• 제목/요약/키워드: Depression in the elderly

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산림치유 활동이 노인에게 미치는 효과에 대한 체계적 문헌고찰 (Systematic Review on the Effect of Forest Healing Activities on the Elderly)

  • 이미진;최정기;김소연
    • 한국산림과학회지
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    • 제112권1호
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    • pp.93-104
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    • 2023
  • 고령화로 인해 기대수명이 높아지고 있으며, 다양한 노인성 질병 등의 문제가 증가하고 있다. 본 연구의 목적은 산림치유 활동이 노인에게 어떠한 영향을 미치는지 체계적으로 문헌을 분석하여 노인 대상 산림치유 활동 확대를 위한 기초자료를 제공하는 것이다. 문헌 수집을 위해 국내는 RISS, KISS, Korea Med, Science On, 국외는 PubMed, Cochrane central, MDPI, Google Scholar를 이용하였다. 수집된 문헌의 방법론적인 질적 평가를 위해 코크란 그룹의 RoB2와 RoBANS를 이용하여 비뚤림 평가를 진행하였다. 2000년부터 2022년 1월 사이에 게재된 노인 대상 산림치유 활동의 연구 논문으로 한정하여 총 1,856편에서 최종 21편의 문헌을 선정하였다. 대상자는 60세 이상이며, 선정된 문헌의 참가자는 최소 7명에서 최대88명으로 총 750명이 참가하였다. 분석결과, 각 지표에서 가장 많이 수행된 검사는 심리지표에서 우울 7편, 인지지표에서 MMSE(Mini Mental State Examination) 2편, 생리지표에서 혈압 4편, 생화학지표에서 멜라토닌 2편, 신체지표에서 체지방과 근력 3편으로 나타났다. 총21편의 연구 중 19편의 연구가 2가지 이상의 검사항목을 사용하였으며, 심리적 지표를 가장 많이 측정하였다. 향후 노인대상 산림치유 활동의 적용을 위해서는 인지기능 예방의 산림치유 프로그램이 다양하게 개발 및 보급되어야 하며, 산림치유 활동에 대한 근거를 제공하기 위해 후속연구는 지속적으로 제시되어야 한다.

일부지역 노인들의 인지기능과 우울에 관련된 요인에 관한 연구 (A Study on the Factors Related to the Cognitive Function and Depression Among the Elderly)

  • 신철호;김수영;이영수;조영채;이태용;이동배
    • Journal of Preventive Medicine and Public Health
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    • 제29권2호
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    • pp.199-214
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    • 1996
  • 노인들의 인지기능과 우울에 관련이 있는 요인을 알아보기 위해 대전시 및 대전시의 인근지역의 노인들 729명을 대상으로 MMSE 및 GDS를 이용한 면접조사를 실시하고 자료를 분석한 결과는 다음과 같다. 1. 조사대상군의 인지기능은 정상이 56.8%, 치매가 의심되는 경도장애가 24.1%, 치매가 거의 확실 한 중증의 장애가 19.1%로 나타났으며, 인지기능에 장애가 심할수록 우울의 정도가 증가하였다. 2. 연령이 증가함에 따라 인지기능은 감소하였으며, 남자보다는 여자에서 인지기능 및 우울증상의 정도가 높게 나타났다. 3. 연령의 효과를 보정한 후 인지기능 장애여부에 관련이 있는 요인은 성, 배우자 유무, 교육정도, 과거직업, 도구적 일상생활능력, 규칙적 운동, 외출빈도와 신체적 증상 중 흉부통중, 시력 및 청력장애, 어지러움증이었다. 4. 연령효과를 보정한 후에 유의한 관련성이 있는 변수를 이용한 회귀모형에서 도구적 일상생활 능력, 연령, 시력장애, 성, 집밖 외출의 요인이 통계적 유의성을 보였다. 5. 단계적 회귀분석을 통해 우울점수에 유의한 관련성을 보인 변수는 교육수준, 집밖 외출과 직업 활동 및 집안일의 참여, 규칙적 운동, 도구적 일상생활능력, 주관적으로 평가한 본인의 건강과 영양상태, 신체적 증상으로 어지러움증, 시력장애 및 흥부통증이었다. 이상의 결과를 볼 때 조사대상 노인들에 있어서 인지 기능과 우울에 관련성이 높은 주된 특성은 신체적 활동 능력과 주관적으로 평가된 건강상태라고 볼 수 있다.

