• 생물정신의학
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• 제21권2호
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• pp.74-80
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• 2014

Objectives More than half of the elders suffer from chronic sleep disturbances. Moreover, sleep disturbances are more prevalent in patients with depressive disorder than in community dwelling elderly. In this study, we aim to estimate the risk factors of poor sleep quality and its effect on quality of life in patients with late life depression. Methods This study included 159 depressive patients aged 65 years or older who completed Pittsburgh Sleep Quality Index (PSQI). A global PSQI score of 5 or greater indicates a poor sleeper. Structural diagnostic interviews were performed using the Korean version of Mini International Neuropsychiatric Interview (MINI). Depression was evaluated by the Korean form of Geriatric Depression Scale (KGDS). Global cognition was assessed by Mini-Mental State Examination in the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet. Quality of life was evaluated by the Korean version of Short-Form 36-Item Health Survey (SF-36). Results The frequencies of poor sleepers were 90.5% in major depressive disorder, 71.8% in minor depressive disorder, 47.1% in subsyndromal depressive disorder, and 73.0% in all types of depressive disorders. Multivariate logistic regression analysis indicated that female [odds ratio (OR) = 2.83, 95% confidence interval (CI) = 1.20-6.67] and higher KGDS score (OR = 1.13, 95% CI = 1.05-1.21) were risk factors of poor sleep quality in patients with late life depression. In the analysis of ANCOVA adjusted for age, gender, education and KGDS score, the mean scores of vitality mental health and mental component summary of SF-36 were lower in poor sleepers than in good sleepers. Conclusions Poor sleepers among patients with late life depression are very common and are associated with female and higher KGDS scores. Poor sleep quality causes a significant negative effect on mental health quality. So researchers and clinicians should be more vigilant in the evaluation and treatment of sleep disturbances in patients with late life depression.

• 가정과삶의질연구
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• 제24권5호
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• pp.113-128
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• 2006

This study was to verify the effectiveness of the Life Review-Narrative group therapy program on decreasing depression and death anxiety in the elderly. The program was organized according to a course of life from childhood to old age. The objectives were for the elderly to enhance self-worth, to become aware of their solitary existence, to accept aging and death, to accept the life: both past and present, and to make the most of experiences in overcoming difficulties. For the most part, the program used reminiscence and re-authoring of the narrative therapy as counseling techniques. Thirty-two elderly people(16 in the experimental group, 16 in the control group) aged 60 years and over were randomly selected from patients at the Daegu Metropolitan City General Welfare Center. Two groups were identified as equivalents for the study in the pre-test. The program for the experimental group was implemented twice a week for 90 minutes per session over a 6-week period(Sep. 8-Oct.14. 2005). The pre-test(Sep. 8 2005), the post-test(Oct. 14. 2005) and the follow-up test(Nov. 14. 2005) were implemented in order to verify the effectiveness of the programs. The instruments used in the study were the Geriatric Depression Scale Short Form(Korean Version) and the Death Anxiety Scale. The data were analyzed using t-testing and One-Factor Repeated Measures ANOVA. This study supplemented other qualitative research methods in order to verify the variation in the depression and death anxiety in the elderly. The findings of the study were as follows: Significant decrease in the depression and death anxiety were reported in the experimental group. The control group however did not show any significant changes in the depression and death anxiety rates. The result of the post hoc multiple comparisons showed that the effects of the life review-narrative group therapy program has lasted effects on decreasing of the death anxiety. Nevertheless, the effects of the life review-narrative group therapy program on decreasing depression are not lasting. The study has limitations so further research is suggested.

• 농촌의학ㆍ지역보건
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• 제26권2호
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• pp.193-203
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• 2001

