• 제목/요약/키워드: Dementia Patient Family

검색결과 37건 처리시간 0.026초

노인성 치매환자 가족간호 향상을 위한 교육프로그램 효과에 관한 연구 (Study on the Effectiveness of Care Giver Education Program on the Home Care of Senile Dementia Patients)

  • 홍여신;이선자;박현애;조남옥;오진주
    • 대한간호학회지
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    • 제25권1호
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    • pp.45-60
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    • 1995
  • This study investigated the effects of education program conducted through individual home visit by CHPs, which was developed ,by the operational re-search technique for families of dementia patients. (Yeo Shin Hong et at,1994) The study was conducted in the form of a primary experimental design with 43 people as subjects, including dementia patients and family member in several Myon areas of Chungcheong Namdo between June 10 and August 20, 1994. The data was collected by questionnaires through the home visit by the CHPs. The results of study are as follows. 1. There is no difference in the quality of life between before and after the education program. 2. Role stress 'before the education program' was significantly different than 'after the education program'. 3. There was no difference in the feeling of burden between before and after the education program. 4. There was a significant difference in the abnormal behaviors of patients between before and after the education program. 5. The knowledge of dementia by the patient's family increased significantly after the education program, compared to that of 'before the education program'. 6. There was a significant difference in the attitude of family members toward the education program on dementia between before and after the education program. 7. The results of analysis on the coefficient relationship of various variables showed that the age of patients and family members have a significant correlation with role stress(p=.01). 8. In the subjective evaluation of family members on changes in actual nursing actions and the improvement of knowledge and technique in terms of daily living, (including abnormal behavior of patients, adjustment of environment for patients, activity programs for patients, communication technique with patients, ensuring the safety of patients, clothing, meals and elimination, 60-65% of family members responded that their knowledge had increased. As for improvement in techniques for each item, the technique for communication with patients showed the greatest improvement while the action program method for patients showed the least change. As for the nursing service provided to patients, most respondents showed a positive change. The specific items for which more than 80% respondents answered positively were as follows : recognizing the demand of patients, getting patients to do simple house works, talking softly and gently, removing dangerous things, preparing comfortable clothes that are easy to put on and take off, and limiting water consumption at night. As a result of study, the following suggestions can be made. The purpose of the study was to examine the effect of an education program developed and applied for dementia patients and family members in the community. This needs to be compared with a similar study conducted in the urban setting. In addition, a community service program (ex : nursing hem and shelter) including the application of the education program should be developed and the study done to investigate its effect.

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치매노인 가족의 누적스트레스 영향요인 (Influencing Factors on File-up Stress in the Caregivers of Patients with Dementia)

