Earticle

목적 : 본 연구의 목적은 감각통합치료가 아동의 섭식 및 구강기능에 미치는 효과에 대한 단일대상연구 설 계 연구의 특성을 확인하고 질적 수준을 알아보는 것이다. 연구방법 : 한국연구정보서비스(Research Information Sharing Service; RISS), 한국학술정보(Koreanstudies Information Service System; KISS)의 원문제공 서비스를 활용하여 2011년에서 2020년에 발간된 논 문 중 감각통합, 감각통합치료, 감각자극, 구강방어를 주요 검색용어로 검색하였다. 총 7편의 단일대상연 구 설계 논문을 대상으로 연구 특성 및 내용, 질적 수준을 확인하였다. 결과 : 연구 설계는 모두 반전설계였다. 독립변수는 감각통합, 구강 관련 중재를 동시에 적용하였고 종속변 수는 식사, 호흡, 자세, 침흘림, 양치질 등 다양하였으며 중재 후 모든 종속변수가 향상되었다. 치료 회 기, 시간, 기간은 다양하였다. 연구의 질적 수준은 대부분 중간 이상이었으며, 변수와 대상에 대한 정의, 시각적 자료 사용 등 기준에 맞는 연구를 수행하고 있었다. 결론 : 감각통합치료는 섭식 및 구강기능에 효과적인 중재법으로 확인되었다. 단일대상연구 설계의 질적 수준은 적절하였으며 추후 연구 결과의 타당성을 높일 수 있는 방법을 적용하여 높은 수준의 연구를 진 행해야 할 것이다.

Objective: The aim of this study was to identify the characteristics and analyze the quality level of studies regarding the effectiveness of sensory integration therapy on feeding and oral function through a single-subject research design. Methods: A total of seven studies were chosen through the Research Information Sharing Service (RISS) and Korean Studies Information Service System (KISS). Keywords were sensory integration, sensory integration therapy, sensory stimulation, and oral defensiveness. The characteristics and quality level were analyzed. Results: A reversal design was used in every study. Sensory integration therapy and oral related intervention were used at the same time. After intervention, dependent variables such as feeding, breathing, posture, drooling, and brushing teeth were increased. The treatment time, number of minutes, and duration varied. The quality level was moderate overall. Conclusion: The effectiveness of sensory integration therapy on feeding and oral function was identified. The quality level of single-subject design research was deemed appropriate. A high quality level of study should be executed using an extra method for increasing the validity in the future.

본 연구는 구강기능향상운동 프로그램을 적용하여 재가 노인의 타액분비량, 구강기능과 삶의 질에 미치는 효과를 검증하여 노인건강향상을 도모하고자 2011년 7월부터 9월까지 3개월 동안 K도 소재 G 보건소를 방문한 64∼86세(평균 75.48세)의 재가 노인 64명을 실험군 31명, 대조군 33명으로 나누어 연구 대상으로 하였다. 구강기능향상운동 프로그램의 진행은 주 1회, 1회에 40분씩, 12주 동안 실시하였고, 수집된 자료는 SPSS 14.0 프로그램을 이용하여 분석하였으며, 그 연구 결과는 다음과 같다. 1) 전반적인 건강에 대해서는 56.3%, 구강건강에 대해서는 62.4%가 건강하지 않다고 인식하는 것으로 나타났으며, 이로 인하여 92.2%가 걱정을 하며 생활하는 것으로 나타났다. 2) 대상자의 타액분비량은 평균 2.05ml/min으로 나타났으며, 구강기능은 2.65점으로 기능이 나쁜 것으로 나타났다. 구강 건강과 관련된 삶의 질 정도는 3.49점으로 불만족을 경험하는 것으로 나타났다. 3) 구강기능향상 운동 전·후 실험군의 타액분비량은 운동 전 1.85ml/min에서 운동 후 2.58ml/min로 유의하게 증가하였고(t=1.85, p< .001), 구강기능은 운동 전 2.33점에서 운동 후 2.91점으로 기능이 향상된 것으로 나타났으며(t=5.08, p< .001), 삶의 질 또한 운동 전 3.46점에서 운동 후 3.79점으로 유의하게 향상된 것으로 나타났다(t=3.03, p< .01). 4) 구강기능향상 운동을 3개월 간 실시한 후, 실시한 집단과 실시하지 않은 집단을 비교분석하였을 때, 운동을 실시한 집단이 운동을 실시하지 않은 집단에 비해 타액분비량(Z=-5.85, p<.001), 구강기능(Z=-6.17, p<.001), 삶의 질(Z=-5.37, p<.001)이 유의하게 증가한 것으로 나타났다본 연구결과를 바탕으로 구강기능향상운동 프로그램은 노인의 타액분비량, 구강기능, 삶의 질에 긍정적인 영향을 미치는 것으로 나타났다. 특히 노인들로 하여금 저하된 구강기능에 관심을 갖도록 하고 기능을 향상시키는 노력과 해결방안을 모색하게 하는 계기를 마련해 주었다. 따라서 추후 본 프로그램이 우리나라 노인구강건강증진사업의 일환으로 포함되어 실시될 것을 기대한다. 다만 본 구강기능향상운동 프로그램을 적용한 선행 연구가 많지 않은 관계로 연구 결과를 다양하게 비교할 수 없었으므로 추후 보건소를 중심으로 확대 적용해 재 검증되기를 바란다.

