21세기에는 본격적인 노인시대가 열릴 전망으로, 인구학적 변화에 따른 보건복지 국가정책방향에 대한 노인 작업치료의 효율적인 준비가 절대적으로 필요하다. 먼저 고령화 사회로 진입한 일본에서의 작업치료가 국가의 복지서비스방향에 따라서 변화하고 발전해온 것을 참고하기 위하여 우리나라와 일본의 보건의료복지서비스 정책, 작업치료사의 연도별 추이, 취업 현황, 교육 상황을 비교 하여서 노인작업치료의 발전방향과 준비를 위한 기초 자료를 제시하고자 하였다.앞으로 우리나라의 노인보건의료정책이 급속한 고령화에 따른 제반문제에 효율적, 합리적으로 대처해 나가길 바라며, 노인작업치료가 이러한 사회적 변화를 주도해 나가기 위한 더 많은 연구가 진행되기를 바란다.

목적 : 본 연구는 현재 실시하고 있는 작업치료 임상 실습의 문제점을 파악하여 보다 효율적인 임상 실습의 운영방안을 마련하고자 한다. 연구방법 : 본 연구에는 2004년 졸업예정자가 있는 11개의 대학(교) 중 2학기에 임상 실습을 실시하는 2개 대학(교)을 제외한 9개의 대학(교)(4년제 2개 학교, 3년제 7개 학교)의 작업치료(학)과 학생을 대상으로 설문을 실시하였다. 총 250부 발송하여 213부 회수되었다. 조사기간은 2003년 10월 5일부터 11월 31까지였다. 분석은 회수된 설문 213부 중 202부를 가지고 카이제곱검정을 사용하였다.결과 : 실습기관의 적합성을 포함한 실습환경에 관한 내용에서 응답자의 89.6% 만족하는 것으로 나타났다. 실습생을 위한 프로그램의 정비와 지도 체계, 실습생 이용 시설과 설비에 대해 응답자의 20 ∼30% 정도가 불만족한 것으로 나타났다. 실습에 대한 만족도를 측정하는 항목에서 80.3%가 긍정적으로 응답하였다. 응답자의 85%가 임상 실습을 통해 전문적인 지식을 획득하였으나 51%는 임상 실습 중에 갈등을 느낀 적이 있다고 하였다.결론 : 본 연구 결과를 통해 작업 치료학생들의 임상 실습이 좀더 체계화된 구조로 이루어져야 야 필요성을 제시하고 있다. 작업 치료는 임상학문이므로 임상 실습 교육이 차지하는 비중이 높기 때문에 향후 임상 실습에 대한 다각적인 연구가 이루어져야 할 것이다.

The driving capacity screening test for the people with physical disabilities has been heavily criticized due to the following reasons. First, the passing scores have been set based on phys-ical power that is much higher than the power actually required for driving. Second, there is a lack of scientific data for the criteria of the passing scores. Third, it does not test persons who might have cognitive and visuo-perceptual deficits which affect safe driving greatly. The current traffic and transportation law warrants that the people with bilateral upper extremity disabilities are allowed to apply for a driver’s license examination if he/she can drive an individually modi-fied vehicle safely. It means that the focus of the driver licensing system for the people with physical disabilities has to be shifted from restricting the driving rights to enabling the potential drivers. In order to protect the individual’s rights and public safety, the driver rehabilitation spe-cialist system which emphasizes comprehensive evaluation and training for the people with physical disabilities has to be introduced. This article presents the critical roles the occupational therapists may play as driver rehabilitation specialists and generalists in the rehabilitation of drivers with physical disabilities.

