• 대한예방한의학회지
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• 제15권2호
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• pp.101-113
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• 2011

Objective : The purpose of this study was to determine the effects of the music therapy on cognition, problematic behavior, and sleep disturbance in elderly with dementia. Method : The study was designed using a nonequivalent control group pretest-posttest design. The subjects comprised of 39 elders (Experimental group : 19, Control group : 20) who living in D city. The instruments used for this study were the MMSE, problematic behavior assessment tool, and sleep assessment instrument. The data were analyzed using SPSS 17.0 program. Results : The repeated measure ANOVA revealed that the music therapy had the effect on the problematic behavior and sleep. There were statistically significant differences in problematic behavior between the pretest and posttest in the experimental group. Conclusion : The study suggests that the music therapy can be applied for the aged with dementia to improve the problematic behaviors.

• 한국노년학
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• 제28권4호
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• pp.1023-1039
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• 2008

본 연구는 집단인정치료가 치매노인에게 미치는 영향에 대해 알아보고자 하였으며 구체적으로는 집단인정치료가 치매노인의 인지기능, 일상생활활동, 문제행동, 우울 및 치매노인의 삶의 질에 미치는 영향에 대해 알아보았다. 이를 위하여 대상자인 치매노인 40명을 실험집단 및 통제집단으로 각각 20명씩 무작위 배정하였고, 두 집단의 동질성 검사와 사전검사 후 집단인정치료를 실시하였다. 이후 사후 검사를 실시하였으며 36명의 최종 결과를 얻게 되었다. 본 연구의 분석 결과, 통계적으로 집단인정치료는 치매노인의 인지기능의 향상, 일상생활활동 증가, 우울 감소, 삶의 질 향상에 유의미하였으나 문제행동 감소에는 유의미하지 않았다. 결론적으로 집단인정치료는 치매노인의 인지기능 향상뿐만 아니라 일상생활활동을 증진시키고 우울을 감소시켰으며, 삶의 질을 높이는데 효과적이었다. 그러므로 향후 집단인정치료는 치매노인을 돕는데 효율적인 심리사회적인 치료방법으로 실무에서 충분히 활용할 수 있을 것으로 기대된다.

• 한국노년학
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• 제36권4호
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• pp.1089-1108
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• 2016

본 연구의 목적은 재가 치매노인 가족이 치매노인의 배회를 효과적으로 관리하기 위한 지침을 개발하고 평가하는데 있다. 연구의 절차는 총 3단계로 구성되어 있으며 첫째, 배회관리 지침 개발 준비 단계에서는 치매노인을 돌보는 가족 10인을 대상으로 포커스 그룹 및 개별 인터뷰를 시행하여 치매노인의 배회 관련 경험을 분석하였다. 둘째, 지침 개발 단계에서는 문헌 고찰을 통해 예비 항목을 작성하고 전문가 8인의 내용타당도 검증과정을 거쳐 최종안을 완성하였다. 셋째, 지침의 평가 단계에서는 치매노인 가족 13인을 대상으로 지침에 대해 교육하고 제공된 배회관리 지침 소책자를 이용하여 일주일 간 적용하도록 한 후 배회 관련 지식, 지침 적용정도, 사용자 만족도를 설문지를 통해 평가하였다. 본 연구에서 최종적으로 개발된 지침은 '배회의 정의', '배회의 원인', '배회 가능성이 높은 경우', '배회 예방', '실종 예방', '배회 발생 시 대처 방법', '실종 발생 시 대처 방법'의 7가지 주제, 총 86항목으로 구성되었다. 배회관리 지침 사용 교육 전 후 가족의 배회 관련 지식 점수가 유의하게 향상하였고(p=0.014), 지침 적용 정도 9문항의 평균은 2.69~3.46(range: 1~4)점이었으며 사용자 만족도의 7개 항목 평균은 2.85~3.38(range: 1~4)점이었다. 본 연구에서 개발된 배회관리 지침은 국내 지역사회거주 치매노인의 배회 특성과 가족의 요구를 반영하여 개발되었으며, 개발된 지침을 가족들에게 시범 적용하고 평가를 시도하였다는 점에서 의의가 있다. 본 배회관리 지침은 가족들이 치매노인의 배회에 대해 보다 잘 이해하고 대처하며 배회로 인한 부정적 결과를 예방하는데 도움이 될 것으로 사료된다.

