• 가정과삶의질연구
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• 제21권3호
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• pp.1-13
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• 2003

The purpose of this study is to understand the importance of exterior environments and to identify the design guidelines for the therapeutic garden for cognitively impaired seniors with Alzheimer's disease and related dementias. The data was collected from 4 Adult Day Care Centers, 2 Nursing Homes, & 1 Assisted living in the U.S.A. from 2001 to 2002 by interview and the floor plan about the outdoor space. Although some may believe that patients with Alzheimer's disease and related disorders are unresponsive to environment, evidence shows that environments especially designed for cognitively impaired seniors can maintain or increase their level of functioning. The use of specially designed exterior environments nay have in reducing incidents of aggressive behavior, and contributing significantly to a wanderer management program. The checklist includes 6 dimensions： safety environment, various sensual stimulations, social interactions, wandering, privacy, and support orientation and reality. The results indicated that the exterior environment have to support wandering behavior, orientation and reality.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1998년도 제50차 추계 학술대회 연제집
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• pp.177-178
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• 1998

• 동의신경정신과학회지
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• 제29권2호
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• pp.111-119
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• 2018

Objectives: To investigate the characteristics of patients diagnosed with dementia or mild cognitive impairment who are treated by means of a blend between Western and Korean medicine. Methods: We searched for outpatients with dementia or mild cognitive impairment by means of a collaboration between Western and Korean medicine from August 1, 2015, to July 31, 2017, through electronic medical records in Wonkwang Hospital. The records were retrospectively analyzed according to the patients' demographic and clinical characteristics, pathway of medical care, diagnostic tests, treatment, and medical expenses. Results: Thirteen patients were included in the analysis. Among them, six patients were diagnosed with mild cognitive impairment, five with dementia, Alzheimer's type, one patient with frontotemporal dementia, and one patient with unspecified dementia. Twelve of the thirteen patients were over 60 years of age. The number of pathways from the Dept. of Neurology to the Dept. of Neuropsychiatry of Korean Medicine was almost the same as the opposite pathway. The most used diagnostic test in Korean medicine was a neuropsychological test such as SNSB, MMSE and GDS. In Western medicine, hematology and neuroimaging were frequently used for patients. Acupuncture in Korean medicine and medication in Western medicine were the most frequently used. In Korean medicine, uncovered service costs were much higher than covered service costs,. whereas, in Western medicine, covered service costs were higher than uncovered service costs. Conclusions: This study describes the basic characteristics of dementia and mild cognitive impairment patients treated by a collaboration between Western and Korean medicine. Based on these results, a clinical pathway of the collaborative practice system between Western and Korean medicine for dementia patients needs to be developed.

• 인간식물환경학회지
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• 제23권3호
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• pp.305-320
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• 2020

Background and objective: The problem that follows the increase of dementia patients is the burden of caregivers caring for dementia patients. The purpose of this study was to examine the effects of horticultural therapy programs improving the quality of life and reducing the depression and burden of caregivers of the elderly with dementia. Methods: In this study, 19 caregivers of the elderly with dementia were selected, and the experiment was conducted by dividing the control group (n=9) and the experimental group (n=10) by random distribution. The experimental group was given eight horticultural therapy programs twice a week for a total of 4 weeks. Subjects were assessed using the depression(CES-D), quality of Life (WHOQOL-BREF), and care burden scales. The evaluation results were verified at a 95% significance level using descriptive statistics, the Mann-Whitney U test, and Wilcoxon signed-rank test. Results: In the case of depression, the control group's score tended to increase, and the experimental group's score appeared to decrease, but it was not a statistically significant change. In the quality of life, the control group was not statistically significant, but scores decreased overall. On the other hand, in the experimental group, the general quality of life increased significantly from 11.60 to 14.20 points (p = .02), and the total quality of life increased to a marginally significant level from 61.59 points to 68.85 points (p = .059). In the post-test of the total care burden score, a marginally significant difference was found between the control group (94.44 points) and the experimental group (82.50 points; p = .079). Conclusion: This study confirmed the applicability to reduce the burden of caregiving and improve the deterioration of quality of life of the caregivers. In particular, the results will serve as an opportunity to confirm accessibility in a new way to support the caregiver of dementia patients by demonstrating the applicability of horticultural therapy at a time when problems such as the burden of supporting the caregiver are emerging as social problems.