Objective : The purpose of this study was to investigate attitudes of Korean occupational therapists toward introducing an accreditation system of occupational therapy education programs. Method : The self-administering written questionnaire was employed for this survey research. The questionnaire was developed and reviewed by the Accreditation Board for the Education of Korean Occupational Therapists and was composed of 18 items which included both closed-ended and open-ended questions. The questionnaire was distributed to Korean occu-pational therapists who attended at the 10th annual conference of Korean Association of Occupational Therapists in October 2002.Results : Among 106 respondents, 80.2% expressed their concern about the sudden increase of new occupational therapy education programs and they believed that the curricula of new in-stitutions and the quality of the institutes’ graduates would be different. On the question of ne-cessity of introducing the accreditation system of occupational therapy education programs, 89.7% responded that it was necessary. All respondents agreed that clinical fieldwork experience was necessary and the preferred length was 16, 24, and 12 weeks in order. The areas to be in-cluded in the accreditation were the number of qualified professors, fieldwork hours, and the contents of curricula in order. 77.4% of the sample responded that they would trust the result and process of the accreditation. Conclusion : Based on the result of the survey, it could be inferred that the majority of oc-cupational therapists were concerned about improving quality of the profession rather than its quantitative expansion. Therefore, it is expected that the accreditation system of occupational therapy education programs would ensure the qualitative growth of occupational therapy pro-fession in Korea.

Objective : This study was conducted as a policy task on the distribution of occupational therapy in community health centers.Method : A questionnaire was sent to 242 community health centers nationwide and (a total of) 135 questionnaires was returned between November 15, 2002 to December 20, 2002. We used frequency analysis and cross analysis for the questionnaires, generated by SPSS for Windows 10.0 version. a statistic analysis program.Results : 1) They do not promote rehabilitation programs for the disabled person significantly in community health centers. 2) Little has been carried out for occupational therapy in the com-munity health centers. The absence of occupational therapist attributes to the lack of knowledge on occupational therapy by outpatients, the lower demand, the lack of budget for hiring occupa-tional therapist, and the lack of understanding on the role of occupational therapist. It also shows that the occupational therapy is currently performed comprehensively by other department. 3) The need for occupational therapists in the community health center was more than one person. Conclusion : The results of this study suggest that appropriate occupational therapy program in the community health center includes the occupational therapy for the disabled person living at home, the occupational therapy for the disabled person in the rehabilitation program in the community health center, and the education on occupational therapy for the disabled person and their families.

Objective : To compare the value of basic activities of daily living between occupational therapists and patients with stroke. Methods : A questionnaire survey was conducted to investigate the relative importance of basic ADL (Activities of Daily Living) with a total of thirty-four item cards. The survey was completed by 36 occupational therapists that have clinical experience of more than three years in a hospital or rehabilitation settings and by 38 inpatients/outpatients with stroke. The relative importance of each activity of daily living was measured by the Q sorting technique. A Mann-Whitney U test was used to test the statistical significance of the mean difference in the Q score between the occupational therapists and the patients with stroke. Results : Among the 34 items, 11 items (‘obtaining and using supplies’, ‘selecting clothing’ etc.) selected by inpatients, showed that the Q score was significantly higher in its importance than that of occupational therapists. The survey showed that ‘caring for nails’ was more im-portant to outpatients than it was to occupational therapists. Several items (18 items for in-patients, 3 items for outpatients) of the total 34 items were statistically significantly different on the value of the basic ADL between occupational therapists and patients with stroke. Conclusion : The relative value of each activity of daily living could serve as a guide for sequencing learning steps during the ADL training in a hostpital or rehabilitation setting.

Objective : The purpose of this study is to introduce Problem-Based Learning (PBL) to practicing occupational therapists and educators of occupational therapy. PBL is the educational method that has been applied to not only a number of universities abroad but also many domestic universities, especially medical colleges. Method : This study presents the definition and features of PBL, explores the current trends of its application and research, and investigate the example of PBL application to one of the programs in domestic universities. Result : PBL has been applied to the 2002 class of the program of occupational therapy for one year. Then the students of the program were asked to answer a questionnaire that surveyed the improvement of presentation, debate, and problem solving skills. Approximately 70% of the students responded affirmatively. Conclusion : In conclusion, the implication of this study is that when it is necessary to enhance the quality of educational service in the occupational therapy field, this study shows that the possible alternatives include PBL.

