동기면담 기반 치매예방프로그램이 요양시설입소 후기노인의 치매예방행동, 우울, 인지기능에 미치는 효과

Abstract

본 연구는 비동등성 대조군 사전·사후 유사실험 설계(Nonequivalent control group pretest-posttest design)로 요양원에 입소한 후기노인을 대상으로 동기면담기반 치매예방프로그램이 후기노인의 치매예방행동, 우울, 인지기능에 미치는 영향을 확인하는 것이다. 연구 대상자는 요양시설에 입소해 있는 75세 이상 후기노인이며 동기면담 기반 치매예방프로그램을 적용한 실험군A 18명, 치매예방프로그램만을 적용한 실험군B 20명, 대조군 19명, 총57명을 대상으로 하였다. 연구방법으로 프로그램 사전, 사후 그리고 추후에 치매예방행동, 우울, 인지기능을 설문지를 통해 측정하였고 분석방법은 SPSS WIN 21.0 프로그램을 이용하여 t-test, ANOVA, Repeated Measure ANOVA를 실시하였다. 본 연구결과를 요약하면 다음과 같다. 1. 본 연구 전체 대상자의 평균 연령은 85.3±5.56세며, 성별은 남자 22.8%, 여자 77.2%이었다. 교육정도는 무학 36.8%, 초졸 33.3%, 중졸이상 29.8%이었고 배우자가 있는 경우 8.8%, 배우자가 없는 경우 91.2%이었다. 연구 참여자 전체의 우울점수는 평균 7.26±4.08으로 중등도 우울이었고 인지기능은 평균 22.74±2.50로 치매의심수준이었다. 2. 실험군A, 실험군B, 대조군의 일반적 특성과 종속변수에 대한 동질성 검사에서 유의한 차이가 없는 것으로 나타났다. 3. 사전, 사후 프로그램 효과검증을 위해 t-test로 분석한 결과, 치매예방행동평균 점수는 실험군A(t=-2.946, p=.009), 실험군B(t=-3.04, p=.007)에서 통계적으로 유의하게 증가한 것으로 나타났다. 우울평균 점수는 실험군A에서 통계적으로 유의하게 감소하였다(t=2.247, p=.038). 인지기능평균 점수는 실험군A(t=-4.914, p=.000)에서 통계적으로 유의하게 증가하였다.;The purpose of Nonequivalent control group pretest-posttest design was to examine the effect of the dementia preventive intervention based on motivational interviewing on dementia preventive behaviors, depression and cognitive function among elderly in last year. Above of age 75 was selected as subject of study, who could be divided into three groups; 18 persons of groupA who were applied by dementia preventive intervention based on motivational interviewing, 20 persons of groupB who were only applied by dementia preventive program and 19 persons of control group, total of 57. By questionnaire, pre-test, post-test, and further dementia preventive behaviors, depression, cognitive function were measured as method of study. By using SPSS WIN 21.0 program, t-test, ANOVA and repeated measure ANOVA were performed as analyzing method. The results of the study are as follows: 1. The mean age for the participants was 85.3±5.56, and sex ratio was male 22.8% and female 77.2%. Educational level was as follows: no schooling 36.8%, primary school graduation 33.3%, and middle school graduation 29.8%, living with spouse was 8.8%, without spouse was 91.2%. Average level of depression for the participants was 7.26±4.08 which belonged to moderate depression, and average cognitive function was 22.74±2.50 which belonged to mild cognitive impairment. 2. Equivalence was verified for there were no significant differences among study groupA, groupB, and control group on general characteristics and dependent variables. 3. Result of t-test to verify the effectiveness of pre and post program are as follows. After intervention program, average level of dementia preventive behaviors were showed statistically significant at study groupA(t=-2.946, p=.009), study groupB(t=-3.04, p=.007). Average level of depression was decreased and showed statistically significant at study groupA (t=2.247, p=.038). Average level of cognitive function was increased and showed statistically significant (t=-4.914, p=.000) at study groupA 4. To verify persistent effectiveness of further test, it was analyzed by repeated measure ANOVA. The results were shown as follows. In score of the dementia preventive behaviors between groups(F=3.556, p=.035) and investigation period(F=5.729, p=.004), there was a significant differences, but no significant difference was found between investigation period and interaction among the groups(F=1.303,p=.274). In score of the depression, there were differences between groups(F=5.549, p=.006), and there was interaction between group and investigation period(F=2.767, p=.031). There was significant difference in score of cognitive function in accordance with investigation period (F=4.860, p=.011). The result of this study confirmed that motivational interviewing based on dementia preventive program increased activity of dementia prevention, which led to decrease in depression, and increase on persistent effect of cognitive function. Therefore, it seems to be verified intervention method for continuing prevention on dementia, controlling depression and cognitive function for elderly in late years. This study can be concluded that there is an academic significance on applying dementia prevention program with motivational interviewing.