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노쇠를 위한 디지털헬스케어 -체계적 문헌고찰-

Digital Healthcare for Frailty(Systematics Review)

박명아|유하진
재단법인 경기연구원 (Gyeonggi Research Institute)|2023.11|GRI연구논총|제25권 제4호|pp. 309-332|DOI 10.23286/gri.2023.25.4.013

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고령화체계적 문헌고찰Systematic Review디지털 헬스케어노쇠FrailtyAgingDigital Health Care

초록

본 연구는 고령화로 인해 의료비용 지출이 증가하면서, 노인의 의료비용 지출과 관련이 높은 노쇠를예방 및 개선하기 위해 디지털 헬스케어가 효과적인지 검증하고자 하였다. 연구 목적을 수행하기 위해노쇠 예방 및 개선을 위한 디지털 기반의 노쇠중재연구 논문을 토대로 체계적 문헌 고찰을 수행하였다. 총 1,293편의 논문 중 선택 및 배제 과정을 거쳐 13편을 선정하였고, 이후 2명의 독립적인 연구자가 독립적으로 비뚤림 위험 평가를 진행한 후 합의의 과정을 거쳐 분석하였다. 본 연구에서 다룬 디지털 기반 노쇠중재로는 엑서게임, 웨어러블 디바이스, APP, ICT 디바이스, VR, 원격 모니터링이 있었으며, 중재 종류와 방식에 따라 노쇠 개선 효과에 차이를 보였다. 참가자의 신체활동을 포함하거나 유도할 경우 노쇠 예방 및 개선에 유의미하였으며, 중증도 강도일 경우 참여율에 효과적이었다. 이는 기존의 노쇠 중재연구에서 신체활동 중재가 노쇠 예방 및 개선에 효과적이라는 결과를 뒷받침하였지만, 디지털기반의 노쇠중재가 기존 중재와 비교해 더 효과적인지에 대한 충분한 근거는 확보하지 못했다는 한계점이 있다. 그러나 본 연구는 고령화와 디지털화를 맞는 시대에 소외되기 쉬운 노인이 디지털화의 수혜자가 될 가능성을 제시한다는 점에서 연구 의의가 있으며 노인을 위한 디지털 헬스케어 관련 정책개발의 기초자료로 활용될 수 있기를 기대한다. 체계적 문헌고찰로서 효과 분석을 수행하지 못한 한계점이있지만, 본 연구의 후속연구로 메타 연구가 진행되길 기대한다.

Abstract

This study attempted to verify whether digital healthcare is effective to prevent and improve frailty which is highly related to the elderly's medical expenditure, as medical expenditures increases due to an aging society. For the purpose of this study, a systematic literature review was conducted based on digital-based intervention research papers for the prevention and improvement of frailty. And a search was conducted after establishing key research questions based on previous research. Among a total of 1,293 papers, 13 papers were selected through a selection and exclusion process. And then two independent researchers independently assessed the risk of bias and analyzed them through a consensus process. In this study digital￾based interventions included exergames, wearable devices, APP, ICT devices, VR, and remote monitoring. And there was a difference in the effect of frailty improvement according to the type of intervention. It was shown that digital-based interventions are significant in preventing and improving frailty when they include or induce physical activity, and participation rates increased during moderate-intensity activities. This result supported the previous studies which were effective in preventing and managing frailty by using physical activity in the frailty intervention. As a limitation of the study, there was not sufficient evidence to determine whether digital￾based interventions were more effective than existing interventions. However The research is significant in that it suggests the possibility that elderly people who are easily marginalized in an age of aging and digitalization, may become beneficiaries of digitalization. I hope that the results of this study can be used as basic data for policy development related to digital healthcare for the elderly. Although this study has the limitation of not conducting an effect analysis as a systematic literature review, it is expected that a meta-study will be conducted as a follow-up study.

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