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Concept Analysis of Frail Elderly based on Walker and Avant's Method

Walker와 Avant 방법에 근거한 허약 노인 개념 분석

  • 김재현 (전주비전대학교 간호학부)
  • Received : 2019.02.08
  • Accepted : 2019.05.03
  • Published : 2019.05.31
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Abstract

The purpose of this study is to clarify the concept of the frail elderly and to obtain theoretical evidence. The research method was conducted using the basic principles for conceptual analysis of Walker and Avant(2005). As a Result of a review of the literature about how to utilize the concept of a frail elderly, frail elderly might be in the intermediate state of health and disease. They can be defined as physically vulnerable in the sarcopenia, inflammation, insulin resistance, and preceding advanced disease, lead to hospitalization, falls, disability, and death. The attributes were physiological, psychological, and socio-environmental and economic factors, so they had multidimensional factors. They were required the assist daily living of another person. Also, their attributes had decreased the amount of recovery time and degree, and exhaustion. The attributes of frail elderly consisted of these facts: dynamic process, multidimensional factors, dependency, vulnerability. The frail elderly was a dynamic process that involves the possibility of change to health and disease, and include physical, mental, cognitive, and social environmental factors. In addition, the frail elderly was difficulty in daily life, physical vulnerability and difficulty in adaption. In conclusion, frail elderly as defined by the results of this study will contribute to the foundation of health care systems, including community visiting nursing to understand the level of frail elderly and systemic management to do not go into long term care.

본 연구의 목적은 허약노인에 대한 개념의 명확한 속성 규명과 이론적 근거를 마련하는 것이다. 연구방법은 Walker와 Avant(2005)의 개념분석을 위한 기본 원리에 근거하여 절차에 따라 진행하였다. 허약노인에 대한 개념 사용의 연구결과는 허약노인은 건강과 질병의 중간상태에 있다. 허약노인은 신체적으로 근감소증, 염증, 인슐린 저항성에서 신체적으로 취약하고, 진행된 질병의 결과로 입원, 낙상, 장애, 사망에 이를 수 있다. 생리적, 심리적, 사회적 생활습관, 경제적 요인과 관련된 다면적 속성을 가지며, 일상생활에 제한으로 다른 사람의 도움을 필요로 하여 의존적이며, 회복시간과 회복의 정도가 저하되는 것과 소진(exhaustion)의 속성을 가지고 있는 것으로 확인되었다. 즉, 역동적 과정(dynamic process), 다면적 요소(multidimensional factors), 의존성(dependency), 취약성(vulnerability)이다. 허약노인은 건강과 질병의 중간 상태로 변화 가능성을 내포한 역동적 과정이며, 신체적, 정신적, 인지적, 사회 환경적 요소를 포함한다. 또한 일상생활에 어려움이 있는 노인으로, 신체적 취약성과 함께 적응에 어려움을 가지고 있는 노인을 의미하였다. 결론적으로 본 연구는 허약노인의 개념분석과 이해를 통해 노인의 허약 수준을 파악하고, 체계적으로 관리함으로써 장기요양상태에 이르지 않도록 지역사회 방문간호를 포함한 보건의료체계 마련을 위한 기초자료 제공에 기여할 것이다.

Keywords

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Fig. 1. Flow of the searching strategies applied

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Fig. 2. Identify antecedent and consequences of frail elderly.

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