주관적 인지 저하 노인의 의사소통 파트너 교육이 인지-의사소통 중재에 미치는 영향
Effects of Communication Partner Education on Cognitive-Communication Intervention of People with Subjective Cognitive Decline
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초록
주관적 인지 저하(subjective cognitive decline: SCD)는 신경학적 질환의 고위험군으로서 크게 주목받고 있다. SCD 대상의 인지-의사소통 중재는 주관적 어려움을 최소화하고 일상생활과 삶의 질을 유지하는 데 초점을 두어야 한다. 본 연구에서는 SCD의 의사소통 파트너 교육이 인지-의사소통 중재에 어떻게 영향을 주는지 알아보고자 하였다. 65세 이상의 SCD 노인 44명이 참여하였고, 이들은 의사소통 파트너 교육 여부를 기준으로 교육 집단 21명, 비교육 집단 23명으로 분류되어 3개월간 의사소통 파트너 교육 및 가정 기반 인지-의사소통 중재 프로토콜이 적용되었다. 주요 결과는 다음과 같다. 첫째, 교육 집단의 중재 효과는 주의력과 구어 작업기억에서 두드러진 반면, 비교육 집단은 주의력에서만 유의한 차이가 있었다. 둘째, 교육 집단은 이해, 표현, 화용언어, 주관적 의사소통 등 의사소통의 모든 영역에서 중재 효과가 유의하게 나타났다. 셋째, 두 집단 간의 중재 효과 차이는 주의력 및 4개의사소통 영역에서 유의미하였다. 본 연구를 통해 의사소통 파트너 교육이 SCD군의 인지 및 의사소통 수행에 긍정적으로 작용함을 알 수 있었다. 이는 중재 시 의사소통 파트너의 참여를 체계화하고 중재 효과를 제고하기 위한 증거 기반적 지침으로 활용할 수 있다.
Abstract
Individuals with subjective cognitive decline (SCD) are at high risk for neurological disorders, and are becoming a more serious issue as time goes on. Based on the considerations of subjective complaints and overall quality of life, the application of a cognitive-communication intervention in SCD is a necessity. The purpose of this study was to analyze the effects of communication partner education on cognitive-communication intervention of people with SCD. Forty-four older adults with SCD over the age of 65 were divided into two groups: education (n = 21) and noneducation (n = 23) groups. They underwent 3 months of communication partner education and home-based cognitive-communication intervention protocol. The main findings are as follows. Firstly, education group improved significantly in attention and verbal working memory while noneducation group was significant in attention. Secondly, the efficacy of education group was significant in all domains of communication including comprehension, expression, pragmatic language, and subjective communication. Lastly, there is a great deal of effect difference in attention and 4 domains of communication. Our results show communication partner education is effective in cognitive-communication improvement of SCD. This study also provides the evidence-based guidelines for educating communication partners systematically, maximizing the transfer effects in cognitive-communication intervention for older adults with SCD.
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