노인의 거주 형태에 따른 일상생활동작(ADL) 및 도구적 일상 생활 동작(IADL)의 수행능력 비교

A comparative study of ADL and IADL of residential home and home for the aged dwelling elderly

연구목적: 본 연구는 가정 거주노인과 시설 거주 노인의 일상생활동작(ADL)과 도구적 일상생활동작(IADL)을 비교 분석하여 노인 돌봄에 관여하는 의료 종사자, 특히 물리치료사와 작업치료사의 업무에 도움을 주고자 시행하였다. 방법: 일상생활동작 및 도구적 일상생활동작의 검진은 한국형 일상생활동작 평가서와 도구적 일상생활동작 평가서를 사용하여 거주 형태가 다른 두 노인 집단의 평가 결과를 분석하였다. 결과: 노인들의 일상생활동작과 도구적 일상생활동작의 수행 능력은 부부 동거, 자녀 수, 수입, 현재 앓고 있는 질병 및 나이에 의해 영향을 받고 있는 것으로 나타났다. 또한 일상생활동작 중에는 한 가지 동작이 도구적 일상생활동작은 한 가지 동작을 제외한 모든 동작에서 수행 능력의 차이를 보이고 있다. 부부가 함께 동거하는 노인이 홀로 사는 노인에 비해 전반적으로 일상생활 활동이 원활한 것으로 나타났다. 결론: 한국형 일상생활동작 평가서와 도구적 일상생활동작 평가서가 한국 노인의 일상생활 활동을 평가하는데 보다 사용하기 좋았다. 노인을 돌보는 의료 종사자 특히 물리치료사 및 작업치료사는 노인의 일상생활 활동을 증진시키기 위해 훈련을 시행한다면 일상생활동작 훈련에서는 목욕하기에 중점을 두고 도구적 일상생활동작의 훈련에서는 거의 모든 동작을 훈련 시켜야 할 것을 조언한다.

Purpose: The purpose of this study was to investigate the activities of daily living (ADL) and instrumental activities of daily living (IADL) of residential home dwelling elderly and home for the aged dwelling elderly. In attempt to address medical professional caring the elderly, this comparative study examines the factors associated with dependence in the ADL and IADL in two samples of elderly people living in two different environments. Methods: The instrument of ADL and IADL widely used Katz ADL and IADL. Katz ADL and IADL was not a perfect fit for Korean. In concern with cultural factors Won developed K(Korean)-ADL and K-IADL scale reflecting Korean's own language expression and cultural factors in year of 2002. The assessment tool of this study was K-ADL and K-IADL. Differences of ADL and IADL were tested for statistical significance using group t-test and x2 test for comparisons between the residential home dwelling elderly and the home for the aged dwelling elderly. Results: Comparison of assessment for K-ADL and K-IADL in two different dwelling types was significant. Performance of ADL and IADL depend upon their living environment such as social status, number of children, income, present illness as well as age group. This study also showed significant differences of performance in some activities of ADL and IADL between the elderly who live in their own home and live in home for the aged. Comparison of performance of ADL and IADL in different dwelling types revealed that only one item of ADL was significant but only one item of IADL was not significant. It means that IADL is more difficult activities in the home for the aged dwelling elderly than the residential home dwelling elderly. The coupled elderly has more independent in some ADL and IADL activities compared with the single elderly. Conclusion: Using K-ADL and K-IADL is more convenient for Korean elderly. Medical professional consider some factors like dwelling style, social status, existing diseases and disabilities in order to care the elderly and train him/her activities of daily living as well as instrumental activities of daily living. Medical professional, especially physical and occupational therapist emphasize the training items which are bathing of ADL and grooming, housework, preparing meals, laundry, traveling, public transportation, shopping, using telephone and taking medicine of IADL based on the result of this study.