• 한국노년학
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• 제37권1호
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• pp.173-200
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• 2017

본 연구의 목적은 노인자살예방을 위해 개발된 통합적 위기개입모델을 경기도를 중심으로 적용한 후 위기개입서비스의 실제 개입효과를 검증하는 것이다. 통합적 위기개입모델은 지역사회 통합시스템 접근과 스트레스 취약성 이론을 포함하는 위기개입 이론에 기초하여 개발되었다. 효과성 검증을 위해 노인우울(GDS-K) 및 자살생각(SSI)척도를 활용하였고, 1차 사전검사 258명, 통합적 위기개입 서비스 6개월 제공 후 2차 사후검사 184명, 2-3년 후 역추적을 통해 3차 추수검사 124명의 자료를 수집하여 분석하였다. 분석은 R Statistics computing을 이용하였고, 서로 다른 시점의 다른 검사를 비교하기 위해 검사 동등화 및 측정 시점 간 수직 척도화를 수행한 후 기술통계와 일변량 분산분석을 실시하였고, 마지막으로 베이지언 추정을 이용해 다층모형 분석을 실시하였다. 연구결과 노인자살예방을 위해 개발된 통합적 위기개입모델 적용 후 사전점수에 비해 사후측정에서 통계적으로 유의하게 노인우울과 자살생각을 감소시키는 것으로 나타났는데, 노인우울 감소에 .56의 효과크기를, 자살생각의 감소에 .39의 효과크기를 나타내 모델의 전체적인 효과성이 입증되었다. 그러나 위기개입 후 2-3년 후 추수검사에서 노인우울 및 자살생각이 다시 높아져 원래 상태를 회복하는 것으로 나타나 개입의 장기적인 유지효과는 확인되지 않았다. 노인우울 및 자살생각 변화량에 영향을 주는 요인을 찾기 위해 다층분석을 통해 위기개입 서비스의 각 유형(위기개입 전문상담, 약물치료, 동료상담)과 내담자특성(성별, 연령), 상담자 특성(전문가 연령, 경력, 전공)들 및 위기개입 서비스 유형(위기개입 전문상담)과 상담자 특성(전문가 연령, 경력, 전공)의 상호작용 효과를 살펴본 결과, 유일하게 약물치료가 단독으로 자살생각을 의미있게 낮추는 것으로 나타났으며, 전문가의 전공이 상담전공일 때 전문상담과 상호작용하여 자살생각을 의미있게 감소시키는 것으로 나타났다. 본 연구는 노인자살예방을 위해 개발된 통합적 위기개입모델의 전체효과와 각 개입서비스 유형의 효과를 검증하여 현장 적용의 근거를 확보했다는 데에 의의가 있다.

• 대한간호학회지
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• 제29권2호
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• pp.429-444
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• 1999

This study was performed to explore the effects of a dance therapy on physical and psychological characteristics in the elderly. The design of this study was a non-equivalent pre-post test experiment. The subjects consisted of elderly persons living in a facility located in Suweon and Bucheon. Fifty eight subjects, aged between 65 and 93 years who had normal cognition, sensory function, balance, and resting blood pressure. They underwent tests of balance, flexibility, muscle strength, depression, and anxiety as baseline data before dance therapy, and at 6th week and at the end of the 12nd week after following dance therapy. Twenty seven elderly persons were assigned to the experimental group and participated with the dance therapy between April and July, 1998. The dance therapy was developed by the author with the help of a dance therapist and a physiatrist. This therapy was based on the Marian Chace's dance therapy and Korean traditional dance with music. The dance therapy consists of 50 minutes session, 3 times a week for 12 weeks. One session was consisted of warming-up, expression, catharsis, sharing, and closing stage. The intensity of the dance therapy was at the 40 % of age-adjusted maximum heart rates. Data were analysed with mead standard deviation, Chi-square test, unpaired t-test, repeated measures ANOVA, and Bonferroni multiple regression using SAS program. 1. The results related to the physical characteristics were as follows : 1) The balance (standing on one leg, walking on the balancing bar), flexibility and muscle strength (knee extensor, knee flexor, ankle plantarflexor and dorsiflexor) of the experimental subjects significantly increased over time mere than that of the control subjects. 2) The experimental group had significantly higher score for balance, flexibility, muscle strength of knee extensor, and knee flexor than the control group at the 12nd week after dance therapy. 3) The experimental group had significantly higher score for muscle strength of ankle dorsiflexor and plantarflexor than the control group at the 6th week and the 12nd week after dance therapy. 2. The results related to psychological characteristics were as follows : 1) Scores of Geriatric Depression Scale, Hamilton Depression Rating Scale, and Zung's Self-rating Anxiety Scale of the experimental group were significantly decreased over time more than that of the control group. 2) The experimental group had significantly lower score for depression than the control group at the 12nd week after dance therapy. 3) The experimental group had significantly lower score for anxiety than the control group at the 6th week and the 12nd week after dance therapy. The findings showed that the dance therapy could be effective in improving the balances, flexibility, and muscle strength of lower limb, and effective in decreasing the depression and anxiety of the elderly. Additional merits of the dance therapy would be inexpensiveness, easy accessibility, and increasing interpersonal relationship. It can be suggested that the dance therapy is effective in the health promotion of the elderly.

