연령에 따른 만성 뇌졸중 환자의 전산화 인지재활이 인지기능과 일상생활활동에 미치는 영향

배원진,박용광,최용원,한승협,감경윤 대한작업치료학회 2013 대한작업치료학회지 Vol.21 No.2

목적 : 이 연구의 목적은 전산화 인지재활 프로그램(Rehacom)이 50대, 60대, 70대 만성 뇌졸중 환자의 인지기능과 일상생활활동에 미치는 영향을 알아보고자 하였다. 연구방법 : 2011년 6월 1일부터 동년 9월 30일까지 부산에 위치한 I병원에 입원한 환자 중 뇌졸중 진단을 받고 발병일로부터 24개월이 경과한 50대, 60대, 70대 각 10명을 대상으로 하였다. 대상자는 한국판 간이 정신상태 검사(Mini-Mental Status Examination-Korean; MMSE-K) 점수 18점 이상 23점 이하의 환자이며, 중재는 1회 30분씩, 주 3회, 9주 동안 Rehacom을 이용한 전산화 인지재활이 제공되었다. 중재 전과 중재 3주, 6주, 9주에 걸쳐 인지기능을 비교하기 위해 한국판 수정 간이정신상태검사(Korean Modified Mini-Mental State Examination; K-3MS)과 신경행동학적 인지상태검사(Neurobehavioral Cognitive Status Examination; NCSE)를 시행하였고, 일상생활활동 수행능력을 비교하기 위하여 수정바델지수(Modified Barthel index; MBI) 와 기능적 독립측정(Functional Independence Measure; FIM)을 시행하였다. 결과 : 중재 전 인지기능과 일상생활활동 능력에서 50대, 60대, 70대 간의 유의한 차이가 있었다(p<.05). 중재가 진행되면서 각 집단의 NCSE와 K3MS 점수는 유의하게 향상되었으나, 공분산 분석에 의하면 중재 후 세 집단 간에는 유의한 차이가 없었다. 일상생활활동 분석결과 50대 군은 중재에 따른 유의한 변화를 보이지 않았으나, 60대와 70대는 유의한 변화를 보였다(p<.05). 중재 후 세 집단 간 비교 시 FIM 평가에서 유의한 차이가 있었다 (p<.05). 연령에 따른 인지기능의 회복정도가 일상생활활동에 미치는 영향을 알아본 결과 전산화 인지재활을 통한 K-3MS의 점수향상과 연령은 MBI점수와 FIM점수 향상에 영향을 미치는 요인으로 나타났다(p<.05). 결론 : 전산화 인지재활 프로그램(Rehacom)이 발병일로부터 24개월이 경과한 만성 뇌졸중 환자에게도 효과를 나타낸다는 것을 알 수 있었으며, 인지기능 향상은 고연령층에서 일상생활활동에 더 긍정적인 효과를 보였다. 본 연구는 만성 뇌졸중 환자나 연령이 높은 환자에게도 전산화 인지재활이 효과적임을 확인하였다. Objective : The purpose of this study was to investigate the effects of computer-assisted cognitive rehabilitation (CACR) on the cognitive function and activities of daily living (ADL) in chronic stroke patients in their 50s, 60s, and 70s. Methods : This study was performed at I Hospital in Busan from June to September, 2011. Thirty participants who passed the 24-month stage from stroke onset were grouped into three age groups: 50s, 60s and 70s. CACR was performed using Rehacom 30 minutes a day, three days a week, for nine weeks. The cognitive functions of the patients were assessed using their K-3MS and NCSE scores, and their ADL performances were assessed through their FIM and MBI scores. The assessments were performed four times: before training, after 3 and 6 weeks of training, and at the end of 9 weeks of training. Results : Before training, the cognitive functions and ADL performances of the patients showed significant differences among the three age groups (p<.05). As time passed, the K-3MS and NCSE scores of the three age groups increased. There was a significant difference in K-3MS score among the three groups after training. Analysis results of the ADL performances showed significant changes in the patients in their 60s and 70s, but not those in their 50s. After training, the FIM scores of the three groups showed significant differences (p<.05). Analysis results of the patients' cognitive function recovery on their ADL performances showed that an improvement of their K-3MS scores based on CACR and age are factors influencing their MBI and FIM scores. Conclusion : The results showed that CACR using Rehacom is effective for an improvement of the cognitive function and ADL performance in chronic stroke patients 24 months after onset. This was more effective for those in their 70s than those in their 50s and 60s. This study suggests that CACR is an effective tool for elderly chronic stroke patients.