Purpose: The purpose of this study was to investigate the effects of oral exercise on oral function and quality of life among community-dwelling elders. Methods: This was a quasi-experimental study. Sixty four participants were recruited from the dental clinic of a public health center in G City, Gyeonggi-do. Thirty one participants were assigned to the experimental group and 33 to the control group. Participants in the experimental group performed oral exercise once a week for a period of three months. Subjects in the The control group received usual oral education. The Scores for oral function and quality of life were measured before and after the treatment. Data were analyzed using SPSS WIN 14.0. Results: After the experiment, statistically significant differences were observed between the two groups. were observed. The amount of saliva (p<.001), and the scores of for oral function (p<.001), and quality of life (p<.001) were higher in the intervention group compared to the control group. Conclusions: Oral exercise programs were effective in improving the oral function and quality of life among community-dwelling elders. Oral exercise could be an effective oral health nursing intervention for older people in the community.

Objective: Oral frailty is associated with a decline in overall function in the elderly and increases the risk of dysphagia and aspiration pneumonia. Early diagnosis is essential to prevent these issues. This study aimed to determine the correlation between the Korean oral frailty diagnostic criteria and oral diadochokinesis (ODK) in community-dwelling elderly individuals. Methods: Six diagnostic criteria for oral frailty were examined and ODK was assessed in 100 elderly individuals aged 60 years and above residing in the Gangwon State. The correlation was analyzed using Pearson’s correlation, Spearman’s rank correlation, and multiple regression analysis. Results: The study found that elderly individuals in the later stages of life had significantly lower tongue pressure, occlusal force, chewing ability, and ODK compared to those in earlier stages. Additionally, increased age and decreased chewing ability and tongue pressure were significantly associated with a decline in ability to rapidly repeat monosyllables /p?/t?/k?/. Conclusion: As age increases in the elderly population, the frequency of /p?/t?/k?/ in ODK assessments may serve as a simple screening tool for oral frailty in community-dwelling elderly individuals.

목적 : 연하장애를 가진 뇌성마비 아동의 구강기능에 대한 구강감각치료의 효과를 알아보고자하였다. 연구방법 : 연구 대상은 OO대학병원 재활의학과에 입원한 뇌성마비 아동 중에서 구강기능척도의 총점이 40점 이하인 18명의 아동이었다. 한 집단의 사전-사후 실험설계로 구강감각치료 전, 후의 구강기능척도의 변화를 비 교하였다. 구강감각치료 방법은 손가락으로 눌러주기, 얼음막대로 자극하기, 전동칫솔로 자극하기이며, 자극 횟수는 치료 매뉴얼에 따라 각 부위 별로 10회씩 시행하였다. 구강감각치료는 1회 당 30분씩, 주 2회씩 하여 8 주 동안 총 16회 실시하였다. 결과 : 구강감각치료는 뇌성마비 아동의 전반적인 구강기능을 향상시켰다. 특히, 구강준비단계에서 필요한 턱 과 입술과 혀의 움직임을 향상시켰고, 구강감각치료 후에 미국언어청각협회 연하척도의 유의한 변화가 있었다. 결론 : 본 연구를 통해 임상에서 뇌성마비아동에게 구강감각치료를 적용에 도움을 줄 수 있을 것이다. 후속 연 구에서는 뇌성마비의 마비 유형과 장애 유형을 고려해서 각 유형 간의 구강기능의 차이를 알아보는 연구가 필 요할 것이다.