• Asian Pacific Journal of Cancer Prevention
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• 제16권2호
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• pp.837-840
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• 2015

Background: The disclosure of a diagnosis of cancer is complex, particularly in older patients. The aim of this study was to investigate the association between age and not knowing the diagnosis, and its impact on mood. Materials and Methods: The study included 70 patients with various types of solid and hematologic cancer in early stages, which were followed up in an outpatient oncology/hematology clinic in Turkey between January, 2014 and June, 2014. Initially the caregivers of patients were asked whether the patients knew their diagnosis or not. A questionnaire for the Geriatric Depression Scale was then administered to the patients. Patient age, gender, marital status and education level were noted and analyzed with respect to knowing the diagnosis and depression. Results: Of the 70 patients, 40% of them were female. The mean age was $68.2{\pm}8.9$. The rate of the patients who does not know their diagnosis was 37.1% (n=26). The overall depression rate with GDS was found 37.1% (n=26) among the participants. There was no association with knowing the diagnosis (p=0.208) although the association between not knowing the diagnosis and age was significant (p=0.01). Conclusions: In this study we revealed no association between not knowing the diagnosis and depression in elderly patients. Contrary to what some has thought, the patient is not protected from psychological distress by not being informed about the diagnosis. We believe this study and similar ones will help to discuss and further explore patient autonomy, the principle of respect to self-determination and end of life issues in different cultures.

• 한국노년학
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• 제29권4호
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• pp.1327-1340
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• 2009

본 연구의 목적은 일 도시 노인의 성공적인 노화의 수준을 알아보고, 성공적인 노화와 관련된 요인을 규명하는 것이며, 또한 의사결정나무분석 방법을 이용하여 성공적인 노화의 점수에 따른 취약 그룹의 특성을 알아보고 우리나라 노인의 성공적인 노화 증진 프로그램을 개발하는데 기초자료로 활용하기 위함이다. 대구의 일 동사무소에 등록된 노인 중에서 연구 참여에 동의하고 설문지 면접을 마친 총 187명을 대상으로 하였다. 연구 참여에 동의한 노인은 면담자가 직접 노인 가구를 방문하여 구조화된 설문지를 이용하여 성공적인 노화, 우울, 신체적 기능상태, 만성 질환 수, 그리고 친구와의 접촉 빈도수에 대한 정보를 수집하였다. 일 도시의 노인에서 남성, 고학력, 배우자와 사별하지 않은, 그리고 가족과 동거하는 노인이 그렇지 않은 노인에 비해 상대적으로 성공적인 노화의 점수가 높았다. 반면에 우울정도가 심하거나 만성질환이 많을수록 성공적인 노화의 점수가 낮았다. 또한 신체기능과 자가 건강 평가수준이 높거나, 규칙적인 운동을 하거나 친구와의 교제가 많을수록 성공적인 노화의 점수가 높았다. 우울은 노인의 성공적인 노화의 점수에 따른 취약그룹을 분류하는데 일차적으로 중요한 결정 요인이었으며, 성공적인 노화의 점수가 가장 낮은 노인 그룹은 우울정도가 심하고 신체적 기능 상태가 좋지 않았으며, 반대로 성공적인 노화의 점수가 가장 높은 그룹은 우울정도가 약하고 신체적 기능상태가 좋은 노인이었다. 우울과 만성질환은 노인이 성공적인 노화를 경험하는데 부정적인 영향을 미칠 뿐 아니라 성공적인 노화의 점수가 낮은 그룹의 공통적인 특성이었으므로 노인의 우울과 만성질환을 위한 중재 프로그램의 제공이 중요하다는 것을 본 연구는 재확인하였다.