특발성 저신장증 환아의 혈중 Insulin-like Growth Factor-I 및 Insulin-like Growth Factor Binding Protein-3 농도

배원진,정지미,정우영 대한소아내분비학회 2008 Annals of Pediatirc Endocrinology & Metabolism Vol.13 No.2

Purpose : The aim of present study was to compare the mean serum levels of Insulin-like growth factor-I (IGF-I) and Insulin-like growth factor binding protein-3 (IGFBP-3) according to the Korean standard growth chart especially in children with idiopathic short stature. Methods : Serum levels of IGF-I and IGFBP-3 were determined in 454 children (252 boys and 202 girls; ages 7-15 yr), grouped into two, according to their height below 10 percentile (idiopathic short stature) and 25-50 percentile based on growth chart- 1998 reported by Korean Society of Pediatrics. Serum levels of IGF-I were measured by RIA method and serum levels of IGFBP-3 were measured by IRMA method. Results : Mean serum levels of IGF-I and IGFBP-3 were lower in below 10 percentile group compared with those of 25-50 percentile group in both sexes. In some age groups, the differences between two groups revealed statistical significance. The difference of serum levels according to growth channel showed more prominence in IGF-I compared than IGFBP-3. Significant statistical correlations were demonstrated in all study groups between serum IGF-I and IGFBP-3 levels according to the age, respectively. Conclusion : Our results strongly suggest that mean serum levels of IGF-I and IGFBP-3 in children with idiopathic short stature were lower than those of control group.

학교 작업치료사의 근무 경험에 관한 현상학적 연구

배원진,정남해 대한감각통합치료학회 2022 대한감각통합치료학회지 Vol.20 No.2

인근 지역의 바다와 연계한 환경교육활동이 유아의 환경감수성 및 생명존중인식에 미치는 영향

배원진,조부경 한국어린이미디어학회 2018 어린이미디어연구 Vol.17 No.4

This study aims to examine the effects of environmental education activities affiliated with regional maritime areas on young children’s environmental sensitivity and the respect for life. The subjects of this study were 26 children(13 for the experimental group, 13 for the control group), 5-year-old children in public kindergartens located in N-gun. The experimental group participated in environmental education activities that are affiliated with neighboring sea and the experiment regarding each subject was carried out from 5 to 7 time for 10 weeks. Children’s environmental sensitivity tests and the children’s environmental preservation tests were conducted on both the experimental group and control groups before and after the experiments. As a result, environmental education activities in cooperation with neighboring area of the sea make the positive effect on the environmental sensitivity and the respect for life but did not make a positive effect on the attitude towards respect for life. These results suggest that environmental education activities in cooperation with neighboring area of the sea can be a meaningful approach to environmental education, and it can also expand the scope of environmental education from the traditional of them like forest experience or playing for gardening. 본 연구의 목적은 인근 지역의 바다와 연계한 환경교육활동이 유아의 환경감수성 및 생명존중인식에 미치는 영향을 알아보는 데에 있다. 연구대상은 N군에 소재하고 있는 유치원에 재원 중인 만5세 유아 26명(실험집단 13명, 통제집단 13명)으로, 실험처치는 인근 지역의 바다와 연계한 환경교육활동의 각 주제에 대해 5~7회에 걸쳐 10주간 이루어졌으며, 사전과 사후에 실험집단과 통제 집단 모두에게 환경감수성검사와 생명존중인식 검사를 실시하였다. 그 결과 인근 지역의 바다와 연계한 환경교육활동이 유아의 환경감수성과 생명존중인식의 대부분에 긍정적인 영향을 미쳤으나, 생명존중태도에는 긍정적인 영향을 미치지 못한 것으로 나타났다. 이와 같은 결과는 인근 지역의 바다와 연계한 환경교육활동이 유아환경교육의 의미 있는 접근 방안이 될 수 있음을 시사하며, 기존의 숲 체험, 텃밭 가꾸기에 치중되었던 환경교육의 범위를 확대하는 데에 그 의의가 있다.