• 한국직업건강간호학회지
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• 제23권4호
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• pp.197-207
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• 2014

Purpose: The purpose of this study was to investigate the status and characteristics of visiting nurses' management for elders with cognitive impairment living in a community focused on health centers in a metropolitan city and five medium-sized cities. Methods: Data were collected from 47 visiting nurses working in a metropolitan city and 47 visiting nurses working in five medium-sized cities from November to December 2012. Results: There were no statistically significant differences in knowledge, attitudes, and nursing behaviors of cognitive impairment between two groups (F=2.13, p=.148; F=3.64, p=.060; F=0.28, p=.595). Among the elders referred to a physician in a metropolitan city by visiting nurses, 42.4% were diagnosed as mild cognitive impairment and 15.2% were diagnosed as severe dementia. The major intervention programs which visiting nurses currently applied for elders were medication and exercise intervention programs, and the intervention programs which they would want to apply in the future were playing, music and recall intervention programs. Conclusion: The cognitive impairment screening test can be done effectively by visiting nurses. This study also suggests to develop various kinds of intervention programs to improve cognitive function for elders living in a community.

• Perspectives in Nursing Science
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• 제3권1호
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• pp.35-45
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• 2006

In Korea, about 8.3% over aged 65 are suffering from Alzheimer's disease or other type of dementia. Among dementia-related behaviors, wandering is the one of strongest factors on burden and stress of caregivers. On Lee and Kwon's report with community living persons with dementia, upto 85% of caregivers reported wandering as a problem. Wandering is a frequently encountered problem in communities and long-term care facilities, but it is among least understood dementia. related behavior. Despite the prevalence of wandering, its significant adverse outcomes, and the increase in persons with dementia in Korea, no systematic research has been conducted in Korea. The purpose of this study is to review on literature related to wandering behavior among persons with dementia. The specific topics related to wandering are included: definition, the prevalence of dementia and wandering behavior, the influencing factor on wandering, outcomes of wandering behavior, and the measurement method. Wandering is defined as "aimless walking" and "Meandering, aimless or repetitive locomotion that exposes one to harm and is incongruent with boundaries, limits, or obstacles". Wandering is viewed as a problematic behavior, however, it has to be understood as need-driven compromised behavior. For example, wandering may be an expression of searching for familiar person and/or place. Recently, in Korea, there is an effort for establishing the therapeutic environment for elders who are wanderers in long-term-care facilities. Cognitive impairment of persons with dementia is found to be a consistent factor on wandering behavior through many national and international studies. The adverse outcomes of wandering are serious problem in persons with dementia as well as their caregivers. The adverse outcomes include falls, fractures, getting lost, use of restraints, or even death. In fact, wandering is one of the major reasons for a patient to be institutionalized. For measurement of wandering behavior, two methods are broadly used: observation using stop watch, and survey form. A revised instrument of the Korean version of Algase wandering scale (K_RAWS) is established the psychometric properties (Son, Song, & Lim, 2006) demonstrating valid and reliable instrument in measuring wandering behavior among persons with dementia who are residing in communities. K_RAWS has a 39 items with six subscales including persistent walking, repetitive walking, spatial disorientation, eloping behavior, negative outcome, and mealtime impulsivity. In conclusion, studies including the prevalence of wandering behavior and predictive factors on wandering should be conducted to understand wandering clearly before developing any types of intervention.

• 대한가정학회지
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• 제40권10호
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• pp.123-139
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• 2002

The purpose of this study was to understand the adult day care center as a place for the elders and adults and to develop an initial understanding of the services and activity programs for adult day care for the cognitively-impaired in the U.S.A. The data were collected from 12 Adult Day Care Centers(ADC) from 2001 to 2002 by personal interview and the documents about the programs. ADC programs provided primarily social, recreational, and health activities and services in a group setting. Centers offered participants to socialize, enjoy peer support, and receive health and social services in a stimulating and supportive environment that promotes better physical and mental health. For this purpose those centers offered not only professional health care, occupational.speech.physical therapies but also socio-recreation and therapeutic-recreation services.

• 대한간호학회지
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• 제39권2호
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• pp.166-176
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• 2009

Purpose: The purpose of the study was to identify functional structure and patterns of dialogue sequence in conversations between elderly patients with dementia and nurses in a long-term care facility. Methods: Conversation analysis was used to analyze the data which were collected using video-camera to capture non-verbal as well as verbal behaviors. Data collection was done during February 2005. Results: Introduction, assessment, intervention, and closing phases were identified as functional structure. Essential parts of the conversation were the assessment and intervention phases. In the assessment phase three sequential patterns of nurse-initiated dialogue and four sequential patterns of patient-initiated dialogue were identified. Also four sequential patterns were identified in nurse-initiated and three in patient-initiated dialogues in the intervention phase. In general, "ask question", "advise", and "directive" were the most frequently used utterance by nurses in nurse-initiated dialogue, indicating nurses' domination of the conversation. At the same time, "ask back", "refute", "escape", or "false promise" were used often by nurses to discourage patients from talking when patients were raising questions or demanding. Conclusion: It is important for nurses to encourage patient-initiated dialogue to counterbalance nurse-dominated conversation which results from imbalance between nurses and patients in terms of knowledge and task in healthcare institutions for elders.