• 성인간호학회지
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• 제23권2호
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• pp.111-122
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• 2011

Purpose: The aim on this study was to establish the validity, reliability and efficiency of a Pain Self-Report Scale for elderly with dementia and compare these results with an observational pain rating scale. Methods: Study subjects were 136 elderly with dementia who were residents in a nursing home, geriatric hospital, or day care center. The subject's pain was measured by five self-report scales and observational scale. DS-DAT (discomfort scale-dementia of the Alzheimer's type) was used for pain behavior observational measure. Cognitive state was assessed using the MMSE (Mini-Mental State Examination). Results: Observational rating correlated moderately with self-report (r=.225~.585, p<.05) and tended to underestimate pain intensity. Test-retest reliability was high for all five self-report scales, and the correlation between these scales was very strong (r=.735~.856, p<.05). Comprehension rate of VDS (verbal descriptor scale) was 88.3%, and NRS (numeric rating scale) 69.9%, FPS (face pain scale) 66.9%, HVAS (horizontal visual analog scale) and VVAS (vertical visual analog scale) 65.4%. Conclusion: Nurses should not apply observational scales routinely in demented patients as many of these are capable of reporting their own pain. Self-report, the highest standard of pain measurement can be reliably performed in a large proportion of demented elderly.

• 대한물리치료과학회지
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• 제19권4호
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• pp.27-34
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• 2012

The aim of study was to assess the effectiveness of dementia elderly persons on the cognitive function, Activities of Daily Living(ADL) and balance-performing ability the group therapeutic exercise programs. Fifteen community-dwelling subjects participated in this study. An 4-week group therapeutic exercise program, including strengthening and balance training, breathing and gait exercise, and recreation, consisted of activities related to daily living. The Mini-Mental State Examination-korean(MMSE-K), Modified Barthel Index(MBI), Berg Balance Scale(BBS), and Timed Up & Go (TUG) test were measured during before and after exercise points The results of this study were as follows : 1) After eight weeks, the MMSE-K and MBI total scores were significantly increased to more after than before(p<.05, p<.01). 2) in the MBI contents, personal hygiene, dressing, ambulation and chair, bed transfers scores were significant increased to after. 3) after BBS, TUG scores were statistically significant higher than the before scores(p<.05, p<.05, p<.01). These findings suggest that group therapeutic exercise program can be used to improve the cognitive function, ADL and balance-performing ability in dementia elderly persons.

• 재활간호학회지
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• 제7권1호
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• pp.58-67
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• 2004

Behavioral symptoms are frequent and problematic components of dementia. The aim of this study was to detect behavioral problem of the 25 item of dementia problem behaviour(DPB)assesment scale for demented older adults. Seventy-three patients with dementia staying in the day care center, group home, dementia hospital, nursing home were recruited data on problematic behavior obtained through interviews with their caregiver during 2 months from March to May 2004. Results shows that problematic behaviors common occurring in 95% of subjects. The most frequently exhibited problematic behaviors were repetitive movement(1.05), repetitive questions(1.03), restlessness(1.0). indifference(0.97). shouting/screaming(0.92). Problematic Behaviors of the demented older adults were closely associated to the distress for caregiver. Most distressful ones for caregivers were repetitive questions(1.46), repetitive movement(1.42), shouting/screaming (1.42), indifference(1.41). restlessness(1.41). Problematic Behaviors of the demented older adults were divided into six subdivisions, among those restless behavior was positively correlated with aggressive behavior, nervous symptom and psychotic symptom. and then nervous symptom was interrelated to psychotic symptom(P<0.01). This study has limitation that field study data were derived from various primary caregivers.