몰입형 가상현실 프로그램 Rapael Smart Glove가 뇌졸중 환자의 상지기능에 미치는 영향

배원진,감경윤,Bae, Wonjin,Kam, Kyungyoon 대한통합의학회 2017 대한통합의학회지 Vol.5 No.3

Purpose: The purpose of this study was to investigate the effects of an immersive, virtual reality-based exercise program on range of motion and dexterity in the upper extremities of stroke patients. Methods: Fifteen patients with hemiparesis after stroke participated in this study. The participants participated in Rapael Semart GloveTM, an immersive, virtual reality-based exercise program, performed for 30 minutes-, 3 times per week for 4 weeks. The Rapael Smart GloveTM program and a Box and Block Test (BBT) were used to measure range of motion and to assess dexterity, respectively, pre-and post-intervention. Results: Range of motion in pronation and supination of the forearm and flexion, extension, and ulnar deviation of the wrist improved after the intervention. Dexterity measured by BBT also improved. However, range of motion in flexion and extension of the fingers and radial deviation of the wrist did not improve. Conclusion: This study presents the effects of an immersive, virtual reality-based exercise program on hand function. In the future, a study comparing an immersive, virtual reality- based exercise program to other upper-extremity interventions for stroke patients should be conducted. A study about the effects of an immersive virtual reality program on activities of daily living is also needed.

2022학년도 작업치료(학)과 신입생의 학과 결정에 관한 연구

배원진,조영석 대한통합의학회 2023 대한통합의학회지 Vol.11 No.2

Purpose : This study aimed to identify factors that influence selection of occupational therapy as a college major by freshmen. Methods : A survey was conducted on 308 freshmen majoring in occupational therapy from March 2022 to September 2022. The questionnaire consisted of five items about general characteristics, two about the choice of college and major, three about the timing of major selection, three about information acquisition, and one about the university application process. Results : While choosing a university, 37% of the students primarily considered the available choice of majors, whereas 41% considered the college application period. Employment rate was another important factor that was considered when choosing a department. Most students learned about occupational therapy through research on physical therapy and primarily gathered information by searching on “Naver and blogs.” Among the descriptions of occupational therapy, the most interesting keyword was “hospital” (54 %). Conclusion : This study investigated the factors that influenced the college major selection by new students in the department of occupational therapy. This study provides meaningful basic data that can be referred to when promoting the department of occupational therapy. A limitation of this study is that a high percentage of students from Gyeongnam were included, and hence, further research that investigates according to region is needed. Moreover, detailed investigations on factors related to university applications in each region are required. It is also necessary to investigate the relationship between the characteristics of freshmen and the determining factors of the department and the admission process.

발달장애인 주간보호센터의 작업치료 요구도 조사: 종사자를 대상으로

배원진(Bae, Won-Jin),정남해(Jung, Nam-Hae) 고령자치매작업치료학회 2019 고령자.치매작업치료학회지 Vol.13 No.2

목적 : 본 연구에서는 주간보호시설 종사자를 대상으로 작업치료의 필요성과 요구도 및 현실적인 어려움에 대하여 조사하였다. 연구방법 : 2019년 1월부터 동년 2월까지 B지역의 발달장애인 주간보호센터 종사자 78명을 대상으로 온라인 설문지로 자료를 수집하였다. 설문지는 총 20문항으로 일반적 특성, 작업치료 인식도 및 요구도로 구성되었다. 자료는 SPSS 20.0으로 분석하였으며, 대상자의 일반적 특성 및 각 항목에 대한 응답은 빈도와 백분율 등 기술통계를 실시하고 일반적 특성에 따른 인식도, 요구도 및 요구하는 프로그램의 차이는 교차분석을 실시하였다. 연구결과 : 본 설문지에 응답한 대상자는 모두 사회복지사이었다. 작업치료에 관해 안다고 응답한 대상자와 작업치료가 필요하다고 응답한 대상자는 각각 63명(80.8%)이었다. 연구대상자는 주간보호시설에서 발달장애인의 일상생활활동, 수단적 일상생활활동 수행 향상을 위해 작업치료가 가장 필요하다고 하였고, 현재 작업치료를 제공 하지 못하는 이유로는 공간적인 부족과 서비스 비용에 대한 부담 등이 있었다. 인식도와 요구도는 연령과 임상경력에 따라 유의한 차이가 있었다. 결론 : 청소년 및 성인 발달장애인을 위한 주간보호센터에서 작업치료를 시행하기 위해서는 관련법의 개정과 보건복지부의 지원이 필요하다. Objective : The purpose of this study was to investigate the need for occupational therapy and the realistic difficulties of social welfare in day care centers. Methods : This study was conducted to collect data of 78 social workers working in daycare center in the area B from January to February 2019. Questionnaire was 20 items consisted of general characteristics, awareness and needs on occupational therapy. Data was analyzed with SPSS 20.0. Results : Sixty-three (80.8%) of the respondents answered they know occupational therapy, and 63 respondents(80.8%) occupational therapy is necessary. Social workers working in the day care centersaid the occupational therapy is the most necessary to improve performance of activities ofdaily living skills and instrumental activities of daily living skills, and realistic difficulties to provideusers occupational therapy include space shortage, burden on cost and so on. Conclusion : In order to implement occupational therapies at the daycare center for adolescents and adultswith developmental disabilities, it is necessary to revise relevant laws and support the Ministryof Health and Welfare, and establish the basis for the effectiveness of occupational therapy foradolescents and adults with developmental disabilities.