본 연구는 노인의 신체적 건강과 우울과의 관계를 파악하기 위한 조사연구이다. 본 연구의 대상자는 대구시에 거주하는 가정노인으로 노인 대상자 중 55세 이상인 자, 노화에 의한 시청각 장애가 심하지 않은 자, 언어적, 비언어적 의사소통이 가능한 자, 연구에 참여하기로 허락한 자로 168명이 선정되었다. 본 연구의 자료수집기간은 2000년 9월 16일부터 10월 16일까지였으며 설문지의 목적을 이해하고 면접방법에 대해 훈련받은 간호학과 학생들이 노인이 있는 가정을 방문하여 대상자를 일대일로 면접하였다. 면접자가 직접 기록하여 회수율이 100%였으며 설문지 작성에 소요되는 시간은 30-40분정도였다. 연구도구는 일반적 특성, 단축형 노인 우울척도(Short form Geriatric Depression Scale)(Sheikh와 Yesavage, 1986), Barthel의 Index(Mahoney와 Barthel, 1965)를 수정한 식사능력, 목욕능력, 세면능력, 화장실 사용능력 등으로 구성된 일상활동 능력 측정도구, 근골격계 증상(통증) 측정도구, Northern Illinois University에서 개발한 Health Self Rating Scale를 수정한 도구로 구성되었다. 자료의 분석은 SPSS WIN 10.0 통계 프로그램을 이용하였으며 연구목적에 따라 서술통계방법 (실수, 백분율), t-test, ANOVA, Pear son Correlation Coefficient, stepwise multiple regression을 이용하였다. 연구결과를 요약하면 다음과 같다. 1. 일반적 특성 중 연령(F=3.17, p=0.026), 배우자 유무(t=-2.44, p=0.016)에 따라 대상자의 우울이 통계적으로 매우 유의한 차이가 있었다. 집단간 차이를 보기 위해 사후검증한 결과 75-84세군이 65-74세군보다 우울 정도가 유의하게 높았으며 무배우자인 대상자의 우울 점수가 유배우자 보다 높았다. 2. 신체적 건강에 따른 우울 정도를 분석한 결과 일상활동능력(ADL)은 6-9점(세가지 이상의존)인 경우가 10- 12점(한 두가지 의존 또는 완전독립)인 경우보다 우울 정도가 유의하게 높았다(t=3.93, p=0.000). 근골격계 증상은 11- 13점(세 가지 이상 증상 있음), 14점 (모든 증상 있음)인 경우가 7점(전혀 증상없음)인 경우보다 우울 정도가 유의하게 높았다(F=5.33, p=0.002). 지각된 건강상태는 건강상태가 나쁘다고 응답한 대상자일수록 우울 정도가 높았다(F=17.04, p=0.000). 3. 일상활동능력이 적을수록(r=-0.293, p=0.000), 근골격계 증상이 많을수록(r=.251, p=0.001), 지각된 건강상태가 나쁠수록(r=-0.522, p=0.000) 대상자의 우울 정도가 높게 나타났다. 4. 신체적 건강 요인들의 우울에 대한 설명력은 29.1%이었으며, 이 중 지각된 건강상태의 표준 회귀계수(Beta)가 -0.456으로 가장 좋은 설명력을 가졌으며 일상활동능력(Beta=-0.140)의 순으로 좋은 설명력을 가졌다. 이상의 연구결과를 토대로 다음을 제안하고자 한다. 1. 우울 정도가 높은 가정노인을 간호하기 위해 가정노인의 우울에 영향을 주는 일상활동능력, 근골격계 증상, 지각된 건강상태 및 인구학적 특성(연령, 배우자 유무)을 고려한 건강프로그램의 개발이 필요하다. 2. 추후 연구에서는 가정노인의 신체적 건강을 측정하기 위해 다양한 도구를 사용할 것을 제안한다.

• 노인정신의학
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• 제21권1호
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• pp.35-40
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• 2017

Objective : This study aimed to investigate the effect of community-based Goal-Achieving program in geriatric depressive symptoms preliminarily. Methods : We obtained data from elderly Korean subjects with major depressive disorder (n=51) aged 60 years or older at baseline, taking case management from community mental health center. Subjects were randomly assigned to intervention group (n=24) and control group (n=27). We investigated depressive symptoms through Short Form Geriatric Depression Scale-Korean version (SGDS-K) at baseline and every month for 3 months to all subjects. We tested interaction between group and time in SGDS-K score to evaluate the effect of program. And post hoc test examined between group differences of SGDS-K at each time points. Results : In quadratic linear mixed effects model analysis, interaction between group and time was statistically significant (Total SGDS-K score : coefficient=0.29, p<0.001 ; SGDS-K dysphoria subscale : 0.18, p<0.001 ; SGDS-K hopelessness subscale : 0.05, p=0.089 ; SGDS-K cognitive impairment subscale : 0.06, p=0.003). And significant between group difference was shown in post hoc test at time points of third month (SGDS-K score of control group : SGDS-K score of intervention group=$10.74{\pm}3.482$ : $7.25{\pm}4.475$, p=0.0184). Conclusion : These results may suggest that 'Community-based the Goal-Achieving program' has efficacy in reducing geriatric depressive symptoms.

• 성인간호학회지
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• 제22권3호
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• pp.281-290
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• 2010

Purpose: This purpose of this study was to identify the factors related to the health related quality of life among institutionalized elders. Methods: The subjects were 247 elders institutionalized among one of the four nursing homes in Busan. Data were collected through interview with four standardized questionnaires from August to October, 2008. Questionnaires were related to health related quality of life (SmithKline Beecham's Quality of Life scale, SBQoL), quality of sleep(Pittsburgh Sleep Quality index, PSQI), activity of daily living (Katz ADL Index), and depression (Geriatric Depression Scale Short Form Korea, GDSSF-K). Data were analyzed for descriptive analysis, t-test, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression by using SPSS/WIN 17.0 program. Results: The mean HRQoL in the subjects was $6.62{\pm}0.91$. Percentage of the respondents reporting sleep disorders were 72.5% and 27.1% reported being vulnerable to depression. The significant predictors of the HRQoL were sleep quality, activity of daily living (ADL), level of education, and depression. The factors accounted for 28.8% of variance in the health related quality of life of institutionalized elders. Conclusion: Sleep quality, activity of daily living, and depression need to be considered as the important control factors for improving the health related quality of life in the institutionalized elders.

