뇌졸중환자의 편측무시를 위한 눈가리기 방법의 효과 : 단일 사례연구 Single Subject Research Design

공명자,유은영 연세대학교 보건과학연구소 2003 보건과학논집 Vol.13 No.-

Online Fieldwork Program for Occupational Therapy Students in the Era of COVID-19: A Pilot Study

공명자,김현정 한국신경근육물리치료학회 2022 한국신경근육재활학회지 Vol.12 No.3

This preliminary study explored the potential effectiveness and efficacy of the online fieldwork program as an alternative to on-site fieldwork placement for occupational therapy students. Eight-week online fieldwork program consisting of diverse topics were provided to enrolled students via the Zoom. Eighteen occupational therapists from five rehabilitation hospitals along with a fieldwork program director led the online program. Students were expected to attend to the program for 7.5 hours (an hour of student presentation, an hour of lecture, and 4.5 hours of group work or study sessions), 5 days a week. Clinical competency, self-efficacy, and motivation for learning were examined. Additionally, reports on favorable part of the program and possible complaints were collected. A total of 82 students participated in survey after the online program. There were no significant differences in clinical competency, self-efficacy, and motivation for learning among students with varying prior fieldwork experiences. Students reported high satisfaction of the overall program and noted satisfaction with the organization of the program, quality of clinical instructors, variety of assignments, convenience of attending, and ease of communication through online platform. However, barriers such as technological problems and lack of hands-on experience were noted. The possibility of providing an online fieldwork program in place of in-person fieldwork was explored. Future research regarding online fieldwork programs need to be explored for more robust statistical investigation.

뇌졸중환자의 편측무시를 위한 눈가리기 방법의 효과 : 단일 사례연구

공명자,유은영 대한작업치료학회 2002 대한작업치료학회지 Vol.10 No.1

Objective: To explore the effect of a eye patching technique in order to decrease patients’ unilateral neglect. For this study, eye patching is easy to get and a simple method that most patients find acceptable. Method: This study used the ABA design. The subject was a male patient at the age of 66 who had the left hemiplegia and left unilateral neglect caused by right cerebral vascular accident. He was required to wear the eye patching on the right eye during all the period of ADL because unilateral neglect causes many problems in the majority of ADL. The assessments for the unilateral neglect had been performed by the Line bisection and the Albert test once a session (day). Results: Regarding the Means of the errors to the Line bisection and the Albert test, the Means of the errors was decreased during the period of the intervention (B) and was decreased after the withdrawal (A'). Conclusions: Right monocular patching was effective to release the unilateral neglect. Further study is necessary to increase the sample size and the duration of experiments.

