초청원고 : 치매 노인의 배회행동에 관한 문헌 조사

홍(손)귀령 ( Gwi Ryung Son Hong ) 서울대학교 간호과학연구소 2006 간호학의 지평 Vol.3 No.1

요양시설 거주 치매노인의 점화방법을 이용한 칫솔질 교육 프로그램의 효과

홍(손)귀령 ( Gwi-ryung Son Hong ),우정수 ( Jung-soo Woo ) 대한구강보건학회 2016 大韓口腔保健學會誌 Vol.40 No.3

Objectives: The purpose of this study was to examine the effect of an educational program using priming on oral health, and dental plaque, and gingival bleeding indices in an elderly population with dementia (EWD) residing in nursing homes.Methods: A pretest and posttest were conducted with a nonequivalent control group. In total, 40 participants from an EWD had the following characteristics: 1) they were aged >65 years, 2) they scored <23 points on the MMSE-DS, 3) they were able to communicate, 4) they were able to hold a toothbrush and brush his or her teeth by themselves, and 5) they had no periodontal treatment for the last 3 months. Through random sampling, participants were assigned into either the experimental (n=20) or control group (n=20). The educational program consisted of twelve 30-minute sessions (twice per week for 6 weeks). The control group was demonstrated the standard tooth-brushing method by the facility during the study period. Results: There were no significant differences in demographics or main variables at pretest. The experimental group showed significant differences in the subjective oral health condition, as compared to the control group. The experimental group showed an increase in the level of tooth-brushing effort (t=―8.816, P<.001) and higher scores of self-evaluative dental health status (P<.001) as compared to the control group. The experimental group showed a reduced plaque index (t=11.179, P<.001) and gingival bleeding index (t=5.812, P<.001) compared to the control group. Additionally, the experimental group showed significant differences in changes of plaque index and gingival bleeding index between the pretest and posttest. Conclusions: An interventional program on tooth brushing with priming effectively improved dental health, plaque index, and gingival bleeding index in EWDs residing in nursing homes. Direct care providers should understand the remaining abilities of EWDs and carry out priming when providing care to them.

치매노인 주 돌봄제공자의 자기돌봄이 소진에 미치는 영향

권정화 (Kwon, Jeong Hwa),홍(손)귀령(Hong, Gwi-Ryung Son) 한국간호과학회 2021 Journal of Korean Academy of Nursing Vol.51 No.2

Purpose: The purpose of this study was to identify the influence of self-care on burnout experienced by primary family caregivers of persons with dementia. Methods: The subjects of the study were 156 primary family caregivers of persons with dementia at home in Korea. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and hierarchical multiple regression using IBM SPSS Statistics ver. 24.0 for Windows. Results: The mean scores for self-care and burnout were 42.35 and 61.60, respectively. Self-care, subjective health status, living with a person with dementia, and behavioral and psychological symptoms of dementia were significant factors affecting burnout in family caregivers. Self-care was identified as the strongest factor affecting burnout, explaining 13.9% of burnout with controlling factors in caregivers and care receivers. Conclusion: To prevent burnout in primary family caregivers of persons with dementia, self-care of family caregivers should be emphasized. In nursing education, family caregivers should be recognized and approached as nursing clients who are responsible for taking care of their health. In nursing practice and research, digital self-care or self-care improvement intervention programs should be designed to help family caregivers, and further studies on self-care centered on health of family caregivers should be conducted.

노인의 삶의 의미 측정 도구 개발

이시은(Lee, Si Eun),홍(손)귀령(Hong, Gwi-Ryung Son) 한국간호과학회 2017 Journal of Korean Academy of Nursing Vol.47 No.1

Purpose: The purpose of this study was to develop and test the psychometric properties of the newly developed instrument, Meaning in Life, for elderly Korean people. Methods: Ten older adults participated in the qualitative research used to develop the initial items. Participants for the psychometric testing were 371 community-dwelling older adults. Validity and reliability analyses included content, construct, and criterion-related validities, internal consistency, and test-retest reliability. Results: The Meaning in Life Scale consisted of 12 items with three distinct factors; value of life, source of life, and will to live, which explained 86.7% of the total variance. A three-factor structure was validated by confirmatory factor analysis. Criterion-related validity was supported by comparison with the Purpose in Life Test (r=.74). Reliabilities were secured with test-retest reliability of Intra-class Correlation Coefficient (ICC) .85 and the Cronbach’s alpha coefficient .90. Conclusion: The results of this study indicate that this instrument is useful to measure meaning in life in Korean elders.

