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Factors Affecting on the Quality of Life of the Elderly with Mild Dementia Living in Some Rural Community in Korea

일 농촌지역 경증 치매노인의 삶의 질 영향요인

  • Received : 2018.09.17
  • Accepted : 2018.09.28
  • Published : 2018.09.30

Abstract

Objectives: The purpose of this study is to investigate the influencing factor of the quality of life of the elderly with mild dementia in rural community. Methods: A total of 123 elderly who were managed by public health center participated. They were diagnosed as mild dementia by MMSE-DS and CDR. Data were collected during the period from May to September in 2017 by a structured questionnaire that included general characteristics, depression, dependence, comorbidity, sleep scale. Data were analyzed by t-test, ANOVA, Pearson's correlation analysis, and multiple regression analysis. Results: The quality of life was correlated significantly with depression. Depression was the factor affecting the quality of life of the elderly with mild dementia in rural community. Depression accounted for 54.0% as a variable of quality of life. Conclusion: This study was meaningful in that it directly measured the quality of life of the elderly with mild dementia is known to be difficult to measure and found meaningful results. it is necessary to identify the cause of depression and establish a linkage system between public health centers and health related organizations in the community. We suggest the need for individualized preventive intervention program and integrated psychological health service considering depression.

본 연구는 농촌지역 경증 치매노인의 삶의 질을 측정하고, 이들의 인구사회학적 특성, 주관적 건강인식, 동반질환, 의존성, 수면, 우울 등 대상자의 삶의 질에 관련된 요인들을 살펴본 상관연구로써, 대상자의 삶의 질 향상을 위한 여러 대안들을 위한 기초자료를 제공하고자 본 연구를 시행하였다. 본 연구의 대상자는 본 연구의 수행에 동의한 충청북도 ${\bigcirc}{\bigcirc}$군 보건소에 등록된 65세 이상의 경증 치매노인으로, 대상자로부터 동의서를 받은 후 설문지를 이용하여 자료 수집을 하였다. 본 연구결과 농촌지역 경증 치매노인의 주관적 건강인식과 의존성, 수면, 우울이 삶의 질과 상관성을 보이는 것으로 나타났고, 우울은 삶의 질의 변인으로써 54%를 설명하는 것으로 나타났다. 결론적으로 삶의 질에 유의한 예측변수는 우울이었다. 위의 결과로 다음과 같은 제언을 하고자 한다. 첫째, 대상자의 삶의 질에 영향을 미치는 우울의 원인을 파악하고, 그에 따른 지원정책을 분류하여 제공할 필요가 있다고 생각된다. 둘째, 대상자의 우울이 삶의 질에 영향을 주는 것으로 볼 때, 치매노인들의 정신적 건강상태에 따른 의료적 환경과 접근에 있어서 보다 더 용이한 환경이 되도록 보건소와 병원, 노인전문요양시설간의 지역사회내의 연계체계 구축을 통해 통합적 정신건강서비스를 제공할 필요가 있다고 생각된다. 특히 지역 간 보건의료자원의 불균형이 심한 농촌지역의 특성을 고려하여 보건소를 기점으로 보건지소나 보건진료소와 같은 공공보건의료체계를 포괄적이고 효율적으로 보강할 것을 제언한다. 셋째, 본 연구는 일개 농촌지역에 국한되어 선정 기준에 맞는 대상자들만 연구에 포함시켰기 때문에 연구결과를 우리나라 전체 경증 치매노인에게 일반화시키는데 제한적이므로 연구지역을 확대할 것을 제언한다. 또한 경증치매 노인을 위해 개발되는 간결한 검증된 도구의 사용이 필요하다고 본다. 넷째, 경증 치매노인이 평균적으로 어느 정도의 우울을 동반하는지에 대한 후속 연구를 통해 치매정도를 고려한 인지향상 프로그램 외에 우울의 정도에 따른 개별화된 예방 중재 프로그램이 개발되어 장기적인 효과를 확인할 것을 제언한다.

