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2019, Vol.27, No.4

  • 1.

    A Systematic Review of the Effects of Occupational Therapy for Persons With Mild Cognitive Impairment or Dementia

    Park, Chang-Hwan | Kwon, Kyu-Joon | kim su kyoung | 2019, 27(4) | pp.1~13 | number of Cited : 1
    Abstract
    Objective: This study aimed to systematically review occupational therapy intervention methods for an improvementin the activity and participation of persons with mild cognitive impairment or dementia. Method: The search terms, “Occupational therapy” and “Dementia” or “Mild Cognitive Impairment” and “Participation,”“작업치료” and “치매” or “경도인지장애” and “참여,” were used to search the literature published between 2001 and2018. For the international studies, we used MEDLINE, EMBASE, cochrane CENTRAL, and PubMed, and forKorean studies, KISS, RISS, NDSL, KMBASE, and KiSTi were used. Result: From the eight papers selected, international studies were found to be of higher quality than Korean studies. The most common intervention targets were persons with Alzheimer's type dementia. Common occupationaltherapy interventions were community occupational therapy and client-centered approaches. Interventions werenoted to often take place in a home environment. There were a larger number of studies on measuring the levelof activity compared to studies measuring the participation. Along with activity and participation, cognitive functionwas the most measured area. Conclusion: In this study, occupational therapy intervention methods to improve the activity and participation ofpersons with mild cognitive impairment or dementia are increasing in number, and a client-centered approach isbeing made as the occupational therapy environment extends from hospitals to communities, although to aninsufficient degree. Thus, more research is needed to improve the activities and participation of persons with mildcognitive impairment or dementia.
  • 2.

    Systematic Review of Occupational Therapist’s Home-based Intervention for Stroke Patients

    Lim, Young-Myoung | Cha tae hyun | 2019, 27(4) | pp.15~29 | number of Cited : 0
    Abstract
    Objective: In this study, a systematic review of overseas literature of the methods and effects of home-basedinterventions conducted by occupational therapists in the home environment of the stroke patients was applied. Methods: Data searches were conducted using the MEDLINE, CINAHL, and Pubmed databases. A total of 13 studieswere included in the final analysis. Based on the research included in the analysis, the data were extracted andanalyzed systematically by applying a Risk of bias assessment and the PICO method. Results: In the 13 studies included in the analysis, occupational therapists were involved in home-basedinterventions. Occupational therapists in home-based interventions consisted of individual intervention andmultidisciplinary rehabilitation teams. The occupational therapist has a role in selecting and improving the dailyliving, meaningful activities, and goal activities of stroke patients against the background of their homeenvironment. Conclusion: In the home-based intervention of stroke patients, occupational therapists are mostly applyingclient-centered intervention to facilitate activity and participation. It is expected that this study can be used asevidence for the role of occupational therapists in applying home-based intervention appropriate for domesticcircumstances.
  • 3.

    Effects of a Community-Based Cognitive Rehabilitation Therapy Based on Occupational Therapy in Elderly People With Mild Cognitive Impairment and Dementia

    HAMMINJOO | Hong, Deok-Gi | Moon, Kyung-Up and 1other persons | 2019, 27(4) | pp.31~43 | number of Cited : 2
    Abstract
    Objective: The purpose of this study was to investigate the effects of community-based cognitive rehabilitationtherapy based on occupational therapy applied to cognitive function, physical function, and occupationalperformance in elderly people with mild cognitive impairment and dementia. Methods: We conducted group cognitive rehabilitation therapy in 10 public health centers in Gangwon-do, over aperiod of approximately 9 months, from March 1 to November 31, 2016. The intervention was provided to 95subjects in total, one session per week, 120 min per session, for an average of 20.8 sessions. We compared thecognitive function, physical flexibility, balance ability, and occupational performance of the subjects. Results: In the testing of cognitive function, the MMSE-DS attention scores improved significantly. In terms ofphysical function, there was a significant shortening of the measured distance in the wall test, which measures theflexibility. In the balance testing, the measured time during a one-legged standing test improved significantly, andthe measured time during a 10-foot timed walk test was significantly shortened. In the occupational performancetesting, COPM occupational performance scores improved significantly. Conclusion: Occupational therapy-based group cognitive rehabilitation therapy was shown to be effective atmaintaining and improving the attention, physical flexibility, balance ability, and occupational performance inelderly people with mild cognitive impairment and dementia, suggesting that this treatment method can be utilizedas a community-based clinical model.
  • 4.

