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2012, Vol.20, No.4

  • 1.

    The Relations Among Degree of Disability Acceptance, Burden, and Coping Behaviors of Caregivers of Inpatients With Spinal Cord Injuries

    신미정 | HAE YEAN PARK | 2012, 20(4) | pp.1~14 | number of Cited : 2
    Abstract
    Objective : The purpose of this study was two-fold: First, it investigated the degree of disability acceptance, burden, and coping behaviors of caregivers of spinal cord injury patients staying in hospitals as a function of the characteristics of the patients and their caregivers. Second, it examined the relationship among these variables. Methods : The subjects were 103 caregivers of spinal cord injury patients who were receiving in-patient treatment at one of the eight rehabilitation therapy hospitals in Seoul, Gyeonggi-do,and Chungcheng-do. The instruments used were Acceptance of Disability (Linkowski, 1971) for the caregiver's acceptance of their patient's disability, Burden Inventory (Lee, 1993) for the caregiver's level of burden, and Ways of Coping (Lazarus & Folkman, 1984) for the caregiver's coping strategies. In addition, several questions were asked to find out the caregiver's demographic information and caregiving characteristics, and the patient's demographic information and disease characteristics. The data were analyzed through descriptive statistics, a t-test, Pearson's correlations, One-way ANOVA, and post hoc Tukey. Results : The major results of this study are as follows: First, the caregivers exhibited a moderate level of acceptance of disability, and had a severe physical burden, and used both problem- and emotion-focused coping strategies, with particular focus on the positive. Second, the female caregivers had more social burden and used emotion-focused coping strategies more compared with the male caregivers. The frequency of caregiving increased with the perceived caregiver's burden, especially time-dependence burden, developmental burden, social burden, emotional burden, and economic burden. The time of the caregiving increased with the perceived caregiver's burden, especially time-dependence burden and social burden, and with the use of 'focusing on the positive'coping strategies. Third, caregivers of patients with cervical and thoracic lesions had greater time-dependency and developmental burdens, and used wishful-thinking coping strategies compared with caregivers of patients with lumbar lesions. The caregivers of the dependent group in daily living had greater time-dependency burden, developmental burden, and financial burden. Conclusion : Caregiver's disability acceptance decreased with their burden and increased with the use of detachment coping strategies. Caregivers with more time-dependent burden used emotion-focused coping strategies, while those with more physical burden used both problemand emotion-focused coping strategies.
  • 2.

    The Relationship Between Body Functions and Activities and the Participation of Community-Dwelling Elderly Persons: Based on ICF

    고효은 | OH MYUNG HWA | Baik Ji Young and 1other persons | 2012, 20(4) | pp.15~28 | number of Cited : 20
    Abstract
    Objective : The purposes of this study were to examine elderly people's body functions and degree of activity and participation, and to look at their correlation and factors affecting them. Methods : The subjects were 147 elderly people aged 65 or older who have a membership at a senior welfare center. To evaluate their body functions such as their degree of depression,cognitive function and motor function, KGDS, MMSE-K and OPTIMAL were used. Their activity and participation levels were measured using an ICF core set. Results : First, 60 out of the 147 subjects had symptoms of depression (40.7%) and 53 had a degraded cognitive function (36.1%). Their average score for 21 items was 52.17±21.32 out of a total score of 105, and they had difficulties in motor function. Their average score for 30items was 17.95±12.40 out of a total score of 120, and they had mild difficulties in their activities and participation. Second, all three functions had a statistically significant correlation with their activity and participation level. In particular, their movement function had the highest correlation with their activity and participation level. Third, among their body functions, their movement function most greatly influenced their degree of activities and participation, followed by their cognitive function and degree of depression. Conclusion : To improve the various activities and participation of elderly persons, occupational therapists should consider both maximizing their motor functions and minimizing their level of cognitive disorder and depression in practice.
  • 3.

