• 대한지역사회작업치료학회지
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• 제5권2호
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• pp.1-9
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• 2015

목적 : 본 연구는 뇌졸중 환자를 대상으로 뇌졸중 환자의 자아방어기제와 스트레스 및 일상생활활동 수행능력과의 상관관계에 대해 알아보고자 한다. 연구방법 : 2014년 3월 14일부터 2014년 5월 15일까지 대구 부산 지역 내에 위치한 1개의 대학병원과 3개의 재활전문병원에 설문조사를 실시하여 빈도분석과 독립 표본 t검정, 피어슨 상관계수를 하였다. 결과 : 연구 대상자의 자아방어기제 유형에 따른 스트레스와 일상생활활동 수행능력을 분석한 결과 미성숙한 자아방어기제 집단이 성숙한 자아방어기제 집단보다 스트레스를 많이 받는 것으로 나타났으며(p<.05), 성숙한 자아방어기제 집단이 미성숙한 자아방어기제 집단보다 일상생활활동 수행능력이 높은 것으로 나타났다(p<.05). 결론 : 뇌졸중 환자의 스트레스가 높을수록 일상생활활동 수행능력이 낮은 것을 알 수 있었다. 뇌졸중 환자의 재활에 있어서 개인의 성격이나 생활양식에 중요한 영향을 미치는 자아방어기제를 적절히 사용함으로써 뇌졸중 환자의 신체적 기능뿐 아니라 스트레스와 같은 심리 사회적 요소에 대한 재활도 가능할 것으로 생각된다.

• 한국인구학
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• 제29권2호
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• pp.115-142
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• 2006

본 연구의 목적은 조손가족의 사회적 지지 실태와 사회적 지지가 조부모외 신체 및 정신건강에 어떤 영향을 미치는지 규명하는데 있다. 미성년 손자녀를 양육하고 있는 대전지역 조손가족 조부모 141명이 연구대상이었다. 분석결과 조손가족은 주로 공적 지지망에 의지하고 있는 것으로 밝혀졌다. 응답자 중 82.3%가 한 가지 활동 이상에 제약이 있을 정도로 조부모의 신체건강이 문제가 있었으며, CES-D로 측정된 우울정도는 평균 27.4로 중등도외 심리적 고통을 느끼는 심각한 수준으로 나타났다. 인구사회학적 특성과 스트레스 요인 중 조부모외 성별, 자녀수, 가사일 부담이 신체적 건강상태를 나타내는 일상활동제약의 유의미한 예측변인이었고 월평균소득, 손자녀 양육기간, 자녀수, 경제적 곤란, 가사일 부담, 사회적 제약이 조부모의 정신건강을 나타내는 우울 정도의 유의미한 예측변인이었다. 사회적 지지와 관련해서는 친구 혹은 이웃으로부터의 지원에 대해 양적으로 충분하다고 여길수록, 친구 혹은 이웃으로부터의 지원에 대해 만족할수록, 종교단체로부터의 지원에 대해 만족할수록 일상활동 제약이 유의미하게 덜 한 것으로 나타났고, 친구 혹은 이웃으로부터의 받는 지원유형수가 많을수록, 사회복지기관으로부터 받는 지원유형수가 많을수록 우울정도가 유의미하게 높았으며, 정부로부터의 지원에 대해 만족할수록 우울정도가 유의미하게 낮은 것으로 밝혀졌다. 연구결과를 토대로 조손가족을 대상으로 하는 정책적, 실천적 함의가 제시되었다.

• 대한간호학회지
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• 제20권1호
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• pp.88-117
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• 1990

