치매예방프로그램의 효과에 관한 연구 = (A)study on the effects of the dementia prevention program

다국어 초록 (Multilingual Abstract)

This study is designed to improve cognitive function of the elderly with cognitive impairment, decrease the depression and improve the life satisfaction. For the purposes, the study designed as a nonequivalent control group pre-post test developed the dementia prevention program and applied it for the elderly with cognitive impairment to demonstrate the effects. The data collection and intervention lasted from Jun 16. 2006 to September 29. 2006. The subjects of the study were 333 male and female elderly whose age was above 65 from one welfare facility and five elderly centers in G city. This study used K-MMSE(Korea Mini-Mental State Examination) for dementia screening test and converted the cognitive scores of 93 subjects who had below 23 of cognitive scores into standard scores in consideration of their age and educational background. Of them, a total of 31 subjects consisting of 15 from the experimental group and 16 from the control group had below -1.0 of standard deviation of K-MMSE scores.
The dementia program consisted of hand exercise (20min.), reminiscence therapy (20 min.), rest (10 min.), therapeutic recreation (20min.), and music therapy (20 min.). It was provided for the experimental group twice a week for ten weeks and a session lasted for ninety minutes. This study used K-MMSE developed by Folstein (1975) and translated by Kang Yeon-ook and et al. (1997) for measuring cognitive function. For measurement of depression, it used Korean version of CES-D developed by Radloff (1977) and translated by Jeon Gyeom-gu et.al (1992). It used the tool developed by Diener et.al (1985) and translated by Cha Gyeong-ho (1995) to measure life satisfaction.
This study measured reliability of the tools using SPSS/PC +11.5 for data analysis and conducted χ2-test to analyse commonality on general characteristics between the two groups. It conducted a paired t-test to demonstrate differences in cognitive function, depression and life satisfaction between the two groups before and after the test and a t-test to analyse cognitive function, depression and life satisfaction between the experimental groups and the control group after the test.
The results of this study are presented as follows:
1. As there was no significant difference in every variable relating to commonality between experimental group and control group, the two groups were equivalent.
2. Hypothesis 1 : The hypothesis that the dementia prevention program will significantly affect improvement of cognitive function of the elderly with cognitive impairment was supported. There was a significant difference in cognitive functions of the experimental group before and after the program (t =- 9.025, p = .000) while there was not significant difference in cognitive functions of the control groups before and after the program. And there was a significant difference in cognitive function scores between the experimental group and the control group after the program (t = 5.126, p = .000). As a result of additional analysis on cognitive function, it was found that the dementia prevention program had a significant effects in attention&calculation (t = 5.498, p = .000), recalling of memory (t = 5.288, p = .000) and language (t = 2.327, p = .027).
3. Hypothesis 2: The hypothesis that the dementia prevention program will have a significant effect on decrease of depression of the elderly with cognitive impairment was supported. There was a significant difference in the depression of the experimental groups before and after the program (t = 4.29, p = .001) while there was no significant difference in the depression of the control group before and after the program. And there was a significant difference in the depression scores between the experimental groups and the control group after the program (t = -3.751, p = .001).
4. Hypothesis 3: The hypothesis that the dementia prevention program will have a significant effect on improvement of life satisfaction of the elderly with cognitive impairment was supported. There was a significant difference in life satisfaction of the experimental group between before and after the program (t = -3.29, p = .005) while there was not significant difference in life satisfaction of the control group before and after the program. And there was a significant difference in life satisfaction scores between the experimental group and the control group (t = 2.116, p = .043).
To sum up the results above, this study concluded that the dementia prevention program was effective in improvement of cognitive function of the elderly with cognitive impairment, decrease of depression and improvement of life satisfaction. Therefore, this study suggests that the program presented above should be more diversified and reorganized properly according to individual differences or conditions.

목차 (Table of Contents)

• Abstract
• 제 1 장 서론 = 1
• 제 1 절 연구목적 = 1
• 제 2 절 연구범위 및 방법 = 4
• 제 2 장 이론적 배경 = 6
• 제 1 절 노인성 치매에 대한 이해 = 6
• 1. 치매의 개념 = 6
• 2. 치매의 원인과 유형 = 7
• 3. 치매의 증상 = 10
• 4. 치매의 진단과 치료 = 13
• 제 2 절 치매예방프로그램의 유형 = 18
• 제 3 절 치매예방프로그램의 효과 = 30
• 1. 노인의 인지기능 향상 = 30
• 2. 노인의 우울 감소 = 33
• 3. 노인의 생활만족도 향상 = 35
• 제 4 절 본 연구에서의 치매예방프로그램 = 37
• 1. 개발배경과 원리 = 37
• 2. 프로그램의 내용 = 40
• 제 3 장 연구설계 = 54
• 제 1 절 연구모형 및 가설의 설정 = 54
• 1. 연구모형의 설정 = 54
• 2. 연구가설의 설정 = 55
• 제 2 절 변수의 조작화 = 55
• 1. 인지기능 측정도구 = 55
• 2. 우울 측정도구 = 56
• 3. 생활만족도 측정도구 = 57
• 제 3 절 실험설계 = 58
• 제 4 절 연구대상 및 자료수집 = 58
• 제 5 절 연구 진행절차 = 59
• 1. 연구 승인절차 = 59
• 2. 연구보조원 훈련 = 60
• 3. 사전조사 = 60
• 4. 실험처치 = 60
• 5. 사후조사 = 75
• 제 6 절 자료분석 = 75
• 제 4 장 치매예방프로그램의 효과 분석 = 76
• 제 1 절 일반적 특성의 동질성 분석 = 76
• 제 2 절 실험 전 측정치에 대한 동질성 분석 = 78
• 제 3 절 가설검증 = 79
• 1. 치매예방프로그램과 인지기능 = 79
• 2. 치매예방프로그램과 우울 = 82
• 3. 치매예방프로그램과 생활만족도 = 84
• 제 5 장 논의 및 결론 = 86
• 제 1 절 논의 = 86
• 1. 치매예방프로그램과 인지기능 = 86
• 2. 치매예방프로그램과 우울 = 88
• 3. 치매예방프로그램과 생활만족도 = 90
• 제 2 절 결론 = 91
• 1. 연구 결과 = 91
• 2. 결어 = 93
• 3. 제언 = 94
• 참고문헌 = 95
• 부록 = 110
• <부록 1> 부탁의 말씀 = 110
• <부록 2> 연구 참여 동의서 = 111
• <부록 3> 인지기능 측정도구 = 112
• <부록 4> 우울 측정도구 = 113
• <부록 5> 생활만족도 측정도구 = 114
• <부록 6> 일반적 특성 = 115
• <부록 7> 회기별 진행 절차 = 116
• <부록 8> 뇌 기능 증진을 위한 손운동법 = 136