    A Phenomenological Study on the Experience of Novice Pediatric Occupational Therapists

    Hong Eun kyoung | Kyeong-Mi Kim | 2012, 20(4) | pp.29~42 | number of Cited : 5
    Abstract
    Objective : The purpose of this study is to understand the meaning of clinical experience for novice pediatric occupational therapists and to comprehend its adaptive strategies. Methods : A phenomenological approach for qualitative research was adopted for this study. The participants were 5 pediatric occupational therapists that had 10 to 11 months of experience. Data were collected through face-to-face interviews and e-mail. The interviews were recoded,transcribed, and analyzed thematically. Results : Five themes emerged form the interview data. The themes were as follows: 1)Expectations regarding pediatric occupational therapy: selection and expectations regarding pediatric occupational therapy. 2) A shortage of competence: uncertainty and a lack of confidence regarding intervention. 3) Emotions toward the organization: satisfaction and dissatisfaction regarding the organization, relational skills with therapists, and job dissatisfaction. 4) Fervent desire about education: recognition regarding education and method of education. 5) Adaptive strategy: adaptive strategy for professional and personal lives. Conclusion : This study was conducted to comprehend the experience process of novice pediatric occupational therapists. The results will assist in the development of an educational curriculum,and clinical support to help in the adaptation of novice pediatric occupational therapists.
  • 4.

    The Change in Spaced Retrieval Training (SRT) Combined With Errorless Learning on Cognitive Function and Depression in Dementia Sufferers

    Jang Jong-Sik | Jaeshin Lee | kim su kyoung and 1other persons | 2012, 20(4) | pp.43~55 | number of Cited : 12
    Abstract
    Objective : The aim of this study was to identify the effects of spaced retrieval training (SRT)and errorless learning training (ELT) on the cognitive change and depression level in dementia sufferers. Methods : SRT and ELT were applied to thirty-one dementia patients between September 2009through November 2010. The SRT and ELT were applied to inpatients of Daejeon and K-city hospital in Chungnam five times a week for a four-week period. To assess the changes in cognitive function, we performed the Korean version of the CERAD neuropsychological battery,and assessed the depression symptoms using the Korean version of the Geriatric Depression Scale (GDS-K). Results : The effects of depression and its cognition improved after SRT and ELT were applied. After the interventions, patients with vascular and mild dementia showed greater declines in depression scores than those with Alzheimer's and moderate dementia. Conclusion : After the interventions, patients with vascular and mild dementia showed greater declines in depression scores than those with Alzheimer's and moderate dementia.
  • 5.

    Impact of Pain Catastrophizing and Motivation for Rehabilitation on the Activities of Daily Living in Stroke Patients

    배자현 | 이택영 | 강대혁 | 2012, 20(4) | pp.57~68 | number of Cited : 5
    Abstract
    Objective : The aims of this study were to investigate the relationships among the pain catastrophizing scale, the motivation for rehabilitation, and activities of daily living (ADL) in stroke patients. Methods : A total of 113 stroke patients recruited from eleven rehabilitation medical centers located in Seoul, Kyung-gi, and Chung-nam participated in this study. All participants scored higher than 24 point on the MMSE. The Pain Catastrophizing Scale (PCS), the Disabled's Motivation for Rehabilitation Scale, and a Modified Barthel Index (MBI) were completed by the participants. The data were analyzed through a frequency analysis, Pearson Product-moment Correlation Coefficient, and Stepwise Multiple Regression analysis using SPSS 12.0. Results : Statistically significant correlations were found between the pain catastrophizing level and ADL, and the task-oriented motivation, obligatory motivation, and amotivation. Additionally, ADL and obligatory motivation showed a statistically significant correlation. The pain catastrophizing level was the factor affecting the stroke patients' ADL, and it explained 11% of the ADL changes. Conclusion : The results of this study indicate that persons with low pain catastrophizing level show a higher motivation for rehabilitation and higher ADL performance. Therefore, occupational therapists need to focus on an improvement in coping skills for the management of pain and the motivation for rehabilitation in stroke patients.
  • 6.