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생태체계적 관점에서 본 생애주기별 자살생각의 위험요인과 보호요인 (Risk and Protection Factor Related to Suicide Ideation in Each Life Course based on an Ecological-system Perspective)

  • 김윤정
    • 한국지역사회생활과학회지
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    • 제22권3호
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    • pp.429-444
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    • 2011
  • The objective of this study was to identify the risk factor and protection factor related to suicide ideation in each life course based on an ecological-system perspective. A questionnaire was carried out for 393 adolescents, 473 adults and 376 aged men living nationwide. The results are as follows. First, the suicide ideation was low with 1.78 points in the full mark of 5 points. Second, the difference in suicide ideation, depression, hopelessness, stress in the organic system variables, family solidarity in the micro system variables, intermediate system variables, residence, the existence/inexistence of counselling center and the influence of mass media in mezo system variables in each life course were significant. Third, the relative influence of organic system variables on the suicide ideation were largest in all life courses. Further, the depression and the influence of mass media in all life courses were a risk factor of suicide ideation and stress was also a risk factor of suicide ideation in the case of adolescents and the aged. When examining protection factors of suicide ideation, family solidarity, minute as it is, works as the protection factor of suicide ideation in the case of adolescents. For the adults, living in a metropolis was a protection factor from suicide ideation. For the aged, family solidarity, family history of suicide and adult children's attention to their friends and neighbors (intermediate system variable) were protection factors from suicide ideation. I suggested that policy, service, counseling and educational program proper to each life course were necessary to lower risk factors of suicide ideation and to improve protection factors.

노인의 기분측정을 위한 도구(Profile of Mood States, POMS)의 타당화에 관한 연구 (A Study on Verification of the Profile of Mood States(POMS) for Korean Elders)

  • 신윤희
    • 대한간호학회지
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    • 제26권4호
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    • pp.743-758
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    • 1996
  • This paper was done to verify the use of the Profile of Mood States (POMS) which was developed by McNair, Lorr, and Droppleman(1992) with modifications so that it is appropriate for Korean elders. Through the modified tool, it is possible to examine the mood of Korean elders and to contribute to the welfare of elders. The subjects were 370 elderly persons over 60 years old and the data for 319 persons(86%) were analyzed. The research tool was the POMS translated by Yun(1993) and corrected by the researcher. Data were collected between February 12 and April 9 in 1996 and analyzed using the SAS package. The result are as follows 1. Items with low Cronbach coefficient alpha which means low correlation with total items were removed. The items were removed : friendly, tense, considerate, relaxed, sympathetic, resentful, good-natured, rebellious, trusting, carefree. 2. Overlapped or ambiguous items were discussed by colleagues and elders through verification of con-tent-validity and were removed. Five items were removed in tense-anxiety, seven, in depression-dejection, three, in vigor-activity, three, in fatigue-inertia, two, in confusion-bewilder-ment, five, in friendliness, and six, in anger-hostility. Thirty four items remainined : angry, clear-headed, lively, confused, sorry, shaky, list-less, peeved, sad, active, blue, hopeless, spiteful, uneasy, unable to concentrate, fatigued, helpful, nervous, lonely, cheerful, bitter, exhausted, anxious, ready to fight, sluggish, helpless, alert, deceived, efficient, worthless, forgetful, terrified, vigorous, and uncertain about things. 3. Factor analysis was done in order to confirm construct validity and three factors were obtained from the result. The first factor, 'anxiety-depression' included 21 items, the second factor, 'vigor' included eight items, and the third factor, 'anger' included five items. Cronbach coefficient alpha for the 34 items was. 95. Based on the result, the following is suggested : 1. a contribute to elder's welfare can be made by examining Korean elder's mood in life. 2. there is a need to develop tools appropriate to Korean culture which can be used to examine elders' mood. 3. The modified POMS tool needs to be reverified with appropriate age groups and settings.

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신체증후군에 대한 탐색적 연구: 한인 노인 이민자를 중심으로 (An Exploration of Somatization among Korean Older Immigrants in the U.S.)

  • 안준희
    • 한국노년학
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    • 제28권4호
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    • pp.1179-1200
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    • 2008
  • 이민자의 신체화증후군에 대한 연구의 중요성에도 불구하고 기존 연구는 제한적으로 이루어져왔다. 선행연구들은 신체화증후군이 노년기 이민자들의 문화적 차이로 인한 우울증 증상의 유형으로 제시하였을 뿐, 이민자의 우울증 설명할 수 있는 실증적인 연구 모형으로 연결되지 못했다. 본 연구에서는 이러한 신체화증후군에 대한 이해를 제고시키기 위해, 관련 변수들과의 인과관계를 파악하기 위한 탐색적 연구를 시도하였다. 미국 뉴욕 대도시 지역에 거주하는 55세 이상의 한국 이민지 234명을 대상으로 선정하였다. 분석결과, 거주형태, 보유 질병의 수, 우울증이 신체화증후군에 영향을 미치는 것으로 나타났다. 또한 신체적 질병 횟수와 주관적 건강 상태는 신체화증후군에 대해 상호작용 효과를 나타내는 것으로 나타났다. 이러한 연구 결과는 노년기 한인 이민자들의 신체화증후군이 우울증을 표현하는 문화 특성적 행동양식임을 확인할 수 있게 해준다. 이를 통해 신체화증후군뿐만 아니라 우울증을 완화시킬 수 있는 문화적으로 민감한 정신보건 서비스를 개발 및 실행하는데 활용될 것으로 기대된다. 또한 신체화증후군의 원인을 규명하는 기반 연구가 될 것이라는 의의를 찾을 수 있다.