Keywords

References

  1. Kim KW, Kim HN, Ahn HY, Kim YJ, Hwang JE, Kim BN, et al. Korean dementia observatory 2016. Research Report. Sejong: National Institute of Dementia. Ministry of Health and Welfare. 2016 December. Report No.:NIDR-1603-0015 (Korean)
  2. Jeon MS. A study on the effects of an integrative cognitive training program on the aged with mild dementia: Targeting elders in daycare. Korean J of Geron Social Welfare 2017;72(1):209-232 (Korean)
  3. Song MS, Kim SK, Kim NC. A study on the correlation between elderly women's depression and physical fitness. J Korean Bio Nur Science 2011;13(1):37-43 (Korean)
  4. Chun JD, Ryu SY, Han MA. Comparisons of health status and health behaviors among the elderly between urban and rural areas. J Agric Med Community Health 2013;38(3):182-194 (Korean) https://doi.org/10.5393/JAMCH.2013.38.3.182
  5. Son HS, Park SJ. The study on quality of life-dementia. J Public Welfare Admin 2007;17(1):153-176 (Korean)
  6. Shin HY. A preliminary study on korean version of the quality of life-alzheimer's disease (QOL-AD) in community-dwelling elderly with dementia. J Prev Medicine and Public Health 2006;39(3):242-248 (Korean)
  7. Park SJ, Ko SH. The study on the rise in quality of life-dementia. Korean J of Pub Admin 2008;18(2):115-142 (Korean)
  8. Berwig M, Leicht H, Gertz H. Critical evaluation of self-rated quality of life in mild cognitive impairment and alzheimer’s disease-further evidence for the impact of anosognosia and global cognitive impairment. J Nutrition, Health & Aging 2009;13(3):226-230 https://doi.org/10.1007/s12603-009-0063-4
  9. Kang JS, Jeong IH, Yang JH. Effects on senior fitness, cognitive function and daily living activity of female elderly with light dementia by continuous and intermittent exercises. J the Korea Acad Industrial Cooperation Society 2010;11(11):4234-4243 (Korean) https://doi.org/10.5762/KAIS.2010.11.11.4234
  10. Kim HJ, Moon SY, Kim SY. Assessment of the quality of life in patients with alzheimer's disease. J the Korean Neur Association 2008;26(4):308-313 (Korean)
  11. Kim YO, Shim MS. Cognitive functions, instrumental activities of daily living, depression and quality of life in the elderly with mild cognitive impairment. J Korean Pubilc Health Nurs 2015;29(2):219-230 (Korean) https://doi.org/10.5932/JKPHN.2015.29.2.219
  12. Stern Y, Albert SM, Sano M, Richards M, Miller L, Folstein M, et al. Assessing patient dependence in alzheimer's disease. J Gerontology 1994;49(5):M216-M222 https://doi.org/10.1093/geronj/49.5.M216
  13. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. International J Chronic Diseases 1987;40(5):373-383 https://doi.org/10.1016/0021-9681(87)90171-8
  14. Buysse DJ, Reynolds CF, Monk TH, et al. The pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Research 1989;28(2):193-213 https://doi.org/10.1016/0165-1781(89)90047-4
  15. Kim EJ. Factors influencing care dependency in patients with dementia. J Korean Society of Nurs Science 2003;33(6):705-712 (Korean)
  16. Scocco P, Fantoni G, Caon F. Role of depressive and cognitive status in self-reported evaluation of quality of life in older people: Comparing proxy and physician perspectives. J Age and Ageing 2006;35(2):166-171 https://doi.org/10.1093/ageing/afj026
  17. Kim CH, Jung JE, Chang MS, et al. The effect of sleep on quality of life in cognitively impaired elder. J Sleep Medicine 2008;5(2):82-88 (Korean)
  18. Logsdon RG, Gibbons LE, McCurry SM, Teri L. Assessing quality of life in older adults with cognitive impairment. Jf Psych Medicine 2002;64(3):510-519
  19. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, et al. Development and validation of a geriatric depression screening scale: A preliminary report. J Psych Research 1983;17(1):37-49 https://doi.org/10.1016/0022-3956(82)90033-4
  20. Cho MJ, Bae JN, Suh GH, Hahm BJ, Kim JK, Lee DW, et al. Validation of geriatric depression scale, korean version (GDS) in the assessment of DSM-III-R major depression. J Korean Neuropsych Association 1999;38(1):48-63 (Korean)
  21. Brickman AM, Riba A, Bell K, Marder, K, Albert M, Brandt J, et al. Longitudinal assessment of patient dependence in alzheimer disease. Archives of Neurology Journal 2002;59(8):1304-1308 https://doi.org/10.1001/archneur.59.8.1304
  22. Marrelli M, Tanner K. Recognizing late-life depression: Why is this important for nurse in the setting. Geriatric Nursing Journal 2005;26(3):145-149 https://doi.org/10.1016/j.gerinurse.2005.03.020
  23. Song MS, Choi CH. Study of difference on activities of daily living and quality of life of dementia patients reported by dementia patients and caregivers. Korean J Oriental Physiology & Pathology 2012;26(3):386-391 (Korean)
  24. Shin SI, Kim YH. A meta-analysis on related variables of elders' quality of life. Korean J Counseling 2013;14(6):3673-3690 (Korean) https://doi.org/10.15703/kjc.14.6.201312.3673
  25. Campbell A. Subjective measures of well-being. American Psychologist 1976;31(2):117-124 https://doi.org/10.1037//0003-066X.31.2.117
  26. Lee SY. The effect of aromatherapy hand massage on cognitive function, sleep disturbance and problematic behaviors of elderly with dementia. J Korean Clinical Nurs Research 2008;14(2):115-126 (Korean)
  27. Kang LJ. The effects of related factors on quality of life for the elderly. J Korean Home Management Association 2008;26(5):129-142 (Korean)
  28. Kim HR, Oh K, Oh KO, Lee SO, Lee SJ, Kim JA, et al. Quality of life in low income korean aged. J Korean Society of Nurs Science 2008;38(5):694-703 (Korean)
  29. Wegner C, Luy M. Determinants of general health status and specific diseases of elderly women and men: A longitudinal analysis for Western and Eastern Germany. Vienna Institute of Demography Working Paper 2009;05
  30. Cockerham WC, Rutten A, Abel T. Conceptualizing contemporary health lifestyles. The Sociological Quarterly Journal 1997;38(2):321-342 https://doi.org/10.1111/j.1533-8525.1997.tb00480.x