Objective : This purpose of this study is to investigate the effect of oral sensory treatment on the oral functionin dysphagic children with cerebral palsy. Methods : Eighteen children with cerebral palsy hospitalized in the department of rehabilitation at a universityhospital were chosen. They were diagnosed with cerebral palsy and received a total score of below 40points in an evaluation of the oral function while feeding. The study was a one-group pre-posttest designand showed a difference in oral function before and after the oral sensory treatment. The oral sensorytreatment included pressing with the fingers, and stimulating the cheek, chin, lips, tongue, and soft palate withan ice stick and electric toothbrush. The oral sensory treatment was conducted thirty minutes per day, twodays a week, for 8 weeks. Results : The results suggest that the oral sensory treatment had an effect in the improvement of the childrensoral function. In particular, ‘chin closing’, ‘closing the lips over a spoon’, and ‘tongue control’ showedsignificant improvement. In addition, after oral sensory treatment, the subjects showed an improvement intheir American Speech-Language-Hearing Association National Outcomes Measurements Systemswallowing scale (ASHA NOMS). Conclusion : Further studies into the co-relationship between the types of cerebral palsy and oral functionshould be conducted.

Objectives : The purpose of this study was to examine the effects of an oral health promotion program. And suggest that education on oral health should be given by a professional. Methods : Sixty-four people over the age of 65 years were selected from three elderly care facility located in Gyeongsangbuk-do, A city. From June 7 to August 19, 2016, an oral health promotion program was given to two experimental groups (N=21 and 20) for a total of eight times. One program was conducted by a professional and the other by a non-professional although both were considered experts. Additionally, a control group(N=23) was a observed. Results : While both experimental groups showed a positive change from the oral health promotion program, the experimental group that was given the oral health promotion program by a professional showed more positive changes in oral cavity function. Conclusions : By using professionals, it is possible to provide a health promotion program that actively monitors the oral cavity of the elderly as well as provide elderly care services for oral hygiene. Appropriate elderly health policies and oral health business model for elderly are needed.

Objectives : The aim of the present study was to propose more substantial data for evaluating the quality of life of adults in terms of oral health as well as provide the basic data necessary to develop an effective oral health care program that improves the quality of life of adults by age group. Methods : Raw data were used from the sixth Korea National Health and Nutrition Examination Survey for the first and second years which was conducted from January 2013 to December 2014. Multiple regression analysis was conducted with the collected data by gender and age group to determine the impact of oral functions on the quality of life of adults. Results : It turned out that oral function has an impact on the quality of life of adults by age group as follows: young people (β=.077), middle-age people (β=.101), young-old elderly people (β=.140), and old-old elderly people (β=.143). It was shown that as people grow older, they have better quality of life only when they have good oral function. Conclusions : It is necessary to develop a proper oral health care program that prevents oral diseases and improves oral function by age group, which eventually will lead to good oral health. Continuous oral healthcare is also considered necessary.

본 연구는 한국 표준직업분류에 따른 근로자의 구강기능문제를 파악하고 근로자들이 집단구강건강관리사업의 혜택을 받을 수 있도록 산업안전보건법의 개정을 촉구하기 위한 근거자료로 제공하고자 시행하였다. 국민건강영양조사 제7기 원시자료(1차,2차)를 이용하여 만 19세 이상 한국 표준직업분류에 따른 근로자를 대상으로 씹기문제와 말하기문 제를 조사한 결과 한국 표준직업분류에 따른 근로자의 유형과 씹기문제, 말하기문제의 연관성이 확인되었다(p<0.05). 이에 근로자의 구강건강을 향상시키기 위해서는 집단구강건강관리사업이 실행되어야 하며 집단구강건강관리사업의 주 최가 될 전문성을 갖춘 전문보건의료관리자를 채용할 수 있도록 산업안전보건법이 개정되어야 할 것이다.