    Validity and Reliability of Tablet PC-Based Cognitive Assessment Tools for Stroke Patients

    Lee, Jung-Min | Won, Jung-Hee | Moonyoung Chang | 2019, 27(4) | pp.45~56 | number of Cited : 0
    Abstract
    Purpose: In this study, we compared Tablet PC-based cognitive assessment tools with MMSE-K and MoCA-K forpeople with cerebrovascular disease to examine their validity and test-retest reliability. Method: The study was conducted from June 18, 2018 to September 16, 2018, and covered 67 subacute strokepatients who were admitted to the Ulsan-based General Hospital and are receiving occupational therapy. Theassessment used MMSE-K, MoCA-K, and Tablet PC-based cognitive assessment tools. The validity andconfidence of the test-retest were verified through a Pearson's correlation. Result: The results of the validity analysis show that the correlation coefficient between the Tablet PC-basedcognitive assessment tool and MMSE-K was r = .85, The correlation coefficient for MoCA-K was r = .86, whichis highly feasible. The reliability was verified with r = .97. Conclusion: Through this study, we were able to verify the validity and reliability of Tablet PC-based cognitiveassessment tools. Therefore, it is expected that such tools will be available for clinical use as a cognitiveassessment approach.
  • 5.

    Analysis of Rating Scale of Korean Participation and Environment Measure for Children and Youth Using the Rasch Model

    Jeong Yunwha | Hong, Deok-Gi | 2019, 27(4) | pp.57~68 | number of Cited : 1
    Abstract
    Objective: The aim of this study was to develop a rating scale of the Korean Participation and Environment Measurefor Children and Youth (KPEM-CY) by applying the Rasch model. Methods: The KPEM-CY data were collected from 184 parents of children 5 to 13 years in age. The KPEM-CYrating scales (participation frequency, involvement, and environmental support/barriers at home, school, and in thecommunity) were analyzed using the Rasch model. Results: The results of the Rasch model showed that it is appropriate to change the 7-point rating scale of homeparticipation frequency to a 3-point rating scale and the 7-point school and community frequency rating scales to4-point rating scales. In terms of the involvement rating scale under three settings, it was considered suitable tochange from a 5-point to a 3-point rating scale. In addition, the 3-point rating scales of environmentalsupport/barriers under three settings were deemed reasonable. However, the 4-point rating scales of theenvironmental support/barriers at home and under a community setting need to be changed into 3-point ratingscales. Conclusion: The KPEM-CY rating scale was developed based on measurement variables using the Rasch model, andcan be applied for an occupational therapy evaluation. It is necessary to analyze the participation patterns ofchildren and the environmental support/barriers according to demographic characteristics and environmentalfactors.
  • 6.

    Relationships Among Self-Efficacy, Social Support, and Community Participation in Breast Cancer Survivors

