11(12):e0168614. https://doi.org/10.1371/journal.pone.0168614
  16. Jung JY, Kim JS, Choi HJ, Lee KY, Park TJ. Factors associated with ADL and IADL from the third Korea national health and nutrition examination survey (KNHANES III), 2005. Korean Journal of Family Medicine. 2009;30(8):598-609. https://doi.org/10.4082/kjfm.2009.30.8.598
  17. Morgan K, Tan MP. Behaviour change theories and techniques for promoting physical activity among older people. In: Nyman SR, Barker A, Haines T, Horton K, Musselwhite C, Peeters G, et al., editors. The Palgrave Handbook of Ageing and Physical Activity Promotion. Cham: Springer Nature; 2018. p. 211-229.
  18. Fisher JD, Fisher WA, Amico KR, Harman JJ. An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychology. 2006;25(4):462-473. https://doi.org/10.1037/0278-6133.25.4.462
  19. Sabin LL, DeSilva MB, Hamer DH, Xu K, Zhang J, Li T, et al. Using electronic drug monitor feedback to improve adherence to antiretroviral therapy among HIV-positive patients in China. AIDS and Behavior. 2010;14(3):580-589. https://doi.org/10.1007/s10461-009-9615-1
  20. Osborn CY, Amico KR, Cruz N, O'Connell AA, Perez-Escamilla R, Kalichman SC, et al. A brief culturally tailored intervention for Puerto Ricans with type 2 diabetes. Health Education & Behavior. 2010;37(6):849-862. https://doi.org/10.1177/1090198110366004
  21. Zarani F, Besharat MA, Sadeghian S, Sarami G. The effectiveness of the information-motivation-behavioral skills model in promoting adherence in CABG patients. Journal of Health Psychology. 2010;15(6):828-837. https://doi.org/10.1177/1359105309357092
  22. Kim YI, Park JS. Development and evaluation of a joint health self-management program for the elderly with knee osteoarthritis in communities: Applying the IMB model. Journal of Korean Academy of Community Health Nursing. 2017;28(1):55-68. https://doi.org/10.12799/jkachn.2017.28.1.55
  23. Chang SJ, Choi S, Kim SA, Song M. Intervention strategies based on information-motivation-behavioral skills model for health behavior change: A systematic review. Asian Nursing Research. 2014;8(3):172-181. https://doi.org/10.1016/j.anr.2014.08.002
  24. Kohn MD, Sassoon AA, Fernando ND. Classifications in brief: Kellgren-Lawrence classification of osteoarthritis. Clinical Orthopaedics and Related Research. 2016;474(8):1886-1893. https://doi.org/10.1007/s11999-016-4732-4
  25. Seo MH, Lee WY, Kim SS, Kang JH, Kang JH, Kim KK, et al. 2018 Korean Society for the Study of Obesity guideline for the management of obesity in Korea. Journal of Obesity and Metabolic Syndrome. 2019;28(1):40-45. https://doi.org/10.7570/jomes.2019.28.1.40
  26. Han JH, Park HS, Kim SM, Lee SY, Kim DJ, Choi WH. Visceral adipose tissue as a predictor for metabolic risk factors in the Korean population. Diabetic Medicine. 2008;25(1):106-110. https://doi.org/10.1111/j.1464-5491.2007.02317.x
  27. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale (NJ): Erlbaum Associates; 1988. p. 75-105.
  28. Suh JW. A comparative study on the constructivism and the structuralism as the educational methods. Journal of Korean Library and Information Science Society. 2009;40(4):81-92. https://doi.org/10.16981/KLISS.40.4.200912.81
  29. Ministry of Health and Welfare (MOHW). 2016 Community integrated health promotion program (physical activity) [Internet]. Sejong: MOHW; c2016 [cited 2019 Jun 11]. Available from: http://www.mohw.go.kr/react/gm/sgm0601vw.jsp?PAR_MENU_ID=13&MENU_ID=1304020503&page=1&CONT_SEQ=293363.
  30. Kim YW, Oh SH. Meta-analysis of the effects of regularly exercise on fitness and body composition in elderly people. The Korean Journal of Physical Education. 2017;56(1):753-769. https://doi.org/10.23949/KJPE.2017.01.56.1.56
  31. Dunbar-Jacob J, Burke L, Schlenk EA, Sereika SM. The Perceived Therapeutic Efficacy Scale. Paper presented at: the 17th International Nursing Research Congress Focusing on Evidence-Based Practice; 2006 Jul 19-22; Montreal, Canada.
