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치매 환자의 특성 및 보호자의 요구도 : 공립요양병원 입원환자와 일반 외래환자

Characteristics of Patients with Dementia and the Demands of Caregivers : Inpatients of Public Long-term Care Hospital versus Outpatients of General Hospitals

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Objective:The aim of this study is to clarify the characteristics of patients with dementia using long-term care hospitals and the demands of their caregivers. It will provide a perspective for establishing the specialized dementia hospital and appropriate dementia services in the future. Methods:The survey was performed to the caregivers of the dementia inpatients of 71 public long-term care hospitals and outpatients from local hospitals. We distributed the questionnaires to 3,600 caregivers. Of these, 1,572 returned and then included in the analysis. Results:High number of both inpatients (85.7%) and outpatients (61.5%) were diagnosed with dementia in psychiatric or neurologic department. Time laps from onset of symptoms thought as dementia to actual diagnosis was about a year. Caregivers of dementia inpatients wanted mostly dementia related welfare and care products (85.5%), physical and exercise program (84.0%), specialized dementia ward (83.1%), behavioral management (82.1%), and cognitive rehabilitation (80.5%). Conclusion:It is important to provide adequate management to both the patients with dementia and the caregivers. Thus, specialized institutional arrangements and medical service improvement supported by government is needed to reduce the psychological and financial burden of caregivers. We hope these results will be used to establish the principals and standards of specialized dementia hospital.

Abstract

Objective:The aim of this study is to clarify the characteristics of patients with dementia using long-term care hospitals and the demands of their caregivers. It will provide a perspective for establishing the specialized dementia hospital and appropriate dementia services in the future. Methods:The survey was performed to the caregivers of the dementia inpatients of 71 public long-term care hospitals and outpatients from local hospitals. We distributed the questionnaires to 3,600 caregivers. Of these, 1,572 returned and then included in the analysis. Results:High number of both inpatients (85.7%) and outpatients (61.5%) were diagnosed with dementia in psychiatric or neurologic department. Time laps from onset of symptoms thought as dementia to actual diagnosis was about a year. Caregivers of dementia inpatients wanted mostly dementia related welfare and care products (85.5%), physical and exercise program (84.0%), specialized dementia ward (83.1%), behavioral management (82.1%), and cognitive rehabilitation (80.5%). Conclusion:It is important to provide adequate management to both the patients with dementia and the caregivers. Thus, specialized institutional arrangements and medical service improvement supported by government is needed to reduce the psychological and financial burden of caregivers. We hope these results will be used to establish the principals and standards of specialized dementia hospital.

참고문헌 (34)