The purposes of this study are to delineate a profile of the state of a stroke patient's adaptation at 3 months after hospitalization and to explore the relationship between the level of adaptation and the variables which influence the adaptation of hemiplegic patients. To these ends, theoretical framework was derived basically from the stress adaptation model. The basic assumption underlying the level of adaptation is influenced by the presenting focal, contextual and residual stimuli. This group of stimuli is further operationalized and represented by a perception of stress. which is the perceived effect of the disability and by the mediating variables such as sociodemographic factors as an external conditioning variables and perceived social support and hardiness personality characteristics as an internal intervening variables. The dependent varibales in this study is the level of physical, psychological and social adaptation and is hypothesized to be a function of the interaction between 3 sets of variables namely, the perceived disability effect, external conditioning variables and internal intevening varibles. A total of fourty three subjects from 3 general hospitals in Seoul were observed and interviewed with the aid of 7 structured instruments. The data were collected twice on each subject : first at the pre-discharge period arid at 3 months post-discharge from hospital for the second time. The study was carried out for the period from February to August, 1988. The instruments used for the study include 4 existing scales and 3 scales developed by the researcher for this study. They are : 1) The ADL dependency scale and the scale of the clinical physical functions for the assessment of physical adaptation. 2) the SDS(self report of depression) to measure the level of psychological adaptation. 3) The scale for the amount of social activities for the measurement of the level of social adaptation. 4) The scale for the perceived effect of disability for the measurement of the focal stimuli. 5) The health related hardiness scale and the perceived interpersonal support self evaluation list(ISEL) for the measurement of the hardiness personality character and the perceived social support. The data obtained were analyzed using percentage, oneway ANOVA, Pearson coefficients correlation and stepwise multiple regression. The findings provide valuable information about the present level of physical adaptation at 3 months after discharge. The patient revealed a decreased ADL dependency and lowered limitation of physical function as compared with pre - discharge state. Psycholcgically, the average degree of depression at follow up was within normal range of depression. Socially, the amount of social activities was very low. The one way ANOVA and the correlational analysis revealed the relationship between the 3 sets of variables and the adaptation level as follows : 1) The perceived disability effect was related to the degree of the depression and the amount of social activities but was not related to the physical adaptation. 2) Among the sociodemographic variables, sex and education were related to the difference of ADL dependency and the change of physical function. These factors indicate that women more than men and educated more than the less educated were found more independent. The education was also related to the degree of depression suggesting that the higher the educational level, the more well adapted the patients were both physically and psychologically. Age, marital status and job state were not found to be related to the patient's adaptation level. 3) Among the internal intervening variables, the health related hardiness characteristic was related to the differences of ADL dependency, physical functions and the social activities, indicating that the higher the hardiness character the higher the level of physical and social adaptation. 4) The perceived social support, another internal intervening variable, was related to the degree of depression and the social activities. This data suggest that the higher the perception of social support, the better adapted the patients were psychogically and socially. In summarizing the results of the correlational analysis, the level of physical adaptation was influenced by sex, the years of education and the hardiness character. The level of psychological adaptation was influenced by the years of education, the perceived disability effect and the perceived social support. And the level of social adaptation was influenced by the perceived disability effect, the hardiness character and the perceived social support. The stepwise multiple regression analysis shows findings as follows : 1) The most important factor to explain the difference of ADL dependency was sex, indicating females were more independent than males. 2) The most important factor to explain the difference of physical function and the degree of depression was the patient's education level. 3) The strongest explaining factor for the amount of social activities was perceived self esteem(one of the subconcepts of perceived social support). Thus the most important factors influencing the level of adaptation were found to be sex, education, the hardiness character and self esteem. From the above findings, the significance of this study can be delineated as follows : 1) Corroboration of the assumed relationship between the various variables and the adaptation level as suggested in the conceptual model. 2) Support for the feasibility of the cognitive approach for nursing intervention such as hardness character training, counselling and teaching for self-care in the chronic patients.

• 대한간호학회지
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• 제23권4호
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• pp.602-616
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• 1993

The purpose of this study was to explore the degree of stress in caregivers caring for patients who had had a cerebro vascular accident as the stress is related to the self- care ability of the patient. The subjects for the study were caregivers of 111 CVA patients, hospitalized at two University affiliated hospitals and two general hospitals in Daejon. The survey instruments used in the study were Kang’s ADL Check List and a modified form of Lee’s Stress Inventory. The survey was conducted from July 16th to August 30th, 1992. The survey results were analyzed using the Statisitical Package for Social Sciences (SPSS) and can be sumerized as follows: 1. The level of self- care for the CVA patients was : 1) complete dependence (M=34.7, 31.2%), 2) complete independence (M=14.8. 13.3%), 3) in-complete independence ( M=17.5, 15.8% ), 4) in-complete dependence (M=14.8, 13.3%) and 5) dependence and independence (M=14.1, 12.7%). The items for which there was a high level of self-care were 1) drinking (M=3.640), 2) returning (M=2.351) and 3) eating (M=2.351) : and the items for which there was a low level of self -care were : 1) ascending and descending stairs (M=2.351), 2) dressing and undressing trousers (M=2.514) and 3) dressing and undressing jacket (M :2.532). 2. There was a statistically difference between the paralytic status and the level of self- care accord-ing to their demographic characteristics ( F=24. 7056, p(.001). 3. There was no significant difference in the degree of caregiver stress according to patient's demo-graphic characteristics. 4. There was a statistically significant difference in the degree of caregiver stress according to the following demographic characteristics : age (F=7.4189, p(.001), education level (F=5.8336, P(.01), family structure (t=2.10, p(.05) and their relationship with the patient (F=6.5099, P〈.01). 5. There was no significant difference in the degree of caregiver stress according to the level of patient self - care.

