장기요양보호대상노인 가족부양자에 대한 개입의 효과성

Effectiveness of Intervention for the Caregivers of Long-term Care Elderly

본 연구는 치매노인과 뇌졸중노인 가족부양자를 대상으로 집단차원의 교육/훈련프로그램을 실시한 후 개입의 효과성을 검토한 것이다. 연구내용은 프로그램 참여를 통한 개입의 효과성을 살펴보는 것으로, 사전사후검증의 타당성을 높이기 위해 유사 전-후 실험 통제집단 연구설계를 이용하였다. 사전사후검증을 모두 마친 가족들은 42명인데, 그 중 실험집단 17명, 통제집단 25명이었다. 개입의 효과성을 파악하기 위해 부양부담 척도와 주관적 삶의 질 척도를 사용하였다. 분석결과 프로그램에 참여했던 가족들은 개입 이후로 부양부담은 유의미한 수준에서 차이가 나타나지 않았지만, 주관적 삶의 질은 차이가 나타났다. 대상노인의 특성별로 분석한 결과를 보면, 치매노인, 노인의 상병기간이 짧을수록, 장애정도가 낮을수록 가족부양자의 삶의 질이 더 높아지는 경향을 나타냈다. 또한 가족의 특성별로는 남성, 고학력, 젊은 부양자일수록 삶의 질이 더 높아지는 경향이었다. 추가적으로 본 연구에서 효과성을 전제로 할 때 우선적인 개입이 필요한 취약한 가족부양자 집단을 확인하였고, 프로그램은 가족의 특성별로 특화하여 실시하는 것이 바람직하다는 점도 알 수 있었다.

The major purpose of this study is to examine effectiveness of an intervention program which aims at education/training caregivers of the dementia and/or stroke elderly. This program was conducted at group level. Participants of this program were the primary caregivers who have taken care of the elderly with dementia and/or stroke. To test the effectiveness of the caregiver education/training program, this study employed an quasi-experimental design: to compare pretest score with posttest ones for the same participants. Total forty two primary caregivers have completed the program. Seventeen caregivers were in experimental group, whereas twenty five ones belonged to control group. Our data suggest that, for the primary caregivers, subjective quality of life was more important than cargiving burden. Subjective quality of life among the caregivers significantly improved, after completing the program. This result suggests that a short-term intervention program at group level is not effective to reduce caregiving burden because an infra structure of community resources, to which the caregivers and their family access, did not remain at sufficient level. However, participants have showed improved mutual solidarity, and they have exposed to wider spectrum of a variety of information. As a result, they have perceived that the level of subjective quality of life has positively changed. Additional factors have influenced on determining the quality of life among the caregivers. The caregivers, whose demented elderly showed lower level of ADL and IADL, or who have experienced the short period of caregiving, were more likely to belong to higher level of quality of life. The quality of life among the caregivers were even more improved in the following group: being young, and highly educated, man. One of the contributions from this study is that we have found caregiver's characteristics, which need an intervention most. In addition, our study implies that specific contents of the caregivers' education/training program should be conducted based on each family's unique characteristics.