This study was conducted to identify the oral function problems of workers according to Korean Standard Classification of Occupations (KSCO) and to provide evidentiary material to promote them to revise the Occupational Safety and Health Act so that workers can benefit from the collective oral healthcare project. For the research materials, it was used the 7th raw data (1st and 2nd) of National Health and Nutrition Examination Survey. It was examined the problems of chewing and speaking for the workers over 19 years old by KSCO. The connection between the types of workers and the problems of chewing and speaking has been confirmed (p<0.05). In order to improve the workers’ oral healthcare, the collective oral healthcare project should be implemented. Therefore, the Occupational Safety and Health Act should be revised to hire professional health care manager with expertise, who will be host of the collective oral healthcare project.

목적 : 본 연구는 구강운동촉진기술(oral motor facilitation technique, OMFT)이 뇌졸중 환자의 구강운동기능에 미치는 효과를 확인하기 위한 목적으로 시행되었다. 연구방법 : 연하장애를 동반한 뇌졸중 환자 72명을 대상으로 시행되었다. 실험군과 대조군은 난수표를활용하여 36명씩 무작위로 분류하였고, 두 그룹 사전-사후 검사 설계로 진행되었다. 실험군은 OMFT 중재를, 대조군은 전통적 연하재활치료를 각각 30분간 1일 1회, 주 5회로 4주 동안 총 20회기 적용하였다. 구강운동기능 평가를 위해 포괄적 구강안면기능척도(Comprehensive Oro-Facial Function Scale, COFFS)를 사용하였고, 기간별 치료 효과 확인을 위한 반복측정 분산분석(repeated ANOVA), 두 그룹간 변화량 차이 분석을 위해 독립표본 t -검정(independence t -test)을 시행하였다. 결과 : 두 그룹 모두 COFFS의 총점이 향상되었다. 실험군은 아래턱 및 입술 움직임, 볼 부풀리기, 혀움직임에서 유의한 변화가 나타났다. 또한 저작 분포도, 음식물 유출, 고체형 및 액체형 음식 삼킴, 목소리 변화 항목에서 치료 기간에 따른 유의한 차이가 있었고, 아래턱 벌리고 닫기 항목에서 두 그룹사이에서 유의한 차이를 보였다. 결론 : OMFT가 뇌졸중으로 인한 연하장애 환자의 구강운동기능에 긍정적인 영향을 미치는 것으로 확인되었으며, 임상에서 기초적인 근거로 활용할 수 있을 것으로 기대된다.

Objective : This study was conducted to confirm the effect of the oral motor facilitation technique (OMFT) on oral motor function in stroke patients. Methods : This study was conducted on 72 stroke patients with dysphagia were included. Thirty-six patients were randomly assigned to the experimental and control groups were randomly classified into 36 patients each using a random table, and a two-group pre-post test was designed. The experimental group underwent OMFT, and the control group underwent traditional dysphagia therapy for 30 min, once a day, 5 times a week for 4 weeks, for a total of 20 sessions. The Comprehensive Orofacial Function Scale (COFFS) was used to evaluate oral motor function. Repeated-measures analysis of variance (ANOVA) was performed to confirm the effect of the period, and an independent t -test was performed to analyze the difference in change between the two groups. Results : Total COFFS scores improved in both groups. The experimental group showed significant changes in mandibular and lip movements, cheek blows, and tongue movements. In addition, there were significant differences depending on the intervention period in terms of masticatory distribution, food spillage, swallowing of solid and liquid foods, and voice changes. There were significant differences in the mandibular opening and closing categories between the two groups. Conclusion : OMFT is effective in improving oral motor function in stroke patients with dysphagia and can be used as basic evidence in clinical practice.

본 연구는 뇌성마비 아동의 대동작 기능과 먹기, 마시기 기능, 구강 운동 기능과의 상관관계를 확인해보고, 뇌성마비 아동의 대동작 기능의 심한 정도에 따른 연하 재활의 필요성을 확인하기 위해 시행되었다. 뇌성마비 진 단을 받은 아동 61명을 대상으로 대동작 기능 분류 체계(GMFCS), 먹기와 마시기 기능분류 체계(EDACS), 구강 운동 기능 검사(OMAS)를 사용하여 대동작 기능, 먹고 마시기 기능, 구강 운동 기능 수준을 평가하고 각 기능 간 상관관계를 확인하였다. 본 연구의 결과는 대동작, 먹고 마시기 기능, 구강 운동 기능 사이에서 유의한 상관관계를 보였다. 즉, 대동작 기능 저하가 심할수록 먹고 마시기 기능과 구강 운동 기능 저하 역시 낮은 기능 수준을 보였다. 본 연구를 통하여 뇌성마비 아동의 섭식활동을 평가하고 치료함에 있어, 아동의 대동작 기능에 따른 먹고 마시기 기능, 구강 운동 기능에 대한 확인이 필요할 것으로 보인다.