  • 서문경애
    • 한국노년학
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    • 제25권2호
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    • pp.195-209
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    • 2005
  • 본 연구는 치매노인 발생이라는 가족 위기에 대하여 이를 돌보는 치매가족의 누적스트레스 정도를 확인하고 누적스트레스에 영향을 미치는 변수를 규명하기 위한 서술적 조사 연구이다. 대상자는 가정 내에서 동거를 하며 치매노인을 돌보는 가족 중 편의표출법에 의해 선택된 102명이었다. 연구도구로는 McCubbin(1987)의 누적스트레스 측정 도구, McCubbin, Patterson과 Thompson(1991)의 가족 강인성 측정 도구, McCubbin, Patterson과 Glynn(1982)의 사회적지지 측정 도구, McCubbin, Larsen과 Olson(1982)의 친척 및 친구지지 측정 도구, 그리고 McCubbin, Larsen 과 Olson(1981)에 의해 개발된 가족의 문제해결 및 대응전략 측정 도구를 이용하였다. 본 연구결과 치매노인을 돌보는 가족의 누적스트레스 정도는 평균 1.74점(범위 1.3-2점)로 나타나 비교적 높은 누적스트레스를 나타내었다. 가족의 강인성, 사회적지지, 친척 및 친구지지, 가족의 문제해결 및 대응전략의 점수가 높을수록 가족의 누적 스트레스 정도가 낮아지는 것으로 나타났다. 가족의 누적스트레스에 영향을 미치는 주요변수들은 8%의 설명력을 보여주었고 여기에 치매노인을 돌보는 가족의 일반적 특성 중 주간호제공자가 인지한 본인의 건강상태, 치매노인의 건강상태, 하루 중 치매노인을 돌보는 시간, 치매노인을 돌본 기간, 치매가족의 총수입, 치매노인을 돌보는데 드는 비용 등 모든 변수를 중심으로 다중 회귀분석을 한 결과 이 모형에서는 21.7%의 설명력을 보여주었다. 이 변수들 중 치매가족의 총수입과 치매노인을 돌보는데 드는 비용이 통계적으로 유의하게 나타났는데, 이는 가족의 누적스트레스를 감소하기 위해서는 그 어떤 변수보다도 가족의 안정을 위한 기본 요소인 경제부분이 많은 영향력을 미치고 있음을 알 수 있었고, 차후 치매노인을 돌보는 비용을 감소할 수 있는 정책적이고 구조적인 장치가 필요함을 시사하고 있다.

치매 환자를 위한 스마트 캐어 시스템 구현 (The implementation of Smart Care System for Dementia Patients)

  • 하은실
    • 한국산학기술학회논문지
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    • 제15권6호
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    • pp.3832-3840
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    • 2014
  • 고령화 사회로 급격히 진행 함에 따라 치매 환자 또한 급속히 증가하고 있으나 진행이 되면 완치가 어려운 실정이다. 초기에 발견하고 진행 과정을 늦추는 것이 치료의 목표이고 환자의 안전, 지속적인 보살핌, 일상 생활, 건강 관리지원이 중요하다. 본 논문의 스마트 케어 시스템은 동작 감지 센서, 가스 누출 감지 센서를 활용한 블루투스 통신 기술을 사용하여 화재, 가스 누출, 가출시 배회등의 각종 응급 상황에 대처 할 수 있게 해주고, 스마트폰을 통해 환자의 일상 생활 수행능력을 지속적으로 관찰, 관리 함으로써 한국의 효 문화의 특성상 환자가 입원 전 가정에 더 오래 머물 수 있도록 하면서도 치매 환자의 부양자들이 갖는 경제적, 신체적, 심리적 부양 부담을 줄일 수 있다. 시스템 내에서 축적된 개인별 데이터베이스는 전문의에게 상담, 치료 가능하며 전문 치료 기관 및 복지 시설과의 연계를 통한 전문 서비스를 지원 받을 수 있다.

치매환자 부양자의 스트레스와 소진경험 (Stress and Burn-Out Experience in Caregivers of Patients with Senile Dementia)

  • 손계순
    • 한국농촌간호학회지
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    • 제1권1호
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    • pp.40-48
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    • 2006
  • Purpose: This study was done to identify the experience of stress and burn-out in caregivers of patients with senile dementia. Method: To evaluate the degree of stress and burn-out in caregivers of patients with senile dementia, 64 caregivers and matched to 64 patients with senile dementia at a Primary Health Care Post in South Kyung Sung Province were selected. The study was carried out from March 6 to March 30, 2001. Data on the degree of dementia in the patients was measured by the MMSE-K (Mini-Mental State Examination-Korea) and caregiver characteristics such as, sex, age, marital status, educational level, job, socioeconomic status, religion, number in family, relationship with patient, duration of care, and chronic disease in caregiver were collected by direct interview with a questionnaire. Results: Of 64 patients with senile dementia, 15.6% were classified as mild dementia (MMSE score 20-24) and 84.4%, as severe dementia. There were no significant characteristics of caregivers associated with the degree of stress and burn-out experience. The degree of burn-out in these caregivers of patients with severe dementia (mean value 94.3) was significantly higher than the 81.4 for those caring for patients with mild dementia (p<0.05). However, the degree of stress was not significantly related with the degree of dementia. The proportion experiencing severe burn-out (above score 4) was 54.7% in the physical domain, 90.6% in the emotional domain, and 73.4% in psychiatric domain, respectively. Conclusion: The above findings suggest that the degree of stress and burn-out experienced by caregivers of patients with senile dementia are high. Also the degree of burn-out experienced by in caregivers of patients with severe dementia was higher than for those caring for patients with mild dementia.

