Journal of Korean Gerontological Nursing 2000;2(2):105-116.

치매노인의 개인위생 기능적 행위의 간호중재

임영미

Abstract

This study tested the extent to which a behavioral intervention improved grooming independence among 8 cognitively mild impaired nursing home residents. A time series design was employed. The PGT(Performance of Grooming Tasks) was used to determine the functional behavior of toothbrushing independence, facewashing independence, and haircombing independence of elders with cognitive impairments. The PGT was composed of PGT-TB(Toothbrushing), PGT-FW(Facewashing). PGT-HC(Haircombing) scale. The PGT was scored on the basis of the proportion of the component behaviors and the caregiver's prompt given for each component steps. A total of 21 sessions were collected in the morning using videotape recording. Baseline and post-intervention assistance was provided by nurse aides. Each resident was asked to brush teeth, wash face, and comb hair in a sequence. Fifteen sessions were conducted by the trained intervener for five weeks. The behavioral intervention consisted of systematic prompting and social reinforcement. Interobserver agreement for the PGT was measured by the trained observers. Hypotheses were tested : There will be a significant improvement in the three kinds of grooming independence of cognitively mild impaired nursing home residents during the behavioral intervention sessions. Wilcoxon test was used to test the hypotheses. There was only statistically significant improvement in the facewashing independence of eight residents. The results showed improved toothbrushing independence (decrease in assistance) from 0.78 at baseline to 0.45 during 5 intervention weeks, facewashing from 0.86 at baseline to 0.60 during intervention weeks, and haircombing from 0,90 at baseline to 0.49 during intervention weeks. This indicates this significant improvement in grooming independence occurred during the behavioral nursing intervention sessions, as compared with the baseline and post-intervention sessions. The data in this research suggest that maintaining or improving functional ability is possible with a behavioral nursing intervention, which was a highly structured and systematic approach through strategies such as prompting and social reinforcement.

Key words: 치매, 개인위생, 기능적 행위