• 한국노년학
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• 제30권3호
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• pp.871-894
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• 2010

본 연구는 외국에서 노인 우울증을 치료하는 유용한 접근으로 검증된 문제해결치료(Problem-Solving Treatment)를 우리나라 노인에 적용하여 그 효과성을 평가하는데 목적을 두고 있다. 춘천시에 거주하는 독거노인 150명을 무작위 선발하여 PHQ-9을 활용한 우울증 스크리닝 검사를 실시하였으며, 중간정도 우울증을 지닌 것으로 판명된 노인 42명을 대상으로 무작위로 실험집단 23명, 통제집단 19명을 나누어 프로그램 효과성을 검증하였다. 훈련된 전문 진행요원이 가정을 직접 방문하여 일주일에 1회씩(약60분) 총 6회기에 걸쳐 1:1 면접을 실시하였으며, CES-D와 KGDS를 활용하여 사전, 사후, 그리고 종료 3개월 후 추후조사를 통해 우울증의 변화 정도를 측정하였다. 연구결과, 사후조사에서 실험집단의 우울수준이 통계적으로 유의미하게 감소되었지만 3개월이 지난 추후조사에서는 다소 증가하는 모습을 보였다. 그렇지만 사전조사와 추후조사를 비교해보면 여전히 실험집단의 우울수준이 추후조사에서 유의미한 감소를 보여 문제해결치료가 노인의 우울감소에 효과가 있음을 알 수 있었다. 반면 통제집단에서는 사전, 사후, 추후조사에서 유의미한 변화가 일어나지 않았다. 이러한 연구결과를 바탕으로 본 논문에서는 점차 증가하고 있는 노인 우울증을 감소시키는 유용한 접근법으로 지역사회에 기반을 둔 문제해결치료의 적용을 제안하였다.

• 한국간호교육학회지
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• 제10권1호
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• pp.7-19
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• 2004

This study has a purpose to devise an education program in relation to Gerontology and geriatrics applicable to Korean nurses through literature review and analysis of education programs utilized by the Geriatric Education Centers (GECs) of USA. Educational contents on gerontology and geriatrics are very diverse in precedent literatures. The education programs of GECs for health care personnel are equally very diverse. Among educational contents, subjects considered important are age-related changes, health problems of the aged, pharmacology, death, fall and osteoporosis, delirium, dementia, depression, urinary incontinence, communication with elderly. Methods used in education program are mainly seminar, workshop and lecture through internet. In addition, case study, small-group discussion and conference are also adopted. The program proposed in this study for nurses in relation to gerontology and geriatrics consists of 32 hours' education; 6 hours for age-related changes, 10 hours for health problems of the elderly, 14 hours for health problems in old age and 2 hours of communication technique. Educational method proposed is to utilize lecture through internet, direct education, workshop, practical exercise, case study and role play in parallel. This study proposed an education program on the basis of precedent literature and the program of GECs. Therefore, it is desirable to develop in the future more practical education program applicable to and required in practicing fields. Of course, this development needs to be based on nurses' educational needs by field in relation to gerontology and geriatrics.

• 생물치료정신의학
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• 제24권3호
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• pp.209-217
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• 2018

Objectives : The purpose of this study was to investigate the prevalence and risk factors of suicidality among community-dwelling elderly. Methods : The participants were 2,201 elderly people whose ages were over 65. The participants were asked to complete questionnaires, including Mini International Neuropsychiatric Interview(MINI), module C, Short Geriatric Depression Scale of Korean version(SGDS-K), Korean Geriatric Anxiety Inventory(K-GAI), The Korean Health Status Measure for Elderly V 1.0, Korean version of Mini-Mental Status Examination for Dementia Screening(MMSE-DS). Their sociodemographic factors were investigated. The data were analyzed using the chi-square test and the logistic regression test to examine the relationship between suicidality and participants' risk factors. Results : The prevalence rate of suicidality was 23.3%. In multiple logistic regression, depressive symptoms (OR=3.301, 95% CI : 2.453-4.440), anxiety symptoms(OR=3.289, 95% CI : 2.515-4.303), low physical function (OR=1.606, 95% CI : 1.229-2.098), no spouse(OR=1.571, 95% CI : 1.037-1.690), elderly aged 80 years or older (OR=1.506, 95% CI : 1.094-1.740) were independently associated with suicidality. Conclusion : Suicidality in community-dwelling elderly was quite high, particularly related to depressive symptoms. The results of this study can be useful for development of community-based prevention and management programs for suicidality.

