• 인간행동과 음악연구
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• 제19권2호
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• pp.1-26
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• 2022

본 연구는 중등도 및 중증 치매 노인을 대상으로 한 국내·외 음악 중재 연구를 고찰하여 연구 동향을 알아보고, 참여자의 임상적 특성이 고려된 음악 중재의 특징을 알아보고자 시행되었다. 검색을 통해 선정된 17편의 문헌을 분석한 결과, 종속 변인은 행동심리증상 등 심리·정서적 변인이 주를 이루는 것으로 나타났다. 중재 참여유형을 살펴보면 내담자의 활동 참여가 요구되는 적극적 유형이 감상만 하는 수용적 유형보다 많았다. 중재의 일반적 특성으로는 과반수가 라이브 음악, 친숙하고 선호하는 음악 선곡, 리듬기반 연주활동을 제공한 것으로 나타났다. 적극적 유형의 음악중재 내용을 살펴보면 음악에 맞춰 그룹 연주나 노래를 하며 유발되는 감정을 말하도록 하는 것으로 참여자가 중등도와 중증이 혼합된 경우와 중증 치매만인 경우 차이점이 없어 중증 치매가 지닌 기능적 한계가 충분히 반영되지 않은 것으로 나타났다. 추후 연구에서는 중증 치매 노인의 의미있는 음악경험을 위한 중재구성과 내담자의 치매 진행 정도에 따른 음악치료 전략 개발이 필요하다.

• 재활치료과학
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• 제11권1호
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• pp.21-33
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• 2022

목적 : 본 연구는 치매환자의 삼킴장애 중재에 대한 체계적 고찰을 통해 치매환자의 특성에 따른 중재접근법과 효과에 대한 과학적 근거를 마련하고자 하였다. 연구방법 : 주요 검색 데이터베이스로 CINAHL, Cochrane CENTRAL, PsycINFO, PubMed, Science Direct를 사용하였으며 2010년 1월부터 2020년 5월까지 발표된 문헌을 수집하였다. 검색어는'Dementia', 'Alzheimer disease', 'Deglutition disorder', 'Swallowing disorder', 'Dysphagia'를 사용하였으며 최종 5편의 문헌을 선정하였다. 결과 : 중등도-중증 환자를 대상으로 한 연구가 1편, 중증 환자를 대상으로 한 연구가 4편 포함되었다. 중재 유형은 교정적 중재가 1편, 보상적 중재가 3편, 포괄적 중재가 1편이었다. 중등도-중증 환자를 대상으로 행동 및 심리관리를 포함한 보상적 중재가 사용되었다. 중증 환자를 대상으로는 경관식이에 대한 교정적, 보상적 중재 및 다학제적 중재를 포함한 포괄적 중재가 사용되었다. 각각의 연구에서 사용한 모든 중재 방법은 삼킴능력과 관련된 결과변수에 긍정적인 영향을 끼쳤다. 결론 : 본 연구에서는 치매환자의 진행단계에 따라 중재의 목적과 중재 요소가 달라지는 것을 확인하였다. 따라서 치매환자의 삼킴장애 중재는 치매환자의 진행단계를 고려하여 개인화된 중재를 시행했을 때 더욱 효과적임을 확인하였다. 이러한 결과는 치매환자의 삼킴장애를 위한 효과적 중재 설계에 방향을 제시해 줄 수 있을 것으로 사료된다.

• 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.

• 한국의류산업학회지
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• 제25권3호
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• pp.346-357
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• 2023

The purpose of this study is to develop clothing customized for dealing with patients with severe dementia. Based on the results of previous studies, The research patient clothing was designed to reduce the physical fatigue experienced by caregivers when dressing and undressing patients by changing the position and shape of the split in the patient's clothing. This study used qualitative and quantitative methods to measure the extent to which these modifications improved the ease of dressing and undressing the research patient. The research patient clothing was developed by moving the rear-center zipper to the side and changing the zipper from being half-open to fully open. Muscle energy consumption and fatigue generation were analyzed using EMG signals at the following sites: brachioradialis, biceps, triceps, anterior deltoid, medial deltoid, posterior deltoid, upper trapezius and erector spinae. Results indicated that the modified research patient clothing required less muscle energy and the occurrence of muscle fatigue decreased overall compared to traditional patient clothing. This was supported by the qualitative subjective evaluation, which revealed that dressing and undressing was easier with the modified clothing. In conclusion, repositioning of the back zipper to the side and the fully open slit shape significantly reduced caregiver fatigue when dressing and undressing patients.

