보호자가 인식하는 알츠하이머 치매 환자의 의사소통 능력

Communication capability of the patients with Alzheimer’s Disease perceived by guardians

본 연구에서는 알츠하이머 치매 환자 264명을 대상으로 치매 발병 이후 의사소통 능력 변화를 알아보고자 하였다. 이를 위해 전남 Y시에 있는 J 종합병원 정신과에 내원한 65세부터 79세의 알츠하이머 치매 노인의 보호자를 대상으로 설문조사를 실시하였으며, 연구문제는 다음과 같다. 첫째, 알츠하이머 치매 노인의 하위범주별 의사소통 특성은 어떠한지 알아본다. 둘째, 치매 정도에 따른 하위범주별 의사소통 점수의 관계는 어떠한지 알아본다. 분석결과 치매 환자의 의사소통 능력 변화는 의미론적 영역에서 가장 뚜렷하게 나타났으며 화용론적 영역, 구문론적 영역 그리고 음운론적 영역 순으로 나타났다. 치매 정도에 따른 변화는 척도형 문항의 경우에는 대화태도를 제외한 모든 문항에서 MMSE-K 점수와 유의미한 상관관계가 있는 것으로 나타났다. 선택형 문항의 경우, 말의 억양은 치매정도가 경미할수록 높아지는 확률이 증가하였다. 말의 속도에 있어서는 치매정도가 경미할수록 ‘변화없음’이 나타날 확률은 다소 증가하고 반대로 ‘빨라짐’의 확률은 감소하였다. 문장길이는 치매정도가 경미할수록 문장의 길이가 짧아지거나 변화가 없는 확률은 증가하는 것으로 나타났다.

This study aimed to investigate the change of communication capability in the patients with Alzheimer’s disease since the development of the disease. To do so, a survey was conducted with 11 questionnaires in the subjects of guardians for the elderly with Alzheimer’s disease from 65 to 79 years old who had visited Psychiatric Clinic in J General Hospital, Y City in South Jolla Province. The detailed study problems were as follows. First, how about communication capability of the patients with Alzheimer’s disease since its development by each questionnaire? Second, how much was the communication capability by each questionnaire changed depending on the degree of the disease? Upon the analysis results, the changes of communication capability in the patients with Alzheimer’s disease were the most remarkable in the areas of semantics followed by pragmatics, syntax, and phonology. With respect to the changes by the degree of the disease, all the questionnaires except for the conversation attitude showed the significant correlation with MMSE test scores in case of scaled questionnaires using Likert scale. That means little change of communication capability was found as the degree of Alzheimer’s disease was milder. In case of multiple-choice questionnaires, the probability of the intonation to be higher was increased as the degree of the disease was milder. In terms of speaking speed, the probability to be ‘no change’ was somewhat increased while the one to be ‘faster’ was decreased as the degree of the disease was milder. For the length of sentences, the probability to be shortened or no change was increased as the degree of the disease was milder.