Goal of this study is to perform the correlation about Gross motor function, eating-drinking function, and oral motor function, to identify necessity for invervention of feeding disorders on severity of the function of children with cerebral palsy. Subjects were 61 children diagnosed with cerebral palsy. The subject were evaluated for oral motor function, feeding function by GMFCS, EDACS, OMAS. The results of this study showed a significant correlation between gross motor function, eating and drinking functions, and oral motor functions. That is, the more severe the deterioration of the motor function, the lower the functional level of eating and drinking and oral motor function deterioration. In evaluating and treating the eating activity of children with cerebral palsy through this study, it seems necessary to check the eating and drinking function and oral motor function according to the gross motor function.

본 연구의 목적은 하모니카를 활용한 입 운동 및 호흡훈련(OMREX)중심의 음악치료 프로그램이 뇌졸중환자의 호흡기능과 구강운동기능에 미치는 효과를 알아보는데 있다. 이에 대한 효과를 알아보기 위해 사전, 사후 진단폐활량계(PF-100)를 사용하여 최대호기유량(PEF)과 1초간 노력성 호기량(FEV1)을 측정하였고, 구강조음기관검사(OSMSE-R)를 사용하여 뇌졸중 환자의 턱, 입술, 혀의 운동기능의 데이터를 측정하였다. 연구 결과, 뇌졸중 환자의 호흡기능에서는 하모니카를 활용한 입 운동 및 호흡 훈련이 최대호기유량(F(1.18)=19.40, p<.001)과 1초간 노력성 호기량의 향상(F(1.18)=29.99, p<.001)에 유의미한 변화가 있었다. 뇌졸중 환자의 구강운동기능에서는 턱의 운동기능(F(1.18)=12.37, p<.01)과 입술의 운동기능(F(1.18)=42.76, p<.01) 그리고 혀의 운동기능의 향상(F(1.18)=41.06, p<.001)에 유의미한 변화가 있었다. 이는 하모니카를 활용한 음악치료프로그램이 뇌졸중환자의 호흡기능과 구강운동기능에 향상된 결과를 가져왔음을 보여주는 연구결과이다.

The purpose of this study was to examine the effects of Harmonica-based Oral Motor and Respiratory Exercise (OMREX) Music Therapy designed to improve respiratory and oral motor functions in patients recovering from a stroke. Assessments of PEF and FEV1 for PF-100 were conducted to measure pre and post-test differences. In addition, OSME-R (Oral Speech Mechanism Screening Examination-Revised) was utilized to assess the oral (jaw, lip and tongue) motor functioning of the patients. Results show that harmonica-based music therapy resulted in statistically significant differences in the oral motor functioning of patients; findings are as follows: respiratory function PEF(F(1.18)=19.40, p<.001) and FEV1(F(1.18)=29.99, p<.001), oral motor function of the Jaw (F(1.18)=12.37, p<.01), the Lips (F(1.18)=42.76, p<.01) and the Tongue (F(1.18)=41.06, p<.001). These results indicate that a music therapy program using the harmonica improve both respiratory function and oral motor function of patients recovering from a stroke.

The oral phase is the critical initial stage of swallowing, where the oral motor function is essential. Oral phase impairment can lead to severe complications such as malnutrition and pneumonia. Therefore, accurate assessments are clinically critical. This study systematically reviewed the characteristics and measurement elements of assessment tools for evaluating the oral function and oral motor function in adult dysphagia patients. A systematic literature search was conducted using PubMed, CINAHL, Google Scholar, and RISS databases for articles published up to June 2025. Ultimately, 43 articles were selected, and 22 standardized assessment tools identified within these studies were analyzed. The assessments were classified into standardized clinical tools (n=22) and instrument-based methods. An analysis of the standardized tools revealed a frequent focus on static measures like ‘Anterior spillage’ (54.5%) and ‘mealtime duration’ (45.5%), while dynamic aspects like ‘tongue propulsion’ (9.1%) were overlooked. The instrument-based methods, including oral diadochokinesis, chewing gum tests, and tongue pressure measurement, had the advantage of quantitatively evaluating the oral function. The results showed that an integrated and standardized assessment protocol capable of deeply evaluating the oral phase is needed. This study provides foundational data for the evidence-based application of oral phase assessments in future clinical practice and research.

