노인 입원환자의 사회적 지지와 건강상태와의 관련성 연구

Abstract

[한글]

이 연구는 노인 입원환자의 건강상태를 분석하여 노인보건 의료서비스 개발을 위한 기초 자료를 제공하기 위해 실시하였다.

조사 대상은 I시의 한 종합병원에 입원하고 있는 65세 이상의 노인 중 설문조사에 참여한 의료급여 환자 53명, 건강보험 환자 98명 총 151명 이었다. 2004년 4월 20일부터 27일 까지 구조화된 설문지를 이용하여 1 대 1 면접조사를 하였다.

조사도구는 육체적 건강상태, 정신적 건강상태, 사회적 지지 및 참여도로 구성되었으며 선행연구에서 각각 개발된 도구들을 활용하였다. 각 조사 항목은 5점 척도로 측정하였다. 육체적 건강 상태는 시력, 청력, 식사능력 등 19개 문항으로 구성되었으며, 정신적 건강상태는 한국판 노인우울척도 도구 15개 문항을 사용하였다. 사회적 지지 정도는 6문항, 사회 참여정도는 4문항으로 구성되었다.

의료급여와 건강보험 노인 입원환자간의 육체적 정신건강상태, 정신적 건강상태, 사회참여 정도, 사회적 지지정도 차이를 고찰하기 위해 t-검정과 상관관계 분석을 하였다. 이들 조사 대상자의 건강상태에 영향을 미치는 요인을 구명하기위해 다중회귀분석을 실시하였다.

전체 응답자의 육체적 건강상태는 평균 4.39점이었고, 의료급여 환자 (4.18점)가 건강보험 환자(4.51점)보다 낮았으나 통계적으로 유의한 차이가 없었다. 전체 응답자의 정신적 건강상태는 3.17점으로 육체적 건강상태보다 낮았으며, 의료급여 환자(3.07점)가 건강보험환자(3.23점)보다 낮았다.

제공자별 사회적 지지정도는 자녀가 가장 높았으며, 친구, 이웃, 형제자매, 배우자 순이었다. 자녀에게서 받는 사회적 지지는 의료급여환자(2.42점)가 건강보험환자(3.82점)보다 훨씬 낮았다.

대상자의 사회 참여 정도는 의사결정권, 단체 활동, 종교 활동, 평생교육으로 각각 의료급여 환자와 건강보험 환자 두 집단간 차이는 통계적으로 유의하지 않았다. 회귀분석 결과 정신적 건강상태에 영향을 미치는 유의한 요인은 육체적 건강상태(회귀계수 0.24, p=0.001)와 자녀의지지(회귀계수 0.10, p=0.01)이었다.

[영문]The purpose of this study was to analyze elderly inpatients'' health status and to provide basic materials in order to develop Elderly Health Medical Services.

Samples were taken in a general hospital in I city from April 20, 2004 to April 27. Among Inpatients over sixty-five years old, fifty-three Medicare Payment inpatients and ninety-eight Medicare Patients who participated in the survey were sampled as subjects and they were one hundred and fifty-one in total. A structured questionnaire was used in a one to one interview.

The questionnaire was composed of the questions asking physical health status, mental health status, social supports and participation level, and the questions developed in previous researches were used for this study. Each survey area was measured with a 5 points scale. For the physical health, the questionnaire contained nineteen questions asking about eyesight, hearing capabilities and eating abilities, and for the mental health, the questionnaire contained fifteen questions measuring the Elderly Depression Scale. For social supports, six questions were used, and for the degree of social participation, four questions were used.

To examine differences related to the physical health, the mental health, the degree of social participation, and the degree of social supports between Medicare Payment elderly inpatients and Medicare elderly inpatients, t-test and correlation analysis were used. Multiple regression analysis was conducted to identify factors that affected health status of subjects of this study. The results analyzed were as follows:

The physical status of the subjects was 4.39 on average, and the average of medical payment patients (4.18) was lower than that of Medicare patients (4.51), but there was no statistically significant difference between the two groups. With regard to the mental status, the average was 3.17, and the average of Medicare patients (3.23) was higher than that of medical payment patients (3.07). Regarding social supports according to the provider, it was found that the degree of social support from children was the greatest, followed by friends, neighbors, siblings and spouse. In the social support from their children between the group of medical payment patients and Medicare patients, the average of the first group (2.42) was lower than that of the second group (3.82). Regarding social participation of the subjects, there was no statistically significant difference between the two groups of medical payment patients and Medicare patients in decision making rights, group activities, religious activities and life long education. According to the results of regression analysis, significant factors influencing mental health status were physical health status (regression index 0.24, p=0.001) and children''s support (regression index 0.10, p=0.01).