• 한국보건간호학회지
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• 제23권1호
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• pp.40-49
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• 2009

Purpose: To investigate the relationships among stress, depression, family function, and activities of daily living in elderly females. Methods: Using a descriptive correlation for the study design, data was collected from 134 elderly females older than 60 years of age. Result: The level of depression among the subjects was 6.04($\pm5.30$) and level of stress was 1.62($\pm.70$). The performance capacity of the activities of daily living was 17.79($\pm0.87$), and the instrumental activities of daily living was 22.33($\pm2.66$). The family function was 2.82($\pm3.47$). Depression and stress showed a positive correlation(p<.001) and had a negative correlation with family function(p=.025), as the correlation with instrumental activities of daily living was negatively related(p=.008). Stress had a positive relationship with family function(p<.001). and was negatively related to instrumental activities of daily living (p=.041). Conclusion: For health promotion of elderly females, it is critical to make an effort to establish and constantly develop a program, as well as policy for the health of the elderly considering and understanding gender differences.

• 한국사회복지학
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• 제58권1호
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• pp.291-318
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• 2006

본 연구는 도시지역 미취업노인들의 취업의사결정 요인들을 규명하기 위하여 노인들의 취업의사와 인구사회학적인 요인, 건강 및 심리사회적 요인, 그리고 노동 및 경제적 요인들과의 관계를 분석하였다. 본 연구는 서울시 소재 노인종합복지관을 이용하시는 60세 이상의 노인들 중에서 총 220명을 편의 모집(Purposive Sampling)하여 구조화된 설문지로 면접자에 의한 설문을 실시하였고, 최종 194명을 분석에 활용하였다. 본 연구의 분석방법으로는 취업의사여부에 따른 조사대상들의 특성은 빈도, 백분율, 평균, $X^2$ 및 t-test 등의 통계를 통해서 산출하였고, 취업의사결정에 영향을 미치는 요인들을 규명하기 위하여 로지스틱 회귀분석(Logistic Regression)을 사용하였다. 본 연구의 주요 결과로는 도시거주 미취업 노인들의 취업의사여부는 노인들의 성별, 연령, 학력, 자녀수, 신체적 건강상태, ADL, 자아 효능감, 경제적 스트레스, 노동 총 종사기간 부동산 소득, 가족후원금 및 연금 급여수준 등 다양한 요인들에 의하여 결정된다는 것이 조사되었다. 이러한 노인취업의사결정에 영향을 미치는 다양한 요인들을 고려안 노인고용관련 정책, 제도 및 프로그램 개발 및 운영이 필요하다. 끝으로 본 연구결과를 바탕으로 고령사회에 대비한 노인취업 활성화를 위한 제언 및 함의를 개괄적으로 제시하였다.

• 지역사회간호학회지
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• 제10권2호
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• pp.372-386
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• 1999

The purpose of this study was to explore the degree of stress in caregivers caring for CVA patients and the level of daily living performance of CVA patients. The subjects for the study were caregivers of 112 CVA patients who enter a hospital or out-patient-department (OPD) at two Oriental medical hospital in Jeonbuk province. The survey instruments used in this study were Kang's ADL check list for daily living performance of patients and Choi's 4 sore scale for stress of caregivers. The survey was conducted from July 4th to August 30th in 1999. The survey results were analyzed with the Statistical Package for Social Science(SPSS) program and can be summarized as follows: 1. The level of daily living performance for the CVA patients was: 1) complete dependence (M=14.9, 13.1%), 2) complete independence (M=23.6, 20.9%), 3) incomplete independence (M=23.9, 21.0%), 4) incomplete dependence (M=26.6, 25%), 5) dependence and independence (M=23.0, 20.0%). The items for with there was a high level daily living performance were: 1) drinking (M=3.62), 2) eating(M=3.25). 3) position returning (M=3.18) : and the items for which there was a low level of daily living performance were: 1) ascending and descending stairs (M=2.08), 2) walking (M=2.47), 3) dressing and undressing trousers (M=2.55). 2. Degree of caregiver stress was: Mean=2.39 at 40 score. The items for which was a high level caregiver stress were: 1) medical fee (M=3.25), 2) being handicapped or recurrence (M=3.02) : and the items for which there was a low level of caregiver stress were: 1) discontinuity of patient's treatment (M = 1.98). 2) change of home atmosphere caused by patient's disease (M = 1.98), 3) desire of patient's knowing about disease (M= 1.99). 3. There was statistically significant difference in the degree of caregiver stress according to the following caregiver's demographic characteristics: education level (F=3.52, P=0.03). change of caregiver (F=5.41. P=0.02). 4. There was a statistically signifiant difference in the level of daily living performance according to the CVA patients demographic characteristics: patient's paralytic status (F=4.48, P=0.01), duration of disease (t=2.76, P=0.03). 5. There was significant difference in degree of caregiver stress according to the CVA patient's demographic characteristics: CVA status (F=4.75, P=0.01). 6. There was statistically significant difference in the degree of caregiver stress according to the level of daily living performance in CVA patients(r=-0.482, P<0.00).