• 재활치료과학
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• 제3권1호
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• pp.31-37
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• 2014

목적 : 본 연구는 국내 장기요양보험서비스를 제공받는 치매환자를 대상으로 다양한 분야에서 이루어진 작업 중심 회상치료 프로그램을 중재 적용한 연구 효과에 대해 검토해보고자 체계적 고찰을 시행하였다. 연구방법 : 2009년부터 2013년 까지 한국교원학술정보원을 통해서 확인되는 논문을 검색하였고 주요 검색용어로는 치매, 시설 서비스, 주간 보호 센터, 회상치료, 작업 중심 프로그램 등의 단어를 사용하였다. 연구결과 : 분석 결과 총 6편의 논문이 선정되었으며 선정된 연구에서의 회상치료는 모두 작업 중심 프로그램을 병행한 집단 회상치료이다. 세부 중재 형태는 의사소통 중심 회상치료, 작업 중심 회상치료로 크게 2가지 형태로 나눌 수 있었다. 치매 환자 대상의 회상치료의 효과는 인지기능 유지 및 회상기능 향상, 우울감소, 문제행동 감소, 의사소통 및 사회적 상호작용 향상, 삶의 질 향상 등 총 5가지 효과가 보고되었으며, 연구의 질적인 측면에서는 적은 대상군, 짧은 연구기간, 추적조사 미시행으로 인해 전반적으로 낮은 수준의 내적, 외적 타당도를 보였다. 결론 : 추후의 연구에서는 보다 많은 수의 대상군의 확보와 추적조사를 통한 지속적인 치료적 효과에 대한 연구가 이루어져야 할 것이며 치매환자 대상의 다양한 형태의 작업 중심 회상치료의 연구가 이루어져야 할 것으로 사료된다.

• 한국노년학
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• 제30권4호
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• pp.1117-1127
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• 2010

본 연구는 치매노인 가족의 부담감, 대처능력과 삶의 질을 파악하고 그 관계를 확인하기위해 구조화된 설문지를 이용해 시행된 서술적 조사연구이다. 연구의 대상자는 치매주간보호센터에 등록되어 서비스를 받고 있는 65세 이상 치매 진단자의 가족으로 경기도 일개 시 주간보호센터 8곳을 임의 표출하여 2010년 4월부터 6월까지 조사하였고 최종 연구대상자는 탈락자를 제외한 93명이었다. 연구결과 치매노인 가족의 부담감과 대처능력, 건강관련 삶의 질 정도를 확인하였고 부담감은 연령, 학력, 직업에 따라 차이가 있었으며 대처능력은 학력과 월소득에 따라, 건강관련 삶의 질은 연령과 결혼형태, 치매노인과의 관계에 따른 차이가 있음을 확인하였다. 본 연구의 의의는 건강관련 삶의 질과 대처능력, 부담감간의 관계를 확인함으로써 건강관련 삶의 질 향상을 위한 중재개발에 기초자료를 제시한 것이며 앞으로 대처능력 향상을 위한 구체적 연구와 치매노인 가족의 대처능력이 스트레스와 부담감에 미치는 영향에 대한 연구가 확대될 것을 제언한다.

• 동의신경정신과학회지
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• 제30권2호
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• pp.47-58
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• 2019

Objectives: To conduct and report the results of a public health promotion program in Korean medicine (KM), namely the KM Visiting Care Service for Solitary Elderly, from November 2018 to April 2019. Methods: Six elderly people living in a rural area received the KM visiting care service, twice a week, for four months. This service consisted of acupuncture, auriculotherapy, and supportive counseling to manage their musculoskeletal pain, cognitive impairment, and/or depression. The changes of symptoms were assessed using Numeric Rating Scale (NRS), Korean version of Mini-Mental State Examination for Dementia Screening (MMSE-DS), Korean version of Montreal Cognitive Assessment (MoCA-K), and Geriatric Depression Scale-Short form Korean (GDS-SF-K). Results: Through the 4-months KM visiting care service, the overall subjects' NRS-rated pain decreased slightly. Most showed improvement in MMSE-DS and/or MoCA-K, except one subject who was diagnosed with Alzheimer's disease. Depression assessed by GDS-SF-K showed improvement in a few subjects who were unable to walk independently. Satisfaction assessed through survey was generally high in all subjects. Conclusions: This KM Visiting Care Service for Solitary Elderly may help improve the pain and cognitive function of frail solitary elderly in rural areas. However, the protocol need to be improved to optimize the effect.