지역사회 거주 노인의 치매예방행위 예측요인 : Factors Predicting Dementia-Preventive Behavior of Elderly Living in the Community

다국어 초록 (Multilingual Abstract)

Purpose: This study aimed to investigate the perceived benefits, perceived barriers, self-efficacy, and dementia-preventive behavior of elderly living in the community based on the Health Belief Model, and to determine the predictors of dementia-preventive behavior.
Method: This descriptive survey study was conducted in August 2022 with 158 elderly, aged 65 and above, who visited senior centers and senior welfare centers located in Suncheon City, Jeollanamdo. The tool used to measure perceived benefits, perceived barriers, and self-efficacy was developed by Song et al. (2001), and revised and supplemented by Song and Park (2018). The measurement tool for dementia-preventive behavior by Lim et al. (2018) was also used. The Cronbach’s α of perceived benefits, perceived barriers, and self-efficacy were 0.74, 0.81, and 0.88 respectively, while the Cronbach’s α of dementia-preventive behavior was 0.76. test , independent t-test, Pearson’s correlation coefficients, and logistic regression of the collected data were analyzed using the SPSS Windows version 27.0 Program.
Results: The mean score of dementia-preventive behavior of participants was 4.02-points. Among the sociodemographic characteristics of participants, statistically significant differences in dementia-preventive behavior were found in age (=8.31, p=.040) and regular gatherings/social activities (p=.010). Regarding health-related characteristics, statistically significant differences were found in dementia education experiences (=4.40, p=.036), dementia patient experiences (=5.12, p=.024), dementia safety center use experiences (=5.93, p=.015), and perceived health status (=7.87, p=.020). Participants with good dementia-preventive behavior showed higher perceived benefits (t=-2.96, p=.004), higher self-efficacy (t=.48, p<.001), and lower perceived barriers (t=3.31, p=.001) compared to participants who had poorer dementia-preventive behavior. Dementia-preventive behavior was positively correlated to perceived benefits (r=.26, p=.001) and self-efficacy (r=.48, p<.001), but was negatively correlated to perceived barriers (r=-.29, p<.001). When perceived barriers increased by 1 point, the odds ratio of good dementia-preventive behavior decreased by 0.53 times (95% CI=0.32~0.87, p=.013), and when self-efficacy increased by 1 point, the odds ratio of good dementia-preventive behavior increased by 1.91 times (95% CI=1.10~3.32, p=.022).
Conclusion: The study findings suggest that there is a need to increase the self-efficacy of participants when developing a nursing intervention program for increasing the dementia-preventive behavior of elderly in the community, considering their perceived barriers.

국문 초록 (Abstract)

목적 : 본 연구는 건강신념모델을 기반으로 지역사회 거주 노인의 지각된 유익성, 지각된 장애성, 자기효능감 및 치매예방행위를 확인하고 치매예방행위의 예측요인을 확인하기 위함이다.
방법 : 본 연구는 서술적 조사연구로 2022년 8월 전라남도 순천시에 소재한 경로당과 노인복지관을 방문하는 만 65세 이상 노인 158명을 대상으로 하였다. 연구도구는 송라윤 등(2001)이 개발하고 송라윤과 박문경(2018)이 수정·보완한 지각된 유익성, 지각된 장애성, 자기효능감 측정도구와 임경춘 등(2018)의 치매예방행위 측정도구를 사용하였다. 지각된 유익성, 지각된 장애성, 자기효능감의 Cronbach’s α는 각각 .74, .81, .88이었으며 치매예방행위의 Cronbach’s α 는 .76이었다. 수집된 자료는 SPSS window version 27.0 Program을 이용하여 test, independent t-test, Pearson’s correlation coefficients, logistic regression으로 분석하였다.
결과 : 연구대상자의 치매예방행위는 평균 4.02점이었고, 대상자의 인구사회학적 특성 중 연령(=8.31, p=.040), 정기적 모임/사회활동 여부(p=.010)에 따라 통계적으로 유의한 치매예방행위의 차이가 있었으며, 건강관련 특성 중 치매교육 경험(=4.40, p=.036), 치매환자 경험(=5.12, p=.024), 치매안심센터 이용 경험(=5.93, p=.015) 및 지각된 건강상태(=7.87, p=.020)에 따라 통계적으로 유의한 차이가 있었다. 치매예방행위를 잘하는 대상자는 그렇지 않은 대상자에 비해 지각된 유익성(t=-2.96, p=.004)과 자기효능감(t=.48, p<.001)이 높았고 지각된 장애성(t=3.31, p=.001)이 낮았다. 연구대상자의 치매예방행위는 지각된 유익성(r=.26, p=.001) 및 자기효능감(r=.48, p<.001)과 양의 상관관계가 있었으며, 지각된 장애성(r=-.29, p<.001)과는 음의 상관관계가 있었다. 지각된 장애성이 1점 상승할수록 치매예방행위를 잘할 확률의 승산비가 0.53배(95% CI=0.32~0.87, p=.013) 낮았으며, 자기효능감이 1점 상승할수록 치매예방행위를 잘할 확률의 승산비가 1.91배(95% CI=1.10~3.32, p=.022) 높았다.
결론 : 본 연구결과를 토대로 지역사회 노인의 치매예방행위를 높이기 위한 간호중재 프로그램을 개발할 때 대상자의 자기효능감을 높일 필요가 있으며, 대상자가 지각한 장애성을 고려할 필요가 있겠다.