간호중재로서의 원예요법에 관한 고찰 (Study Review of Horticultural Therapy As a Nursing Intervention)

  • 김부영;김정선
    • 성인간호학회지
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    • 제13권3호
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    • pp.409-419
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    • 2001
  • The reference study was performed to investigate the nursing importance which was based a theoretical background related to horticultural therapy and to examine the possibility which horticultural therapy was applicable as a nursing intervention through analysis on a preceding study. The research subjects related to the areas of horticultural therapy which related as a nursing intervention, were psychological, physical, environmental, and psycho-social aspects. It is judged that the horticultural therapy is effective in treating depression, emotional disruption or anxiety. It seems to be also effective in increasing the muscular tension and, thereby, expanding the scope of joint movements. Such theories show that horticultural therapy may be a good alternative nursing means. Plants act to create a pleasant interior atmosphere by generating anion, controlling the temperature and humidity and purifying the air, and therefore, the horticultural therapy may be applied to clinic or environmental therapy. When horticultural therapy is used as a nursing intervention, patients' sociopsychological needs may be fulfilled. It has been found that horticultural therapy is instrumental in treating perceptive or emotional disruption, depression, loss of self-respect, disrupted everyday activities and social behaviors. In particular, horticultural therapy seems to be effective in managing chronic patients' crisis or improving life quality. Intervention method applied on a preceding study was activity therapy and scene therapy in the horticultural therapy The above findings suggest that the pro-environmental horticultural therapy is useful as a new paradigm of nursing or holistic nursing conducive to improvement of health. So, it is desirable to prove its effects by applying it in the clinic. In order to apply horticultural therapy as a nursing intervention, it will be necessary to educate nurses on principles and methods of horticultural therapy and encourage them to apply it in nursing and clinics. Moreover, it may well be necessary to develop landscape therapy as nursing intervention as well as a variety of horticultural therapy programs befitting the clinic conditions. On the other hand, we need to provide for some scientific ground for horticultural therapy through continued studies. In this regard, this study which focuses on patients' health improvement through change of environment. may well provide for a framework for such studies.

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노인의 무력감 완화를 위한 심리 재활에 관한 연구 (A Study on Psychological Rehabilitation to Decrease Powerlessness in the Elderly Population)

  • 김조자;임종락;박지원
    • 대한간호학회지
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    • 제22권4호
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    • pp.506-525
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    • 1992
  • Older people, because of the psychological and physiological changes related to the aging process are more vulnerable to experiencing powerlessness than any other age group. This self destructive cycle of depression in older people related to the experience of continued and long term powerlessness can lead even to death. The purpose of this study was to measure powerlessness and resources to increase power in older people, and to measure the effectiveness of a psychological rehabilitation program for reducing powerlessness. The research methodology used was a two step process. In the first step, a survey was done of perceived powerlessness and power resources comparing four groups of elderly people ; those living at home, those in hospital, those living in nursing homes and those attending educational programs for the elderly. The total sample size was 236. In the second step, a psychological rehabilitation program was carried out, pre and post measurements were taken related to this program. The sample consisted of 29 residents in a nursing home. The results of the study are as follows : 1. Powerlessness was classified as cognitive, emotional, activity and learning. The lowest score for powerlessness was in the area of activity, that is the people in the sample felt more power concerning their activities. The highest score was in the area of cognition where they felt they had less power. 2. When the different groups of elderly were compared, it was found that the residents of the nursing home had the highest score on perceived powerlessness and the group who were living at home had the lowest score. 3. Among the general characteristics, the factors influencing the powerlessness score were age, sex, level of education, financial resources and health status. In the interaction effects among these factors, it was found that level of education and health status were factors influencing perceived powerlessness. The elderly with lower education and poorer health status had the higher scores for perceived powerlessness. 4. The power resources could be classified into the following areas : physical strength, emotional strength, positive self-image, energy, knowledge, motivation and belief system. Belief system was given the highest score among the power resources and energy, knowledge and motivation were given low scores. 5. The group participating in an educational program for the elderly had the highest score for power resources while the group made up of residents of a nursing home had the lowest score as well as the highest score for perceived powerlessness. 6. The factors influencing the power resource scores were sex, level of education, financial resources and health status. In the analysis of the interaction effect among the factors, it was found that sex, level of education and financial resources were the factors that influenced the power resource score, that is, women, those with a low level of education and those with poor financial resources reported a lower level of power resources. 7. There was a negative correlation between perceived powerlessness and power resources in the elderly in this study. Since power resources explainded 49% of the variance for powerlessness, it can be concluded that the power resources can be used to reduce powerlessness. 8. The psychological rehabilitation program was carried out with the nursing home residents over a period of five weeks. No statistically significant difference was found in the scores on powerlessness between the pre and post tests, but there was a slight decrease in the raw scores on the post test for emotional, activity and learning powerlessness. There was a statistically significant increase in the power resource scores for emotional strength, positive self-image, energy, knowledge and motivation in the post test as compared to the pre test. In conclusion, the study indicates that a psychological rehabilitation program for the elderly could be effective in increasing power resources and this in turn could lead to a decrease in perceived powerlessness.