초기 치매환자 가족 돌봄제공자의 공유 의사결정에 대한 인식: 질적 내용분석 연구 (Perception about Shared Decision Making of Family Caregivers of Early Dementia Patients: A Qualitative Content Analysis Study)

  • 김윤재;송준아
    • 한국노년학
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    • 제38권3호
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    • pp.501-519
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    • 2018
  • 본 연구의 목적은 초기 치매환자 가족 돌봄제공자의 공유 의사결정에 대한 인식을 탐색하는 데 있다. 이를 위해 서울시 3개 치매지원센터에 등록된 초기 치매환자를 돌보는 가족 돌봄제공자 12명(여성 8명, 평균연령=$71.4{\pm}10.4$세)을 대상으로 반 구조화된 개별 심층면담을 이용하여 수집된 자료에 대해 질적 내용분석을 시행하였다. 본 연구를 내용 분석한 결과 6개 범주, 17개의 하위 범주가 도출되었는데 구체적인 연구결과는 다음과 같다. 초기 치매환자 가족 돌봄제공자의 공유 의사결정에 관한 인식은 치매환자와의 의사소통 촉진 수단과 치매환자의 자율성 보장 수단, 치료 촉진 기회, 가족 돌봄제공자의 부담감 증가 원인, 치매환자와의 관계 악화 원인, 우선순위 변화에 따른 선택 사항의 여섯 가지 범주로 나타났다. 또한, 공유 의사결정의 상황과 시기 및 공유 의사결정에 대한 인식이 가족 돌봄제공자의 경험을 통해 만들어졌다는 점을 알 수 있었다. 따라서 치매 관련 교육 시 간접경험을 통해 공유 의사결정을 선택 사항으로 생각하는 가족 돌봄제공자들에게 공유 의사결정을 경험할 수 있는 기회 등을 제공하는 것이 공유 의사결정에 대한 인식 제고에 도움이 될 수 있을 것으로 사료된다. 이상 결과에 근거하여 초기 치매환자의 자기결정권 존중과 가족 돌봄제공자들의 부담감을 감소시키기 위해 공유 의사결정을 성공적으로 할 수 있는 실제적이고 총체적인 교육 프로그램의 개발 및 평가 연구를 제언한다.

치매노인의 증상정도가 부양자의 자살생각에 미치는 영향에 대한 연구: 부양부담의 매개효과를 중심으로 (A Study on the Effect of Caregiver Burden on Suicidal Ideation among Caregiver for the Elderly with Dementia)