낙상 후 골절 수술 노인의 퇴원 후 낙상 두려움 영향 요인

김진영(Kim, Jin-Yeong),홍(손)귀령(Hong, Gwi-Ryung Son) 한국노인간호학회 2021 노인간호학회지 Vol.23 No.4

Purpose: The purpose of this study was to identify the factors associated with the fear of falling after discharge in older adults who had surgery for fall fractures. Method: The participants were 143 older adults aged 65 or older hospitalized at the General Hospital due to a fall fracture. Data were collected from July 2019 to June 2020 using questionnaires for activities of daily living, pain, depression, and fear of falling. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson’s correlation, and multiple regression. Results: The average age of the subjects was 75.34 ± 6.89 years, and 74.1% were women. The influencing factors on the fear of falling after discharge were activities of daily living (β=.305, p=.001), age (β=.204, p=.004), the need for walking aids or assistance in walking before the fall (β=.203, p=.005), and pain (β=.150, p=.027). Total explained variance was 54.6% (F=13.174, p<.001). Conclusion: Based on the results of this study, it is necessary to actively intervene the fear of falling once older adults are hospitalized, considering the factors associated with the fear of falling after discharge in older adults who had surgery after experiencing a fall fracture and to develop an educational program to reduce the fear of falling.

거주 지역에 따른 독거노인의 인지 기능 저하 영향요인

이윤희(Yun Hee Lee),홍(손)귀령(Gwi-Ryung Hong(Son)) 한국노인간호학회 2023 노인간호학회지 Vol.25 No.2

Purpose: This study aimed to identify the risk factors of cognitive decline in older adults living alone in local communities and to find cognitive nursing methods by the area of residence. Methods: The participants were 164 people living alone for 12 years. The data were analyzed using a generalized estimating equations method. Results: The following factors were identified as statistically significant predictors that increased cognitive decline in older adults living alone: 1) rural areas: age (odds ratio [OR]=1.02, 95% confidence interval [CI]=1.01~1.02), low education (OR=1.53, 95% CI=1.13~2.07), number of diseases (OR=1.07, 95% CI=1.01~1.14), 2) urban areas: women (OR=1.27, 95% CI=1.09~1.49), age (OR=1.02, 95% CI=1.01~1.03), low education (OR=1.26, 95% CI=1.14~1.40), body mass index (OR=0.98, 95% CI=0.96~0.99), instrumental activities of daily living (OR=1.02, 95% CI=1.00~1.04), depressive symptom (OR=1.14, 95% CI=1.03~1.25). Conclusion: The older adults who lived alone had different risk factors for cognitive decline depending on their areas of residence. Preventive management for cognitive decline should be presented according to the areas of residence among older adults living alone.

시설거주 노인여성을 위한 근력강화 훈련이 요실금과 신체기능에 미치는 효과

강혜경(Kang, Hyekyung),홍(손)귀령(Hong, Gwi-Ryung Son) 한국간호과학회 2015 Journal of Korean Academy of Nursing Vol.45 No.1

Purpose: This study was done to determine whether muscle strength training programs have an impact on improving symptoms of urinary incontinence (UI) and physical function among elderly women with UI who reside in long-term care facilities. Methods: A randomized controlled trial was conducted. Participants had to be over 65 years, score over 15 score on the mini-mental state examination, and be able to walk alone or with an assistant. Seventy residents were randomly allocated to either the training group (n=35) or control group (n=35). The program consisted of 50 minutes, twice a week for 8 weeks, and included Kegel’s exercise, Thera-band training and indoor walking. Main outcomes were UI symptoms, peak vaginal pressure and physical functions measured with timed up and go test (TUG), one leg standing test (OLST), activities of daily living (ADL) and grip strength. Changes in outcome measurements were calculated from baseline to 4 weeks and to 8 weeks using repeated measures ANOVA. Results: There were significant differences in peak vaginal pressure (p<.001), TUG (p<.001), OLST (p=.012) and grip strength (p<.001) in the interaction between groups and time. Conclusion: Future studies are suggested to confirm the effect of muscle strength training in long-term care facilities where elderly women with UI reside.

남성 독거노인의 배우자 사별 경험

황영란(Hwang, Young-Ran),홍(손)귀령(Hong, Gwi-Ryung Son) 한국노인간호학회 2021 노인간호학회지 Vol.23 No.2

Purpose: This phenomenological study was conducted to understand the meaning and essence of the bereavement experience in older men living alone. Methods: The data were collected from November 2020 to February 2021 through face-to-face in-depth interviews with nine older men who experienced spousal bereavement. Data were analyzed using Colaizzi s phenomenological 7-step method. Results: Results of this study comprised three categories with eight theme clusters. The three categories were “Facing unprepared death”, “Taking on multiple roles”, and “Surviving as a being”. Participants experienced a negative impact on their daily lives and physical and psychological health since their spousal loss. Participants’ long-lasting health issues included troubles in family relationships, loneliness, controlling sexual desires and preparing meals, but they tended not to seek help due to cultural characteristics because they were reluctant to reveal their feelings and difficulties to others, which can lead to secondary problems. Conclusion: Social and spiritual support from healthcare professionals is essential for promoting a positive coping and adaptation process after spousal loss. To provide effective nursing interventions, nurses must consider the spouse’s culture when caring for dying people and develop holistic nursing intervention strategies, including communication skills and comprehensive assessment, to explore their unexpressed health problems. Further investigation regarding bereavement experiences in different population groups and building a support system is necessary for the bereaved in the healthcare system.

