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치매 단계별 일상생활수행능력의 차이 비교

Comparison of Activities of Daily Living Differences with Dementia Stage

  • 장종식 (극동대학교 작업치료학과)
  • 투고 : 2017.11.02
  • 심사 : 2017.12.08
  • 발행 : 2017.12.31

초록

본 연구는 지역사회와 시설에 거주중인 치매환자들의 단계에 따라 기본적 일상생활수행, 수단적 일상생활수행을 파악하여 임상현장에 근거를 제시하고 치매환자 관리를 위한 기초자료를 제공하고자 하였다. 자료 수집은 전국에 소재한 요양원, 주간보호센터, 지역사회, 보건소, 요양병원, 요양원, 광역치매지원센터 등 15개의 기관에서 실시하였으며, 2015년 10월 1일 ~ 2015년 11월 20일까지 지역사회거주 치매환자 100명, 시설거주 치매환자 100명을 평가하였다. 모든 자료는 연구자와 평가방법에 대해 충분한 교육을 받은 평가자들이 ADCS-ADL, S-IADL, S-ADL, MMSE-K를 직접 평가하였다. 치매환자의 단계별 일상생활수행수준의 차이를 비교하기 위해 일원배치 분산분석 후 사후검정과 시각적 그래프를 통해 분석하였으며 거주형태와 치매단계에 따른 분석은 독립표본 t 검정을 실시하였다. 지역사회거주 치매환자와 시설거주 치매환자의 일상생활수행수준의 차이를 비교한 결과 수단적 일상생활수행과 기본적 일상생활수행의 모든 항목이 중등도 치매단계에서 차이를 보였으며(p<.01), 사후검정결과 최경도, 경도와 중등도 간에 차이가 있는 것으로 보였다. 치매거주 형태별로 일상생활수행의 차이를 확인한 결과 모든 단계에서 유의한 차이를 보이지 않았다(p>.05). 본 연구의 결과로 미루어 볼 때 향후 진행되는 치매연구에서는 효과의 지표로써 일상생활수행평가의 적용 시 기본적 일상생활수행보다는 수단적 일상생활의 변화를 확인하는 것이 매우 중요할 것으로 사료된다.

This study aims to obtain information about the ADL and I-ADL functions of people with dementia living in the community and nursing care facilities regarding their dementia stages for the purpose of supporting occupational therapists working in dementia care centers. The information was collected from 100 people with dementia living in the community and 100 people with dementia staying in care facilities from October 1 to November 20, 2015. 15 facilities participated in this study, including nursing homes, day care centers, health centers, geriatric hospitals and metropolitan dementia centers. All of the assessors were trained in the use of the instruments, ADCS-ADL, S-IADL, S-ADL and MMSE-K, by the researcher before conducting any evaluations or interviews. In order to compare the differences in the levels of ADL according to the dementia stage, an analysis was made via the post-hoc test after conducting a one-way ANOVA. An analysis of the residence type and dementia stage was made through the independent t-test. The comparison of the level of ADL between the people with dementia living in the community and those living in nursing homes showed differences in the moderate level of dementia for all items of the I-ADL and ADL (p<.01). The post-hoc test showed that there is a difference among the minimum, mild, and moderate levels. When the differences in ADL according to the residence type were examined, there were no significant differences in any of the stages (p>.05). Considering these results, it may be critical to identify the changes in the I-ADL rather than those in the ADL for the outcome index when conducting future intervention studies on dementia.

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참고문헌

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