• 한국의류학회지
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• 제45권5호
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• pp.788-803
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• 2021

This study aims to obtain basic data to develop clothes for dementia patients by classifying types of dementia patients. Data was collected from those dementia patients who entered a nursing home. This study analyzed a total of 221 sheets. Furthermore, descriptive statistics, cross-tabulation, and K-means clustering were performed for statistical processing using Minitab 14. As a result, dementia patients were classified into four types: inactive-dependent, active-problematic behavior, activity-autonomy, and inactive-offensive. Inactive-dependent type was a group with the most severe disability in cognitive and daily activity functions; however, they lacked behavioral and psychological symptoms and problematic behavior with clothes. Active-problematic behavior type showed the most behavioral and psychological problems and problematic behavior with clothes. Activity-autonomy type was a group without any problematic behaviors. Moreover, the inactive-offensive type had very good cognitive function toward humans. The study imply that it is necessary to provide clothes with proper functions based on the types of patients rather than providing them uniform clothes because clinical and clothes behaviors differ significantly depending on the types of dementia patients.

• 한국의류산업학회지
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• 제25권2호
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• pp.185-198
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• 2023

The purpose of this study is to obtain information necessary for the development of patient clothes that can reduce physical fatigue of caregivers by quantitatively measuring the muscle load and fatigue. The patient clothes used in this study can be broken down into three types: A type (back center zipper open suit), B type (top-to bottom separated patient clothes), and C type (front zipper open suit). The EMG measurement sites are as follows: hand muscle (brachioradialis), upper arm (biceps, triceps), shoulder (anterior deltoid, medial deltoid, posterior deltoid, upper trapezius), and waist (erector spinae); additionally, the EMG signals were measured. Through this experiment, muscle load, muscle energy consumption, and muscle fatigue generation tendency were analyzed. The results of the study revealed that the C type patient clothes required the most strength in the muscles of the shoulders, upper arms, hands, and back when being put on and taken off compared to other patient clothes. The A type clothes required a relatively large force in opening the zipper. In terms of muscle energy consumption, B type generally called for more strength when it came to the zip-up and putarmsup motions. With regard to the cover the body and put legs/hips up motions, C type used the highest amount of muscle energy, whereas A type used relatively little energy. In terms of the occurrence of muscle fatigue during the putting on and taking off of the patient's clothing, there was a difference in the area and degree of muscle fatigue in the A, B, and C types, and there was also a tendency for muscle fatigue to occur when performing repetitive movements.

• 한국병원경영학회지
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• 제28권2호
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• pp.9-20
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• 2023

Purpose: This study classified the actual functions of geriatric hospitals and examined the differences in their characteristics, in order to provide a basis for discussions on defining the functions of geriatric hospitals and how to pay for care. Methodology: This study used various administrative data such as health insurance data and long-term care insurance data. Cluster analysis was used to categorize geriatric hospitals. To examine the validity of the cluster analysis results, we conducted a discriminant analysis to calculate the accuracy of the classification. To examine cluster characteristics, we examined structure, process, and outcome indicators for each cluster. Findings: The cluster analysis identified five clusters. They were geriatric hospitals with relatively short stays for cancer patients(cluster 1; cancer patient-centered), geriatric hospitals with relatively large numbers of patients using rehabilitation services(cluster 2; rehabilitation patient-centered), geriatric hospitals with a high proportion of relatively severe elderly patients(cluster 3; severe elderly patient-centered), geriatric hospitals with a high proportion of mildly ill elderly patients with various conditions(cluster 4; mildly ill elderly patient-centered), and geriatric hospitals with a significantly higher proportion of dementia patients(cluster 5; dementia patient-centered). The largest number of geriatric hospitals were categorized in clusters 4 and 5, and the structure and process indicators for these clusters were generally lower than for the other clusters. Practical Implications: We have confirmed the existence of geriatric hospitals where the medical function, which is the original purpose of a geriatric hospital, has been weakened. It has been observed that the quality level of these geriatric hospitals is likely to be lower compared to hospitals that prioritize enhanced medical functions. Therefore, it is suggested to consider the conversion of these geriatric hospitals into long-term care facilities, and careful consideration should be given to the review of care-giver payment coverage.

