경도인지장애 환자의 수단적 일상생활활동의 학습을 위해 Cognitive Orientation to daily Occupational Performance( CO-OP)접근법을 적용해보고 그 효과성을 검증하고자 한다. 연구대상자는 경도인지장애로 진단받은 69세 남자를 대상으로 AB 개별 실험 연구설계를 사용하였다. 캐나다 작업수행평가(Canadian Occupational Performance Measure; COPM)를 통해 선정된 문자 보내기, 일정 알람 맞추기, 장기 두기의 3가지 활동을 CO-OP접근법으로 훈련하였다. 매 회기 Performance Quality Rating Scale (PQRS)와 Pittsburgh Rehabilitation Participation Scale (PRPS)로 수행의 질적 수준과 참여도를 측정하였고, Assessment of Motor and Process Skills (AMPS)로 작업수행 능력과 독립성을 중재 전· 후 측정하여 시각적 분석방법으로 분석하였다. 세가지 활동에서 모두 PQRS로 측정한 수행의 질적 수준이 기초선(A) 평균 3.70점에서 중재기간(B) 평균 5.70점으로 증가되었고, 활동의 참여수준도 기초선(A) 평균 1.00점에서 중재기간(B) 평균 3.20점으로 향상되는 결과를 보였다. AMPS는 중재 전 운동기술은 2.38, 처리기술은 1.45이었고, 중재 후에 운동기술은 2.45, 처리기술은 1.77이었으며, 운동기술은 0.07, 처리기술은 0.32 향상되었다. 경도인지장애 환자에서 일상생활에서의 활동과 참여에 영향을 미치는 과제의 학습에 CO-OP접근법이 긍정적인 영향을 주어 CO-OP접근법이 경도인지장애 환자 의 활동에 대한 중재방법으로 적용 가능성을 제안하는 바이다.
For the learning of activity of daily living for mild cognitive impairment patients, Cognitive Orientation to daily Occupational Performance (CO-OP) approach will be applied to prove the effectiveness.
The research target was 69-years old man who was diagnosed with mild cognitive impairment. To verify the effect of CO-OP approach, AB single experimental research design was used to train CO-OP approach of three activities that included sending a message, setting alarm, and playing chess. Every cycle, the degree of participation and qualitative level of Performance Quality Rating Scale (PQRS) and Pittsburgh Rehabilitation Participation Scale (PRPS) were measured. To evaluate independence and occupational performance skill, before and after intervention were measured as Assessment of Motor and Process Skills (AMPS). They were analyzed with visual array.
In all three activities, the qualitative level of the measured performance increased from an average of 3.70 points to 5.70 points, and the participation of activity increased from an average of 1.00 point to 3.20 points. The motor skill before intervention was 2.38, process skill 1.45, and the motor skill after intervention was 2.45, process skill 1.77, where motor skill increased by 0.07 and process skill by 0.32.
It was identified that CO-OP approach gives positive influence in the task that influences the participation and activity of daily living in mild cognitive impairment patients.