• 대한청각학회지
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• 제25권3호
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• pp.138-145
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• 2021

Background and Objectives: This study aimed to evaluate the audiologic results after cochlear implantation (CI) in older patients and the degree of improvement in their quality of life (QoL). Subjects and Methods: Patients over 65 years old who underwent CI at implant center in Bozyaka Training and Research Hospital were included in this study (n=54; 34 males and 20 females). The control group was patient over 65 years old with normal hearing (n=54; 34 males and 20 females). We administered three questionnaires [World Health Organization Quality of Life-BREF (WHOQOL-BREF), World Health Organization Quality of Life-OLD (WHOQOL-OLD)], and Geriatric Depression Scale (GDS) to evaluate the QoL, CIrelated effects on activities of daily life, and social activities in all the subjects. Moreover, correlations between speech recognition and the QoL scores were evaluated. The duration of implant use and comorbidities were also examined as potential factors affecting QoL. Results: The patients had remarkable improvements (the mean score of postoperative speech perception 75.7%) in speech perception after CI. The scores for the WHOQOL-OLD and WHOQOL-BREF questionnaire responses were similar in both the study and control groups, except those for a two subdomains (social relations and social participation). The patients with longer-term CI had higher scores than those with short-term CI use. In general, the changes in GDS scores were not significant (p<0.05). Conclusions: The treatment of hearing loss with CI conferred significant improvement in patient's QoL (p<0.01). The evaluation of QoL can provide multidimensional insights into a geriatric patient's progress and, therefore, should be considered by audiologists.

• Journal of Audiology & Otology
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• 제25권3호
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• pp.138-145
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• 2021

Background and Objectives: This study aimed to evaluate the audiologic results after cochlear implantation (CI) in older patients and the degree of improvement in their quality of life (QoL). Subjects and Methods: Patients over 65 years old who underwent CI at implant center in Bozyaka Training and Research Hospital were included in this study (n=54; 34 males and 20 females). The control group was patient over 65 years old with normal hearing (n=54; 34 males and 20 females). We administered three questionnaires [World Health Organization Quality of Life-BREF (WHOQOL-BREF), World Health Organization Quality of Life-OLD (WHOQOL-OLD)], and Geriatric Depression Scale (GDS) to evaluate the QoL, CIrelated effects on activities of daily life, and social activities in all the subjects. Moreover, correlations between speech recognition and the QoL scores were evaluated. The duration of implant use and comorbidities were also examined as potential factors affecting QoL. Results: The patients had remarkable improvements (the mean score of postoperative speech perception 75.7%) in speech perception after CI. The scores for the WHOQOL-OLD and WHOQOL-BREF questionnaire responses were similar in both the study and control groups, except those for a two subdomains (social relations and social participation). The patients with longer-term CI had higher scores than those with short-term CI use. In general, the changes in GDS scores were not significant (p<0.05). Conclusions: The treatment of hearing loss with CI conferred significant improvement in patient's QoL (p<0.01). The evaluation of QoL can provide multidimensional insights into a geriatric patient's progress and, therefore, should be considered by audiologists.

• 원예과학기술지
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• 제28권5호
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• pp.884-890
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• 2010

반신마비 뇌졸중 환자의 심리적 정서적 재활에 대한 원예작업치료의 효과를 확인하고자 40명의 반신마비 뇌졸중 환자 가운데 20명을 대상으로 원예치료와 작업치료를 시행하였다(치료군). 나머지 20명을 대상으로 작업치료만을 실시하였다(대조군). 원예치료 프로그램은 다양한 실내원예활동으로 구성되었으며 1주일을 기본으로 4주 단위로 3단계 즉 3개월 동안 실시하였다. 선정된 원예작업은 동기유발, 적응, 사회성, 관계와 소통의 4개의 단위로 구성되었다. 원예작업치료의 효과 분석을 위해 손기능척도(GPT), 노인우울척도(GDS), 일상생활동작검사(FIM)를 실시하였다. 그 결과 대조군과 달리 원예작업 치료를 받은 처리군에서 재활 효과가 우수하였으며 GPT, GDS, FIM 모두 통계적으로 고도로 유의한 결과를 나타냈다. 또한 원예작업치료를 통해 환자들의 재활치료에 대한 동기부여는 물론 FIM의 하부요소인 의사소통, 사회인지도, 자기보호 항목도 크게 향상되었다. 본 연구를 통해 원예작업치료가 반신마비 뇌졸중 환자에 대한 작업치료 프로그램으로 활용될 수 있다는 것을 확인 가능하였다.