1. 연구의 필요성
변비는 모든 연령층에 흔하게 나타나는 소화기계 질병으로 전체 인구에 비해 노인인구에서 유병률이 더 높은 것으로 보고되고 있으며 허약노인이 거주하는 요양시설에서의 유병률은 지역사회에 거주하는 노인보다도 더 높다. 우리나라에서 활동적인 노인을 주요 대상으로 한 연구에서의 변비 유병률은 20.3% (Kwon et al., 2010), 26.6%(Kim,Wonetal.,2006)보고되었으나26.6%(Kim,Wonetal.,2006)보고되었으나 요양시설에 거주하는 노인에서는 47.5% (Lee & Sung, 2008), 59.1% (Yang, 2007)의 유병률을 보여 요양시설 거주노인에서 훨씬 높았다. 미국과 유럽의 조사보고에서도 재가노인의 약20%에서 변비증상이 있는 반면, 요양시설에 거주하는 사람들의 약 50%에서 변비가 있는 것으로 보고되었다(Tariq, 2007).일반적으로 노인에서 나타나는변비는대부분식사,활동량감소,수분섭취 부족, 부적절한 배변습관, 약제복용,정신적 요인(Hong & Cho, 1999) 등과 관련이 깊다. 변비를유발하는 약물로는 항콜린성 약물, 비스테로이드성 진통소염제(Non-steroidal Anti inflammatory Drugs, NSAIDs),마약성 진통제, 칼슘 길항제, 알루미늄을 포함한 제산제, 칼슘제, 철분제 등이 있다(Lee, 2005). 신경계질환인 뇌졸중, 척수 손상, 치매, 우울, 파킨슨병(Jost, 2010)과 대사질환인 당뇨병과 갑산선 기능 저하증, 고 칼슘혈증, 대장암으로 인한 기계적 협착 등도 변비를 유발할 수 있다(Kim,Byeon et al., 2006; Lembo & Camilleri, 2003). 특히 노인환자는 다약제 복용 비율이 높을 뿐 아니라 여러 만성질환을 가지고 있으며 운동능력이 떨어질 뿐 아니라 일상생활수행 정도가 낮아 변비 발생 위험이 더욱 높다(Lee, 2005).
변비의 의학적 치료는 흔히 의사의 처방에 따른 완화제투여 및 좌약이나 관장 적용 등의 약물요법이 시행되고 있다.
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