Since the commencement of the government health insurance program in 1977, there has been criticism that the national insurance fee for health care service had been set too low by the Korean government. The existing insurance fee schedule for occupational therapy service was developed first in 1980 in Korea. But they are not reflecting the current health care environment. Even though the fee schedule has been revised almost every year, the fee has been estimated too low to warrant a quality service. To make the situation worse, Health Insurance Review Agency has recently proposed to substantially cut down the fee for occupational therapy service. Many medical institutions opening occupational therapy clinics are avoiding investment in this “financial deficit” department. This is threatening the survival of the occupational therapy profession that is essential for rehabilitation process. The objective of this study is to review and analyze the current Korean health insurance fee schedule and its changing process in occupational therapy service and suggest the better solutions. The researcher suggests that the health insurance fee schedule must cover computer-based occupational therapy, a Pediatric occupational therapy and evaluation, and treatment for the use of equipment such as Baltimore Therapeutic Equipment. Also, the government must increase the fee for occupational therapy service at least up to the level of consumer price index.

Objective : This paper presents an empirical study on the bias toward the disabled by the students studying occupational therapy, who will make an expert group to take care of them in the future. It was investigated how much sense of distance the students had according to the physical characteristics of the disabled. Method : Total 128 students majoring in occupational therapy were asked to fill out a self-administered questionnaire. The physical characteristics of the disabled and the sense of distance toward the disabled were measured as follows: The visible physical characteristics of the disabled were restricted to the disorders of external physical functions based on the Article 29 ‘Classification of the Disabled’ of the Disabled Welfare Act. The functional characteristics of the disabled were measured by using the FIM (Functional Independence Measure) method. Meanwhile, Westie (1952)’s inventory of the sense of distance was adopted for the inventory for the sense of distance toward the disabled in the study. Results : The subjects showed the biggest sense of distance toward the disabled in the order of the disabled with encephalopathy, physical handicap, language disorder, visual disturbances and acoustic disturbances. As for the functional characteristics, the sense of distance was the greatest in the order of the completely dependent disabled, partially dependent disabled, and completely independent disabled. The average sense of the distance was compared in terms of the subjects’ school and year, and the results revealed there were statistically significant differences in all the areas except for the sense of distance toward the completely dependent disabled. Conclusions : The sample needs to be expanded in number, and random sampling is required to secure diverse social and cultural backgrounds. In addition, the causality verification should be done in order to understand the nature of sense of distance in a study on it according to the physical characteristics of the disabled. Finally, an evaluation tool needs to be developed that can be used to measure the sense of distance toward the disabled.

Though it has passed over 50 years since occupational therapy was introduced into Korea, the Korean occupational therapy is still in the beginning stage. This researcher investigated the reality of educating students and the problems in the field of occupational therapy. The quality of manpower is determined by how we can secure specialties in the process of educating students, and it is highly related with the standards of service. Therefore, the efforts to acknowledge the present situation of supply and demand for educating occupational therapy students should be made cautiously. To assure the quality of occupational therapists and make the better circumstances for them and predict the promising future in the field of occupational therapy, the basic regulations and minimum standards for educational institutions and practice institutions must be established immediately.

The purposes of establishing accreditation standards for the occupational therapy program are to assure the quality of the program and to assist in the development of the program. Accreditation serves the public as accredited programs modify their requirements to reflect changes in knowledge and practice generally accepted in the field. To students, accreditation provides an assurance that the educational activities of an accredited program have been found to be satisfactory, and therefore meet the needs of students. Also it assists in the transfer of credits between institutions, or in the admission of students to advanced degrees through the general acceptance of credits among accredited institutions when the performance of the students has been satisfactory and the credits to be transferred are appropriate to the receiving institution. The occupational therapy programs benefit from accreditation through the stimulus provided for self-evaluation and self-directed program improvement and strengthening of program self-evaluation by the review and counsel provided through the accrediting agency. At the same time, this process enhances the reputation of an accredited program because of public regard for accreditation. Lastly, the profession of occupational therapy can be strengthened by contributing to the unity of the professions in an activity directed at improving professional preparation and professional practice.