작업적 역할: 고찰

공명자(Kong Myung-Ja),정민예(Jung Min-Ye) 한국노인작업치료학회 2019 한국노인작업치료학회지 Vol.1 No.1

목적: 본 연구의 손상과 장애를 가진 사람들의 사회적 복귀 측면에서의 역할과 그 역할 수행을 알아보고자 문헌을 통해 작업적 역할 개념, 의미와 종류들을 비교하고, 향후 재활치료에서 대상자들의 역할 수행에 대한 이해를 돕고자 한다. 연구방법: 연세대학교 학술정보원 홈페이지와 Google Scholar에서 “role”, “activity or occupation”, “occupational therapy”을 조합하여 역할에 대한 논문과 도서를 검색하여 고찰하였다. 결과: 역할에 관련된 작업치료 이론은 인간 수행의 생태학, 사람-환경-작업 모델, 사람중심의 작업 모델, 캐나다 작업수행 모델 및 작업치료 실행 체계 등에서 역할의 정의와 특징을 설명하였다. 역할 평가도구에는 Role checklist와 Client-Oriented Role Evaluation이 있다. 역할은 연령에 따라 변화하고 다양해진다. 역할에 대한 작업치료는 역할 인식, 역할 수행을 위한 활동들을 파악하여 역할 습득 및 역할 전환을 중재한다. 결론: 본 연구는 질병과 장애로 인해 역할 소실, 역할 전환되어야 하는 클라이언트들에게 삶의 질과 만족을 향상시켜 줄 수 있도록 작업치료사는 역할과 역할에 맞는 활동을 확인하고 역할 수행을 위한 작업을 중재해야함을 확인하였다. 우리나라 맥락에 맞는 역할 수행을 측정할 수 있는 평가도구를 개발이 필요하다. Objective: This study was conducted to the role of people who have become permanently disabled as well as the physical functional treatment of patients with impairment and disability in rehabilitation, as well as their roles in the social return side. This study aimed to compare the concepts, meanings, and types of occupational roles. In addition, we aimed to increase the occupational therapists’ understanding of the client’s role. Methods: This study was conducted to investigate occupational role. The website of Yonsei University and Google Scholar were searched using a combination of the terms “role”, “activity or occupation,” and “occupational therapy”. Results: Occupational therapists have defined occupational role in the Ecology of Human Performance framework, Person-Environment-Occupation model, Model of Human Occupation, Canadian Model of Occupational Performance, and occupational therapy execution system. Role evaluation tools includes the Role checklist and Client-Oriented Role Evaluation. Roles varied and changed with age. Occupational therapies for roles included role acquisitions and role transitions by identifying activities for role recognition and role performance. Conclusion: In this study, we found that occupational therapists should identify activities appropriate to their roles and intervent occupation for role performance. It may be helpful to develop an evaluation tool that can measure the performance of roles in the context of the Korean population.

장애영유아의 보육 시설 참여 현황과 재활치료서비스 지원 요구조사

고명숙,공명자 한국신경근육물리치료학회(구 한국신경근육재활학회) 2015 한국신경근육재활학회지 Vol.5 No.1

This study investigated the activity participation of child-care facilities in young children with disabilities and explored the support demand of rehabilitation services for them. 55 nursing teachers in 25 Day-care centers completed a survey questionnaire for data collection. The questionnaire consisted of class participation of children with disabilities, physical environmental factors, behavioral properties, and rehabilitation services. In this study, 83% of the children with cerebral palsy were ambulant outdoors, and decreased motor function was considered as main factor limiting participation of child-care facilities. In addition, the results showed that individual education planning, diagnosis, and evaluations for children with disabilities were specific items required for rehabilitation services. Further studies should be continued to establish support system and rehabilitation service for the increase of activity participation in children with mild or severe disabilities in the community.

집단 거울치료가 지역사회 거주 뇌졸중 환자의 상지 운동과 감각 기능에 미치는 효과

고명숙,공명자 한국신경근육물리치료학회(구 한국신경근육재활학회) 2020 한국신경근육재활학회지 Vol.10 No.2

The purpose of this study was to demonstrate the effects of a group mirror therapy on upper limb and sensory functions in community-living individuals with chronic stroke. Seven patients with chronic stroke living in the community volunteered for this study, and they underwent a group mirror therapy. Measurements were made with Fugl-Meyer assessment (FMA) and monofilament test, which were evaluated before and after the intervention, and 2-week follow-up. A group mirror therapy was performed for average 90 minutes daily, 5 times a week for 2 weeks (a total of 10 sessions), consisting of trainings for the upper extremity: Warm-up, main training (active range of motion exercise and functional task training), and cool-down. A Friedman test was used to compare the changes of measurement values. The results of the study showed that FMS scores were statistically significantly improved after intervention, and gain was maintained at the 2-week follow-up (p<.05). However, there was not significantly different for the monofilament test scores after the intervention and the follow-up, despite of positive change after the intervention (p>.05). These findings suggest that a group mirror therapy might be beneficially used to improve the upper limb function of patients with stroke. Further studies with robust design warrant study results.

