대한지역사회작업치료학회지 (The Journal of Korean society of community based occupational therapy)

대한지역사회작업치료학회 (Korean Society of Community Based Occupational Therapy Association)
권호 표지
DOI QR코드

DOI QR Code

노인 뇌졸중 환자의 후유증 유무에 따른 HRQOL 요인별 중요도 분석

A Study on Health Status' Factors Affecting HRQOL in the Elderly Stroke Patients With or Without Sequela

  • 김석범 (제주한라대학교 작업치료과) ;
  • 김동현 (김천대학교 작업치료학과)
  • Kim, Souk-Boum (Dept. of Occupational Therapy, Cheju Halla University) ;
  • Kim, Dong-Hyun (Dept. of Occupational Therapy, Gimcheon University)
  • 투고 : 2017.03.12
  • 심사 : 2017.04.18
  • 발행 : 2017.04.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

목적 : 본 연구는 치료를 받고 있는 뇌졸중 환자 중 후유증의 유무에 따라 건강관련 삶의질(HRQOL)에 영향을 주는 건강상태의 중요도가 어떻게 달라지는지를 조사하여, 건강 관련 삶의 질 향상 방안을 위한 기초자료로 활용하는데 있다. 연구방법 : 뇌졸중 환자의 후유증 유무에 따라 HRQOL에 영향을 미치는 요인들의 중요도를 분석하기 위하여 국민건강영양조사 제5기의 자료를 활용하여 65세 이상 치료를 받고 있는 뇌졸중 환자 91명을 대상으로 2차 분석을 실시하였다. 결과 : 첫째, 후유증이 있는 뇌졸중 환자의 경우 없는 그룹보다 HRQOL과 주관적 건강상태가 유의하게 낮았으며(p<0.05), 자살 생각이 있을 위험도는 3.64였다. 둘째, 전체 그룹의 경우 주관적(${\beta}=0.39$), 정신적(${\beta}=0.29$), 의학적(${\beta}=0.23$) 건강상태가, 후유증이 있는 그룹의 경우 정신적(${\beta}=0.45$), 주관적(${\beta}=0.36$) 건강상태가, 후유증이 없는 경우 의학적(${\beta}=0.45$), 기능적(${\beta}=0.32$), 정신적(${\beta}=0.25$) 건강상태 순으로 HRQOL에 크게 영향을 주는 요인으로 추출되었다(p<0.05). 결론 : 종합하면 재활치료에 있어 뇌졸중 환자의 HRQOL 향상을 위해서는 후유증이 중증일 경우는 정신적 건강상태에 영향을 미치는 우울과 자살에 대한 조기 발견 및 조기 중재가 중요하며, 후유증이 경증이거나 없는 경우에는 기능적 회복에 초점을 맞추어 진행해야 하고, 후유증 유무와 상관없이 자신의 현 상태를 긍정적으로 받아들일 수 있도록 지속적인 지지를 해준다면 뇌졸중 환자의 기능적 회복과 더불어 HRQOL을 더욱 향상시켜 최종적으로 뇌졸중 환자의 독립적 자립에 긍정적인 영향을 줄 수 있을 것으로 사료된다.

Objective : The main purpose of this study was to analyze factors affecting a health related quality of life(HRQOL) in the elderly stroke patients with(Group 1) or without(Group 2) sequela. Methods : This survey performed secondary analysis with 'the fifth korea national health and nutrition examination survey', and investigated 91 elderly stroke patients over 65 years. Results : The results were as followed: HRQOL and self rated health had a significantly lower in Group 1(p<.05). In all groups, HRQOL was affected by self rated health(${\beta}=0.39$), mental health, and medical health significantly(p<.05). In group 1, HRQOL was affected by mental health(${\beta}=0.45$), self rated health significantly(p<.05). In group 2, HRQOL was affected by medical health(${\beta}=0.45$), functional health, mental health significantly(p<.05). Conclusion : In order to improve the HRQOL of stroke patients during rehabilitative therapy, it is important that early detection and early intervention of depression and suicide, which affect mental health status, are important in the case of severe aftereffects. If the patient continues to support his/her current status regardless of aftereffects, he/she can improve the HRQOL with functional recovery of the stroke patient, and finally have a positive effect on the independence of the stroke patients.