• 농촌의학ㆍ지역보건
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• 제35권3호
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• pp.274-286
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• 2010

본 연구는 지역사회서비스투자사업의 일환으로 실시된 지역개발형 사업으로 중재서비스를 제공하는 작전연구의 일환으로 조손가정의 양육, 건강 및 영양중재서비스 효과를 분석한 분석적 연구이다. 연구대상자와 연구기간은 서비스제공집단과 비제공집단 간의 비교는 2008년 1월 현재 양육과 건강중재서비스 효과를 보았으며, 서비스제공집 단만의 조사는 2009년 1월에는 건강중재서비스의 효과를, 7월에는 영양중재서비스효과를 보았다. 조손가정의 인구사회학적 특성은 서비스제공집단과 비제공집단 간에 동질성이 확인되었으며, 조부모는 조모가 많은 편으로 평균 연령은 68.3세-70.1세이었고, 생활수준은 못 사는 편에 속하는 가정이 전체의 2/3 정도로 경제적 어려움을 보여주었으며, 교육수준은 "무학"이 가장 많았고, 배우자가 있는 조부모는 과반수이상이었다. 조부모의 양육스트레스는 서비스 제공집단과 비제공집단 간에 통계적으로 유의한 차이는 나타나지 않았으나, 아동이 지각한 조부모의 양육태도는 서비스를 받은 아이들의 우울수준이 현격하게 낮았다(t=2.90, df=116, p<.01). 부모영역의 스트레스는 통계적으로 유의한 차이를 보였고(t=1.85, df=116, p<.10), 학업영역에서는 현격한 차이를 보여 중재서비스의 효과(t=3.98, df=116, p<.001)가 검증되었다. 조부모의 건강상태에 대한 서비스제공집단과 비제공집단간에는 우울, 급성질환이환율, 수단적 일상생활수행 능력, 인지기능 및 운동실천율에서 유의한 차이가 있는 것으로 중재서비스의 효과가 나타났다. 하지만, 서비스제공집단만의 1년 후의 효과에서는 중재서비스의 효과가 없는 것으로 나타났지만 상태는 유지된 것으로 나타났다. 영양중재서비스는 총점에서 통계적으로 유의한 효과는 없었으나, 하부영역인 주관적 영양 평가항목에서 유의한 차이가 있는 것으로 검정되었다(t=18.230, p<.0001). 결론적으로 조손가정의 양육, 건강과 영양중재서비스가 효과가 있는 것으로 나타나, 앞으로 조손 가정을 위한 중재서비스가 정책적으로 시도되어야 할 것이다.

• 농촌의학ㆍ지역보건
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• 제36권4호
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• pp.207-217
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• 2011