    Comparison of sEMG Activation on Swallowing-Related Muscles According to the Bolus Viscosity and Volume

    박미진 | Woo, Hee-Soon | Kiyeon Chang and 1other persons | 2012, 20(4) | pp.69~80 | number of Cited : 7
    Abstract
    Objective : This study aims to present the basis of dysphagia rehabilitation treatment and intervention by objectively investigating the consistency and volume of food in healthy adults, and measuring the changes in muscle activities when gradually increasing the consistency and volume. Methods : Forty healthy adults (20 male, 20 female) attending ○ ○ University in D metropolis participated in this study. sEMG was used to measure the amplitude of suprahyoid and infrahyoid muscle activity from an oral phase to a pharyngeal phase according to the consistency and volume of food. VAS was used to show the objective numerical value of the swallowing effort changes according to the food consistency and volume. Results : The results of this study showed an increase in suprahyoid muscle activity when increasing the food consistency, and an increase in suprahyoid and infrahyoid muscle activities when increasing the food volume. Conclusion : This study will be helpful in determining the food consistency and volume in a dysphagia diet for patients who have a decreased oral motor control and pharyngeal swallowing reflex. Moreover, the results of this study will help to guess (assume) the degree of suprahyoid and infrahyoid muscle activities during the swallowing of food.
  • 7.

    Effects of Snoezelen on BPSD and EEG Activity of the Elderly With Dementia

    Han sang woo | Jaeshin Lee | kim su kyoung and 1other persons | 2012, 20(4) | pp.81~94 | number of Cited : 2
    Abstract
    Objective : The purpose of this study is to investigate the effects of Snoezelen on the BPSD and EEG Activity of elderly persons with dementia. Methods : A single-subject A-B-A’ experimental design was used to determine the effects of Snoezelen therapy. The participants of the study were three elderly participants with Behavioural and Psychological Symptoms of Dementia (BPSD). They participated in nine 20-30 minute sessions over a 6-week period. The ratings of the BPSD recorded by video were taken before,during, and after the intervention phase. EEG measurements and brain mapping consisting of eight channels were performed immediately before and after the treatment sessions. Results : The participants showed a decrease in the frequency of BPSD with wandering, repetitive behavior, delusions, and anxiety. The results of the EEG measurements showed increased alpha and beta waves, and a reduction of theta and gamma waves, for 2 patients. Conclusion : These findings provide evidence of the neurophysiologic aspects supporting that Snoezelen is an effective approach for the treatment of BPSD on elderly persons with dementia.
  • 8.

    Study on the Application of ICF-Based SPG Case-Management Frame With a Focus on SCI

    곽내화 | Kiyeon Chang | 안규환 and 1other persons | 2012, 20(4) | pp.95~110 | number of Cited : 8
    Abstract
    Objective : This study was carried out to propose a goal-setting process reflecting the desires of single patients and to seek the possibility of application of ICF within a structuralized rehabilitation system by applying the ICF-based Swiss Paraplegic Group (SPG) case-management frame, which emphasizes a patient-centered goal-oriented approach, to Korean patients with spinal damage. Methods : The subject of this study was a 62 year-old man admitted to a hospital in D Metropolitan City after an automobile accident who was diagnosed with damage to C4-C5 of his spinal cord (ASIA D). The patient participated in the rehabilitation program and set his social participation and return to work as his global goals, and an independent life as his service program goal. Based on these goals, an improvement of mobility, self-help management, and an enhancement of memory and ability to use a computer were set as three subordinate cycle goals. Results : A rehabilitation team was created in accordance with the goals of the patient. The achievement of the patient in accordance with his set intervention goals independently included an overall improvement in areas of self-management, and the patient was able to independently urinate and defecate through a continuous drug therapy. In addition, although walking with the aid of a walker was possible, it was determined that the patient failed to reach the targeted value in terms of independent walking, since walking with the aid of a supplementary tool does not fulfill the goal of returning to work, as set by the patient. This result considers the context of individuals emphasized in ICF. Conclusion : For the ICF-based SPG form applied in this study, the goals were determined and the elements of intervention were set through the desires and context of the patient, and there was an advantage in being able to objectively compare the patient and prognosis prior to and following treatment. Therefore, it is suggested for future researches that the process of goal setting reflecting the desires of an individual patient be suggested by applying an ICF-based SPG case-management frame to a diverse range of diseases and patients with a wide range of ages,and to pursue the application of ICF within a structuralized rehabilitation system.
  • 9.