    Kim, Hye-Mi | PARK GYEONGA | park, Jin-Ju and 1other persons | 2019, 27(4) | pp.69~82 | number of Cited : 1
    Abstract
    Objective: The purpose of this study was to examine the self-efficacy, social support, and community participationin Korean breast cancer survivors. Methods: Data were collected through questionnaires from 40 women with breast cancer in an outpatient setting ata hospital in H city, Korea. The instruments included self-efficacy checked using SESSM-B, social supportchecked based on MSPSS, and community social participation using K-CPI. The data were analyzed usingdescriptive statistics, frequency, percentage, and Spearman’s correlation coefficients through SPSS WIN 18.0 forWindows. Results: The mean score for self-efficacy was 3.70±.38, social support was 3.49±.66, and community participationwas 3.27±.65, out of a total possible score of 5. In the results on the frequency of engagement in activities andthe percentage of participants who view activities as important, most of the participants reported that spendingtime with family, cooking and housework, and engaging in hobbies or leisure activities are important activities. However, their frequency of such activities was low. Social support showed a positive correlation withself-efficacy (p < .01) and community participation (p < .001). Conclusion: Implications for those working in survivorship care include the need to consider addressing theirassociated social roles, relationships, and responsibilities when designing strategies to increase the participation ofbreast cancer survivors. Additional studies are needed, however.
  • 7.

    Effects of Dementia-related Experiences on Dementia Awareness and Career Hopes of Occupational Therapy Majors

    Mi-hwa Kwon | 2019, 27(4) | pp.83~91 | number of Cited : 2
    Abstract
    Purpose: The purpose of this study was to investigate the effects of experience on completed dementia-relatedsubjects, clinical practice, volunteerism, and social services regarding the cognition of dementia in occupationaltherapy majoring college students according to changes in the dementia policy due to an aging population. Thepurpose of this study was to provide a direction of education that can raise the interest in dementia and geriatricoccupational therapy of occupational therapy majors. Methods: The survey was conducted online, targeting university students in Daejeon, Chungnam, Chungbuk, andKyungbuk. The questionnaire was conducted for one month from May 1, 2018, and 207 participants participated. A frequency analysis, independent t-test, Pearson’s correlation coefficient, and hierarchical regression wereconducted for the analysis results. Results: Dementia knowledge and policy perception were significantly higher in subjects with dementia-relatedexperiences, and dementia-related experiences and dementia knowledge and policy perception were significantlycorrelated. In addition, dementia-related experiences and awareness of dementia had a significant effect on careerhopes for dementia-related organizations, and the explanatory power of the model was 26.4%. The influence ofvariables on career hopes showed the need for dementia education, policy awareness, experience using socialservices, dementia-related subjects, and gender. Conclusion: To increase interest in dementia knowledge and related policies of college students majoring inoccupational therapy, it is necessary to search for ways to provide various dementia-related experiences withinthe curriculum. Through this, directions for careerists hoping to achieve social change will be suggested, with thehope that it will help improve the professionalism of geriatric occupational therapy.
  • 8.

    A Survey Study of Occupational Therapists of Busan, Ulsan, and Gyeongnam Regarding Their Awareness and Implementation of Occupation-Based Practice

    Kang, Ki-Tae | Kim, Ye-Seong | Chang, Moon-Young | 2019, 27(4) | pp.93~106 | number of Cited : 3
    Abstract
    Objective: The purpose of this study is to determine the perception and implementation status of Occupation-BasedPractice (OBP) for occupational therapists working in the Busan, Ulsan, and Gyeongnam areas. Method: Occupational therapists in the Busan, Ulsan, and Gyeongnam areas responded to a questionnaire in which atotal of 194 questionnaires were analyzed. Result: The definition of OBP from the occupational therapists point of view included the client’s self-awareness ofoccupation and participation during intervention, the occupation and activities chosen by the clients themselves,and the use of occupation as an evaluation and intervention method. The perception of OBP showed a mean valueof 5.21, whereas occupational understanding and knowledge resulted in a mean score of 4.98. The frequency ofapplication of OBP showed a mean value of 2.68 out of 10 each day. Assessment tools often used to implementOBP include interviews, clinical observations, and the Canadian Occupational Performance Measure (COPM). Conclusion: Occupational therapists in the Busan, Ulsan and Gyeongnam areas showed a moderate level ofawareness of OBP, and a low level of implementation.
  • 9.

