요양시설 치매노인의 배회 관리를 위한 시설기반 그룹 걷기 프로그램의 효과: 예비연구 = Effects of an Institution-based Group Walking Program(IGWP) to Manage Wandering Behavior of Persons with Dementia Residing in Nursing Homes: A Pilot Study

다국어 초록 (Multilingual Abstract)

Purpose: The purpose of this study was to do a preliminary examination of effects of an Institution-based Group Walking Program (IGWP) on affect and depression, wandering and other behavioral and psychological symptoms of dementia (BPSD), and sleep in persons with dementia (PWDs) who wander. Methods: This study used an A (baseline measure)- B (treatment condition)- A (baseline measure)- B (treatment condition) single case research design (n=10). Participants (mean MMSE=11.11±7.56; mean age=81±6.27) were encouraged to walk in a group along the pre-planned path every evening after supper for 30 minutes from Monday to Friday. Data were collected for four weeks: every day for affect and sleep; every week for wandering, BPSD, and depression. Using repeated measure ANOVA, within-subject effects and within-subject contrasts were evaluated. Results:　Within-subject effect was found on wanderer's affect (F=12.73, p =.001), depression (F=5.26, p =.005), neuropsychiatric symptoms (F=5.87, p =.016), hours of sleep (F=3.99, p =.018), sleep efficiency (F=3.99, p =.018), and frequency of wake-ups during sleep (F=5.05, p =.007). Conclusion: Results of this study imply that a regular group walking program may be beneficial for improving affect, mood, and night time behavior of wanderers. Further studies with larger samples and longitudinal design are necessary to confirm the findings obtained in this study.

참고문헌 (Reference)

1 김정란, "한국판 Cohen-Mansfield 초조 척도(K-CMAI)의 표준화 연구" 대한생물치료정신의학회 14 (14): 31-42, 2008

2 송준아, "요양시설치매노인의배회행동" 한국간호과학회 38 (38): 29-38, 2008

3 Algase, D. L., "Wandering: Clues to effective management" 8 (8): 55-59, 2005

4 Lai, C. K. Y., "Wandering behavior in people with dementia" 44 : 173-182, 2003

5 Algase, D. L., "Wandering and the physical environment" 25 (25): 340-346, 2010

6 Song, J. A., "Validation of the revised algase wandering scale-nursing home version among Korean elders with dementia" 2008

7 Hope, T., "The structure of wandering in dementia" 9 : 149-155, 1994

8 Cummings, J. L, "The Neuropsychiatric Inventory: Assessing psychopathology in dementia patients" 48 (48): S10-S16, 1997

9 Song, J., "Relationship of premorbid personality and behavioral responses to stress to wandering behavior of residents with dementia in long term care facilities" University of Michigan 2003

10 Laurin, D., "Physical activity and risk of cognitive impairment and dementia in elderly persons" 58 : 498-504, 2001

11 Landi, F., "Physical activity and behavior in the elderly: A pilot study" 9 : 235-241, 2004

12 Cohen-Mansfield, J., "Nonpharmacologic interventions for inappropriate behaviors in dementia: A review, summary, and critique" 2 (2): 288-308, 2004

13 Hermans, D., "Non-pharmacological interventions for wandering of people with dementia in the domestic setting" (1) : 2009

14 Algase, D. L., "Need-driven dementiacompromised behavior: An alternative view of disruptive behavior" 18 (18): 10-19, 1996

15 Carillo II, J., "Nature walk: From aimless wandering to purposeful walking" 49 (49): 50-54, 2000

16 Algase, D. L., "Mapping the maze of terms and definitions in dementia-related wandering" 11 (11): 686-698, 2007

17 Young, S. H., "Managing nocturnal wandering behavior" 14 (14): 6-12, 1988

18 Howard, R., "Guidelines for the management of agitation in dementia" 16 (16): 714-717, 2001

19 Robb, S. S., "Exercise treatment for wandering behavior, In Alzheimer's disease: Problems, prospects, and perspectives" NY 1986

20 Holmberg, S. K., "Evaluation of a clinical intervention for wanderers on a geriatric nursing unit" 11 (11): 21-28, 1997

21 Hughes, J. C., "Ethics and the psychiatry of old age, In Psychiatry in the elderly" Oxford University Press 2002

22 Robinson, L., "Effectiveness and acceptability of nonpharmacological interventions to reduce wandering in dementia, a systematic review" 22 : 9-22, 2007

23 Tappen, R. M., "Effect of a combined walking and conversation intervention on functional mobility of nursing home residents with Alzheimer's disease" 14 (14): 196-201, 2000

24 Delweiler, M. B., "Does a Wander Garden influence inappropriate behaviors in dementia residents" 23 (23): 31-45, 2008

25 Volicer, L., "Dimensions of decreased psychological well-being in advanced dementia" 13 (13): 192-201, 1999

26 Kwon, J. D., "Development of the measurement tool and model for the caregiving" Hongikjae 1995

27 Alexopoulos, G. S., "Cornell scale for depression in dementia" 23 : 271-284, 1988

28 Rowe, M. A., "Antecedents, descriptions and consequences of wandering in cognitively-impaired adults and the Safe Return (SR) program" 16 (16): 344-352, 2001

29 Kang, Y., "A validity study on the Korean Mini-Mental State Examination(K-MMSE) in dementia patients" 15 (15): 300-308, 1997

30 Cohen-Mansfield, J., "A description of agitation in a nursing home" 44 (44): M77-M84, 1989