퇴원을 준비하는 노인 호흡기질환자의 일상생활수행능력과 관련 요인

Abstract

This study aimed to investigate the level of ADL (activities of daily living) of elderly pulmonary disease patients preparing for discharge and the factors affecting it. The data were collected from November 28, 2018 to March 15, 2019 using a structured questionnaire and individual semi-structured interviews with elderly patients aged over 65 years who were diagnosed with chronic obstructive pulmonary disease, pneumonia, interstitial lung disease, and infectious disease in mycobacterium (pulmonary tuberculosis and nontuberculous mycobacteria) at an acute care hospital in Seoul. A total of 104 responses were used in the final analysis. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficients, and multiple linear regression analysis using SPSS 24.0. The following are the result of this study. 1. The average age of the subjects was 75.02 ± 6.59 years and 62.5% (65 of them) were male. Moreover, 81 (77.9%) were married, 33 (31.7%) were high school graduates, and 85 (81.7%) were unemployed (including housewives). 2. The average score of respiratory symptom experience was 14.75 ± 9.93 out of 72, and that of social support was 5.28 ± 1.17 points out of 6. The anxiety and depression scores were 7.04 ± 4.60 and 9.19 ± 4.61, respectively, and the average score of ADL was 1.56 ± 1.81. 3. The level of ADL had a statistically significant difference according to the main caregiver (F=3.147, p=0.028) and ADL levels were lower with more underlying disease(F=3.735, p=0.027), those with a history of neurological or psychiatric disease had lower levels of ADL than those without it(t=3.218, p=.002). 4. The higher the level of social support, the higher was the level of ADL(r=-.212, p=030). Further, the higher the anxiety (r=.303, p=.002) and depression (r=467, p<.001), the lower was the level of ADL. 5. In the enter method multiple linear regression analysis, the model explained 38.1% of the ADL(F=4.259, p<.001). The higher the depression of the elderly pulmonary disease patients, the lower was their level of ADL (β=.425, p<.001), and the elderly patients without a history of neurological or psychiatric disease had higher levels of ADL than the elderly patients with it (β=-.224, p=.024). These findings suggest that intervention based on depression and history of neurological or psychiatric disease should be involved in promoting ADL of elderly pulmonary disease patients preparing for discharge. The purpose of this study was to investigate the level of ADL in elderly pulmonary disease patients preparing for discharge and provide a comprehensive understanding of the factors affecting ADL. In addition, the results of this study can be used as a fundamental information to assess the readiness for hospital discharge of the elderly pulmonary disease patients and improve the health - related quality of life by promoting ADL of the elderly.