• 대한간호학회지
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• 제24권3호
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• pp.448-460
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• 1994

This study was conducted to investigate risk factors for senile dementia as well as care givers' stresses and thier needs for nursing care. It was done using a retrospective survey. A convenience sample or In senile dementia patients and l20 nor-mal elders in a rural area was used. The tools used in the study were the MMSE-K(Mini-Mental State Examination-Korea) for dementia screening test and a questionaire developed by the research team. Data were collected through home visits by Com-munity Health Practitioners. Data were analyzed using descriptive statistics, T-test, and Chi-square test. The findings are as follows : 1. There were significant differences in age, marital status, and religions between the two groups. 2. There was a significant difference in smoling behavior between the two groups. 3. There was a significant difference in past his-tory of cancer between groups. 4. There was a significant difference in past and present elderftmily relationship between the two groups. 5. There were significant differences in intellectual activities, assuming major role in family and seeking other's help in daily life troubles between the two groups. 6. There were significant differences in stress factors such as child problem, family conflict, health problem and illegal behavior between the two groups. 7. The major problems out by families in caring for dementia patient were catastrophic reactions, dirtiness, mood change, devouring and tremor. The most serious problems faced by families was dirtiness. with catastrophic reactions, sleep distrubance, changeableness, and a suspcio-usness following. The care givers expressed chronic fatigue, anxiety, tension, depression, disorder in daily life, shamefulness, blame from neighbours and guiltiness. 8. There is need for geriatric hospitals, nursing homes, burden sharing, and counselling or education for family care givers. A replicate study in the urban area is recommended to validate the findings of this study. To explore the impact of stress in life and ‘han’ on senile dementia, a qualitative study is recommended.

• 고령자･치매작업치료학회지
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• 제12권2호
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• pp.19-28
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• 2018

목적 본 연구는 노인의 장악력을 표준화하고 장악력, 신체계측인자, 우울, 삶의 질 사이에 상관관계를 알아보고자 하였다. 연구방법 연구자는 2016년 국민건강영양조사를 분석에 이용하였으며, 활동제한이 없는 오른손잡이 노인 중 장악력 검사를 완료한 919명의 자료를 분석하였다. 노인 전체, 남성, 여성의 장악력을 65세~69세, 70세~74세, 75세~79세, 80세 이상으로 구분하여 장악력을 표준화하였다. 신체계측인자에는 키. 몸무게, 체질량지수, 허리둘레가 포함되었다. 우울은 PHQ-9로 측정되었고, 삶의 질은 EQ-5D로 평가되었다. 연구결과 노인의 오른손잡이의 비율은 87.8%, 왼손잡이 4.9%, 양손잡이 5.7%로 나타났다. 표준화 결과 및 상관분석에서, 남녀노인 모두 나이가 증가함에 따라 장악력이 감소하였다(p<.01, r=-.308~-.305). 장악력은 키와 가장 높은 상관성을 나타냈다(p<.01, r=.747~.741). 장악력은 우울(p<.01, r=-.172~-.163)과 삶의 질(p<.01, r=.285~.267) 사이에 유의한 상관이 있었다. 결론 본 연구의 결과는 노인의 연령별 장악력 수준을 고려할 때, 키, 우울, 삶의 질에 따라 장악력의 차이가 나타날 수 있음을 고려할 필요가 있음을 시사한다.

• 생물정신의학
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• 제20권3호
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• pp.104-110
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• 2013

Objectives : The aim of this study was to examine the prospective impact of the apolipoprotein E (APOE) ${\varepsilon}4$ on cognitive performance in the community-dwelling elderly individuals with Alzheimer's disease (AD). Methods : The total number of subjects was 30 (12 men and 18 women) who were diagnosed with AD from a Korean project of "Early Detection of Dementia". People aged 65-85 years were included in the analysis. The eight neuropsychological domains from the Korean version of Consortium to Establish a Registry of Alzheimer's Disease (CERAD-K) were conducted to test subjects. They have been followed at 24-month intervals with the same assessments at each interval. Their cognitive performance at 2 year intervals was compared by the occurrence of the APOE ${\varepsilon}4$. Results : The impact of ${\varepsilon}4$ allele was significant in the Word List Memory Test (WLMT, F = 4.345, df = 1, p = 0.021) and Word List Recall Test (WLRT, F = 5.569, df = 1, p = 0.033). Conclusions : The APOE ${\varepsilon}4$ allele was significantly correlated especially with verbal episodic memory domain in community-dwelling elders diagnosed with AD.