논문 상세보기
pp.85-94
목적 : 본 연구에서는 뇌졸중 환자에게 Cognitive Orientation to daily Occupational Performance (CO-OP) 접근법을 적용하여 작업수행 향상에 효과가 있는지 알아보고자 하였다.
연구방법 : 연구대상은 외래재활치료를 받고 있는 2명이었고, 연구디자인은 ABA 개별 실험 연구설계로 실 시하였다. 기초선 기간(A)은 자료가 안정되는 시기까지 2회기, 중재 기간(B)은 주 2회 60분 동안 8회기, 재기초선 기간(A’)은 중재 후 기초선과 동일하게 2회기 실시하였다. 작업수행 향상을 검증하기 위해 총 세 가지 활동을 선정하였는데, 2개는 CO-OP접근법으로 훈련을 실시하였고, 나머지 1개 활동은 일반화를 알 아보기 위해 훈련하지 않았다. 결과측정 도구는 활동에 대한 수행의 질을 평가하는 Performance Quality Rating Scale (PQRS)과 수행 기술 및 독립성을 평가하는 Assessment of Motor and Process Skills (AMPS)을 사용하였다. 결과 분석은 작업수행의 질은 시각적 분석으로, 수행 기술 및 독립성은 AMPS 9 프로그램을 사용하여 비교하였다.
결과 : 작업수행의 질은 대상자 A와 B 모두에서 CO-OP접근법으로 훈련한 두 과제 모두 기초선에 비해 중재 기간에 향상되었고, 재기초선 기간에도 유지되었으며, 훈련하지 않는 과제도 수행의 질이 유지되는 경향을 보였다. 작업수행 기술의 독립성은 대상자 A는 기초선에 비해 운동기술은 0.35로짓, 처리기술은 0.04로짓 증가되었으며, 대상자 B는 운동기술 0.31로짓, 처리기술 0.55로짓 증가하였다.
결론 : CO-OP접근법은 뇌졸중 환자의 작업수행을 증진시킬 수 있는 중재방법이며, 지역사회에 거주하는 뇌졸중 환자에게 적용하여 긍정적인 결과를 도출할 수 있었다.
Objective : This research was conducted to plan a strategy on the activities for stroke patients who want to improve, and to use the strategy to find out how it influences the occupational performance when applying Cognitive Orientation to a daily Occupational Performance (CO-OP) method approach.
Methods : From September to October of 2014, two local outpatient rehabilitation targets diagnosed as suffering a stroke were selected to execute an ABA single-subject research design. It took two sessions for the data to become stable for use as a baseline (A). It took 10 sessions of 60 minutes per session, twice a week, for intervention. Finally, it took two sessions for the data to become stable for the baseline’ (A’). For the goal task, three activities were selected from COPM. Two activities executed intervention training through the CO-OP method approach. No training was selected as the other activity to determine a generalization, and the baseline, intervention, and baseline' were measured once each. For the outcome measurement, a Performance Quality Rating Scale (PQRS), which evaluates the quality of performance, and an Assessment of Motor and Process Skills (AMPS), which evaluates the independence and performance skill, were used. The quality of the performance was determined through a visual analysis, whereas the occupational performance and independence performance used the AMPS 9 program for an analysis and comparison.
Results : The quality of the occupational performance increased during intervention compared to the baseline for the two tasks through the CO-OP approach method for subject A. Baseline’ (A’) was also maintained without training. For the independence of the occupational performance skill, subject A showed 0.35 logit in exercise skill, and 0.04 logit in handling skill. Subject B showed 0.31 logit in exercise skill, and 0.55 logit in handling skill.
Conclusion : Based on the above outcome, the CO-OP method approach was shown to be an intervention method that can increase the occupational performance of stroke patients. It can also increase the effect on local stroke patients.
