KJC Korea
Journal Central

Objective : This study aims to provide clinical occupational therapists with proper evidence of the appliablestandard of Intermittent Oroesophageal tube (IOE tube) feeding, and an increased recognition of the IOE tube. Methods : The subjects were 57 patients who were asked to apply IOE tube feeding. The characteristics of thesubjects were investigated by reading their medical records, and their cognitive function was evaluated usingKorean Version of Mini Mental State Examination (K-MMSE). The study divided the subjects into successful andfailed groups in IOE tube training and compared the characteristics of both groups. Results : IOE tube feeding was successfully applied to 45 of the 57 subjects (78.9%), but failed in 12 of them(21.1%). The causes of failure were poor cognitive functions (4 subjects), gag reflex (3 subjects), refusal oftraining method (3 subjects), and pneumonia (2 subjects). The successful group showed significantly higherscores compared to the failed group in K-MMSE. However, there were no significant differences in terms of theaverage age or training period variation. Conclusion : IOE tube feeding is appliable only if the patients and their care givers fully understand the treatmentmanner and agree with its implementation. In addition, IOE tube feeding can be considered not only a transitionalnutrition supply, but also a treatment method for patients who have the proper cognitive function without a severegag reflex. However, IOE tube feeding needs to be restricted to those patients who have pneumonia or a backwardflow. For safe and long-term application of IOE tube feeding, close management for patients and their care giversis required.

Objective : The purpose of this study was to investigate the effects of action observation training on theswallowing function of stroke patients with dysphagia. Methods : Sixteen stroke patients with dysphagia were randomly allocated into an Action Observation (AO) groupor Control (CTL) group. The AO group had watched a movie clip containing a normal person eating a meal, andimitated the movements of this person for five minutes. In contrast, the CTL group observed a video with onlyscenery for an equal period of time. Each group was offered the same therapeutic program with the exception ofthe video intervention. The Functional Dysphagia Scale (FDS), Clinical Dysphagia Scale (CDS), and Oral TransitTime (OTT) based on a Videofluoroscopic Swallowing Study (VFSS) were performed to verify the effect of theintervention. Results : The results of FDS, CDS, and OTT were significantly improved for puree, solid, and liquid types of dietafter intervention in the two groups (p<.05). However, the AO group showed a significant improvement in theswallowing function for all types of diets measured by the FDS, as compared with the CTL group (p<.05). Conclusion : These results show that action observation training is effective for an improvement in the swallowingfunction of stroke patients with dysphagia.

Objective : The purpose of this study was to investigate the effect of treatment according to the neuromuscularelectrical stimulation intensities in dysphagic patients. Methods : Fifty-six patients suffering from a subacute stroke were randomly assigned to either a motor stimulationgroup or a sensory stimulation group. Both groups underwent conventional dysphagia treatment, and differentintensities of the electrical stimulation was applied for 30 minutes, five days a week for six weeks. Theirswallowing function was evaluated using the VDS (Videofluoroscopic Dysphasia Scale) and PAS (Penetration-Aspiration Scale), and the L-tube removal rate was confirmed. Results : Both groups showed a statistically significant difference in the pharyngeal stage and PAS (p<.05), and theresult of the comparison of the two groups also showed a significant difference in the pharyngeal stage and PASafter the intervention (p<.05). Before and after intervention, the result of the change showed that the motorstimulation group was 12.58±8.15, the sensory stimulation group was 4.00±5.07 in the pharyngeal stage, andthere were significant differences between the two groups (p<.05). The L-tube removal rate was 52% in themotor stimulation group, and 29% in the sensory stimulation group. Conclusion : This study showed that both motor and sensory stimulation are effective interventions for thepharyngeal stage in the swallowing function of dysphagic patients, and that motor stimulation is more effectivethan sensory stimulation.

