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Current Trends and Future-Oriented View of Clinical Measurement Used by Neurological Occupational Therapist

신경계 작업치료사의 평가도구 사용 현황 및 향후 방향

  • 송창순 (전남과학대학, 작업치료과)
  • Received : 2012.10.16
  • Accepted : 2012.11.08
  • Published : 2012.11.30

Abstract

Occupational therapist is required for patient-centered approaches to actively seek the perspectives of patients and their families in clinical settings. The purpose of this study was to investigate the current trends and to suggest future-oriented view of examination and assessment used by neurological occupational therapist in clinical settings. Sixty-six occupational therapists who work in persons with neurological disorders participated in this study. The survey was measured from Seoul and GyeongGi by means of E-mail about commonly used assessment tools and selecting considerations. The participants were 66 neurological occupational therapists. The number of patients by one day was from 10 to 14 persons, and the length of time for initial evaluation was 20-40 minutes per one patient, and reexamination periods was every 1 month or as functional changes were detected. The using tool was not limited only neurological tools, and choice consideration was the reliability and validity of clinical measures. The most frequently used tools for adults were: JHFT for motor function in upper extremity, MMSE-K for cognitive perceptual assessment, MBI for daily activity assessment, and COPM for occupational performance. The most frequently used tools for child were: MVPT for cognitive perceptual assessment and Wee-FIM for daily activity assessment. The results of this study suggest that it is necessary to integrate and associate patient-report, care-giver report, and results of performance-based assessment for estimating plan of care more quality.

작업치료사의 환자중심훈련(patient-centered practice)은 치료사에게 환자와 그 가족의 관점에서 능동적으로 환자의 기능부전을 찾아야 가능하다. 본 연구는 신경계 작업치료사가 검사 및 평가를 실시하기 위하여 현재 임상에서 사용하는 평가도구의 사용빈도 및 평가도구 선택시 고려사항을 알아보고, 평가에 관한 향후 방향을 제시하기 위함이었다. 연구대상자는 신경계 질환자를 대상으로 치료하는 서울 경기지역에 근무하는 작업치료사 66명이었다. 설문지는 연구대상자의 일반적인 특성, 평가관련 정보, 신경계 작업치료사가 사용하는 평가도구의 내용, 성인 평가도구 및 아동평가도구에 관한 내용으로 구성되었다. 결과분석은 설문에 응답한 66명의 자료를 대상으로 기술적 통계량을 사용하였다. 연구결과, 1일 환자 수는 10인 이상 15인 미만이 가장 많았으며, 초기평가는 20분 이상 40분 미만이 가장 많았고, 환자 재평가 주기는 1개월과 기능적 차이가 보일 때가 가장 많았다. 평가도구는 신경계 관련 도구에만 국한되지 않았으며, 평가도구 선택시 고려사항은 평가도구의 신뢰도와 타당도가 가장 높았다. 성인을 대상으로 사용한 평가도구는 '상지운동기능'은 JHFT, '인지 및 지각'은 MMSE-K, '일상생활동작'은 MBI, '작업수행'은 COPM이 가장 많았다. 또한 아동을 대상으로 한 평가도구는 '인지-지각 평가도구'는 MVPT, '일상생활동작 평가도구'는 Wee-FIM이 가장 많았다. 마지막으로 영역에 따른 평가도구 선택시 고려사항도 평가도구의 신뢰도와 타당도가 가장 높았다. 본 연구결과를 통하여 서울.경기지역에 근무하는 신경계 작업치료사의 영역별 평가도구의 사용빈도와 그 평가도구를 선택할 때 고려하는 사항을 알아볼 수 있었고, 이 결과를 바탕으로 향후 신경계 작업치료사가 평가를 수행할 때 환자수행중심 평가뿐만 아니라 환자와 보호자의 관점을 통합하여 치료계획을 수립할 필요성이 있다고 제언하는 바이다.

Keywords

References

  1. M. V. Radomski, "Occupational therapy for physical dysfunction 6th ed.", pp1-55, Churchill Livingstone, 2010.
  2. J. Cremeens, C. Eiser, and M. Blades, "Characteristics of health-related self-report measures for children aged three to eight years: A review of the literature", Qual Life Learning Disabl, 15(4):739-754, 2006.
  3. J. Kramer, P. Bowyer, J. O'Brien, et al., "How interdisciplinary pediatric practitioners choose assessments", Can J Occup Ther, 76(1), 56-64, 2009. https://doi.org/10.1177/000841740907600114
  4. T. Brown, S. Rodger, A. Brown, et al., "A profile of Canadian pediatric occupational therapy practice", Occp Ther Health Care, 21(4):39-69, 2007. https://doi.org/10.1300/J003v21n04_03
  5. G. Weinstock-Zlotnick and J. Hinojosa, "Bottom-up or top-down evaluation: Is one better than the other?", Am J Occup Ther, 58(5), 594-599, 2004. https://doi.org/10.5014/ajot.58.5.594
  6. S. Rodger, G. T. Brown, and A. Brown, "Profile of paediatric occupational therapy practice in Australia", Aus Occup Ther J, 52(4):311-325, 2005. https://doi.org/10.1111/j.1440-1630.2005.00487.x
  7. C. Kisner, and L. A. Colby, "Therapeutic exercise", pp4-19, DavisPlus, 2008.
  8. S. Y. Park, and E. Y. Yoo, "The use of occupational therapy assessment tool by Korean occupational therapist", J Kor Occup Ther, 10(2):99-108, 2002.
  9. E. Y Yoo, M. Y. Jung, S. Y. Park, et al., "Current trends of occupational therapy assessment tool by Korean occupational therapist", J Kor Occup Ther, 14(3):27-37, 2006.
  10. American Occupational Therapy Association (AOTA), "Occupational therapy practice framework", Am J Occup Ther, 56:609-639, 2002. https://doi.org/10.5014/ajot.56.6.609
  11. M. Law, C. Baum, and W. Dunn, "Measuring occupational performance: Supporting best practice in occupational therapy", pp10-51, Slack, 2001.
  12. J. Fricke and S. Darzins, "Measuring occupational performance: Supporting best practice in occupational therapy", Aus Occup Ther J, 53(3):246, 2006. https://doi.org/10.1111/j.1440-1630.2006.00589.x
  13. H. Marsh, G. Richards, S. Johnson, et al., "Physical self-description questionnaire: phychometric properties and a multitrait-multimethod analysis of relations to existing instruments", J Sport Exer Psycho, 16(3):270-305, 1994. https://doi.org/10.1123/jsep.16.3.270
  14. W. Cools, K. Martelaer, C. Samaey, et al., "Movement skill assessment of typically developing preschool children: A review of seven movement skill assessment tools", J Sport Sci Med, 8:154-168, 2009.
  15. D. Green and B. N. Wilson, "The importance of parent and child opinion in detecting change in movement capabilities", Can J Occup Ther, 75(4): 208-219, 2008.. https://doi.org/10.1177/000841740807500407
  16. N. Dunn, N. Shields, N. Taylor, et al, "A systematic review of the self-concept of children with cerebral palsy and perceptions of parents and teachers", Phys Occup Ther Pediatr, 27(3), 55-71, 2007. https://doi.org/10.1080/J006v27n03_05
  17. C. Missiuna and N. Pollock, "Perceived efficacy and goal setting in young children", Can J Occup Ther, 67(2), 101-109, 2000. https://doi.org/10.1177/000841740006700303

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