Feeding is the most basic activity of daily living(ADL) necessary for survival from birth and throughout the life span. Handicapped children who have feeding problem may have abnormal feeding behavior like tongue thrust, swallowing difficulty, lack of jaw stability, lack of chewing, and drooling etc. The occupational therapist designing oral motor treatment must have both complete understanding and experience of oral motor problem which handicapped children may have had .and treatment technique. Thus, this paper has the purpose to pro-vide an overview of evaluation and treatment of oral motor function.

Purpose: This study aimed to assess combined effects of early oral feeding after Cesarean section (C/S) under regional anesthesia on bowel function, gastrointestinal complications and surgical recovery. Methods: A systematic literature search was conducted using KISS, RISS, PubMed, CINAHL, EMBASE, CENTRAL and Google Scholar to identify randomized clinical trials comparing early oral feeding (EOF) with delayed oral feeding (DOF) after C/S. Outcome variables were bowel function and gastrointestinal complications and surgical recovery. Effect size was calculated using weighted mean differences (WMDs) and relative risks (RRs), with 95% confidence intervals (CIs). Results: Seven studies involving 1,911 patients from 568 studies, 7 studies were included in meta-analysis. EOF was significantly associated with shorter time to recover bowel movement compared with DOF (WMD, - 2.50; CI, - 3.50~- 1.50). EOF was not associated with nausea (RR, 1.15; CI, 0.87~1.53) and vomiting (RR, 0.96; CI, 0.65~1.42), but lower incidence of abdominal distension (RR, 0.70; CI, 0.50~0.98). EOF was significantly associated with shorter time to discontinuation of intravenous fluids (WMD, - 8.88; 95% CI, - 16.65~- 1.11) and removal of urinary catheter (WMD, - 15.23; CI, - 25.62~- 4.85). Conclusion: This meta-analysis provides evidence that EOF after C/S under regional anesthesia not only accelerates return of bowel function and surgical recovery but also reduces gastrointestinal complications. These results suggest that EOF should be offered to women who have undergone C/S to improve the recovery experience and reduce overall medical costs.

Purpose: This study was conducted to examine the effects of the oral care program for improving swallowing function of the elderly using welfare centers on depression, self efficacy, subjective oral health status and swallowing related quality of life. Methods: The intervention in this study was systematically developed through the six stages of Intervention Mapping Protocol (IMP) and was based on Mead’s symbolic interaction theory and Bandura's self efficacy theory. A non equivalent control group pre and post-test design was conducted on a total of 37 elderly people (experimental group: 19, control group: 18) from D city. The oral care program was administered to the experimental group once a week for five weeks, totaling five times, and the exact program ran for 50 minutes. The collected data were analyzed using the SPSS/WIN 25.0 program. Results: Following the intervention, subjective oral health score, and swallowing related quality of life were significantly improved in the experimental group. Conclusion: The oral care program presented in this study was found to be effective in increasing subjective oral health status, and swallowing related quality of life for the elderly using welfare centers.

Proper dental and occlusal development plays a fundamental role not only in mastication but also in the establishment and maintenance of oral-phase swallowing. This review outlined the biological development of diphyodont and heterodont dentition and explored the relationship between dental growth and swallowing function. We examined how anomalies such as hypodontia, malocclusion, oral habits, and developmental disabilities can compromise oral coordination. Preventive oral care strategies based on age, the rational use of fluoride, and comprehensive oral management for patients with dysphagia were also discussed. The role of pediatric dentists in early intervention and interdisciplinary collaboration to support optimal swallowing outcomes and oral health was emphasized. In conclusion, age-tailored preventive dental care and interdisciplinary collaboration led by pediatric dentists are essential to optimize swallowing outcomes and oral health.