Objective : This study examined the impact of eight-week categorization training on the attention, memory, andself-efficacy of stroke patients with cognitive and psychological difficulties. Methods : Thirty stroke patients who were divided into an experimental group and a control group participated inthis study from December 2013 to March 2014. Attention and memory changes were measured using aComputerized Neurocognitive Function test (CNT), and their self-efficacy was evaluated using the general andspecific self-efficacy scale. Results : The findings indicate that, first, there was a significant difference in attention, memory, and generalself-efficacy changes in both groups when comparing before and after the intervention. Second, after theintervention, the memory of the experimental group was significantly higher than that of the control. In contrast,attention and self-efficacy did not differ between both groups. Conclusion : When considering the categorization training with improved memory function of the participants, wesuggest that further studies will be needed to examine more extensive cognitive functions and occupationalperformance with a larger sample size.

Objective : The purpose of this study was to look at a meta-analysis on the effects of occupational therapy forActivities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Quality of Life (QOL), depressionfrom dementia, and QOL of care givers in the community. Methods : Compliance with a qualitative analysis of the research evaluation framework divided along the subjectand study characteristics was coded. The study used a PEDro score for each section in the evaluation of thequality, and the effect size was determined using the Comprehensive Meta-Analysis 2.0 program. and thus manykinds of subject studies were analyzed based on the sample size, pre-post average, and pre-post standarddeviation in a meta-analysis. Results : The study selected 9 studies with a PEDro score of greater than 5. There were a total of 957participants in selected articles. The effective sizes based on the dementia residents in the community for ADL0.781, IADL 0.155, dementia client’s Quality of life 0.285, depression 0.273, caregivers quality of life 0.455consumption respectively. The effective size of the ADL and QOL, depression from dementia, and QOL of the caregivers was statistically significant (p<.01), which demonstrates a “medium size effect”. Conclusion : Applying occupational therapy for residents with dementia proved to be effective in terms of theirADL, QOL, and depression. A variety of individualized occupational therapy research and applied research areneeded on the level of dementia and age-related cognitive function.

Objective : This study attempted to develop evaluation items used to measure elderly drivers’ quality of life. Methods : Opinions from experts were collected from 39 elderly driving-related expert panels from April throughOctober 2014 using the Delphi method. A Delphi survey was carried out three times, and based on previousstudies, the first Delphi survey gathered opinions using a mix of 40 closed-ended questions and open-endedquestions reconstructed regarding the meaning of the quality of life. The second Delphi survey was conductedafter the processes of deleting and modifying certain items based on the first Delphi survey. Including the resultsand responses of the second survey, the comments were reconsidered and modified through a third Delphi survey. Results : 64 items were selected as the first Delphi result, and as the second Delphi result, 51 items were analyzedafter the processes of deleting and modifying the values below a content validity ratio of .33 and the items witha duplicated meaning. Finally, in the third Delphi result, two invalid items out of 51 items were deleted, 49 itemswere drawn out. The average content validity ratio of the final Delphi survey was .84, stability, .13, convergence,.30, and consensus, .85, which were high. Conclusion : This study verified the content validity of the evaluation items for elderly drivers’ quality of life. Inthe future, it is expected that, through verifying validity and reliability, they will be used as a standardizedassessment tool in the clinical environment.

Objective : The aim of this study was to investigate the effectiveness of multi-strategic memory training onmemory, metamemory, and depression in older adults. Methods : For eleven older adults with Subjective Memory Complaints (SMCs), we executed multi-strategicmemory training for a 10 week period. This program consisted of 10 sessions, once a week, with 90 minutes persession. Before and after the program, we examined the effects of this memory training on their memory,metamemory, and depression. Results : After the program, the subjects showed significant changes in their Word List Memory, Word List Recall,Constructional Praxis, and Multifactorial Memory Questionnaire-Strategy (MMQ-S), Short form GeriatricDepression Scale-Korean version (S-GDS-K) scores. Conclusion : The results of this study show that a multi-strategic memory training for older adults with subjectivememory complaints is a useful therapeutic approach.