  • 김재엽;김준범;장대연;송인한
    • 한국노년학
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    • 제36권3호
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    • pp.883-903
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    • 2016
  • 본 연구는 부양자가 인지한 치매노인의 증상 정도와 치매노인 부양자의 자살생각의 관계에서 부양부담의 하위 요인을 세분화하여 매개효과를 검증하고, 치매노인 부양자를 위한 사회복지적 개입 방안 제시를 목적으로 한다. 이를 위해 2015년 현재 서울시, 경기도와 부산의 각 지역에서 데이케어센터 및 요양기관을 이용하는 치매노인 부양자를 대상으로 설문을 진행하였고 총 428부의 자료를 수집하였으며, 이들 중 응답이 부실한 13부을 제외한 415부의 설문지를 최종분석에 사용하였다. SPSS 21.0을 사용하여 매개효과와 그 유의성을 검증하였고 그 결과는 다음과 같다. 첫째, 치매노인 부양자 중 최근 1년간 자살에 대한 생각을 해본 적이 있다고 응답한 부양자는 21%로 나타냈다. 둘째, 치매노인의 증상 정도는 부양부담에 정적인 영향을 미치는 것으로 나타났다. 셋째, 부양자의 부양부담은 부양자가 인지한 치매 노인의 증상정도와 부양자의 자살생각과의 관계를 부분적으로 매개하고 있었고 이 매개효과는 통계적으로 유의미한 결과를 보여주었다. 이를 통해 부양자의 자살생각에 정적인 영향을 미치는 부양부담을 낮추기 위한 방안으로서 치매노인과 부양자에 대한 접근이 개선되어야 한다는 점을 제시하였고 이를 달성하기 위한 사회복지 중심의 프로그램 도입을 제안하였다.

간호학생의 치매환자 간호 임상실습 체험 연구 (The Study of the Nursing Students Lived Experience of Clinical Practice Nursing of Dementia Patients)

  • 황윤영
    • 한국간호교육학회지
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    • 제10권1호
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    • pp.161-171
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    • 2004
  • Purpose: The purpose of the study is to investigate the reality of nursing students lived experience of clinical practice nursing of dementia patients, which will provide the basic research material to enhance the effect of their clinical practice. Method: Van Manens hermeneutic-phenomenological method has been used to analyze the data. Participants consisted of 8 second-year nursing students who did the clinical practice at a dementia unit in C hospital. Data was collected from in-depth face to face interviews. Result: $\ulcorner$being confused by the unfamiliar environment of nursing practice$\lrcorner$, $\ulcorner$being disordered about the patients' duality behaviour$\lrcorner$, $\ulcorner$perceiving necessity to accept patients' behaviors$\lrcorner$,$\ulcorner$feeling personal connections likely to grandmother$\lrcorner$, $\ulcorner$realizing the patients affection of their family$\lrcorner$,$\ulcorner$being frustrated by the patients' hopelessness$\lrcorner$,$\ulcorner$lessening biased view on dementia$\lrcorner$, $\ulcorner$feeling the anxiety about the unsecured future$\lrcorner$, $\ulcorner$realizing the necessity of the gradual and individual care$\lrcorner$,$\ulcorner$understanding the nursing of dementia as comprehensive nursing$\lrcorner$Conclusion: We are able to obtain an in-depth understanding about the nursing students lived experience of clinical practice nursing of dementia patients. Based upon this, there is a need to develop a better nursing intervention in order to enhance the effect of the nursing students clinical practice.

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지역사회 내 치매환자가족의 돌봄부담감에 미치는 영향요인 (Factors Influencing the Caring Burden of Families with Dementia in a Community)

  • 이혜경;김소율
    • 한국응용과학기술학회지
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    • 제36권4호
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    • pp.1373-1384
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    • 2019
  • 본 연구는 지역사회 내 치매환자가족의 돌봄부담감에 미치는 영향요인을 분석하기 위한 서술적 조사연구이다. 자료수집은 2018년도 11월 30일~12월 9일까지 10일간 지역사회 내 치매환자가족 223명을 대상으로 하였다. 연구의 결과 인구사회학적 특성에 따른 돌봄부담감 정도는 치매환자가족의 주돌봄자 연령대, 치매환자와의 관계, 치매환자 돌봄기간, 치매환자 돌봄 시 어려운 점에 따라 통계적으로 유의한 차이가 있었으며 돌봄부담감은 치매지식과 부적상관관계(r=-.145, p=.030)가 있었다. 치매환자가족의 돌봄부담감에 미치는 영향요인으로는 치매환자 돌봄기간(β=.408, p=.006), 치매환자 돌봄시 어려운 점(β=-.307, p=.023), 치매환자와의 관계(β=-.299, p=.013), 치매환자가족의 주돌봄자 연령대(β=-.265, p=.007) 순으로 영향을 미치고 있음이 확인되었다. 이에 지역사회 내 치매환자가족의 돌봄부담감 완화를 위한 실질적이고 지속적인 돌봄중재 프로그램이 필요하며 특히 치매환자 가족돌봄자를 대상으로 체계적이고 주기적인 신체적·정신적 건강관리가 필요하다.

