정신장애인의 회복에 대한 정신보건전문요원들의 태도 연구

하준선,윤숙자,변은경 한국장애인복지학회 2010 한국장애인복지학 Vol.- No.12

This study was made to see how the disabled people’s participating in the economic activities, social support and disability identity and discrimination experience affect on the social integration. The utilized data is the disabled people’s discrimination and experience survey(Lee Ick-Seop, et al., 2009) to analyze 531 disabled adults. The analytical result, social support and disability identity acted as the partial mediator in the process between their participating in the economic activities and social integration. The discrimination experience is shown to have the moderating effect in the process between their participating in the economic activities and social integration. Therefore, the social effort that is the basic premise of the disabled people’s independent living should be given in various levels. In the macroscopic level, the active employment policy of the disabled people and the Disability Discrimination Act should be thoroughly fulfilled and monitored. It is necessary to induce the understanding and discrimination change of the disabled people in the community level, and promote the member of community to be the social support resource. The disability service provider or disabled group should be interested in the disabled people’s intensifying disability identity. 본 연구는 정신장애인의 회복에 대한 정신보건 전문요원들의 태도를 살펴보고, 정신보건전문요원들의 특성에 따른 차이를 알아보고자 하였다. 정신보건전문요원들의 정신장애인의 회복에 대한 태도는 매우 긍정적이었고, 정신보건사회복지사와 정신보건간호사간의 회복태도에도 차이가 없었다. 정신보건전문요원들의 연령, 학력, 근무기관, 근무연수는 정신장애인의 회복에 대한 태도에 차이를 보이는 변인으로 나타났다. 기관소재, 기관장배경, 기관운영 연수, 기관주체 변인들은 정신보건전문요원들의 정신장애인 회복에 대한 태도에 차이를 나타냈다. 직원구성에 있어서 정신보건전문요원인 정신보건간호사, 정신보건임상심리사, 정신보건사회복지사가 모두 상주해 있는 시설의 정신보건전문요원들의 정신장애인에 대한 회복태도가 비상주 시설보다 더 긍정적이었다.

정신장애인가족의 임파워먼트와 자기옹호 증진을 위한 프로그램의 효과

하준선 ( Jun Sun Ha ),배경의 ( Kyung Eui Bae ) 부모자녀건강학회 2008 부모자녀건강학회지 Vol.11 No.1

Purpose: This study was to verify the effectiveness of group program for promoting empowerment and self-advocacy of the the mentally disabled persons` families. Methods: This program was set up for the mentally disabled persons` families to share their experiences, do consciousness raising, advocate themselves through group process. A pre-post control group design was used for this study. Results: The results of this study verified that group program was effective to promote empowerment and self advocacy of the mentally disabled persons` families. Also group program helped to express and ventilate family burden actively. Conclusion: This study suggests as follows. In the mental health social work practice we need to develop group programs for family to talk about themselves, to ventilate their emotions, to understand their circumstances and to initiative the change of mental health circumstances as well as education and coping skills about mental illness. For this, there is a need for mental health social worker to have a macroscopic viewpoint and work with family. Also there is a need for mental health social worker to promote family self-help groups and to support their construction and growth.

정신과 실습학생의 실습만족과 정신장애에 대한 태도 차이 연구 : 간호학과와 사회복지학전공 학생들을 대상으로

윤숙자,변은경,하준선 한국장애인재활협회 2007 재활복지 Vol.11 No.2

정신분열병 환자에서의 한국어판 사회적응 척도의 개발 : 신뢰도 및 타당도 연구

김철권,서지민,김상수,조진석,하준선,김정옥,변원탄 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.6

연구목적: 정신분열병 환자의 사회적응 정도를 측정하는데 사용되는 사회적응 척도의 한국어판을 개발하기 위함이다. 방 법: 사회적응 척도를 번역한 후 정신분열병 환자 67명과 정상인 78명을 대상으로 신뢰도와 타당도를 검증하였다. 결 과: 자료분석 결과 검사-재검사 신뢰도는 0.85, 검사자간 신뢰도는 0.89, 내적 일치도는 0.87로 높은 수치였다. 변별 타당도를 검증하기 위하여 정신분열병 환자군과 정상 대조군을 비교한 결과 정신분열병 환자군에서 사회적응 정도가 유의하게 낮았다. 구성 타당도를 알아보기 위하여 10개 영역간의 상관관계를 측정한 결과 성적적응 영역을 제외한 모든 영역들에서 유의한 상관관계를 보였다. 본 척도의 전반적 평가 영역 결과와 GAF 결과간의 상관성을 통해 간접적으로 검증한 공존 타당도 역시 유의하였다. 결 론: 한국판 사회적응 척도는 우수한 신뢰도와 타당도가 입증되었고 나아가 정신분열병 환자의 사회적응 정도를 평가하는데 유용하게 사용되어질 수 있을 것이다. Objectives: The purpose of this study was to develop the Korean version of the Social Adjustment Scale Ⅱ-Revised Version(KSAS Ⅱ-RV) in the schizophrenics. Methods: KSAS Ⅱ-RV was administered to 67 schizophrenic patients and 78 matched normal controls for examining the reliability and validity. Results: Data analysis showed statistically significant reliabilities and validities of KSAS Ⅱ-RV. The test-retest reliability, inter-rater reliability, and internal consistency for total scores of KSAS Ⅱ-RV were 0.85, 0.89. and 0.87, respectively. Evidence for discriminant validity of KSAS Ⅱ-RV comes from the results that the mean scores of schizophrenic patients were significantly high than those of normal controls. Construct validity was assessed by calculating the 10 inter-subareas correlations of the KSAS Ⅱ-RV, and all except the sexual adjustment area were statistically significant. Significant correlations between the global area scores of KSAS Ⅱ-RV and those of Global Assessment of Functioning Scale lend support for the concurrent validity of this instrument indirectly. Conclusions: KSAS Ⅱ-RV was found to be a valid and reliable instrument which can be used to evaluate the degree of social adjustment in the schizophrenic patients.