Objective : This study analyzed the emotional labor, burnout, and job attitude based on the duties of occupationaltherapists and investigated the relationship between these factors. Methods : We conducted surveys from March 27 to April 27, 2014. The general characteristics, emotional labor,burnout, and job attitude of the therapists were examined using a frequency analysis, and descriptive statisticswere presented. The differences between emotional labor, burnout, and job attitude based on their generalcharacteristics were analyzed using a t-test and ANOVA. We used the Pearson’s correlation coefficient to seewhether there was a correlation between emotional labor, burnout, and job attitude. To see what factors have aneffect on job attitude, we also conducted a multiple stepwise regression analysis. Results : A significant positive correlation in emotional labor and burnout (r=.477), and a significant negativecorrelation in burnout (r=-.449) and emotional labor (r=-.215), were found regarding the job attitude. Burnoutwas the main factor affecting the job attitude (F=22.400, Adjusted R2=.19). Conclusion : Our results show that as therapists experience more intense emotional labor, they show a higherburnout and a drop in job attitude. Burnout was shown to have an effect on their job attitude; the less burnoutexperienced by a therapist, the better their job attitude is.

Objective : The purpose of this research was to study how to use the evidence-based practice of occupationaltherapists in a hospital setting. Methods : The participants included eight occupational therapists working in hospitals. The data were collectedthrough in-depth interviews conducted from November 2013 to December 2013. The interviews were taperecorded and transcribed verbatim. The data were analyzed using Giorgi’s phenomenological analysis and theATLAS.ti software program. Results : The results of this study consist of 84 manageable units, 14 sub-structures, and seven structures. Thecomponents regarding the occupational therapists’ use of evidence-based occupational therapy were ‘searchingthe data’, ‘information from practice’, ‘advice’, and ‘client preference’. In addition, components regarding thebarriers were a ‘lack of ability’, ‘poor motivation’, and ‘a restrictive hospital environment’. Conclusion : To facilitate evidence-based occupational therapy, activation of education and an improvement in thehospital environment are needed.

Introduction : This study aimed to examine the current situation of the personnel and manpower of domesticoccupational therapists, the differences between occupational therapists’ duties and relevant areas defined in thelaw, the current status of the payment system of medical insurance companies for occupational therapy, and thedifferences between the current situations of the national health insurance for occupational therapy in Korea andother countries in order to analyze the problems of domestic medical insurance for occupational therapy, suggestdirections for revising the occupational therapy insurance payments, and provide foundational materials for such arevision. Results : It is necessary to cultivate manpower quantitatively, provide qualitative management, and develop aninstitutional support system through a survey on the current situation of the personnel and manpower of domesticoccupational therapists. In addition, through a comparison on the occupational therapists’ duties and relevant areasdefined in the law, this study found that it is necessary to revise the law related with the insurance systemlimiting the duties or performances of occupational therapists. Moreover, the researchers have learned thatproblems exist, resulting from the use of an academic definition of ‘occupational therapy’ as the name of thebehavior used for insurance payments, limitations on the range of duties, an imbalance among specializedtreatment areas for rehabilitation services, or an imbalance in payments of relative value. In addition, according toa comparison of the current situations of insurance payments for occupational therapy in Korea, the US, andJapan, Korea is the only country that strictly restricts the qualifications for acts of rehabilitation. Conclusion : Because insurance payments for occupational therapy do not reflect the duties of occupationaltherapists properly, it is necessary to improve the payment system based on the international standards toclassify such acts. It is expected that further legislative·institutional improvements in the domestic occupationaltherapy insurance payment system will support occupational therapists in improving national health and the qualityof life.

Objective : The purpose of this study was to identify the knowledge, skills, attitudes, and characteristics requiredof occupational therapists for an efficient performance of occupational therapy as a means to developingcompetency indicators for Korean occupational therapists. Methods : To derive the competency indicators of occupational therapists, the researcher first conducted aliterature review and conducted Behavior Event Interviews (BEI’s) on eight occupational therapists selected as agroup with superior performance. Next, an expert committee was formed with six members, which went throughtwo Delphi surveys conducted on 23 panelists. Results : The competency model for occupational therapists developed in this study is structured into a three-levelhierarchy, consisting of two competency clusters, ten competency components, and 54 indicators. For the jobexecution competency cluster, four competencies were derived, and for the professional qualifications competencycluster six components were derived. Conclusion : The competency indicators revealed in this study can be used as basic critical data to fosteroccupational therapists, train clinical occupational therapists, and improve the relevant curricula in the future. Identification of these competencies in different areas will provide more meaningful reference data for setting upnew training and education courses.