재가 치매노인의 길찾기(Way-finding)와 배회(Wandering)와의 관계

임영미(Lim, YoungMi),홍(손)귀령(Hong, Gwi-Ryung Son),송준아(Jun-Ah Song) 한국노년학회 2008 한국노년학 Vol.28 No.1

본 연구목적은 재가 치매노인의 길찾기 효율성과 배회행동과의 관계를 알아보기 위함이다. 본 연구의 대상자는 편의추출법에 의해 전국 7개 중소도시 및 대도시에서 가정에 거주하는 60세 이상이며 한국판 간이형 정신상태 검사도구 (K-MMSE) 점수가 24점 이하의 기준을 가진 치매노인과 만 18세 이상으로 집에서 노인을 돌보는 일차적인 가족 수발자 84명이었으며, 설문지 조사를 통해 자료를 수집하였다. 연구도구는 K-MMSE와 ADL, IADL, 그리고 연구팀에 의해 번역과 역번역이 실시된 한국판 길찾기 효율성 도구 (KWES)와 한국판 지역사회용 배회 척도 (KRAWS-CV)이었다. 자료 분석은 서술통계, t-test, ANOVA, 상관관계분석을 이용하여 치매노인의 일반적 특성, 인지기능 및 신체기능을 파악하고, 이에 따른 길찾기 효율성과 배회행동을 알아보며 두 변수간의 상관관계를 분석하였다. 치매노인의 인지기능과 신체기능을 통제한 상태에서 총 길찾기 효율성 도구점수와 총 배회 척도의 점수와의 상관관계가 통계적으로 유의하였다. 길찾기 도구의 4개 하부영역과 배회 도구의 6개 영역과의 상관관계를 분석한 결과 길찾기의 '단순목적지 길찾기'와 '포괄적 전략'의 점수가 낮을수록 배회의 '이탈행동'과 '공간적 방향상실'의 점수가 높았다. 길찾기의 '분석적 전략'은 배회 도구의 모든 하부영역과 관련성이 없는 것으로 나타났다. 결론으로, 길찾기 능력과 배회는 같은 개념이라기보다 서로 관련이 있는 개념이며, 추후 각 개념에 영향을 미치는 인자를 찾아서 한국의 실정에 맞는 재가노인을 위한 배회 예방 프로그램을 개발하여야 한다. The purpose of this study was to evaluate the relationship of wandering and way-finding, especially what particular way-finding decrements are linked to specific dimensions of wandering in a community dwelling elders with dementia in Korea. A total of 84 community dwelling elders with dementia and their family caregivers were participated. Data were collected using interview with family caregivers. Wandering was measured using Korean Revised Algase Wandering Scale - Community Version (KRAWS-CV) along with its six dimensions: Persistent Walking, Repetitive Walking, Spatial Disorientation, Eloping Behavior, Negative Outcomes, and Mealtime Impulsivity. Way-finding was measured using Korean way-finding Effectiveness Scale (KWES) with four subscales (Complex Way-finding Goals, Analytic Strategies, Global Strategies, and Simple Way-finding Goals). Correlational analysis was used to determine the relationship between KRAWS-CV subscales scores and the KWES subscales scores, controlling K-MMSE, PADL, and IADL. Overall, the KRAWS-CV and the KWES correlated at -.35 (p < .01). At the level of subscales, the all KRAWS-CV subscales were significantly correlated with all KWES subscales except AS (r = .65 to -.22). The SD had the highest correlation of any KRAWS-CV subscales with the overall KWES (r = -.66). These findings support the assertion that particular wayfinding deficits are a potential explanation for specific dimensions of wandering.

위해 근무환경에 대한 간호사의 경험: 현상학적 접근

고영주(Ko, Yeong Ju),홍(손 )귀령(Hong, Gwi-Ryung Son) 한국간호행정학회 2018 간호행정학회지 Vol.24 No.3

Purpose: This study was conducted to expand nurse`s experience of harmful work environments Methods: Data were collected through in-depth dividual interviews and analyzed using Colaizzi phenomenological analysis methodology. Results: Harmful work environments experienced by nurses were categorized as followed: ‘Neglect concerning infections’, ‘Being thrown into a violent working environment’, ‘The hard times of being alone’, ‘Struggling with the harmful work environments’. Conclusion: The results of this study provide a deep understanding of the harmful work environments. It is necessary to create safe work environments and it is important to improve awareness in the system of organizations as well as individuals. Also, it is necessary to develop tools to measure work environment including risk factors.