키워드

참고문헌

  1. Bruce, H., & Dobkin, M. D. (2003). The Clinical Science of Neurologic Rehabilitation, 2nd ed. New York: Oxford University Press.
  2. Carod-Artal, F. J., Ferreira, L., Trizotto, D., & Menezes, C. (2009). Poststroke depression prevalence and determinants in Brazilian stroke patients. Cerebrovascular Disease, 28(2), 157-165. https://doi.org/10.1159/000226114
  3. Chung, J. H., Kim, J. B. & Kim, J. H. (2016). Suicidal ideation and attempts in patients with stroke: a population-based study. Journal of Neurology, 263(10), 2032-2038. https://doi.org/10.1007/s00415-016-8231-z
  4. Hackett, M. L., Duncan, J. R., Anderson, C. S., Broad, J. B., & Bonita, R. (2000). Health-related quality of life among long-term survivors of stroke: results from Auckland Stroke Study, 1991-1992. Stroke, 31, 440-447. https://doi.org/10.1161/01.STR.31.2.440
  5. Kang, E. J., Kim, D. J., Sun, W. D., Yoon, S. S. (2006). Development of Health Care System for the Elderly with Medical Expenditure Analysis. Seoul: Korea Institute for Health and Social Affairs.
  6. Kim, H. C., Kim, S. J., Choi, N. K., Kim, Y. S., Lee, B. C., Lee, B, C. et al. (2002). Quality of Life after Stroke: a Two-Month Follow-UP. Journal of the Korean Neuropsychiatric Association, 41(4), 681-692.
  7. Kim, S. B. (2014). Analysis of structural relationship among factors of health related quality of life in the elderly with or without a stroke in korea. published doctoral dissertation, University of Daegu, Gyeongsan.
  8. Kim, S. B. (2015). Analysis of Structural Relationship Among Factors of Health Related Quality of Life in the Elderly With or Without a Stroke. The Journal of Korean Society of Occupational Therapy, 23(3), 53-66. https://doi.org/10.14519/jksot.2015.23.3.05
  9. Korea Centers for Disease Control and Prevention. (2011). The Fifth Korea National Health and Nuturition Examination Survey (KNHANES V), Cheongju.
  10. Kranciukaite, D., Rastenyte, D., Jureniene, K., & Sopagiene, D. (2007). Quality of life in stroke survivors. Medicina(Kaunas, Lithuania), 43(9), 736-745.
  11. Lee, J. M. (2012). The effect of modified constraint induced movement therapy on activities of daily living and quality of life for stroke patients. published master's thesis, University of Daegu, Gyeongsan.
  12. Naes, H., Waje-Andreassen, U., Thomassen, L., Nyland, H., & Myhr, K. M. (2006). Health-related quality of life among young adults with ischemic stroke on long-term follow-up. Stroke, 37, 1232-1236. https://doi.org/10.1161/01.STR.0000217652.42273.02
  13. Patel, M. D., Tilling, K., Lawrence, E., Rudd, A. G., Wolfe, C. D. A., & Mckevitt, C. (2006). Relationships between long-term stroke disability, handicap and health-related quality of life. Age and Ageing, 35, 273-279. https://doi.org/10.1093/ageing/afj074
  14. Shin, H. S. (2011, Summer). Estimating the burden of diseases in korea. Health and Social Affairs Issue & Focus, 96, 1-8.
  15. Statistics Korea. (2015. 9. 24). 2015 Statistics on the Aged. Retrieved February 24, 2017, from http://www.kostat.go.kr.
  16. Statistics Korea. (2016. 11. 30). Causes of Death Statistics in 2016. Retrieved February 24, 2017, from http://www.kostat.go.kr.
  17. Strum, J. W., Donnan, G. A., Dewey, H. M., Macdonell, R. L., Gilligan, A. K., Srikanth, V. et al. (2004). Quality of life. Stroke, 35, 2340-2345. https://doi.org/10.1161/01.STR.0000141977.18520.3b

피인용 문헌

  1. 요양병원 입원노인의 우울과 자아효능감이 삶의 질에 미치는 영향 vol.8, pp.1, 2017, https://doi.org/10.18598/kcbot.2018.08.01.03