본 연구는 노인이 하나의 동일한 성격을 가진 집단이 아니라 연령에 따라 다양한 경험과 세대 차이가 있는 하위 집단으로 이루어져 있다는 것을 전제로 하여 65~75세 미만의 전기노인과 75세 이상의 후기 노인들의 특성과 개인별 건강행태 특성, 그리고 현재의 건강상태 등을 비교하고자 하였다. 이를 위하여 상주시 관내 24개 읍 면 동 지역의 경로당 이용자 617명(전기노인 287명, 후기 노인 330명)을 대상으로 설문 조사를 실시하고 실태를 비교분석한 결과는 다음과 같다. 인구사회학적 특성에 따른 결과는 남 여 모두 학력과 직업, 결혼상태, 동거가족에서 전 후기노인간에 유의한 차이가 있었다. 주 3회 이상 10분 이상 걷기 횟수는 남자 후기 노인이 전기노인에 비해서 유의하게 높았고 수면 시간은 남자와 여자노인 모두 전기노인의 수면시간이 후기노인에 비해서 유의하게 많았다. 질병 이환율은 여자 후기노인이 전기노인에 비해서 유의하게 높았고 제시한 16가지 계통의 질병중에서 남자 노인은 신경통 관절염이, 여자노인은 고혈압이 전기노인에 비해 후기노인의 이환율이 유의하게 높았다. 대상자의 생활수행능력은 경로당을 이용하는 건강한 노인이라는 특성이 반영되어 ADL(일상생활수행능력) 6개 항목을 모두 스스로 실천하는 응답자는 96.4%, IADL(수단적 일상생활능력) 6개 항목을 모두 실천하는 응답자는 90.8%로 매우 높게 나타났다. 건강상태에서 여자는 스트레스와 자살을 생각해본 경험이 후기노인이 전기노인에 비해 유의하게 많았고, 구강건강 상태와 청력, 시력은 남자와 여자 모두 전기노인이 후기노인에 비해서 유의하게 좋은 것으로 나타났다. 전 후기 노인의 건강행태와 건강상태에 대한 비교에서 남자는 주 3회 이상 10분 이상 걷기, 수면시간, 구강건강, 청력이, 여자는 수면시간, 스트레스, 청력, IADL이 유의한 변수로 분석되었다. 이상의 연구에서 후기 노인은 전기 노인에 비해서 인구사회학적인 특성에서 취약하며 이환된 질환의 수는 많았으나 규칙적으로 운동을 하는 노인은 적었다. 또한 신체활동능력과 정신건강 그리고 구강건강, 청력, 시력이 전기 노인에 비해서 좋지 못하였다. 따라서 후기노인에게 나타나는 신체적 정신적 건강의 취약성을 노화과정의 하나로만 볼 것이 아니라 연령층에 따라 나타나는 다양한 특성중의 하나라고 받아들이고 전 후기 노인들의 건강행태와 건강상태의 특성에 맞춘 다양한 질병예방, 건강 증진프로그램을 개발하고 적용할 수 있는 국가적 차원의 관리와 지원이 요구된다.

• 보건교육건강증진학회지
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• 제12권1호
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• pp.83-110
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• 1995

The purpose of this study was to investigate the status of the problematic behavior for the demented elderly and the stress among family members, and the effects of the problematic behavior upon the stress in order to offer the basic data for the adult and the elderly health education about dementia. For this purpose, 70 families who were resident in Seoul and Inchon were surveyed by quetionnaires. This was carried out from 26 July, 1994 to 11 September, 1994. Datum was analysed by using SPSS\PC+ including percentage, mean, t - test, ANOVA, Pearson correlation. So, the results of this study were as follows: 1. In view of socia-demographic characteristics, female were 82.9%, and of the female daughters-in-law of the demented elderly were 44.9%. 40th years old were 32.9% and 88.6% wase married. The christian were 34.8%, those who graduated university 47.1%, and those who had a job 32.9%. 2. Of the demented elderly, female were 74.3%, 80 years old were 37.1%, and their average age was seventy-seven point one years old. 66.2% of the elderly has been lived alone and the christian were 27.5%. In addition, those who graduated elementary school were 66.5%. 3. Of the behavior problem for the demented elderly, Activities of the Daily Living(ADL) was the most severe problem. The 2nd was cognitive function problem, the 3th, change of personality, the 4th, emotional disturbance, and the last, misconduct behavior. 4. For the status of behavior problems, females were more severe than male, and 80th years elderly ware the most severe groups. The longer disease period was, the severe problematic behaviors were, and in 4-6 years of the disease period the status was the highest(p＜0.05). Those who diagnosed the disease had more severe problems(p＜0.001). 5. The orders of the stress among family members caring for the demented elderly in this study were as follows : 1. The deficiency of supporting network 2. Decrease of elderly's cognitive activities 3. Assistance of BADL(Basic Activities of Daily Living) 6. Elderly's abnormal behavior 5. Assistance of IADL(Instrumental Activities of Daily Living), 6. As for the status of the stress among family members, female respondants were higher than male. On the ages, 20th years' stress score were the highest. Daughters-in-law were stressed more than other family members. The longer the time of caring per day was, the highest the status of the stress(p＜0.05), 7. Those who caring for female elderly and more than 80 years had more stressed. When the elderly was received the diagnosis, the family members were more stressed. On the disease period, 1-2 years was the highest and after 2 years the status of the stress was decreased and more than 6 years was the lowest(p＜0.05). 8. Behavior problems of the demented elderly were closely associated to the stress for family members. Of the problems, change of personality was the most related factor(r = 0.6552). The factors of Basic Activities of the Daily Living(BADL) was most correlated on assistance of Basic Activities of Daily Living (BADL), emotional disturbance the assistance of IADL(Instrumental Activities of Daily Living). Change of personality was most related to the stress of the decrease of cognitive activities and elderly's abnormal behavior. The deficiency of supporting network was most related to misconduct behavior.