비만여성을 위한 웃음치료프로그램의 효과 : 스트레스, 심리신경내분비면역 반응
Effect of Laughter Therapy Program for Obese Women: Stress, Psychoneuroendocrinoimmuno Response
- 주제(키워드) 웃음치료프로그램 , 지각된 스트레스 , 심리신경내분비면역반응 , 스트레스 반응 , 비만여성
- 발행기관 아주대학교
- 지도교수 현명선
- 발행년도 2015
- 학위수여년월 2015. 2
- 학위명 박사
- 학과 및 전공 일반대학원 간호학과
- 실제URI http://www.dcollection.net/handler/ajou/000000019396
- 본문언어 한국어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
본 연구는 Lazarus와 Folkman(1984)의 스트레스 대처 이론과 PNI model을 적용하여 비만여성을 위한 웃음치료프로그램을 개발하여 그 효과를 파악하고자 시도하였다. 본 연구방법은 다음과 같다. 첫째, 비만여성을 위한 웃음치료프로그램을 개발 후 Lynn(1986)의 전문가 내용 타당도를 거쳐 수정·보완한 후 개발하였다. 둘째, 개발된 웃음치료프로그램의 효과를 검증하기 위하여 경기도 P보건소에서 비만여성을 대상으로 2014년 7월 10일부터 2014년 8월 19일까지 주 2회 6주간 회당 60분씩 비동등성 대조군 전후설계의 유사 실험연구를 실시하였다. 연구대상자는 실험군 24명, 대조군 26명으로 총 50명이었고, 개발된 프로그램의 효과는 지각된 스트레스와 스트레스 반응은 설문조사를 통하여 심리신경내분비면역반응 HRV기계와 혈액검사를 통하여 측정하였다. 수집된 자료는 SPSS 19.0 프로그램을 이용하여 정규분포를 이루는 변수는 사전검사결과를 Covariate로 통제한 후 ANCOVA로 분석하였고, 정규 분포를 이루지 않는 변수는 사후-사전의 차이 값이 정규분포를 이루는 것이 확인되어 사후-사전의 차이 값을 Independent t-test로 분석하였다. 본 연구의 결과를 요약하면 다음과 같다. 첫째, 실험군과 대조군의 지각된 스트레스 점수 검증 결과 실험군이 대조군보다 통계적으로 유의하게 감소하였다. 둘째, 실험군과 대조군의 심리신경내분비면역반응에 대한 평가는 부가설을 통하여 검증되었다. 1-1. 실험군과 대조군의 교감신경계 활성도, 부교감신경계 활성도와 LF/HF ratio검증 결과 실험군은 대조군보다 통계적으로 유의한 차이가 없었다. 2-1. 실험군과 대조군의 혈중 Cortisol 수치 검증 결과 실험군은 대조군보다 통계적으로 유의한 차이가 없었다. 2-2. 실험군과 대조군의 공복시 혈당 검증 결과 실험군이 대조군보다 통계적으로 유의하게 감소하였다. 3. 실험군과 대조군의 IL-6수치와 TNF-α 수치 검증 결과 실험군이 대조군보다 통계적으로 유의하게 감소하였다. 셋째, 실험군과 대조군의 스트레스 반응 점수 검증 결과 실험군이 대조군보다 통계적으로 유의하게 감소하였다. 본 연구에서는 비만여성을 위한 웃음치료프로그램을 개발하였고, 지각된 스트레스를 감소시켜 스트레스 반응의 감소와 신경심리내분비면역 반응의 향상 가능성을 제시하였다. 이는 세계적으로 증가추세인 비만여성에게 새롭고 실천 가능한 프로그램을 제시하였다는 측면에서 그 의의가 있다. 따라서 본 연구에서 개발한 웃음치료프로그램은 비만 여성의 신체적·정신적 건강의 향상에 효과적이므로 비만여성에게 유용한 간호중재 방법 중 하나로 실무에 적용 가능할 것으로 사료된다.
more목차
감사의 글 ·············································································· i
표차례 ·················································································· v
그림차례 ················································································ vi
부록차례 ················································································ vii
국문요약 ················································································ viii
Ⅰ. 서론 ················································································ 1
A. 연구의 필요성 ································································ 1
B. 연구목적 ········································································· 5
C. 연구가설 ········································································· 5
D. 용어정의 ········································································· 6
Ⅱ. 문헌고찰 ··········································································· 9
A. 비만여성의 스트레스 ······················································· 9
B. 지각된 스트레스, 스트레스 반응, 심리신경내분비면역 반응 ··········· 12
C. 비만여성을 위한 중재프로그램 ····································· 20
D. 비만여성을 위한 웃음치료프로그램 효과 ···················· 22
Ⅲ. 연구의 이론적 기틀 ························································ 25
Ⅳ. 연구방법 ··········································································· 28
A. 연구설계·············································································· 28
B. 연구대상·············································································· 29
C. 실험처치·············································································· 31
D. 연구도구·············································································· 43
E. 자료수집 방법 ··································································· 46
F. 윤리적 고려 ······································································· 48
G. 자료분석방법 ···································································· 49
H. 내·외적 타당도 ·································································· 50
V. 연구결과 ············································································ 51
A. 대상자의 동질성 검증 ····················································· 51
B. 정규성 검정 ······································································ 59
C. 가설검증 ··········································································· 60
VI. 논의 ·················································································· 76
A. 웃음치료프로그램 개발 ·················································· 76
B. 프로그램 효과 검증 ························································· 79
C. 연구의 의의 ······································································ 85
ⅥI. 결론 및 제언 ··································································· 87
A. 결론 ··················································································· 87
B. 제언 ··················································································· 89
참고문헌 ················································································ 90
부록 ······················································································· 107
Abstract ················································································ 163