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안전·안심디자인을 위한 고령자의 손상 위험요인에 관한 연구 (Study on Injury Risk Factors of the Elderly for Safety·Security Design)

  • 김미영
    • 한국콘텐츠학회논문지
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    • 제17권2호
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    • pp.105-112
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    • 2017
  • 본 연구는 고령자의 안전 안심디자인을 위한 기초연구로 손상을 사전 예방이 가능한 사회문제로 인식하고, 손상 위험요인을 명확하게 규명하고자 하였다. 이를 위해 국민건강영양조사 제6기 원시자료를 이용하였고 분석결과, 사회적 특성은 '성별, 교육수준, EuroQoL(운동능력, 일상활동, 통증 불편), 삶의 질(PHQ-(1)(2)(4)항목), 스트레스 인지율, 일상생활 활동제한 여부와 사유(골절, 관절부상)'이었다. 역학적 특성은 만성질환인 '엉덩관절통, 당뇨병'이었고, 건강행태적 특성은 '흡연, 아침식사 횟수, 고강도의 신체활동 여부'이었다. 결론적으로 고령자의 손상위험은 여성, 교육수준이 낮을수록, 보행 및 일상 활동에 지장 및 제한이 있고, 통증 및 불편도가 심할수록, 스트레스 인지율이 높을수록, 일을 하는 것에 대한 흥미나 재미가 없고, 가라앉은 느낌, 우울감 혹은 절망감, 피곤감, 기력이 저하됨을 느낄수록, 골절 및 관절부상, 일상생활에 제한이 있고 그 사유가 골절 및 관절부상인 경우, 엉덩관절통과 당뇨병이 있을수록, 흡연자이고, 아침식사를 거의 안할수록, 고강도의 신체활동을 하지 않을 경우에 높아짐을 알 수 있었다. 이를 토대로 유기적인 관계 속에서 발생하는 손상 요인에 대한 디자인 측면에서의 효과적인 해결방안 모색이 가능할 것으로 사료된다.

Hospitalization Risk According to Geriatric Assessment and Laboratory Parameters in Elderly Hematologic Cancer Patients

  • Silay, Kamile;Akinci, Sema;Silay, Yavuz Selim;Guney, Tekin;Ulas, Arife;Akinci, Muhammed Bulent;Ozturk, Esin;Canbaz, Merve;Yalcin, Bulent;Dilek, Imdat
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권2호
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    • pp.783-786
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    • 2015
  • Background: Utilizing geriatric screening tools for the identification of vulnerable older patients with cancer is important. The aim of this study is to evaluate the hospitalization risk of elderly hematologic cancer patients based on geriatric assessment and laboratory parameters. Materials and Methods: In this cross sectional study 61 patients with hematologic malignancies, age 65 years and older, were assessed at a hematology outpatient clinic. Standard geriatric screening tests; activities of daily living (ADL), instrumental activities of daily living (IADL), Mini Nutritional Assessment (MNA), Mini Mental State Examination (MMSE), timed up and go test (TUG), geriatrics depression scale (GDS) were administered. Demographic and medical data were obtained from patient medical records. The number of hospitalizations in the following six months was then recorded to allow analysis of associations with geriatric assessment tools and laboratory parameters. Results: The median age of the patients, 37 being males, was 66 years. Positive TUG test and declined ADL was found as significant risk factors for hospitalization (p=0.028 and p=0.015 respectively). Correlations of hospitalization with thrombocytopenia, vitamin B12 and folic acid deficiency were statistically significant (p=0.004, p=0.011 and p=0.05 respectively). Conclusions: In this study, geriatric conditions which are usually unrecognized in a regular oncology office visit were identified. Our study indicates TUG and ADL might be use as predictive tests for hospitalization in elderly oncology populations. Also thrombocytopenia, and vitamin B12 and folic acid deficiencies are among the risk factors for hospitalization. The importance of vitamin B12 and folic acid vitamin replacement should not be underestimated in this population.