신경발달 장애 아동의 지하철 이용하기 작업에 대한 작업기반 중재의 적용

라대엽,공명자,장기연 대한작업치료학회 2018 대한작업치료학회지 Vol.26 No.4

Objective : This study implemented occupation-based practice as a group program for children withneurodevelopmental disabilities, and investigated the quality of occupational performance, performance andsatisfaction, and efficacy levels of the program. Methods : ADOC-S(Aid for Decision making in Occupation Choice-School) and COPM(Canadian OccupationalPerformance Measure) were used to establish common meaningful occupational goals for 10 children withneurodevelopmental disabilities. After occupational analysis of the ‘subway use’, the Performance Quality RatingScale(PQRS) were used to evaluate the quality of occupational performance. Occupation-based interventions wereimplemented by participants individually performing meaningful occupations in the most natural and real-lifeenvironments as possible. The trial consisted of 1 session of pre-intervention assessments, 8 sessions ofintervention, where a single session of 100 minutes is provided once a week. Post-intervention evaluation wasconducted over one session. Results : The quality of occupational performance by PQRS was 38.10 higher than before intervention. Theoccupation-based intervention as a group program used the maintain and modify(compensation, adaptation)approaches and acquisition model. In the early stages of intervention (1 to 4 sessions), the occupationalperformance was greatly improved. The performance level of COPM increased by 5.80 and the satisfaction levelwas increased by 7.00. In addition, high scores were found in program satisfaction through parental interview. Conclusion : The results of implementing occupation-based interventions to children with neurodevelopmentaldisabilities showed increase in quality of occupational performance, performance, and satisfaction along withpositive effects of satisfaction levels for the program. 목적 : 본 연구는 신경발달 장애 아동들에게 작업기반(occupation-based) 중재를 그룹 프로그램으로 적용하여 작업 수행의 질, 수행도 및 만족도, 프로그램에 대한 만족도의 효과를 알아보고자 하였다. 연구방법 : 신경발달 장애 아동 10명을 대상으로, ADOC-S(Aid for Decision making in OccupationChoice-School) 및 COPM(Canadian Occupational Performance Measure)을 사용하여, 모든 클라이언트에게 의미 있고 공통된 작업 목표를 수립 하였다. ‘지하철 이용’ 작업수행 분석한 후에 PQRS(Performance Quality Rating Scale)를 사용하여 작업수행의 질 변화를 조사하였다. 작업기반 중재는가장 자연스럽고 실제생활과 비슷한 상황에서 의미 있는 작업을 직접 수행하며 진행되었다. 실험은 사전평가 1회기, 중재기는 주 1회, 회기당 100분, 8주간, 총 8회기 진행되었고 사후 평가 1회기 실시되었다. 결과 : 작업수행의 질인 PQRS에서는 중재 전에 비해 중재 후 38.10의 증가를 보였다. 유지, 보상 및 적응접근을 적용하여 초기 회기(1~4회기)에 큰 증가율이 나타났다. COPM의 수행도는 중재 전에 비해5.80, 만족도는 7.00의 증가가 나타났다. 또한 보호자 인터뷰를 통한 프로그램 만족도에서 높은 점수가나타났다. 결론 : 작업기반 중재는 신경발달장애 아동의 작업수행을 향상시킬 수 있는 중재방법이며, 수행도 및 만족도, 프로그램 만족도에 긍정적인 결과를 도출할 수 있었다.

