본 연구에서는 치매환자 가족보호자들이 경험하는 간병 부담감과 우울 및 신체증상의 수준을 확인하고, 가족보호자들의 심리적, 신체적 건강에 부정적인 영향을 미치는 치매환자의 문제행동 증상을 유형별로 탐색하였다. 이를 위해 치매 진단을 받은 환자를 간병하는 가족보호자 101명을 대상으로 간병 부담감(Burden Interview; BI), 우울증상(Center for Epidemiologic Studies Depression Scale; CES-D), 신체증상(Physical Health Questionnaire; PHQ)과 더불어 한국판 노인행동평가 척도(Older Adult Behavior Checklist; OABCL)를 사용하여 가족보호자가 보고한 치매환자의 문제행동 증상을 측정하였다. 분석 결과, 치매환자의 문제행동은 가족보호자의 건강관련 지표와 부적 상관관계를 보임과 동시에 보호자들의 부담감과 우울 및 신체증상을 예측하는 것으로 나타났으며, 특히 치매환자의 외현화 문제행동과 함께 내현화 문제행동이 동반되어서 나타날 경우, 가족보호자들의 부담감(R2 : .218 ➝ .257)과 우울(R2 : .274 ➝ .334) 및 신체증상(R2 : .324 ➝ .356)에 미치는 영향력이 증가하는 것으로 확인되었다. 이러한 결과는 치매환자가 외현화 문제행동과 내현화 문제행동이 동반될 경우, 이들을 간병하는 가족보호자들의 심리적, 신체적 건강수준이 더욱 저하된다는 사실을 의미하며, 치매환자의 외현화 문제행동 외에도 내현화 문제행동 증상에 대한 관심과 중재의 필요성을 시사한다. 이와 같이 본 연구에서 나타난 의의와 시사점을 바탕으로 치매환자의 문제행동 증상에 관한 후속연구의 필요성에 대해 논의하였다.
In the present study, we confirmed caregiver burden, depressive symptoms, and physical symptoms among family caregivers of dementia patients ; in addition, we determined dementia patient`s behavior problems that affect caregiver’s psychological and physical health by type. A total of 101 dementia family caregivers were asked to complete questionnaires assessing caregiver burden(Burden Interview; BI), depressive symptoms(Center for Epidemiologic Studies Depression Scale; CES-D), physical symptoms (Physical Health Questionnaire; PHQ), and dementia patient`s behavior problems using Older Adult Behavior Checklists(OABCL). In hierarchical regression analysis, the presence of internalizing behavior problems in addition to externalizing behavior problems were significantly higher predictors of caregiver burden, depressive symptoms, and physical symptoms. Thus, family caregivers experienced deteriorated psychological and physical health as a result of externalizing behavior problems accompanied by internalizing behavior problems. The study results suggested the necessity for concern and intervention targeting internalizing behavior problems. Implications for improving psychological and physical health of dementia patient`s family caregivers and suggestions for future research are discussed.
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