  32. Kim CJ, Won YY, Kim JS. Self-efficacy for physical activity on the relationship of osteoarthritis index to quality of life in adults at risk for metabolic syndrome: A preliminary finding. In: Korean Society of Nursing Science, editor. Proceedings of the 21st East Asian Forum of Nursing Scholars and 11th International Nursing Conference; 2018 Jan 11-12; Korean Society of Nursing Science, Seoul, Korea. p. 30.
  33. Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-Country reliability and validity. Medicine and Science in Sports & Exercise. 2003;35(8):1381-1395. https://doi.org/10.1249/01.mss.0000078924.61453.fb
  34. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. The Journal of Rheumatology. 1988;15(12):1833-1840.
  35. Bae SC, Lee HS, Yun HR, Kim TH, Yoo DH, Kim SY. Cross-cultural adaptation and validation of Korean Western Ontario and McMaster Universities (WOMAC) and Lequesne osteoarthritis indices for clinical research. Osteoarthritis and Cartilage. 2001;9(8):746-750. https://doi.org/10.1053/joca.2001.0471
  36. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285(19):2486-2497. https://doi.org/10.1001/jama.285.19.2486
  37. Kim DJ. Insulin resistance measurement method and clinical application. The Korean Journal of Medicine. 2007;73(Suppl 2):S744-S776.
  38. The EuroQol Group. EuroQol - A new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199-208. https://doi.org/10.1016/0168-8510(90)90421-9
  39. Kim SH, Jo MW, Ahn J, Shin S, Ock M, Park J, et al. The valuation of EQ-5D-5L health states in Korea. Value in Health. 2014;17(7):A753. https://doi.org/10.1016/j.jval.2014.08.211
  40. Field A. Discovering statistics using IBM SPSS statistics: And sex and drugs and rock 'n' roll. 4th ed. Los Angeles (CA): SAGE; 2013. p. 396-399.
  41. Munro BH. Statistical methods for health care research. 5th ed. Philadelphia (PA): Lippincott Williams & Wilkins; 2005. p. 57-63.
  42. Jeong HC, Seong KM, Jeong MY. The effect of a hospital life guidance movie for elderly in-patients. Journal of Korean Academy of Fundamentals of Nursing. 2010;17(2):142-148.
  43. Yun JY, Lee JK. Effects of a Thera-Band exercise program on pain, knee flexion ROM, and psychological parameters following total knee arthroplasty. Journal of Korean Academy of Nursing. 2015;45(6):823-833. https://doi.org/10.4040/jkan.2015.45.6.823
  44. Ogilvie D, Foster CE, Rothnie H, Cavill N, Hamilton V, Fitzsimons CF, et al. Interventions to promote walking: Systematic review. BMJ. 2007;334(7605):1204. https://doi.org/10.1136/bmj.39198.722720.BE
  45. Seo K. The effects of a group motivational interviewing for older adults in a senior center to improve physical activity: A randomized controlled trial [dissertation]. Seoul: Seoul National University; 2014. p. 1-125.
  46. Sliepen M, Mauricio E, Lipperts M, Grimm B, Rosenbaum D. Objective assessment of physical activity and sedentary behaviour in knee osteoarthritis patients - beyond daily steps and total sedentary time. BMC Musculoskeletal Disorders. 2018;19(1):64. https://doi.org/10.1186/s12891-018-1980-3
  47. Ha SM, Kim DY, Kim JS, Hyun SJ, Kim JH, Kim JW. Effects of combined exercise on SFT, metabolic syndrome risk factors and insulin resistance in obese elderly women. Journal of Korean Association of Physical Education and Sports for Girls and Women. 2018;32(1):113-129. https://doi.org/10.16915/jkapesgw.2018.03.32.1.113
  48. Shin DS, Lee CJ, Im KC, Roh DJ, Kim SM, Kim S. Effects of combined exercise on body composition, atherogenic index and Insulin resistance in obese middle-aged women. The Korea Journal of Sports Science. 2013;22(2):1217-1228.
  49. Glouzon BKJ, Barsalani R, Lagace JC, Dionne IJ. Muscle mass and insulin sensitivity in postmenopausal women after 6-month exercise training. Climacteric. 2015;18(6):846-851. https://doi.org/10.3109/13697137.2015.1083002