Therapeutic Science for Rehabilitation (재활치료과학)

Korean Society of Neurological Occupational Therapy (대한신경계작업치료학회)
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Factors Affecting the Quality of Life of Patients With Dementia: A Systematic Review of Literature Focusing on the Subjects Admitted to an Overseas Long-term Care Facility

치매 환자의 삶의 질에 미치는 요인 분석: 국외 요양시설에 입소한 대상자를 중심으로 체계적 문헌고찰

  • Kim, Sun-Il (Dept. of Occupational Therapy, Graduate School, Yonsei University) ;
  • Jung, Min-Ye (Dept. of Occupational Therapy, College of Health Science, Yonsei University)
  • 김선일 (연세대학교 일반대학원 작업치료학과) ;
  • 정민예 (연세대학교 보건과학대학 작업치료학과)
  • Received : 2019.01.16
  • Accepted : 2019.01.31
  • Published : 2019.02.28
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Abstract

Objective: The purpose of this study was to perform a systematic literature review focusing on international studies to identify various factors affecting the quality of life(QOL) of dementia patients admitted to long-term care facilities. Methods: From January 2000 to July 2018, the articles published in foreign journals were searched through CINAHL and MEDLINE databases. The main search terms were'dementia or Alzheimer's'. 'quality of life', 'long-term care', 'care home', 'nursing home', 'care institution', 'residential care', 'small- scale setting'. The first 1706 articles were searched, but 10 studies were selected using the selection and exclusion criteria. Results: Analysis of ten cross-sectional studies showed that factors such as physical functioning status, ability to perform activities of daily living, and cognition showed a positive correlation with QOL. Depression and anxiety, severity of dementia, and neuropsychiatric symptoms were found to be negatively correlated with QOL. In addition, two longitudinal studies have confirmed that factors affecting QOL are affected by individual functional status and social environmental factors rather than the size and form of care facilities. Conclusion: This study summarized 10 papers and analyzed them through a systematic review of literature. We found that factors such as individual characteristics and social environment determine QOL of patients with dementia. In this study, various intervention methods to improve QOL of patients with dementia should be developed and used in long-term care facilities by identifying the factors affecting QOL of dementia patients and using them.

목적: 본 연구는 장기요양시설에 입소한 치매 환자의 삶의 질에 영향을 미치는 다양한 요인을 확인하기 위해 국외 연구를 중심으로 체계적 문헌고찰 방법을 시행하였다. 연구방법: 2000년 1월부터 2018년 7월까지 국외 학술지에 게재된 논문을 CINAHL, MEDLINE complete를 통하여 검색하였다. 주요 검색 용어로는 'dementia or Alzheimer's', 'quality of life', 'long-term care', 'care home', 'nursing home', 'care institution', 'residential care', 'small scale setting'을 사용하였다. 최초 검색된 논문은 1706편이었으나 선정 및 배제기준을 거쳐 10편의 연구가 선정되었다. 결과: 횡단적 연구 8편을 분석하여 신체적 기능상태, 일상생활활동(ADL) 수행능력, 인지 등의 요인들은 삶의 질과 긍정적 상관관계를, 우울증 및 불안, 치매의 중증도(severity), 신경 정신병적 증상 및 약물 사용 여부 등의 요인들은 삶의 질과 부정적 상관관계를 보이는 요소로 작용함을 확인했다. 또한, 2편의 종단적 연구를 통해 삶의 질의 변화와 그에 미치는 요인들이 환자가 있는 시설 규모 및 형태보다는 개인적 기능상태 및 사회적 환경 요인들에 의해 변화됨을 확인했다. 결론: 본 연구는 국외 장기요양시설에 입소한 치매 환자를 대상으로 삶의 질 결정요인을 분석한 10편의 논문을 정리하고, 체계적 문헌고찰을 통해 분석하였다. 개인의 다양한 특성과 사회적 환경과 같은 요소들이 치매 환자의 삶의 질을 결정하는 요인으로 작용함을 확인했다. 본 연구를 통해 치매 환자의 삶의 질에 영향을 미치는 요인을 확인하고, 이를 활용해 치매 환자의 삶의 질을 증진시킬 수 있는 다양한 중재 방법이 장기요양시설에서 개발 및 이용되어야 할 것이다.

Keywords

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Figure 1. Flow Diagram of the Literature Selection Precess

Table 1. Methodological Quality of Included Studies

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Table 2. Factors Related to Quality of Life (QoL): Cross-Sectional Studies

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Table 3. Factors Related to Change in Quality of Life (QoL) Over Time: Longitudinal Studies.

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