• 대한물리치료과학회지
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• 제31권2호
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• pp.41-51
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• 2024

Background: The purpose of this study was to identify the effect of home-based exercise program in elderly with chronic diseases on balance, activities of daily living, depression and quality of life. Design: One group pretest-posttest design Methods: The subjects consisted of 21 elderly people over the age of 65 years with chronic diseases lived in seo-gu, Gwangju. Home-based exercise program was performed twice a week, for an hour, during 6 weeks under supervision of an experienced instructor. The home-based exercise program was structured to last a total of 1 hour, consisting of 10 minutes of warm-up, 30 minutes of main exercises, and 20 minutes of concluding exercises. For the warm-up, we performed range of motion, stretching, and flexibility exercises. The main exercises comprised of strength, weight-bearing and balance exercises, and endurance exercises. The concluding exercises were tailored to the individual's home environment and needs, including task-oriented daily living training such as getting up from bed, moving to the restroom, and walking indoors. The subjects were assessed before and after the exercise program with berg balance scale(BBS), Korean-version modified barthel index(K-MBI), euro quality of life questionnaire 5-dimensional classification(EQ-5D), and geriatric depression scale short form-Korea(GDSSF-K). The collected data was analyzed using SPSS Win 18.0 program. Results: The results showed statistically significant difference in all domains of the BBS, K-MBI, EQ-5D, GDSSF-K after the exercise program. Conclusion: These results suggest that Home-based exercise program has resulted in a significant improvement on ADL, depression and quality of life in elderly with chronic diseases.

• 여성건강간호학회지
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• 제9권4호
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• pp.449-456
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• 2003

Purpose: The purpose of this study was investigate the relationships among perceived social support, instrumental support needs, and depression of healthy, community dwelling elderly women. Method: This study was designed to examine whether the perceived social support and instrumental support were correlated with depression in elderly women. Data were cross-sectional and community-dwelling elderly individuals. The subject was 98 elderly women recruited from Elderly Welfare Center and Community center for Elderly. The instruments for this study were Personal Resource Questionnaire-part II, Geriatric Depression Scale (Short Form), and Instrumental Support Activities Checklist. Data were gathered by means of structured personal interviews. The internal consistency of the instruments was relatively good. Result: The participants' perceived social support was moderately high and instrumental support needs was low. Depression was mild and moderate relatively. The correlation analysis showed that the perceived social support was negatively related to depression and negatively related with instrumental support needs. Conclusion: The findings suggested that more perceived social support, less their depressive symptom in elderly women. It also revealed that the age, marital status, and socioeconomic status of elderly women also are important indicator of the elderly depression. Therefore nursing assessment and the design of intervention that incorporate the determinants supported in this study, such as perceived social support of the elderly women are needed in adopting and maintain health promoting lifestyle for the mental health and effective functioning in later life in women.

• 동의신경정신과학회지
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• 제22권4호
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• pp.101-109
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• 2011

Objectives : The aim of this study was to evaluate the effects of EFT-I(EFT program for insomnia) for insomnia in the elderly as a preliminary study. Methods : This study was a single group pre-post comparative study that involved 10 elderly women(mean age=$76.3{\pm}4.29$), who visited a senior welfare center, complained of insomnia symptoms. Subjects received 8 sessions(twice a week for 4 weeks and 1 hour for each session) of EFT-I group training. Insomnia severity, depression, state-anxiety, and life satisfaction of each subject were evaluated twice at pre and post of EFT-I. Korean Sleep Scale, Short form of Geriatric Depression Scale(SGDS), State-Trait Anxiety Inventory(STAI), and life satisfaction scale were used as evaluation tools. The data were analyzed using paired-samples T-test. Results : Insomnia severity, life satisfaction, depression, and state-anxiety were significantly improved by EFT-I. Conclusions : Result of this study showed that EFT-I can be a useful treatment program for elderly insomnia. Larger clinical trials are needed to verify effect of EFT-I as a community based insomnia management program for the elderly.

• 대한불안의학회지
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• 제3권2호
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• pp.128-133
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• 2007

Objective : Obesity has been considered to be associated with numerous physical, mental and psychological diseases. Depression, which is a major psychological factor affecting occurrence and treatment of obesity, can be a cause of obesity as well as can be triggered by obesity. This study aimed to find out the need of positive consideration to the existence of depressive mood in the management of obesity. Methods : A total of 101 subjects were enrolled among those who were 60 years old and over at one local clinic. Obese group (n=49) was defined as BMI${\geqq}$25 and normal weight group (n=52) as 20$5.2{\pm}2.5$) was significantly higher than that of the normal weight group ($3.8{\pm}1.7$)(p<0.05). In male subjects, there was no significant difference in the mean GDSSF-K score between both groups, but in female subjects, the mean GDSSF-K score of the obese group, $6.4{\pm}2.6$ was significantly higher than that of the normal weight group ($4.0{\pm}1.8$)(p<0.05). Conclusion : The elderly obese group showed higher depressive scale score than elderly normal weight group, especially in female elderly. Since the elderly obese female group had a depressive predisposition, comprehensive management including mental and psychological approach is required in obesity control programs.

• 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.