    Review the Level of Quality of Single Subject Research Design in the Field of Korean Occupational Therapy by Using the Journal of Korean Society of Occupational Therapy

    Choi, Yoo-Im | Kim Eun Joo | Park Eun young | 2012, 20(4) | pp.111~124 | number of Cited : 5
    Abstract
    Objective : The purpose of this study was to review the level of quality about content and method of single subject research design published in the Journal of Korean Society of Occupational Therapy. Methods : This review analyzed 31 single subject research design published between 2002 and 2011. The contents and quality of research design were examined. Results : The results revealed that the frequency dependent variables were in order of behavior change, function of upper extremity, activities of daily living. The participant of single study were similar in children, adults and the elderly. The highest percentage of diagnosis in children and adult or the elderly subject was cerebral palsy and autism and stroke, respectively. The highest percentage of design was reversal. The report frequency of maintain and generalization was low. The strong quality of methodology was 4 of 31 study and the rest studies were moderate. The most studies reported sufficiently well description of participants and setting, operationally defined independent and dependent variables, visual analysis followed standard conventions, and cleary and correctly stated type of design. However, there were no study employed intervention blind and the report of interrater or intrarater reliability was rare. Also, the percentage of performance about an adequate number of data points and a appropriate visual analysis was low. Conclusion : Based on these results, the content and level of quality of single subject research design applied in occupational therapy were investigated. Further studies should be fulfill the quality rating standard to establish evidence and improve the quality of single subject research design in occupational therapy.
  • 10.

    Utility of the Canadian Occupational Performance Measure in Evaluating the Outcome of Rehabilitation Services for People With Mental Disorders

    강대혁 | 2012, 20(4) | pp.125~136 | number of Cited : 11
    Abstract
    Objective : The aim of this study was to examine the utility of the Canadian Occupational Performance Measure (COPM) in evaluating the outcome of rehabilitation services for people with mental disorders. Methods : The subjects were 49 psychiatric patients participating in rehabilitation programs at three mental health institutions in Kyungsang, Jeonla, and Choongchung provinces. The study was conducted between September 2010 and October 2011. The COPM was used to identify self-perceived performance problems, and the COPM Utility Survey was employed to measure the subjects' receptiveness to the COPM. The Behavior and Symptom Identification Scale (BASIS-32) and the Abbreviated Life Skills Profile-16 (LSP-16) were utilized to measure the criterion-related validity of the COPM. Results : After the initial assessment of the COPM, 46 out of the 49 participants (94.0%) responded that the COPM helped them establish a treatment plan. The self-perceived problem areas were productive activities(38.5%), leisure (35.0%), and self-care (26.5%) in that order. No significant correlations were found among the COPM, LSP-16, and BASIS-32 except for a few sub-items. Conclusion : The results of this study infer that the COPM provides unique information such as self-perceived personal problems that other assessment tools, widely used in mental health settings, do not assess. In addition, unlike psychiatric patients in foreign countries, Korean psychiatric patients focus on productive activities as their primary treatment goals. These findings imply the importance of vocational training and the role of occupational therapists in rehabilitation services for people with mental disorders.
  • 11.

    Neurobiological Influence of Occupation on Neurological Disorders Through Experience-Dependent Plasticity

    Park, Ji-Hyuk | Han Dae-Sung | Kwon Jae Sung | 2012, 20(4) | pp.137~150 | number of Cited : 4
    Abstract
    The purpose of this review is to investigate neurobiological evidence of the importance of occupational therapy for neurorehabilitation, and to suggest what features should be included for inducing therapeutic effects on patients with neurological disorders. In occupational therapy, occupation is the therapeutic media used to improve the functional performance of participation and quality of life. Natural motivated behavior increases the levels of neurotrophic factors enhancing neural plasticity. Experience-dependent plasticity means that neural plasticity depends on the experience of the individual. Experience and occupation guide changes in the neural system, as reported by neuroscientific evidence in animals and humans. For various neurological disorders, experience-dependent plasticity was induced through occupational therapy. Occupational therapy should be a motivated task-oriented activity specified to a target performance skill, reparative, highly intensitive, and close to a real occupation in everyday life. This kind of therapeutic activity can enhance a patient's functional recovery through experience-dependent plasticity in the human brain.