지역사회 재가노인의 삼킴장애 위험실태와 관련인자

국문 초록 (Abstract)

본 연구는 지역사회에서 거주하고 있는 재가노인을 대상으로 삼킴장애 위험군을 선별하여 위험 실태를 파악하고 관련 인자를 조사하고자 하였다. 서울, 경기 및 충북 지역에 거주하는 65세 이상 재가노인 419명을 대상으로 2012년 9월에서 12월까지 일대일 면접방법으로 설문자료를 수집하였다. 주요 연구 결과는 다음과 같다. 첫째, 전체 응답자 가운데 과반수(53.50%)가 삼킴장애 위험군으로 판정되었고 삼킴장애 위험점수는 평균 13.17점으로 국내외 선행연구보다 높은 수준이었다. 둘째, 노인의 삼킴장애 위험도는 65~74세군보다 75세 이상군에서 높았고, 의치를 하는 경우와 일상생활에서 독립성이 떨어지는 경우에 유의하게 높았다. 셋째, 삼킴장애 위험군과 비위험군에서 노인의 식품섭취 문제와 그에 따른 향후 섭취 문제 위험 여부를 조사한 결과 삼킴장애 위험군은 비위험군보다 식욕부진, 식사량 감소, 잦은 결식, 입맛이 나쁘다고 응답한 경우가 많았으며 이에 따라 향후 섭취 문제 위험도가 유의하게 높은 것으로 나타났다. 결론적으로 국내 재가노인의 삼킴장애 실태는 간과하기 어려운 수준이며 향후 지역사회의 다양한 환경에 있는 노인들을 대상으로 연구가 확대되어야 할 것이다.

다국어 초록 (Multilingual Abstract)

The present study investigated the risk and prevalence of dysphagia as well as related factors among free-living elders. Subjects were 419 elderly men (116) and women (303) aged 65 years and older (74.49±4.70 y) living in Seoul, Gyeonggi-do and Chungcheongbuk-do area in Korea. Data were collected by personal interviews using questionnaires and analyzed by descriptive statistics, t-test, and chi-square test. Prevalence of dysphagia was 53.50% among participants. Risk of dysphagia was significantly different according to age (P<0.001), use of dentures (P<0.05), and activities of daily living (P<0.05). Moreover, dysphagia risk group had significant food intake problems, including poor appetite, smaller portions to reach satiety, frequent meal skipping, as well as poor taste compared to the normal group, accompanied by high risk of weight loss as assessed by simplified nutritional appetite questionnaire (P<0.01). Taken together, risk of dysphagia was more prevalent in older people, affecting the majority of those living independently in the community. This could indicate an association with undernutrition due to factors affecting food intake.

목차 (Table of Contents)

• ABSTRACT
• 서론
• 대상 및 방법
• 결과 및 고찰
• 요약
• REFERENCES

참고문헌 (Reference)

1 박지은, "한국 노인의 저작능력에 따른 식품 및 음식섭취 특성: 2007~2010년 국민건강영양조사 자료에 근거하여" 한국영양학회 43 (43): 285-295, 2013

2 장지은, "질적연구방법론을 이용한 여성노인의 식품선택 속성 및 제공 식사(편이식) 요구도 조사" 한국식생활문화학회 29 (29): 163-177, 2014

3 황선아, "재가노인의 연하장애 위험 실태와 영향요인" 한국노년학회 34 (34): 37-48, 2014

4 윤옥종, "연하장애 위험 여성노인의 노래중재 적용 효과" 성인간호학회 24 (24): 380-389, 2012

5 방활란, "노인요양시설 거주 노인을 위한 한국형 근거기반 연하장애 간호 프로토콜 개발" 대한근관절건강학회 20 (20): 31-42, 2013

6 Hanisah R, "Validation of screening tools to assess appetite among geriatric patients" 16 : 660-665, 2012

7 Cho MJ, "Validation of geriatric depression scale, Korean version(GDS)in the assessment of DSM-Ⅲ-R major depression" 38 : 48-63, 1999

8 Won CW, "The validity and reliability of Korean activities of daily living(K-ADL)scale" 6 : 98-106, 2002

9 Kim MS, "The risk of dysphagia and dysphagia-specific quality of life for the elderly users of the community welfare facilities" Seoul National University 2013

10 Logemann JA, "The evaluation and treatment of swallowing disorders" PRO-ED Inc. 216-217, 1998

11 Logemann JA, "Swallowing disorders" 21 : 563-573, 2007

12 Donini LM, "Senile anorexia in different geriatric setting in Italy" 15 : 775-781, 2011

13 Bloem BR, "Prevalence of subjective dysphagia in community residents aged over 87" 300 : 721-722, 1990

14 Chen PH, "Prevalence of perceived dysphagia and quality-of-life impairment in a geriatric population" 24 : 1-6, 2009

15 Kawashima K, "Prevalence of dysphagia among community-dwelling elderly individuals as estimated using a questionnaire for dysphagia screening" 19 : 266-271, 2004

16 Holland G, "Prevalence and symptom profiling of oropharyngeal dysphagia in a community dwelling of an elderly population : a self-reporting questionnaire survey" 24 : 476-480, 2011

17 Park YH, "Prevalence and associated factors of dysphagia in nursing home residents" 34 : 212-217, 2013

18 Phillips MB, "Nutritional screening in community-dwelling older adults : a systematic literature review" 19 : 440-449, 2010

19 Ohara Y, "Masseter muscle tension and chewing ability in older persons" 13 : 372-377, 2013

20 Palmer JL, "How to try this : preventing aspiration in older adults with dysphagia" 108 : 40-48, 2008

21 Health and Welfare Ministry, "Health and Welfare Ministry survey elderly living conditions and welfare needs across the country: the old man of his examination in 2008" 2008

22 Landi F, "Effects of anorexia on mortality among older adults receiving home care : an observation study" 16 : 79-83, 2012

23 Roy N, "Dysphagia in the elderly : preliminary evidence of prevalence, risk factors, and socioemotional effects" 116 : 858-865, 2007

24 Sura L, "Dysphagia in the elderly : management and nutritional considerations" 7 : 287-298, 2012

25 Turner MD, "Dry mouth and its effects on the oral health of elderly people" 138 : 15S-20S, 2007

26 Fukada J, "Development of dysphagia risk screening system for elderly persons" 10 : 31-42, 2006

27 Yoon HS, "Clinical survey of dysphagia in stroke" 14 : 196-202, 1990

28 Wilson MM, "Appetite assessment : simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents" 82 : 1074-1081, 2005

29 Davies S, "An interdisciplinary approach to the management of dysphagia" 18 : 22-25, 2002

30 Clark HM, "Age and sex differences in orofacial strength" 27 : 2-9, 2012

31 이승재, "50세 이상 성인과 노인의 우울여부에 따른 식습관 및 식품섭취상태에 관한 연구" 한국영양학회 47 (47): 67-76, 2014