노인성 치매 환자의 돌봄경험에 대한 문화기술지 (Ethnography of Caring Experience for the Senile Dementia)

  • 김귀분;이경희
    • 대한간호학회지
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    • 제28권4호
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    • pp.1047-1059
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    • 1998
  • Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the fomer is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. These differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoetical model of nusing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants (4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure" . At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. They, also, experience indifference such as being upset and left alone. The forth is "acceptance" They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning others' recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequences enable us to summarize the principles of cue experience such as, in the early stage, negative response such as physical·psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is an initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above : however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encouraged if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses and positive responses are constantly being converted. I would like to suggest the following based on the above conclusions : First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.

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치매노인 가족부양자의 대처방법에 관한 연구 (A Study on a Coping Method of the Family Caregivers of Demented Patients)

  • 유광수
    • 지역사회간호학회지
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    • 제13권4호
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    • pp.648-667
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    • 2002
  • This was a descriptive study designed to identify the level of coping method and its influencing factors on the family caregivers of demented patients, and resolve the family caregivers' level of stress. The data were collected from September 10 to October 10, 2001. Subjects for this study were recruited from four clinics, which were chosen from 15 clinics located in Chunbuk-Do as the study sites because of their cooperation for the study. They were similar in terms of size, the characteristics of the local community. and the population and registration status of the demented patients. The instruments used for the study were as follows: 1. Problematic behaviors of demented patients are measured by the Memory and Behavior Problem Checklist (Zarit, 1980), and the Linguistic Communication Symptoms Questionnaire (Bayles and Tomoeda, 1991) 2. The ability to carry out daily activities was measured using the Barthel Index (1965) and Katz Index (1963), which as well-known ADL assessment methods. 3. Burden was measured using Cost of Care Index by the Kosberg and Cairl (1986). 4. Coping strategy was measured Bell's 18 methods (1977). The data were analyzed using SPSS/PC. The study results were as follows: 1. The total stress score was 2.90 out of a maximum score of 5. The highest score reported was 3.09 on the dimension of restriction of individual and social activities, and the lowest region reported was 2.58 on the dimension of mental and physical health. 2. The total score of the coping method was 2.65 out of a maximum score of 5. The highest score reported was 4.01 on the dimension of thinking that includes an ideation such that it is better than any possible worst case, and the lowest score reported was 1.45 on the dimension of the self-image as a scapegoat. 3. There were significant differences in coping method among the subjects by age (F=2.752 p=0.04), caregiver (F=4.33 p=0.003), care-giving period (F=2.68 p=0.049), and dementia stage (F=2.87 p=0.034). 4. There were highly negative correlations ($\gamma$=-0.301 p=0.000) between problematic behaviors of demented patients and the coping method of their family caregivers. The highest correlation coefficient ($\gamma$=-0.339 p=0.000) was found between aggressive behaviors of the demented patients and the coping method of their family caregivers. 5. There was a low negative correlation ($\gamma$=-0.201 p=0.019) between the ADL of the demented patients and the coping method of their family caregivers. 6. There were highly negative correlations ($\gamma$=-0.213 p=0.005) between stress and the coping method of the family caregivers. The highest correlation was found between financial burden ($\gamma$=-.327 P=.000) and the coping method of the family caregivers. There was no significant correlation among unpleasant aspects of the demented patients, willingness to the demented patients, and the coping method of the family caregivers.

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