목적 : 본 연구는 노인들의 인지기능과 삶의 만족도간의 관계에서 노인구강건강요인의 매개효과를 분석하 기 위해 수행되었다. 연구방법 : 8차 고령화연구패널조사(2020년)에 수집된 60세 이상의 중고령자 6,169명을 대상으로 분석하 였다. 노인구강건강 요인은 노인구강건강평가지수(Geriatric Oral Health Assessment Index; GOHAI)의 기능적 차원 요인, 심리사회적 차원 요인, 통증 및 불편함 요인으로 세분화하였고 각 요인의 매개효과를 Mplus 8.4를 활용하여 경로분석을 수행하였다. 결과 : 6,169명의 평균 연령은 70.77세였다. 인지기능과 삶의 만족도 사이에서 노인구강건강 요인 중 구강건 강관련 기능적 차원 요인(β = 0.207, 95% Confidence Interval; CI = 0.169, 0.207)이 23%로 가장 큰 부분매개효과를 나타났다. 심리사회적 차원 요인은 22%(β = 0.202, 95% CI = 0.171, 0.236), 통증 및 불편함 요인은 16%(β = 0.146, 95% CI = 0.119, 0.175)로 기술한 순으로 부분매개효과를 나타냈다. 결론 : 인지기능과 삶의 만족도 사이에 구강건강 관련 기능적 차원 요인, 심리사회적 차원 요인, 통증 및 불편함 요인이 미치는 영향력을 확인하였다. 따라서 노인의 인지수준을 고려하고, 삶의 만족도에 영향을 미치는 구강건강 요인을 세분화하여 파악한 결과를 통해 개개인의 맞춤형 재활치료 접근 전략을 세우고 노인의 삶의 만족도를 높일 필요성을 제시하고자 한다.

Objective: This study was conducted to analyze the mediating effect of oral health factors in the relationship between cognitive function and life satisfaction in the elderly. Methods: This study analyzed 6,169 elderly people aged 60 years or older described in the 8th Korean Longitudinal Study on Aging (2020). The oral health factors of the elderly were divided into "functional dimension factors," "psychosocial dimension factors," and "pain or discomfort factors" of the Geriatric Oral Health Assessment Index (GOHAI). To determine the mediating effect of each factor, a path analysis was conducted using Mplus 8.4. Results: Between cognitive function and life satisfaction, among the oral health factors in the elderly, the functional dimension factor showed the largest partial mediating effect at 23% (β = 0.207, 95% confidence interval; CI = 0.169, 0.207). The psychosocial dimension factor was 22% (β = 0.202, 95% CI = 0.171, 0.236), and the pain and discomfort factor was 16% (β = 0.146, 95% CI = 0.119, 0.175), showing a partial mediating effect. Conclusions: The influence of three oral health-related factors on cognitive function and life satisfaction was confirmed. Therefore, it is necessary to consider the cognitive level of the elderly and identify oral health factors in detail. Accordingly, it is necessary to establish a personalized rehabilitation treatment access strategy and increase the life satisfaction of the elderly.

목적: 본 연구는 요양보호사의 구강건강관리 지식과 실천 수준 및 노인의 섭식·연하 기능의 관련 요인을 파악하 고자 한다. 방법: 2025년 9월25일부터 10월16일까지 경상남도 소재 6개 노인요양시설 기관 요양보호사 201명 대상으로 일반 적 특성 및 노인 구강건강관리 교육 관련 요인에 따른 구강건강관리 지식과 실천, 노인 섭식·연하기능의 차이, 노 인 섭식·연하기능 관련 요인을 알아보기 위해 독립 표본 t-test 및 일원 배치 분산분석, 사후분석 scheffe, 상관분 석과 다중회귀분석을 실시하였다. 결과: 구강건강관리 지식은 13.30±1.16점으로 나타났으며 일반적 특성에 따른 유의한 차이는 없었다. 구강건강관 리 실천은 여성, 50–59세와 60세 이상, 요양병원·노인요양시설 근무자에서 유의하게 높았다(p＜0.05). 구강건강 관리 실천은 섭식·연하기능과 부적 상관을 보여 실천 수준이 높을수록 기능 저하가 낮은 경향을 보였다(r=-.29, p ＜0.001). 회귀분석에서도 구강건강관리 실천(β=-.29)은 기능 저하와 부적 상관을 보였으며, 주당근무시간 40시간 미만(β=.16)은 기능 저하 증가와 관련성이 확인되었다(p＜0.05). 결론: 구강건강관리 실천은 노인의 섭식·연하기능 유지에 유의한 관련성을 보여 노인 섭식·연하기능 저하 예방 을 위한 실천 중심의 교육 프로그램 개발의 기초자료로 활용될 수 있을 것이다.

