가정환경개선 서비스가 지역사회 치매 노인의 낙상 위험성과 일상생활 독립성에 미치는 영향 = Effect of Home Modification Service on Fall Prevention and Independence of Activities of Daily Living for the Elderly with Dementia Residing in the Community

국문 초록 (Abstract)

목적 : 본 연구는 지역사회 거주 치매 환자를 대상으로 가정환경개선 서비스를 제공하고 효과성을 검증하기 위함이다. 연구방법 : 태안군 치매안심센터에서 총 16명의 치매 진단을 받은 노인을 연계 받아 총 8주간 가정환경개선 서비스를 진행하였다. 각 대상자 개인별로 1주일에 1회씩 총 6회기의 재가방문 서비스를 제공하였다, 사전-사후 평가를 포함하여 개인 행동평가, 가정환경 컨설팅, 가정환경개선, 일상생활 훈련, 및 인지 전략 교육 등을제공하였다. 서비스 전후 효과를 알아보기 위하여 가정환경평가 프로토콜(HEAP)과 추가로 활동-특정 균형 자신감 척도(ABC), 낙상 행동요인 척도(FaB), 한국판 일상생활활동 평가(K-ADL)과 수단적 일상생활활동 평가(K-IADL)의 독립성 변화를 평가하였다. 사전-사후 점수 비교는 Jamovi 2.2.2를 통해 분석하였다. 결과 : 중재 결과 가정 내 위험환경, 적응, 시각적 단서, 관찰에서는 통계적으로 유의미한 환경변화가 있었다(p<.001). 단, 가정환경의 편안함은 통계적으로 유의한 개선이 없었던 것으로 나타났다. 또한, 중재 후 균형자신감, 낙상 행동요인, 수단적 일상생활의 독립성에 통계적으로 유의한 변화가 있었던 것으로 나타났다(p<.001). 반면 일상생활의 독립성에는 변화가 없었다(p=.186). 전반적 서비스 만족도는 10점 만점에 9.6점으로 매우 높게 나타났다. 결론 : 지역사회 거주 치매 환자를 대상으로 하는 가정환경개선 서비스는 가정 내 생활 환경의 개선뿐만 아니라노인의 낙상을 예방하고 수단적 일상생활의 독립성을 향상하는데 효과적인 것으로 나타났다. 추후 더 많은모집단을 통해 서비스를 제공하고 서비스의 효과성을 체계적으로 분석해볼 필요가 있다.

다국어 초록 (Multilingual Abstract)

Objective : The aim of this study was to provide a home modification service for elderly people with dementia living in the community and to verify its effectiveness. Methods : Sixteen elderly people diagnosed with dementia participated in the home modification service provided in this study. Six home visits were provided for each individual subject. Including pre-and post-evaluation, personal behavior evaluation, home environment consulting, home environment modification, daily activities training, and cognitive strategy education were provided. To examine the effects before and after the service, changes in the environment, balance confidence, fall behavioral factors, and independence of ADL and IADL were evaluated. The preand post-score comparisons were analyzed using Jamovi 2.2.2. Results : The intervention showed statistically significant environmental changes in home hazards, adaptation, visual cues, and observation (p<.001). However, there was no statistically significant improvement in the comfort of the home environment. Also, there were statistically significant changes in activity-specific balance confidence, fall behavioral factors, and independence in IADL after intervention (p<.001). On the other hand, there was no change in independence in ADL (p=.186). Overall satisfaction with the service was very high at 9.6 out of 10. Conclusion : The home modification service for the elderly with dementia living in the community was found to be effective not only in improving the living environment at home, but also in preventing falls and improving the independence of IADL. In the future, it will be necessary to provide services to a larger population and investigate its effectiveness.

목차 (Table of Contents)

• Ⅰ. 서론 Ⅱ. 연구 방법 Ⅲ. 연구 결과 Ⅳ. 고찰 Ⅴ. 결론

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