요양병원 치료사의 코로나19 대응 경험에 대한 질적 연구

배원진(Won-Jin Bae),박주영(Ju-Young Park) 한국엔터테인먼트산업학회 2021 한국엔터테인먼트산업학회논문지 Vol.15 No.4

본 연구는 요양병원에 근무하는 치료사의 코로나 19 대응 전략 및 치료실 감염관리 시스템 개선을 위한 기초자료를 제공하고 치료사의 감염관리 업무 이해를 돕고자 실시한 질적 연구이다. 연구방법은 Colaizzi의 현상학적 연구 방법을 적용하였다. 요양병원에서 근무 중인 작업치료사와 물리치료사 9명을 대상으로 전화 인터뷰를 실시하였다. 인터뷰 내용은 연구대상자의 동의하에 녹음하였으며, 추가적인 내용 확인은 이메일로 받았다. 녹음된 내용은 전사 뒤 분석하여, 코로나19에 대처한 경험의 의미와 본질을 기술하였다. 인터뷰 내용은 6개의 주제와 17개의 중심의미, 49개의 의미단위로 정리하였다. 코로나19 상황에 따라 요양병원 내 감염관리 교육 강화, 감염관리 실천, 업무시간 외 감염관리 감독으로 감염관리 시스템이 강화되었으며, 치료실 내 거리두기 실천, 업무시간 내 휴식 및 식사시간 조정, 감염관리 강화로 치료활동 제약으로 치료 환경이 변화된 것을 알 수 있었다. 또한 치료사의 역할이 확대되고 언택트 중재방법에 대한 고려하는 등 치료의 패러다임이 변화되었으며, 코호트 격리, 코로나19 사전검사, 백신접종과 부작용경험으로 코로나19에 따른 새로운 경험을 하였음을 확인하였다. 하지만 감염업무로 인해 치료사의 업무부담이 가중되고, 코로나19 확산에 따른 두려움과 우울감, 업무 스트레스를 겪고 있으며, 백신접종 후 휴식 보장, 감염관리 도구 및 장비 지원 등 요양병원 치료인력 지원의 필요성도 인식하고 있었다. 본 연구의 결과는 요양병원 치료실 내 감염병 대응 전략 프로그램 개발 및 요양병원 감염관리를 위한 인적, 물적 지원의 기초 자료로 활용되기를 기대한다. This study is a qualitative study conducted to provide basic data for therapists working in long-term care hospitals to improve their countermeasure strategies for new infectious diseases and improvement of the treatment room infection management system, and to help therapists understand their infection management work. Colaizzi"s phenomenological research method was applied as the research method. Telephone interviews were conducted with nine occupational therapists and physical therapists working in nursing hospitals. The contents of the interview were recorded with the consent of the study subjects, and additional confirmation was received by email. The recorded content was analyzed after transcription, and the meaning and nature of the experience coping with COVID-19 were described. The content was organized into 6 themes, 17 main meaning and 49 meaning units. In accordance with the COVID-19 situation, the infection control system has been strengthened by reinforcing infection control education in nursing hospitals, practicing infection control, and supervising infection control outside business hours. It was found that the treatment environment was changed due to the restriction of treatment activities by practicing distancing in the treatment room, adjusting rest and meal times during working hours, and strengthening infection control. In addition, the therapist"s role has been expanded and the paradigm of treatment has changed, such as considering the untact intervention, and they have experienced cohort quarantine, pre-tested for COVID-19, vaccinations, and side effects from COVID-19. However, due to the infection work, the therapist"s work burden is increased, and the person is experiencing fear, depression, and work stress from the spread of COVID-19. They were also aware of the need for nursing hospital care personnel support, such as guaranteeing rest after vaccination and providing infection control tools and equipment. The results of this study are expected to be used as basic data for human and physical support for the development of infectious disease response strategy programs in nursing hospital treatment rooms and for infection control in nursing hospitals.

