목적 : 치매노인 증상과 보호자의 부담감에 따른 방문작업치료 프로그램의 요구도를 파악하여 이를 토대로 방문작업치료 프로그램을 개발하는 데 필요한 기초 자료를 제시하고자 한다. 연구방법 : 2010년 4월 5일부터 5월 15일까지 서울에 위치한 치매지원센터 5곳을 방문하여 외래 치료를 받고 있는 치매노인의 주 보호자 120명을 대상으로 설문조사를 하였다. 그 중 89부를 대상으로 SPSS 17.0을 이용하여 서술통계, t 검증, 분산분석, 상관분석을 하였다. 결과 : 치매노인의 중증도에 따라서는 환경수정, 여가활동 요구도가 통계적으로 유의하게 높았으며, 문제행동에 따라서는 여가활동, 보호자교육 요구도가 통계적으로 유의하게 높았다(p<.01). 치매노인의 인지수준에 따라서는 환경수정, 일상생활 요구도가 통계적으로 유의하게 높았으며, 보호자 부담감에 따라서는 일상생활, 문제행동 요구도가 통계적으로 유의하게 높았다(p<.01). 결론 : 치매노인의 특성과 보호자의 부담정도에 따라서 방문작업치료 요구도에 차이가 있었다. 치매노인의 중증도가 중등도 일 때, 인지수준은 목적지향적 학습단계(4.0~4.8) 일 때, 문제행동이 심할수록 요구도가 높았으며, 보호자 부담감은 중등도일 때 프로그램에 대한 요구도가 높았다. 따라서 이러한 내용을 고려한 방문작업치료 프로그램 개발을 위한 연구가 지속되어야 한다.

Stroke is a serious disease despite recent improvement in medical and surgical treatment. Hence, identification of modifiable risk factors for stroke is important. This case-control study was done to demonstrate that relationship between smoking, alcohol consumption, obesity, perception of saltness and the incidence of stroke and to identify that smoking, alcohol consumption, obesity and perception of saltness, after adjusting for age, hypertension. A structured interview was carried out from April 15, 1996 to May 3, 1996 in Yonsei Medical Center. The study group consisted of 59 neurologically confirmed stroke patients as the study group and 59 non-stroke patients as controls. Analysis of the data was done by means of -test and logistic regression analysis. The results were as follows. In the study group: 1) Hypertension in males had a 10.2 odds ratio (p<0.05), cardiovascular disease in females had a 11.3 odds ratio (p<0.05) and a farnily history of stroke in males had a 3.1 odds ratio (p<0.05). 2) Females smoking one or more cigarettes had a 8.3 odds ratio (p<0.1), but males had no direct relationship with odds ratio of 1.5 (non-significant). 3) Alcohol consumption in males had a 0.4 odds ratio, and in females had a 0.8 odds ratio. The odds ratio was decreased in alcohol consumption group (non-significant). 4) Males with more than 20 cigarettes pack-years history had a 2.5 odds ratio (p<0.05), more than 25 Body Mass Index had a 3.1 odds ratio (p<0.05) and more than 220 ml ethanol weekly consumption had a 1.5 odds ratio (non-significant). 5) Female smokers had a 8.3 odds ratio (p<0.1), drinkers a 0.8 odds ratio and more than 25 Body Mass Iidex, a 43.1 odds ratio (p<0.05). 6) Females without saltness perception from a 0.5% salt solution had a 6.8 odds ratio (non-significant). 7) By logistic regression analysis independent risk factors for stroke in males were found to be hypertention, age, and obesity. The study was limited because number of subjects was too small for practical implications. However, like as other results, this study suggest that people should be advised to control hypertension, and obesity since these carry a risk of stroke.

The purpose of this study was to evaluate the cognitive perceptual performance in relation to activities of daily living in stroke patients who were treated at department of rehabilitation medicine of the Samsung Medical Center from December 5. 1996 to April 10, 1997. The cognitive perceptual performance was measured by the Lowenstein Occupational Therapy Cognitive Assessment (LOTCA) and by the Modified Barthel Index (MBI) to evaluate activities of daily living(ADL). Sixty-seven stroke patients were the subjects in this study. Collected data analysis were completed by using t-test. ANOVA, correlation analysis, and multiple regression analysis. The following were as follow: 1. Among the subtest of the LOTCA, orientation to time, plain block design, reproduction of puzzle showed significant difference depending on patient's affected side. Orientation to time score was higher with left hemiplegic patients. Plain block design and reproduction puzzle score were higher with right hemiplegic patients. 2. Among the subtests of the MBI, dressing, ambulation, and self-care were significantly correlated with the subtests of the LOTCA in order of thinking operation, visuomotor organization, perception and orientation. 3. The result of the cognitive perceptual function affecting the MBI performance using multiple regression analysis, thinking operation was the most influential factor. The cognitive perceptual perfomance have significant correlation with activities of daily living skills. Also, it is an important factor to functional recovery after stroke. Therefore, accurate evaluation of cognitive perceptual performance after stroke with treatment of each patient's appropriate level should be done simultaneously with rehabilitation treatment to improve patient's activities of daily living skills.