Objective: This study examined the levels of oral healthcare knowledge and practices among care workers and explored their associations with older adults’ eating and swallowing function. Methods: A self-administered survey was conducted with 201 care workers in six care facilities in Gyeongsangnam-do from September 25 to October 16, 2025. Independent t-tests, one-way ANOVA with Scheffé post-hoc tests, correlation analysis, and multiple regression analysis were performed. Results: Oral healthcare knowledge averaged 13.30±1.16 with no significant group differences. Oral healthcare practice was significantly higher among women, workers aged 50–59 and ≥60 years, and those employed in care hospitals or nursing homes (p<0.05). Practice showed a negative correlation with eating and swallowing function (r=-.29, p<0.001). Regression analysis revealed that oral health practice (β=-.29) was negatively correlated with functional decline, while working less than 40 hours per week (β=.16) was positively associated with increased functional decline (p<0.05). Conclusion: Care workers’ oral healthcare practice showed a significant association with older adults’ eating and swallowing function, suggesting its potential role in supporting functional maintenance. These findings provide foundational evidence for developing practice-oriented oral healthcare education programs for care workers.

Bacillus subtilis BB-1 (KFCC 11344P)으로부터 분리된 혈전용해효소 유전자 (BCF-1)를 대량발현 벡터인 pEB 벡터에 크로닝하여 순수분리 된 혈전용해효소를 rat에 경구 투여하여 출혈시간, 혈액의 응고, serum의 혈전용해능 등에 대한 in vivo 실험을 실시하였으며, 혈전용해효소의 단회경구투여에 따른 독성을 검사하였다. 효소의 경구투여에 따른 rat의 출혈시간에서는 대조군에 비하여 모든 경구 투여군에서 출혈시간이 유의적으로 약 1.75배 이상 길게 나타남을 확인하였고(P<0.05), 혈액의 출혈시간 또한 활발히 진행됨을 관찰하였다. 혈액으로부터 분리된 serum의 혈전용해작용 있어서는 경구투여 후 1시간부터 채혈한 혈액 내에서 혈전용해효소의 활성이 검출되기 시작하여 3시간째까지 높은 활성을 보였으며 4시간째부터 서서히 활성이 감소하는 것을 확인하였고 혈액의 응고 역시 대조군에 비하여 경구 투여군에서 상당히 지연되는 것을 알 수 있었다. Western blot에 의한 효소 검출에서는 경구 투여군에서 30,000 Da 크기의 단일밴드를 확인하였으며, 혈전용해효소의 rat에 대한 단회경구투여 독성실험에서 중량의 변화, 장기의 이상여부, 사망률 등에서 어떠한 이상이나 병변이 발견되지 않았다. 이상의 결과로 동물실험을 통한 혈전용해 효소의 경구투여에 의한 작용을 혈액 내에서 확인 할 수 있었으며, 본 효소의 단회 경구투여 시의 독성은 전혀 없음을 확인할 수 있었다.

A fibrinolytic enzyme gene (BCF-1) was subcloned to the pEB vector which is high expression vector in the Bacillus host. The enzyme was purified by using FPLC after ammonium sulfate precipitation. The enzyme was oral-administrated to the rat and checked the bleeding time, blood clotting time and fibrinolytic effect of the serum. In the bleeding time retardation test, it was longer about 1.7 fold in the feeding rat than without feeding. The serum of rat feeded with the enzyme had the fibrinolytic activity from 1 hour to 3 hours after oral-administration. After 3 hours from feeding, the fibrinolytic activity was decreased gradually. Also blood clotting time after bleeding was longer than that of control rat. The enzyme could be detected at band of 30,000 Da in the blood by western blotting. The enzyme was not harmful to the all internal organs of the rats. Taken together, the enzyme originated from B. subtilis BB-1 can be a candidate to develop the drug for thrombosis, arteriosclerosis and myocardial infarction.