DOI QR코드

DOI QR Code

Factors related to Quality of Life in the Elderly People in Long-term Care Center

장기요양시설 노인의 삶의 질에 관련된 요인

  • Shin, Min-Woo (Department of Dental Hygiene, Chungbuk Health & Science University) ;
  • Ahn, Kwon-Suk (Department of Dental Hygiene, Chodang University) ;
  • Cho, Young-Chae (Department of Preventive Medicine and Public Health, College of Medicine, Chungnam National University)
  • 신민우 (충북보건과학대학교 치위생학과) ;
  • 안권숙 (초당대학교 치위생학과) ;
  • 조영채 (충남대학교 의과대학 예방의학교실)
  • Received : 2017.03.03
  • Accepted : 2017.06.09
  • Published : 2017.06.30

Abstract

This study examined the relationship between the sociodemographic characteristics, health related factors, physical functions (ADL, IADL), mental functions (CES-D, MMSE-K), oral health impact profile (OHIP-14), and the quality of life (WHOQOL-BREF) for the elderly in long-term care facilities. The research was conducted in 602 facility allowance beneficiaries authorized to be eligible for long-term care in long-term care facilities through personal interviews using a structured questionnaire from May 1 to June 30, 2016. As a result, the quality of life was lower among females than males in the group receiving government subsidies than the group whose livelihood was maintained by themselves or their children, in the group with a longer period of care, in the drinking group than the non-drinking group, in the group with irregular exercise than the regular exercise, in the group with irregular meals than regular meals, in the group with poor subjective health conditions than good subjective health condition, in the group with a smaller number of daily toothbrushing, in the group with xerostomia than no xerostomia, in the group with a lower OHIP-14, in the group with a lower ADL and IADL, and in the group with a lower CES-D and MMSE-K. In particular, the quality of life was affected more by health-related factors and CES-D and MMSE-K than by other factors. Therefore, it is necessary to make efforts to prevent depression and cognitive impairment, including health-related behavior, with the objective of improving the quality of life for the elderly in long-term care facilities.

본 연구는 장기요양시설 노인의 삶의 질에 관련된 요인을 알아보기 위하여 조사대상자의 인구사회학적 특성, 건강관련행위특성, 구강건강영향지수(OHIP-14), 신체적 기능(ADL, IADL) 및 정신적 기능(CES-D, MMSE-K)과 삶의 질(WHOQOL-BREF)과의 관련성을 분석하였다. 조사대상은 장기요양인정자로 판정받은 장기요양시설급여노인 602명으로 하였으며, 2016년 5월 1일부터 6월 30일까지의 기간 동안에 구조화된 설문지를 이용한 직접 면접조사와 구강검사를 실시하였다. 연구결과, 조사대상자의 삶의 질은 남성보다 여성에서, 생활비조달을 본인이 하는 경우보다 자녀가 조달하거나 정부의 보조를 받는다는 군에서, 요양기간이 길수록, 비음주군보다 음주군에서, 규칙적인 운동을 한다는 군보다 하지 않는다는 군에서, 식사를 규칙적으로 한다는 군보다 하지 않는다는 군에서, 주관적인 건강상태가 건강하다는 군보다 건강하지 않다는 군에서, 1일 칫솔질 횟수가 적을수록, 구강건조증이 없다는 군보다 있다는 군에서, 구강건강영향지수(OHIP-14)가 낮을수록, 신체적 기능(ADL, IADL)이 낮을수록, 정신적 기능(CES-D, MMSE-K)이 낮을수록 유의하게 낮았다. 특히 삶의 질은 다른 요인보다 건강관련행위특성과 정신적 기능(CES-D, MMSE-K)에 의해 더 큰 영향을 받고 있는 것으로 나타났다. 따라서 장기요양시설 노인의 삶의 질을 증진시키기 위해서는 바람직한 건강관련행위를 비롯하여 우울 및 인지기능장해를 예방하기 위한 노력이 필요할 것으로 생각된다.