The first national occupational therapy licensing examination was administered by the National Institute of Health in 1965. In 1998, National Health Personnel Licensing Examination Board assumed responsibilities for the development, administration, and implementation of the licensing process based on current and valid standards for occupational therapy practice. The purpose of awarding license is to identify for the public those persons who have demonstrated both the knowledge and the skills necessary to provide occupational therapy service. As an effort to develop, maintain, and defend the content validity of practice-based occupational therapy licensing examination, National Health Personnel Licensing Examination Board sponsored and authorized the occupational therapy practice analysis study in 2000. Based on the occupational therapy practice analysis study, Minimum Standards for the Education of Occupational Therapists By World Federation of Occupational Therapists, and The National Occupational Therapy Practice Analysis in the USA, this article points out several problems concerning the existing national occupational therapy licensing examination and suggests the alternatives that reflect current professional practice.

Nowadays, there are many issues in introducing accreditation of occupational therapy education in Korea. Accreditation is a system for recognizing educational institutions and professional programs affiliated to those institutions on a level of performance, integrity, and quality which entitles them to the confidence of the educational community and the public they serve. I believe accreditation system in the United States is well-established through nongovernmental, voluntary institutional or professional association. On the basis of analyzing accreditation system of the United States, this study introduces the arrangement for establishing of accreditation policy in Korea.

Objective: To examine the effects of occupational therapy intervention on hand function after botulinum toxin injection in a patient with dystonia. Method: The subject was a 41 year old female and the study was carried out from February 25th to May 24th in 2002. The Jebsen Hand Function Test and Nine Hole Peg Test were used for assessment, and also hand and finger powers were assessed by grip strength, lateral pinch strength and three jaw chuck pinch strength. The scores were obtained during occupational therapy sessions at 4 weeks and 12 weeks after the injection. Modified Ashworth Scale was employed to grade spasticity before the injection, at 4 weeks, and 12 weeks after the injection. Results: Among the subtests of Jebsen Hand Function Test, the speed increased in the writing (15.4%), turning cards (64.4%), simulated feeding (92.0%), moving empty large cans (30.0%) and moving weighted large cans (41.6%), however, the speed of other subtests which were checkers(-26.8) and picking up small objects (0.0%) did not increase. The performance on Nine Hole Peg Test did not change (0.0%). Hand power of grip strength increased by 275%. Finger power increased in lateral pinch strength (40.0%) and three jaw chuck pinch strength(150.0%). Based on Modified Ashworth Scale, spasticity decreased from grade 4 before the injection to grade 1 at 4 weeks and 12 weeks after the injection in wrist and fingers. Conclusion: Occupational therapy intervention after botulinum toxin injection can improve the hand function in a patient with dystonia.

Objectives: The purpose of this survey research was to Investigate how well the national occupational therapy certification examination was reflecting the current occupational therapy practice. Method: The researchers developed a survey with input from 159 occupational therapists out of 230. The content of the survey consisted of four areas which were demographic information, the relationship between the current national occupational therapy certification examination, the tasks that occupational therapists perform in the clinical settings, and the knowledge bases that occupational therapists need to know to perform the tasks. Results: The findings can be summarized as follows; 1) All the current examination subjects except for ADLs (activities of daily living) had low relationship with clinical occupational therapy practice; 2) 84% of the respondents agreed on that the current examination needed to be revised based on the tasks that occupational therapists actually do in the clinical settings; 3) the new subjects proposed for the national occupational therapy certification examination showed high relationship with the clinical occupational therapy practice; 4) the new subjects were composed of occupational therapy evaluation, treatment plan, intervention, re-evaluation, management, and professionalism. Conclusions: The findings are expected to be useful for revising the content of the current national occupational therapy certification examination and developing occupational therapy curriculum of the new educational programs.