지역사회 정신보건현장에서 근무하는 정신보건전문요원들의 전문성과 직무만족

변은경(Byun, Eun-Kyoung),하준선(Ha, Jun-Sun),윤숙자(Yoon, Suk-Ja) 한국지역사회복지학회 2008 한국지역사회복지학 Vol.0 No.25

정신재활 치료가 정신분열병 환자의 재발율, 입원횟수, 입원일수 그리고 치료 경비에 미치는 효과 : 2년 추적조사 연구

조진석,공지현,김진원,심경순,하준선,김철권,강동호,장정희,변원탄 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

목 적 : 사회기술훈련, 환자교육, 가족교육, 집단치료, 예술치료, 작업치료와 같은 포괄적인 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 정신분열병 환자의 재발율, 입원횟수, 입원일수, 직접 치료경비 등에 어떤 효과가 있는 지를 알아보기 위함이다. 연구방법 : 1993년 9월부터 1995년 2월까지 양산 신경정신병원의 폐쇄병동에서 퇴원한 20∼35세 사이의 정신분열병 환자 173명을 대상으로 46명에게는 6개월동안 정신재활 치료를 시행하였고 127명에게는 통상적인 외래치료만 시행한 후 연구시작 시점을 포함하여 2년동안 양군에 속한 환자들을 대상으로 재발율, 입원횟수, 입원일수, 직접 치료경비 등을 1년 단위로 추적 조사하였으며, 연구시작 시점을 기준으로 전과 후의 매년 평균 입원횟수, 입원일수, 직접 치료경비도 서로 비교하였다. 결 과 : 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 재발율, 입원횟수, 입원일수, 직접 치료비용이 현저히 감소되었다. 그리고 정신재활 치료를 받은 군에서는 치료 전에 비해 치료 후에 재발율, 입원횟수, 입원일수, 직접 치료비용이 유의하게 감소하였지만 통상적인 외래치료만 받은 군에서는 치료 전과 후간에 유의한 변화를 보이지 않았다. 결 론 : 정신분열병 환자들에게 정신재활 치료를 약물치료와 병행할 경우 약물치료만 시행할 때에 비해 환자의 임상적 경과를 호전시킬 뿐 아니라 가족의 경제적 부담도 줄일 수 있다. Objective : We evaluated the clinical efficacy of a comprehensive psychiatric rehabilitation of schizophrenia, including family psychoeducation, patient education, social skills training, group psychotherapy, art therapy, and occupational therapy. Method : From September 1993 to February 1995, 173 chronic schizophrenics who met DSM-IV criteria and were discharged from a locked ward were assigned into the psychiatric rehabilitation service group(psychiatric rehabilitation group, n=46) or the customary out-patient service group(out-patient group, n=127) prospectively, but not randomly. Assignment was based on preferences of patients and their relatives, Each subject included in the psychiatric rehabilitation group received twice weekly patient education, social skills training, family psychoeducation, group psychotherapy, art therapy, occupational therapy and maintenance chemotherapy during a 6-month period. Those in the out-patient group received individual supportive psychotherapy and maintenance chemotherapy according to their clinical needs for 10-20 minutes once per week. After entry into the study, all subjects were assessed for the number of readmission, days of hospitalization, and the direct treatment costs through the first and second year of follow-ups. These outcome variables were also compared pre-and post-2 years at the time point of entry into the study. Aftercare chemotherapy on a weekly to monthly basis continued for the remainder of the two year follow-up period. Results : With regard to the mean number of hospital admissions per year, the mean days of hospitalization per year, and the direct treatment costs per year, the psychiatric rehabilitation group had significantly decreased all clinical outcomes 2 years after compared with before receiving psychiatric rehabilitation. But there were no significant differences in the all clinical outcomes between before and after study intake in the out-patient group. For the number of relapse regardless of drug compliance, 4 patients(9%) during first year and 14 patients(30%) during second year were relapsed in the 46 subjects of the psychiatric rehabilitation group. In contrast, 75 patients(59%) during first year and 90 patients (71%) during second year relapsed in the out-patient group. When considering the effect of drug noncompliance to relapse, 4(9%) and 14 patients(30%) were relapsed while on medication respectively during the first and second year in the 46 of the psychiatric rehabilitation group, vs. 27(34%) of 79 patients on medication during the first year and 31(46%) of 68 patients on medication during the second year were relapsed in the out-patient group. Conclusions : These results indicate that the comprehensive psychiatric rehabilitation can be useful therapeutic intervention both to improve the clinical outcomes of schizophrenic patients and to reduce the economical burden of their relatives.

지역주민의 정신보건자원봉사활동에 따른 정신장애 태도 연구

윤숙자(Yoon, Suk-Ja),하준선(Ha, Jun-Sun) 한국지역사회복지학회 2007 한국지역사회복지학 Vol.0 No.23