Keywords

References

  1. National Statistical Office., Korea Statistical Yearbook. The 55th Edition, Daejeon, National Statistical Office; 2014.
  2. Kim H. S., Park J. Y., Kwon I. S., Cho Y. C., Quality of Life and Its Association with Physical and Mental Function in the Elderly People Affiliated with Long-term Care Insurance Services, Journal of the Korea Academia-Industrial Cooperation Society, vol. 11, no. 10, pp. 3808-3819, 2010. DOI: https://doi.org/10.5762/KAIS.2010.11.10.3808
  3. Yang S. O., Cho H. R., Lee S. H., A Comparative Study on Influencing Factors of Health Related Quality of Life of the Elderly in Senior Center by Region : Focus on Urban and Rural Areas, Journal of Digital Convergence, vol. 12, no. 1, pp. 501-510, 2014. DOI: https://doi.org/10.14400/JDPM.2014.12.1.501
  4. An M. H., Kim K. Y., A Study of Quality of Life and Depression for the Elderly in Senior Welfare Center, Journal of the Korea Academia-Industrial Cooperation Society, vol. 13, no. 8, pp. 3544-3551, 2012. DOI: https://doi.org/10.5762/KAIS.2012.13.8.3544
  5. Kim J. I., Prediction of Quality of Life among the Elderly at Care Facilities for the Elderly according to Health States, Physical and Cognitive Functions, and Social Supports-Focused on D Metropolitan City, Journal of the Korea Academia-Industrial Cooperation Society, vol. 16, no. 7, pp. 4656-4667, 2015. DOI: https://doi.org/10.5762/KAIS.2015.16.7.4656
  6. Kim E. K., Ha S. K., The Effects of Social Participation and Social Support on Quality of Life of the Elderly, Journal of Digital Convergence, vol. 11, no. 12, pp. 811-820, 2013. DOI: https://doi.org/10.14400/JDPM.2013.11.12.811
  7. Chang K. O., Lim H. J., Construction of a Structural Model about the Perceived health status, Pain, Sleep pattern and Quality of life in the Elderly, Journal of the Korea Academia-Industrial Cooperation Society, vol. 15, no. 7, pp. 4336-4345, 2014. DOI: https://doi.org/10.5762/KAIS.2014.15.7.4336
  8. Kim K. H., Lee S. K., Yoon H. J., Kwon K. H., The effects of Social Capital of old-old elderly of more than 70- year-old on their health-related quality of life, Journal of the Korea Academia-Industrial Cooperation Society, vol. 16, no. 6, pp. 3889-3901, 2015. DOI: https://doi.org/10.5762/KAIS.2015.16.6.3889
  9. National Health Insurance Corporation, Elderly people in long-term care insurance awareness survey, 2008.
  10. Korea National Statistical Office, Korean Statistical Information Service. [cited 2012 October 31]. Available form: http:/www.koss.kr.
  11. Shin M. W., Kwon I. S., Cho Y. C., Factors Related to Quality of Life in the Rural Elderly People Affiliated with Long-term Care Insurance Services, Journal of the Korea Academia-Industrial Cooperation Society, vol. 12, no. 2, pp. 795-804, 2011. DOI: https://doi.org/10.5762/KAIS.2011.12.2.795
  12. Ryu K. J., The relevance between level of oral health and oral health-related life quality among the elderly. Graduated School of Chungnam University, Doctor's Thesis, 2008.
  13. Kim J. H., Kang S. H., Jeong MY, Assessment on quality of life: based on oral health conditions, Journal of the Korea Academia-Industrial Cooperation Society, vol. 11, no. 12, pp. 4873-4880 2010. DOI: https://doi.org/10.5762/KAIS.2010.11.12.4873
  14. Hong MH, Impact of physical stress symptoms and psycho-emotional stress symptoms on oral health in adults, Journal of the Korea Academia-Industrial Cooperation Society, vol. 15, no. 3, pp. 1663-1670 2014. DOI: https://doi.org/10.5762/KAIS.2014.15.3.1663
  15. Park HR, A study on social efficacy of senior citizens in welfare centers in some areas according to their subjective oral health and their quality of life related to oral health, Journal of the Korea Academia-Industrial Cooperation Society, vol. 15, no. 2, pp. 1000-1009, 2014. DOI: https://doi.org/10.5762/KAIS.2014.15.2.1000
  16. Chang I. J., Jeong S. H., Park YA, et al., Association between denture satisfaction and perceived oral health among the elderly with removable denture, Journal of Korean Academy of Oral Health, vol. 30, no. 3, pp. 360-369, 2006.
