지역사회 중년여성의 심뇌혈관질환 예방교육프로그램 개발 및 평가

Abstract

Cardio-cerebrovascular disease (CVD) prevalence and mortality are increasing, with women at higher risk of CVD than men, especially after middle-age; therefore, it is necessary to prevent CVD among middle-aged women. The aim of this study was to develop and evaluate the effectiveness of a CVD prevention program on basic psychological needs, physical health, and mental health for middle-aged women in the community, applying the self-determination theory model of health behavior change. Self-determination theory model of health behavior change was applied as a theoretical framework for the development of the program. This program was also developed according to the five steps outlined in the ADDIE model. The contents of the program included CVD management, antecedent disease of CVD management, and lifestyle risk factors of CVD management, based on a survey of middle-aged women's needs for CVD prevention and through literature review. A strategy was used to create an environment that supports autonomy and satisfies basic psychological needs. The program consisted of a total of 14 sessions: eight face-to-face education, two non-face-to-face education, and four phone consultations. To verify the effectiveness of the CVD prevention education program, middle-aged women who used community health centers in two districts of B City were recruited. This non-equivalent control group with a pre-post test study design was used. Data collection was conducted for 8 weeks from 1 February to 29 March 2023, and the final analysis was performed on 26 participants in the experimental group and 33 in the control group. To examine the effectiveness of the program, awareness of CVD warning symptoms, health behavior practice, aging anxiety, loneliness and social isolation, and resilient coping were measured by questionnaire. All data were analyzed with SPSS/WIN 26.0 using independent t-test and Mann-Whitney U test. The results of this study showed a significant difference in awareness of myocardial infarction warning symptoms(p=.001), awareness of stroke warning symptoms(p<.001), health behavior practice(p<.001), aging anxiety(p=.001), loneliness and social isolation(p<.001), and resilient coping(p<.001) between the experimental group and the control group. The results demonstrated that the CVD prevention education program developed in this study for middle-aged women, which applied the self-determination theory model of health behavior change, improved both physical and mental health. This program can be applied in various communities accessible to middle-aged women, and can effectively contribute to the prevention of cardiovascular diseases in this population by maintaining and spreading these positive effects throughout the community.

Keywords: Cardiovascular Disease, Stroke, Prevention, Middle-aged Women, Self-determination Theory