요양시설 치매 환자의 초조행동에 미치는 영향요인
Factors Affecting Agitation in Nursing Home Patients with Dementia
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초록
Purpose: The purpose of this study was to identify factors affecting agitation in patients with dementia who live in nursing homes. Factors including background and proximal factors based on the Algase’s Need-Driven Dementia- Compromised Behavior model were tested. Methods: Data collection was performed from Dec. 1 to 28 2015, and 193 elders from 4 nursing homes participated in this study. The instruments included CMAI (Cohen-Mansfield Agitation Inventory), K-MMSE (Korean Mini-Mental State Examination), Holden Communication Scale, K-ADL (Korea Activity of Daily Living scale), DS-DAT (Discomfort scale-Dementia of the Alzheimer’s Type), CSDD (The Cornell Scale for Depression in Dementia), NPI (Neuropsychiatric Inventory), as well as items on the physical and psychosocial environment. Data analysis was performed using descriptive statistics, t-test, ANOVA, Scheffé and Dunnet T3, Pearson correlation and multiple regression. Results: Multiple regression analyses identified hallucination (β=.24), delusion (β=.22), pain (β=.15), and the total period of being diagnosed with dementia (β=.10) as significant predictors of agitation and these factors explained 36.0% of the variance in the model. Conclusion: The findings of this study show that hallucination delusion, pain and total period of being diagnosed with dementia need to be considered when developing intervention programs to control agitation in patients with dementia.
Abstract
Purpose: The purpose of this study was to identify factors affecting agitation in patients with dementia who live in nursing homes. Factors including background and proximal factors based on the Algase’s Need-Driven Dementia- Compromised Behavior model were tested. Methods: Data collection was performed from Dec. 1 to 28 2015, and 193 elders from 4 nursing homes participated in this study. The instruments included CMAI (Cohen-Mansfield Agitation Inventory), K-MMSE (Korean Mini-Mental State Examination), Holden Communication Scale, K-ADL (Korea Activity of Daily Living scale), DS-DAT (Discomfort scale-Dementia of the Alzheimer’s Type), CSDD (The Cornell Scale for Depression in Dementia), NPI (Neuropsychiatric Inventory), as well as items on the physical and psychosocial environment. Data analysis was performed using descriptive statistics, t-test, ANOVA, Scheffé and Dunnet T3, Pearson correlation and multiple regression. Results: Multiple regression analyses identified hallucination (β=.24), delusion (β=.22), pain (β=.15), and the total period of being diagnosed with dementia (β=.10) as significant predictors of agitation and these factors explained 36.0% of the variance in the model. Conclusion: The findings of this study show that hallucination delusion, pain and total period of being diagnosed with dementia need to be considered when developing intervention programs to control agitation in patients with dementia.
참고문헌 (30)
- Lee HJ, "Influencing factors and caregiving burden among primary caregiver for demented elderly", Korean Journal of Care Work, 2(1), pp.33~60 (2006)
- "3rd National dementia management plan" (2015)[URL]
- 오병훈, "치매의 행동•정신 증상 진단 및 관리", 대한의사협회지, 52(11), pp.1048~1054 (2009), 대한의사협회[DOI]
- Jiska Cohen-Mansfield, "Agitated behavior in persons with dementia: The relationship between type of behavior, its frequency, and its disruptiveness", Journal of Psychiatric Research, 43(1), pp.64~69 (2008), Elsevier BV[DOI]
- Cerejeira J, "Behavioral and psychological symptoms of dementia", Frontiers in Neurology, 3(73), pp.1~21 (2012)[DOI]
- Guk-Hee Suh, "Agitated behaviours among the institutionalized elderly with dementia: validation of the Korean version of the Cohen-Mansfield Agitation Inventory", International Journal of Geriatric Psychiatry, 19(4), pp.378~385 (2004), Wiley-Blackwell[DOI]
