치매노인의 행동심리증상 돌봄부담 예측요인

Abstract

본 연구는 치매 가족부양자와 치매노인의 특성에 따른 가족부양자의 자기효능감과 행동심리증상의 돌봄부담을 알아보고 행동심리증상의 돌봄부담 예측요인을 확인하기 위해 수행된 서술적 조사연구이다. 자료 수집은 2019년 1월부터 2019년 2월까지 시행하였고, 연구 대상자는 B종합병원 신경과 치매센터를 이용하는 재가 치매노인의 가족부양자 총 147명을 대상으로 하였다. 본 연구에 사용된 측정도구는 치매노인의 인지기능은 K-MMSE(Korean version of Mini-Mental Status Examination), 일상생활능력은 K-ADL(Korean Activity of Daily Living Scale), 행동심리증상은 RMBPC(The Revised Memory and Behavior Problems Checklist), 행동심리증상 돌봄부담은 RMBPCr(The Revised Memory and Behavior Problems reaction Checklist), 자기효능감은 일반적 자기효능감 척도를 사용하였고, 수집된 자료의 분석은 SPSS WIN 25.0 프로그램을 이용하였다.

본 연구결과는 다음과 같다. 치매노인 가족부양자의 성별은 여성이 74.1%로 많았고, 평균연령은 58.16세(±12.78), 치매노인과의 관계는 배우자(38.1%), 딸 41명(27.9%), 아들 35명(23.8%), 며느리 11명(7.5%), 기타 4명(2.7%)순이었다. 치매노인의 돌봄기간은 평균 39.84개월(±32.04), 돌봄시간은 하루평균 15.32시간(±8.15)으로 나타났다. 치매노인의 행동심리증상은 96점 만점에 평균 43.15점(±13.66), 가족 부양자의 자기효능감은 120점 만점에 평균 79.98점(±12.57), 돌봄부담은 96점 만점에 평균 47.48(±17.09)으로 나타났다. 치매노인 가족부양자의 돌봄부담은 행동심리증상 빈도(r=.822, p<.001), 치매노인의 연령(r=-.230, p=.005), 인지기능(r=-.199, p=.015), 부양자의 자기효능감(r=-.463, p<.001)과 상관관계를 보였다. 치매노인의 행동심리증상에 따른 가족부양자의 돌봄부담 예측요인은 행동심리증상 빈도(=.77, p<.001), 자기효능감(=-.26, p<.001),치매노인의 연령(=-.14, p=.004)이 돌봄부담의 유의한 예측요인으로 나타났으며 설명력은 총 76%(F=116.29, p<.001)였다.

본 연구결과 치매노인의 행동심리증상이 심할수록, 가족부양자의 자기효능감이 낮을수록, 치매노인의 연령이 낮을수록 돌봄부담이 높은 것으로 나타났으며 가족부양자의 돌봄부담 완화를 위해서는 행동심리증상의 적극적인 관리와 중재가 필요하며, 부양자의 자기효능감 상승을 위한 프로그램의 개발을 통해 치매노인 부양자의 돌봄부담 감소와 삶의 질 향상에 도움을 줄 것으로 사료된다.; Purpose : This study is a descriptive research in order to identify self-efficiency of family care givers and care burden of behavioral psychological symptoms, depending on characteristics of family care givers and dementia patients, and then it is to verify predictive factors on care burden of behavioral psychological symptoms. Method : This study collected data from January to February in 2019. It selected 147 family caregivers as research subjects, whose patients utilize a dementia center of neurology in a B general hospital. This study utilized measuring tools. In case of cognitive function of dementia patients, it used K-MMSE (Korean version of Mini-Mental Status Examination). In case of daily life capacity, it used K-ADL (Korean Activity of Daily Living Scale). In case of behavioral psychological symptoms, it used RMBPC (The Revised Memory and Behavior Problems Checklist). In case of care burden by behavioral psychological symptoms, it used RMBPCr (The Revised Memory and Behavior Problems reaction Checklist). In case of self-efficacy, it used a self-efficacy scale. It analyzed collected data by using SPSS WIN 25.0 program. Result : This study showed results as follows. In case of gender of family care givers on dementia patients, female took 74.1% and it was high. Average age was 58.16 (±12.78). In case of relationship with dementia patients, there were spouse (38.1%), 41 daughters (27.9%), 35 sons (23.8%), 11 daughters-in-law (7.5%), and the 4 others (2.7%) in order. Care period on dementia patients was average 39.84 months (±32.04), and care time was average 15.32 hours (±8.15) per day. This study found that behavioral psychological Symptoms of Dementia Patients received average 43.15 points (±13.66) out of 96 points, self-efficacy of family care givers received average 79.98 points (±12.57) out of 120 points, and care burden received average 47.48 points (±17.09) out of 96 points. The care burden of family caregivers for dementia patients had correlation with behavioral psychological symptom frequency (r=.822, p<.001), age of the patients (r=-.230, p=.005), cognitive function (r=-.199, p=.015), and self-efficacy of caregivers (r=-.463, p<.001). Depending on behavioral psychological symptoms of dementia patients, this study found significant predictive factors of care burden showed care burden of the predictive factors on care burden of family care givers, including frequency of behavioral psychological symptoms (=.77, p<.001), self-efficacy (=-.26, p<.001), and age of the patients (=-.14, p=.004), and its explanatory power is total 76% (F=116.29, p<.001). Conclusion : As results of this research, this study found that care burden becomes higher when behavioral psychological symptoms of dementia patients are more severe, self-efficacy of the family caregivers is lower, and age of the dementia patients is younger. In order to alleviate the care burden of family caregivers, active management and mediation should be needed for behavioral psychological symptoms. Through developing programs for improving self-efficacy of caregivers, this study expects it to help reduce care burden of caregivers on dementia patients and improve their quality of life.

Keywords: Family Care Givers of Dementia Patient, Behavioral Psychological Symptoms, Care Burden, Self-Efficacy