    Effects of Repetitive Transcranial Magnetic Stimulation (rTMS), Transcranial Direct Current Stimulation (tDCS) and Neuromuscular Electrical Stimulation Therapy (NMES) on Stroke Dysphagia Using Meta-Analysis

    Shin, Chi-Hwan | Cha, Sun-A | 2019, 27(4) | pp.107~124 | number of Cited : 1
    Abstract
    Objective: Randomized controlled trials (RCTs) using neuromuscular electronic stimulation (NMES) andnon-invasive brain stimulation (NIBS) were applied for early access to clinicians included in a post-strokeswallowing intervention. A meta-analysis of the research will provide concrete effects and suggestions forimprovement. Methods: We searched articles from 2008 to 2019 published in Pubmed, CINAHL (EBSCOhost), Psycinfo, KoreanStudies Information Service System (KISS), and the Research Information Sharing Service (RISS). The main keywords are “stroke OR CVA OR cerebrocascular accident OR vascular accident” AND “dysphagia OR swallowingdisorder OR deglutition disorder” AND “tDCS OR transcranial direct current stimulation OR rTMS OR repetitivetranscranial magnetic stimulation OR NMES OR neuromuscular electronic stimulation” AND “RCT OR randomizedcontrol trial,” “뇌졸중” AND “연하장애,” AND “경두기 자기자극 OR 경두개 직류자극 OR 신경근전기자극” AND “무작위대조실험.” The inclusion and exclusion criteria were applied to a total of 11 studies. Results: The electrical stimulation intensity of transcranial direct current stimulation (tDCS) was 1 mA, theelectrical stimulation intensity of repetitive transcranial magnetic stimulation (rTMS) was 3-5 Hz, theneuromuscular electrical stimulation (NMES) varied from 8 to 15 mA, tDCS and rTMS showed large effect sizes,and NMES demonstrated a medium effect size. Conclusion: This study confirmed the effects of three treatments through a meta-analysis and confirmed thevarious results according to the patients' characteristics and mediation direction. However, three treatments aredeemed effective for the recovery of swallowing disorder after a stroke in Korea and are considered safe. Inaddition, it is necessary to study various factors leading to a recovery of a swallowing disorder.
  • 10.

    Psychometric Characteristics for Clinical Application of Korean Version of Adelaide Driving Self Efficacy Scale

    Park Myoung Ok | KIM Myeong Ju | 2019, 27(4) | pp.125~140 | number of Cited : 0
    Abstract
    Objective: The purpose of this study is to identify the psychological characteristics of the clinical application of theKorean translated version of the Adelaide Driving Self-Efficacy Scale (K-ADSES). Methods: K-ADSES was developed after a translation and verification by a group of experts. To verify thereliability and validity of the K-ADSES, 114 elderly persons with more than 1 year of driving experience wereevaluated using K-ADSES, K-SDBM and K-Drivers 65 plus. Results: As a result of the content validity, the CVI score for all 12 items was an average of .95 points. Accordingto an analysis of the correlation between the evaluations conducted to verify the convergent validity, the totalscores of K-ADSES and K-Drivers 65 plus are r = -.644 (p < .001), and the total scores of K-ADSES andK-SDBM are r = .792 (p < .001). These results indicate a statistically significant correlation. The Cronbach’s αvalue, which verifies the internal consistency of K-ADSES, showed a high reliability of .975, and the test-retestreliability result shows a statistically significant correlation of .813 in the intra-class correlation coefficient. Conclusion: K-ADSES has been identified as a driving self-efficacy measurement tool for older drivers withreliability and validity. Based on this study, it is expected that K-ADSES will be widely used as a tool to measurethe driving-related self-efficacy of elderly and vulnerable drivers in a driving rehabilitation clinic where there isno such assessment tool for driving.
  • 11.