- D. L. Algase, "Need-driven dementia-compromised behavior: An alternative view of disruptive behavior", American Journal of Alzheimer's Disease and Other Dementias, 11(6), pp.10~19 (1996), SAGE Publications[DOI]
- Ann M. Kolanowski, "Toward Holistic Theory-Based Intervention for Dementia Behavior", Holistic Nursing Practice, 14(2), pp.67~76 (2000), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Mark E. Kunik, "Causes of Aggressive Behavior in Patients With Dementia", The Journal of Clinical Psychiatry, 71(09), pp.1145~1152 (2010), Physicians Postgraduate Press, Inc[DOI]
- Jiska Cohen-Mansfield, "An analysis of the relationships among engagement, agitated behavior, and affect in nursing home residents with dementia", International Psychogeriatrics, 24(05), pp.742~752 (2012), Cambridge University Press (CUP)[DOI]
- Talerico KA, "Mental health correlates of aggression in nursing home residents with dementia", The Gerontologist, 42(2), pp.169~177 (2002)[DOI]
- Martha D. Buffum, "A pilot study of the relationship between discomfort and agitation in patients with dementia", Geriatric Nursing, 22(2), pp.80~85 (2001), Elsevier BV[DOI]
- Volicer L, "Relationship between symptoms of depression and agitation in nursing home residents with dementia", International Journal of Geriatric Psychiatry, 27(7), pp.749~754 (2012)[DOI]
- 김종임, "노인요양시설 치매노인의 문제행동에 영향을 미치는 요인", 한국생활환경학회지, 19(5), pp.584~594 (2012), 한국생활환경학회
- Kim MS, "Relationship between premorbid personality and behavioral and psychological symptoms in dementia (BPSD) in Korean patients with Alzheimer's disease", pp.2012
- 임동영, "치매노인 문제행동과 간호제공자의 대처행동 관계", 한국산학기술학회논문지, 16(7), pp.4805~4815 (2015), 한국산학기술학회[DOI]
- Folstein MF, "Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician", Journal of Psychiatric Research, 12(3), pp.189~198 (1975)
- Kang YW, "A validity study on the Korean Mini-Mental State Examination (K-MMSE) in dementia patients", Journal of the Korean Neurological Association, 15(2), pp.300~308 (1997)
- Holden UP, "Reality orientation: psychological approaches to the confused elderly", pp.341~ (1988), Churchill Livingstone
- Gang MH, "Effects of horticultural intervention program on cognition, emotion, communication and problematic behavior in older adults with Alzheimer", pp.2005
- Won CW, "The development of Korean Activities of Daily Living (K-ADL) and Korean Instrumental Activities of Daily Living (K-IADL) scale", Journal of The Korean Geriatrics Society, 6(4), pp.273~280 (2002)
- Ann C. Hurley, "Assessment of discomfort in advanced Alzheimer patients", Research in Nursing & Health, 15(5), pp.369~377 (1992), Wiley-Blackwell[DOI]
- Kim SJ, "A study on pain-causing factors for the dementia suffering with aged women", master, pp.2006
- Alexopoulos GS, "Cornell scale for depression in dementia", Biological Psychiatry, 23(3), pp.271~284 (1988)[DOI]
- Dementia care assessment packet, "Kim KU", The Korean Association for Dementia, 107~ (2005)
- J. L. Cummings, "The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia", Neurology, 44(12), pp.2308~2308 (1994), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Choi SH, "The Korean version of the Neuropsychiatric Inventory: a scoring tool for neuropsychiatric disturbance in dementia patients", Journal of Korean Medical Science, 15(6), pp.609~615 (2000)[DOI]
- Kang YS, "A study on disturbing behaviors of demented elderly staying at home", The Journal of Korean Academy Community Health Nursing, 11(2), pp.453~469 (2000)
- 김진하, "서울시 치매 노인의 행동심리증상과 일상생활 수행능력 간의예측 관계", 노인간호학회지, 17(1), pp.1~9 (2015), 노인간호학회[DOI]
- Whall AL, "DeCicco B, et al. Factors associated with aggressive behavior among nursing home residents with dementia", Gerontologist, 48(6), pp.721~731 (2008)[DOI]