• 지역사회간호학회지
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• 제15권3호
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• pp.450-459
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• 2004

Purpose: The purpose of this study is to grasp the welfare service for the demented people staying at home and the service that caregivers want to use. Therefore, we are going to develop a Korean senile dementia-care management model. Method; It analyzed the data of 185 demented people and caregivers, who registered in 16 public dementia care centers in B city since June 2002. Results: 1) The types of services used by the aged people with dementia staying at home were, in the order of frequency of use, the day-care center(26.5%), and home-help service (21.6%). 2). The types of services according to the degree of dementia were as follows; mild cases: home care service (5.4%), moderate cases: day-care service (40.0%) and severe cases: day-care service (26.0%). 3). The caregivers who want to use senile welfare institutions accounted for 23.3%, and the major reason they could not use the institutions was due to their economic situation. 4) The Korean senile dementia care management system must be excuted, considering caregivers' economic state and severity of dementia. Since the system was actively operated, many small sized welfare service institutions showed development. Conclusion: The welfare services appropriate to the severity of dementia should be provided. With the model developed in this study, the dementia management requires sufficient care and should be achieved to reduce the caregivers burden.

• 한국콘텐츠학회논문지
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• 제17권5호
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• pp.45-55
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• 2017

본 연구의 목적은 시설에 거주하는 치매노인의 활동 참여, 정서, 문제행동을 파악하는 것이다. 본 연구는 관찰조사연구이며, 치매노인 81명을 대상으로 활동참여 여부와 정서, 문제행동을 각 대상자 당 20분 간격으로 1일 12회 4시간 관찰 측정하여 총 7일간 6,804회 자료를 분석하였다. 연구 결과 대상자들의 인지기능은 중증이 90.1%이었다. 정서는 7점 만점 중 4.0점이었다. 활동 참여는 주로 앉아있거나 누워있는 등의 목적 없는 활동을 대부분 하고 있었으며, 사회적 활동을 할 때 대상자의 정서는 가장 긍정적으로 나타났다. 문제행동은 반복적인 행동과 소음발생 행동의 빈도가 가장 높았고, 시간대별 문제행동 유형의 발생빈도는 다소 달랐다. 대상자의 인지기능과 정서, 문제행동의 상관관계는 유의하였다. 따라서 시설 거주 치매노인의 활동참여를 높이고, 긍정적인 정서를 보이는 활동에 참여할 수 있도록 유도하고, 시간대별로 가장 두드러지게 나타나는 문제행동을 낮추기 위한 효과적인 방법이 모색되어야 한다.

• 동의생리병리학회지
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• 제22권1호
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• pp.256-261
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• 2008

Anorexia is a common symptom in the elderly patients. Causes of anorexia in the elderly are very diverse and multifactorial. Causes include physiological changes associated with aging, mental disorders such as depression, anorexia tardive, dementia, medical diseases such as cancer(lung and gastrointestinal cancer), benign gastrointestinal disorders, cardiac disorders, pulmonary disease, thyroid disorders, infection. Medications such as digoxin, theophylline have also been implicated in the problem. No cause is found in about one quarter of patients. Management is directing at treating causes and providing nutritional support. In Oriental medicine, the appetite has close relation to Biwi. The main cause of anorexia is the insufficiency of Biwi. The physiology of Biwi is that Bi sends clarity(food essence) upward and Wi sends digested food downward. Specially if the physiologic function of Wi is disordered by various factors, Wi cannot send digested food downward. As a result, the anorexia can present by the disorder of Wi function. We experienced a case of an 74 years old female patient with ill-defined severe anorexia differentiated as Wijoongheohan. The patient was managed with fluid therapy and Jeonghyangsiche-tang. The anorexia and other symptoms improved continuously during hospitalization.