자폐스펙트럼장애 아동을 위한 상황이야기 중재의 효과 연구에 대한 체계적 고찰

배원진 ( Won-jin Bae ),박주영 ( Ju-young Park ) 대한통합의학회 2021 대한통합의학회지 Vol.9 No.2

Purpose : The purpose of this study was to systematically review the studies on the effects of social story intervention on the individuals with autism spectrum disorders(ASD) to provide the basis for evidence-based practice. Methods : In order to find out the studies on the effect of social story intervention on individuals with ASD, studies published from 2011 to December 2020 were searched on Google Academic Search. The keywords used were "autism spectrum disorder AND social story". A total of 16,900 studies were searched, and from these, 12 studies were selected based on the application of the selection and exclusion criteria. The included studies comprised of 10 single subject design studies and 2 randomized controlled trials design studies. The included studies were analyzed in accordance to population, intervention, outcome measures and results. Results : As a result of analysing the subjects of the included studies, we found out that pre-school children and adolescents were the most common groups of individuals diagnozsed with ASD. In addition to ASD, the diagnosis of the subjects included intellectual disability, Asperger, and Prader-willi. We found out that there were more interventions that were mixed with other interventions, than just the pure social story interventions. In particular, video modeling was found to be the most frequent intervention. This was followed by photo-based social stories. For outcome measure, autism social skills profile was found to be the most often used standardized assessment. For a non-standardized assessment, social desired behavior was found to be the most frequently evaluated behavior, followed by personal problem behavior. Of all the dependent variables, the dependent variable reported as "effective" was the most, followed by "some effective". Conclusion : This study is organized to help the individuals with ASD, families, researchers, and therapists understand the effects of social story intervention on the individuals with ASD in an easy fashion. Further, therapists can use this study as the basic data for evidence-based practice.

작업치료사의 임상적 추론에 대한 자기 평가 연구

박명옥,배원진 대한작업치료학회 2020 대한작업치료학회지 Vol.28 No.4

목적 : 연구의 목적은 국내 작업치료사들을 대상으로 임상적 추론에 대한 자기 평가를 알아보는 것이었다. 연구방법 : 본 연구는 단면적 설문조사 연구로 전국의 143명의 작업치료사를 대상으로 하였다. 설문지는 일반적 특성, 임상적 추론 시행 여부로 구성되었고, 임상적 반영과 추론에 관한 자기 평가(Self-Assessment of Clinical Reflection and Reasoning; SACRR)을 실시하였다. SACRR은 번역·역번역 및 내용타당도 검증의 과정을 거쳤다. 조사기간은 2019년 1월부터 2월까지이었고 자료 분석은 SPSS 20.0으로 기술통계를 실시하 였다. 결과 : 임상적 추론을 사용하고 있다고 응답한 대상자는 39.2%이었고, 사용하지 않는다고 응답한 대상자 는 20.3%이었다. 임상적 추론을 사용하지 않는 이유로는 ‘시행하는 방법을 알지 못해서’, 시간적 제약과 지식 부족이 있었다. SACRR 평가 결과, 작업치료사들은 클라이언트의 가족, 동료 등의 관점, 치료사로 서의 경험을 중요하게 생각하는 것으로 나타났고, 이론을 찾아보고 적용하는 것을 어려워하는 것으로 나 타났다. 결론 : 작업치료사의 임상적 추론 강화를 위한 교육을 마련해야 하고, 임상적 추론의 적용을 중요하게 생 각하는 임상 환경조성이 필요하다. Objective: The purpose of this study is to investigate the self-assessment of clinical reasoning for occupational therapists in Korea Methods: This study was a cross-sectional survey study and targeted 143 occupational therapists nationwide. The questionnaire was composed of general characteristics and whether clinical reasoning was applied. In addition, a Self-Assessment of Clinical Reflection and Reasoning (SACRR) was conducted. SACRR went through the process of translation, reverse translation, and content validity verification. The survey period was from January to February 2019, and a data analysis was conducted using SPSS 20.0 for descriptive statistics. Results: A total of 39.2% of the respondents said they used a clinical inference, and 20.3% said they did not use clinical reasoning. The reason for not using clinical reasoning was because the respondent did not know how to do so, a time constraint, and lack of knowledge. As a result of the SACRR, it was found that occupational therapists value the perspectives of the client’s family and colleagues, and the experience as a therapist, and found it difficult to find and apply different theories. Conclusion: Education for reinforcing clinical reasoning of occupational therapists should be provided, and the creation of a clinical environment that considers the application of clinical reasoning is important.