    Development and Evaluation of Bath Chair Considering the Convenience and Safety of Stroke Patients

    Son, Young-Hyo | Ji-Young Baek | Chung Hyunae and 6other persons | 2019, 27(4) | pp.141~153 | number of Cited : 0
    Abstract
    Objective: The purpose of this study was to develop a bath chair and verify its effectiveness in terms of theconvenience and safety of stroke patients. Methods: The subjects were 20 stroke patients admitted to a rehabilitation hospital in a metropolitan city. As aresearch tool, a bath chair prototype was developed based on a Delphi survey and subjective opinions from thesubjects. A Rapid Entire Body Assessment (REBA), questionnaire (usability assessment and open questionnaire),and Korean version of Quebec User Evaluation of Satisfaction Assistive Technology (K-QUEST 2.0) were usedas assessment tools. As a statistical analysis, a t-test was conducted before and after applying the bath chairprototype. Results: As the results from before and after using the bath chair prototype indicate, the REBA levels of actionregarding the use of bath ware and a showerhead are lowered from ‘high’ to ‘normal’ and ‘low,’ respectively. Inaddition, in the usability test, convenience was considered to be ‘proper’ and seven other items expressed valuesof ‘normal’. In addition, the prototype was deemed ‘satisfactory’ in terms of effectiveness, whereas seven otherindicators showed a level of ‘normal’. Conclusion: The bath chair developed in this study is expected to not only be effective in improving theconvenience and safety of the bathing activity of stroke patients but also to serve as an assistive device to reducetheir physical burden.
  • 12.

    Challenges and Opportunities for Occupational Therapy in Big Data Research

    Hong Ickpyo | Meredith F. Shields | Mi Jung Lee and 4other persons | 2019, 27(4) | pp.155~165 | number of Cited : 0
    Abstract
    The advance of information technology with governmental support allows researchers to utilize big data to conductrigorous rehabilitation-related studies in both the United States and Korea. While big data research has beenactively conducted in the United States, few Korean rehabilitation scientists currently conduct big data research. Inthis paper, we discuss the existing rehabilitation-related big data in Korea and introduce the current big dataresearch trends in the United States. In addition, we provide potential research areas by discussing the previousbig data studies in the United States, including 1) functional outcomes, 2) geographical variation, 3) linkage of apopulation-based cohort to hospital data, 4) cross-national comparison, and 5) scale development. We also discussvarious statistical methods required in big data research and compare how these methods differ compared to thetraditional research methods in rehabilitation research. Lastly, we discuss the importance of workforce developmentin rehabilitation-related big data research. We hope this paper will provide occupational therapy scientists andclinicians with practical and useful information about big data research and accelerate big data rehabilitationresearch communities in Korea.
  • 13.

    Validation of Sensory Outcome Measure: Findings from the 2011 Survey of Pathway to Diagnosis and Services

    Mi Jung Lee | Karen Ratcliff | Claudia L. Hilton and 1other persons | 2019, 27(4) | pp.167~182 | number of Cited : 0
    Abstract
    Objective: To evaluate item-factor structures of the 15 sensory items from the Survey of Pathways to Diagnosisand Services (Pathways) and examine the best fitting model. Methods: The study subjects were 1,968 children aged 6-17 years, who had ever been diagnosed with AutismSpectrum Disorder (ASD) and/or Intellectual Disability (ID). Factor analyses and item response theory modelswere used to determine the best fitting item-factor structure of the sensory items. The Strengths andDifficulties Questionnaires (SDQ) was used to test the concurrent validity of the sensory severity estimates. Results: A bifactor MIRT model (a general and four sensory factors) was selected as the best fitting model. Allitems statistically fitted to the bifactor model (p > .01) and showed moderate correlations with all five subscalesof the SDQ (rs = .31 ~.51, p < .0001). The general sensory score differentiated the four different diagnosticgroups (ASD, ID, ASD with ID, and no current symptoms) [F (3,1961) = 207.4, p < .0001]. Conclusion: The Pathways sensory items yielded reliable estimates of the general and each corresponding sensoryfactor by applying a bifactor MIRT model. The sensory score can be used as a valid sensory measure in thepopulation survey.