  17. Faul F, Erdfelder E, Lang AG et al. G*power 3: A flexible statistical power analysis program for the social, behavioral, and science. Behav Res Methods, vol. 39, no. 2, pp. 175-191, 2007. DOI: https://doi.org/10.3758/BF03193146
  18. Katz S., Studies of illness in the aged: the Index of ADL: A standardized measure of biological and psychosocial function. J of Am Med Assoc, 185:pp. 914-919. 1963. DOI: https://doi.org/10.1001/jama.1963.03060120024016
  19. Pfeiffer E., Multidimensional functional assessment: the OARS methodology. A manual. Durham, North Carolina: Duke University, Center for the Study of Aging and Human Development, 1975.
  20. Weissman MM, Locke BZ., Comparison of a self-report symptom rating scale(CES-D) with standardized depression rating scales in psychiatric populations. Am J Epidemiol, 102:pp. 430-431. 1975. https://doi.org/10.1093/oxfordjournals.aje.a112183
  21. Radloff LS., The CES-D scale: A self-report depression scale for research in the general population. Appl Psychol Measurement, 1:pp. 385-401. 1977. DOI: https://doi.org/10.1177/014662167700100306
  22. Folstein MF, Folstein SE & McHugh PR., Mini-mental state: A practical method for grading the cognitive stste of patients for the clinician, Journal of Psychiatric Research, 12:pp. 189-198. 1975. DOI: https://doi.org/10.1016/0022-3956(75)90026-6
  23. Park JH, Kwon YC., Part I : Development of the test for the elderly = Korean Version of Mini-Mental State Examination (MMSE-K), Journal of the Korean Neuropsychiatric Association, vol. 28, no. 1, pp. 125-131, 1989.
  24. Slade GD, Spencer AJ., Development and evaluation of the Oral Health Impact Profile. Community Dent Health 1994; vol. 11, no. 1, 3-11
  25. Min SK, Lee CI, Kim KI, et al., Development of Korean version of WHO quality of life scale abbreviated version(WHOQOL-BREF), Journal of The Korean Neuropsychiatric Association, vol. 39, no. 3, pp. 571-579, 2000.
  26. Nam SK, Shim OS. A study on the influence factors on quality of life of elderly with chronic disease, Journal of Welfare for the Aged, 53, pp. 239-259, 2011.
  27. Nam YS, Jang JY. Potential factors associated with the quality of life in south Korean senior people: based on oral health, Journal of Dental Hygiene Science, vol. 13, no. 3, pp. 281-289, 2013.
  28. Lee HJ, Kim CM, Effects of Oral Health Impact Profile (OHIP) on Depression and Quality of Life among Community-dwelling Korean Elderly Persons, J Korean Acad Community Health Nurs. vol. 23, no. 3, pp. 338-346, 2012. DOI: https://doi.org/10.12799/jkachn.2012.23.3.338
  29. Kim EH, Kwon YC, Factors Influencing Quality of Life of Elders in Urban Regions, Journal of Digital Convergence, vol. 11, no. 7, pp. 225-235, 2013. https://doi.org/10.14400/JDPM.2013.11.7.225
  30. Chang KO, Effect of Self-esteem and Life satisfaction on Quality of life of Elderly School Program Participants, Journal of the Korea Academia-Industrial Cooperation Society, vol. 15, no. 8, pp. 5078-5087, 2014. DOI: https://doi.org/10.5762/KAIS.2014.15.8.5078
  31. Locker D, Clarke M, Payne B: Self-reported oral health status, psychological well -being and life satisfaction in an older adult population. J Dental Res, 79:pp. 970-975. 2000. DOI: https://doi.org/10.1177/00220345000790041301
  32. Seo H. S., Han Y. H., Effects of health-related indexes on life satisfaction for the elderly people. Korean journal of research in gerontology, 15:pp. 159-170, 2006.
  33. Vinkers DJ, Gussekloo J, Stek ML, Westendorp RG, Mast RC., Temporalrelation between depression and cognitive impairment old age :Prospective population based study, Brain Medication Journal, 2004; 329, pp. 74-71.
  34. Barge-Schaapveld DQ, Nicolson NA, Berkhof J, deVries MW., Quality of life in depression: daily life determinants and variability. Psychiatry Res, vol. 88, no. 3, pp. 173-189. 1999. DOI: https://doi.org/10.1016/S0165-1781(99)00081-5
  35. Li Y, Meyer JS, Thornby J., Depressive symptioms among cognitively nomal versus cognitively impaired elderly subjects. International Journal of Geriatric Psychiatry, 2001; 16, pp. 455-461. DOI: https://doi.org/10.1002/gps.360