구강 기능의 연령별 발달 수준

강찬희,공명자,박경채 대한작업치료학회 1993 대한작업치료학회지 Vol.1 No.1

인지운동치료의 편측무시 감소효과: 사례연구

이성아,공명자,박형식 한국인지운동치료협회 2013 한국신경인지재활치료학회지 Vol.5 No.-

목적: 본 연구는 사례 연구를 통해 재활치료 접근 중 하나로 편측 무시에 대해서 신경-인지 훈련을 실시하였으며 무시 증상감소효과에 대해 확인하였다. 방법: 사례 연구의 대상자는 왼쪽 편에 대해서 편측 무시를 가진 우측 뇌 손상 환자로서 치료는 신경-인지 치료를 1일 4회 4주간 윌요일부터 금요일까지 실시하였다. 편측 무시에 대한 변화는 알버트 검사, 선나누기 검사와 MVPT 검사 및 그림검사와 대상자의 프로파일의 변화로 확인하였다. 결과: 신경-인지 훈련에 따라 대상자는 자신의 신체 인식과 공간 인식에 향상이 있었으며, 좌측의 무시 현상이 감소되었다. 결론: 본 사례 연구 결과 오른쪽 대뇌 반구 손상에 따른 왼쪽 편측 무시 증상에 대해서 신경-인지 훈련은 증상의 감소에 효과가 있었다. Objective: In this study, we assessed the decrease effects of Neuro-Cognitive training for the unilateral spatial neglect patients as another approach of rehabilitation therapy. Methods: One case patients diagnosed with left side neglect is due to right hemisphere injury was selected as the simple case study design was used. The treatment procedures of therapy had been done for thirty minutes for four weeks from Mon. to Fri. and 4time/day. Each week, Neuro-Cognitive training was conducted order. Patient`s change of neglect were measured by Albert test, Line-bisection test, MVPT, drew a person and subject`s village and profile, To compare the decrease effects, we used a visual table. Results: The comparison table of Neuro-Cognitive training showed significant decrease of neglect. Also we found that Neuro-Cognitive training was effectiveness for neglect with patient. Conclusion: This study showed that Neuro-Cognitive training can produce enduring improvements in right hemisphere injury patient suffering left unilateral neglect. (J Korean Society of Neurocognitive Rehabilitation 2013;5:19-27)

초등학생의 작업수행활동 평가항목 개발연구

최은정,장기연,공명자,이은진 대한작업치료학회 2022 대한작업치료학회지 Vol.30 No.3

목적:본 연구는 문화적, 사회적, 환경적 특성이 반영된 초등학생들의 작업수행활동 항목을 도출하여 아동 평가 및 부모 상담 시 유용하게 사용할 수 있도록 작업수행활동 평가도구를 개발하기 위한 기초를 제공하고자 시행하였다. 연구방법:문헌 조사를 통해 수집된 항목 분류 및 평가도구의 항목 중 총 645개의 활동 항목을 수집하여 최종 46개의 항목을 선정하였다. 이후 작업치료실행체계-Ⅲ(Occupational Therapy Practice Framework-Ⅲ; OTPF-Ⅲ의 작업 범주와 생활시간조사(2014)의 행동분류를 기준으로 기초 항목 도출 과정을 거쳐 작업치료사 16명, 초등학교 교사 16명, 작업치료학과 교수 8명, 총 40명의 전문가를 대상으로 3차례의 델파이 조사를 시행하여 최종 항목을 선정하였다. 조사도구로는 리커트 척도인 구조화된 질문과 개방형 질문이 혼합된 설문지를 사용하였다. 결과:델파이 조사를 통해 수거된 설문지의 응답을 토대로 항목의 적합성을 항목별 중요도, 안정성, 내용타당도(Content Validity Ratio)로 확인하였고 개방형 질문에 대한 의견을 수렴하여 항목의 삭제, 수정 및 추가 여부를 결정하였다. 이후 OTPF-Ⅲ 작업 범주의 4개 영역, 생활시간조사 행동분류의 7개 영역에 따라 작업수행활동 29개의 항목을 추출하고 분류하였다. 결론:본 연구를 통해 문화적, 사회적, 환경적 배경이 반영된 국내 초등학생의 작업 수행 활동은 29개 항목으로 최종 도출되었다. 본 연구결과를 바탕으로 향후 임상 작업치료사들이 의미 있는 작업 목표 선정을 위한 활동평가 도구개발에 활용하고 부모 면담 시 간편하고 유용하게 사용하기를 기대한다.