  1. "Ministry of Health and Welfare"[URL]
  2. "National Statistical Office"[URL]
  3. Kim KW, "A nationwide survey on the prevalence of dementia and mild cognitive impairment in South Korea", J Alzheimers Dis, 23, pp.281~291 (2011)
  4. Jorm AF, "Projections of future numbers of dementia cases in Australia with and without prevention", Aust N Z J Psychiatry, 39, pp.959~963 (2005)
  5. Montgomery RJ, "Caregiving and the experience of subjective and objective burden", Fam Relat, 34, pp.19~26 (1985)
  6. Beery LC, "Traumatic grief, depression and caregiving in elderly spouses of the terminally ill", Omega, 35, pp.261~279 (1997)
  7. Stirling C, "Measuring dementia carers’ unmet need for services--an exploratory mixed method study", BMC Health Serv Res, 10, pp.122~ (2010)
  8. van der Roest HG, "What do community-dwelling people with dementia need? A survey of those who are known to care and welfare services", Int Psychogeriatr, 21, pp.949~965 (2009)
  9. McClendon MJ, "Survival of persons with Alzheimer’s disease : caregiver coping matters", Gerontologist, 44, pp.508~519 (2004)
  10. Gilley DW, "Caregiver psychological adjustment and institutionalization of persons with Alzheimer’s disease", J Aging Health, 17, pp.172~189 (2005)
  11. Black BS, "Unmet needs of community-residing persons with dementia and their informal caregivers : findings from the maximizing independence at home study", J Am Geriatr Soc, 61, pp.2087~2095 (2013)
  12. Covinsky KE, "Patient and caregiver characteristics associated with depression in caregivers of patients with dementia", J Gen Intern Med, 18, pp.1006~1014 (2003)
  13. Lyketsos CG, "Depression in Alzheimer’s disease : overview and treatment", Biol Psychiatry, 52, pp.243~252 (2002)
  14. González-Salvador MT, "The stress and psychological morbidity of the Alzheimer patient caregiver", Int J Geriatr Psychiatry, 14, pp.701~710 (1999)
  15. 지역사회 장기요양치매 환자에 대한 안정적 의료서비스 제공을 위한 모델 개발, "유승호", 보건복지부, 30~43 (2013)
  16. Conroy S, "Medical services for older people in nursing homes--comparing services in England and the Netherlands", J Nutr Health Aging, 13, pp.559~563 (2009)
  17. Hoek JF, "The role of the specialist physician in nursing homes : the Netherlands’ experience", Int J Geriatr Psychiatry, 18, pp.244~249 (2003)
  18. 이대희, "노인요양병원과 신경과 의사의 역할", 대한신경과학회지, 32(1), pp.1~7 (2014), 대한신경과학회
  19. Brodaty H, "Why caregivers of people with dementia and memory loss don’t use services", Int J Geriatr Psychiatry, 20, pp.537~546 (2005)
  20. Bourgeois MS, "Skills training for spouses of patients with Alzheimer’s Disease : outcomes of an intervention study", J Clin Geropsychology, 8, pp.53~73 (2002)
  21. Teri L, "Behavioral treatment of depression in dementia patients: a controlled clinical trial", J Gerontol B Psychol Sci Soc Sci, 52, pp.P159~P166 (1997)
  22. Gallagher-Thompson D, "Impact of psychoeducational interventions on distressed family caregivers", J Clin Geropsychology, 6, pp.91~110 (2000)
  23. Zanetti O, "Effectiveness of an educational program for demented persons’ relatives", Arch Gerontol Geriatr, 6, pp.531~538 (1998)
  24. Sörensen S, "How effective are interventions with caregivers? An updated meta-analysis", Gerontologist, 42, pp.356~372 (2002)
  25. Callahan CM, "Effectiveness of collaborative care for older adults with Alzheimer disease in primary care : a randomized controlled trial", JAMA, 295, pp.2148~2157 (2006)
  26. Bartels SJ, "Caring for the whole person: integrated health care for older adults with severe mental illness and medical comorbidity", J Am Geriatr Soc, 52(12 Suppl), pp.S249~S257 (2004)
  27. Ciechanowski P, "Community-integrated home-based depression treatment in older adults : a randomized controlled trial", JAMA, 291, pp.1569~1577 (2004)
  28. Unützer J, "Improving primary care for depression in late life : the design of a multicenter randomized trial", Med Care, 39, pp.785~799 (2001)
  29. "Ministry of Health and Welfare"[URL]
  30. Gonyea JG, "The Role of Alzheimer’s Disease Support Groups in Families’ Utilization of Community Services", J Gerontol Soc Work, 16, pp.43~55 (1991)
  31. Sleath B, "African-American and white caregivers of older adults with dementia : differences in depressive symptomatology and psychotropic drug use", J Am Geriatr Soc, 53, pp.397~404 (2005)
  32. Brandt J, "Handbook of memory disorders", pp.33~55 (1995), John Wiley & Sons Ltd
  33. Morris RG, "Handbook of the Clinical Psychology of Ageing", pp.655~682 (1996), John Wiley & Sons Ltd
  34. Ylvisaker M, "Perspectives on rehabilitation of individuals with cognitive impairment after brain injury:rationale for reconsideration of theoretical paradigms", J Head Trauma Rehabil, 17, pp.191~209 (2002)

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