목적 : 본 연구의 목적은 국내 인지재활의 가정환경 프로그램 모델을 소개하고 프로그램 적용의 효과를 알아보기 위함이다. 연구방법 : 2005년 6월부터 12월까지 발병 후 6개월 이상 된 뇌졸중 환자로 재활치료 기관에서 정기적인 인지재활치료를 받지 않은 환자 6명을 대상으로 하였다. 가정환경 인지재활 프로그램은 전반적인 행동지침, 체계적 인지훈련 지침서, 고안된 인지활동, 독립적 일상생활활동 참여의 4개 영역으로 구성되어져 있다. 가정환경 프로그램은 가정에서 선별된 가족 구성원과 협력하여 전문치료사 2명이 체계적인 모니터와 면담을 통해 중재하고 통제하였으며 총 12주간 진행되었다. 프로그램 적용 전후 인지기능 수준과 기본적, 수단적 일상생활동작 수행 수준을 평가하고 비교하기 위해 LOTCA와 MBI, S-IADL을 시행하였다.결과 : 비모수 검증인 윌콕슨 부호순위검증을 통해 프로그램 중재 전후 인지기능 수준과 일상생활 수행력 수준을 비교한 결과 인지기능 수준을 반영하는 LOTCA 점수에서 적용 전 보다 적용 후에 유의한 향상을 보였고(p<.05), 수단적 일상생활 수행력을 반영하는 S-IADL에서 의미 있는 점수의 차이를 보였다(p<.05). 그러나 기본적 일상생활 수행력을 반영하는 MBI 점수에서는 유의한 차이를 보이지 않았다.결론 : 본 연구에서 제시한 인지재활의 가정환경 프로그램은 뇌졸중 환자에게 있어서 전반적인 인지기능의 향상과 가정환경 및 지역사회로의 적응도를 높이는데 효과적일 것으로 사료된다.

Objectives: The objectives of this study were to demonstrate daily occupations and their self-perceived quality in persons with disability. Methods: Twenty five participants responded to a questionnaire, The Occupation Schedule (modified from an Activity Configuration Log). The subjects were asked to categorize their daily activities such as sleep, self-maintenance, work, rest, leisure and to rate their self-perceived quality. Results: The subjects had a high rate of unemployment (64%) and 12 subjects did not classify any occupation as work. The same occupation was classified into several different categories. The quality of occupation was rated at the satisfaction, importance, stress, and time adequacy. Conclusions: The results suggest that the subjects’ classification of occupations and their meanings are important sources of information for the science of occupation and the occupational therapy practice. Occupational therapists need to explore the alternative satisfying occupations to replace the category of work.

The purpose of this study was to examine the importance of social role performance in the life satisfaction among spinal cord injuried persons. The study consisted of 81 participants. discharged from the hospital and resided at a private residence, who responded to a mailed questionnaire. The questionnaire contained questions on demographic characteristics: gender. age. marital status, level of education. religious affiliation, empolyment. income, severity of injury, age at onset of injury, time since injury, and duration of hospitalization, life satisfaction index-Z(LSI-Z) and a state of six social roles: working conditions, family relationships, friends relationships, social activities. leisure activities, and religious paticipation. The question on each social role was rated on five-point Likert scale ranging from 1 "very poor" to 5 "very good". The subjects were divided into 1-3/4-5(poor/good performance group) and the subjects who had not performed the social role were classified as poor performance group. The study found over seventy-five percent of participants belonged to the group with poor performance in all six roles. Also, only social activities of social roles was restricted by a severe disability but it was not restricted the others. Income was found to be associated with three social roles: friends relationships, social activities, and leisure activities. In addition, empolyment, income, and duration of hospitaization were found to be associated with life satifaction, however, the severity of injury was not. Subjects in the group with good performance in four social roles: working condition, family relationships. friends relationships, and social activities had significantly higher life satisfaction. Result from a multiple regression analysis indicated that income. role in working condition and family relationships were the significant predictors of life satisfaction. The finding was that the life satisfaction of persons with spinal cord injury appeared to be influenced by income and some aspects of social role performance but not by their disability. The results suggest that we need to encourage to provide financially independent environment and to perform social role designed to yield improvements in life satisfaction for persons with spinal cord injury.