Objective: The purpose of this study was to research the current state of occupational assessment tools and their use by Korean occupational therapist. Method: Data was obtained from October 13, 2001 to December 30, 2001 by means of a survey questionnaire. The participants were 96 occupational therapists (general hospitals, university-related hospitals, rehabilitation center, etc.). Analysis of the data was done by using descriptive statistics. Results: The length of time for initial evaluation was 42 minutes per one patient and reevaluation periods were every 3 months or as functional changes were detected. Among the assessment tools, the most frequently used tools w ere: Purdue Pegboard Test (47.9%) for assessing motor area, Motor-free Visual Perception Test (56.3%) and Mini-Mental Status Examination (54.2%) for cognitive perceptual assessments, Functional Independence Measure (56.3%) for daily activity assessment, Denver Developmental Screening Test (51%) for development assessment, Sensory Profile (14.6%) for sensory integration assessment, and Canadian Occupational Performance Measure (16.7%) for occupational performance assessment. Conclusion: The results of this study supported that the choice of evaluation tools may be depended on the administration length of time and simple procedures. Based on the results, provisions of more extended educational opportunities would promote the use of a greater variety of standardized assessment tools by Korean occupational therapists.

The model of human occupation is an outgrowth of the occupational behavior tradition which emphasizes the original philosophical premises of the occupational therapy profession. The model employs general systems theory to explain the human system and its interaction with the environment. The model conceptualizes the human as an open system that consists of three subsystems: volition, habituation, and mind-brain-body performance. The subsystems are hierachically ordered from the highest to lowest and each subsystem has its own structure and function. The highest subsystem is referred to as volition which is responsible for freely and consciously choosing occupational behavior. The middle subsystem is habituation which organizes occupational behavior into patterns or routines. The lowest subsystem is mind-brain-body performance which makes possible the skilled achievement of occupations. The human is also understood as a dynamical system performing in an environment composed of objects, tasks, social groups, and culture. Although the language of the model may be unfamiliar at first the basic theoretical principles of the model share the common concept with those of the oriental philosophy. The model is recognized as a holistic and comprehensive model which is one of the first to develop a strong focus on occupation in the occupational therapy profession.

The purpose of this study was to establish marketing strategy and efficiency management of the department of occupational therapy in the University and College. The subject population included 890 students from six college and five university in National area. Data were collected through a survey questionnaire in a period from April 5 to May 5, 2001. The results are as follows: 1. It appeared that regarding criteria for selection of college by among students’ in the University and College, two type of college (University and College) were motivation of job obtain. 2. It appeared that regarding satisfaction of college life, University students are more satisfied than college students. Also it appeared that regarding satisfaction of department’s operation and environment of educations, University students are more satisfied than college students. 3. The opinion of development in the college setting efforts to develop of field-based learning curriculum. Also, in the university setting to obtain of able professor.

It is expected that the demands of medical services in terms of health medical and social welfare will be increased rapidly due to the development of old-aged society and medical technologies. Accordingly the roles and tasks of the occupational therapist become more important, and the demands for the occupational therapist will be also increased. Therefore more systematic and effective manpower management on the occupational therapists is required. When the occupational therapists are classified by their job sites - clinic, health, and other, this study shows that the proportion of occupational therapist in clinic is the biggest. It is also expected that the proportion will be kept in the future. On this point of view, the demand and supply for the occupational therapists in clinics are discussed in this study. The number of occupational therapists demanded are usually depended upon the factors such as health care needs from public, system of medical fee payment and medical insurance, medical policy, share and coordination system of the role of medical service suppliers, and usage of medical facilities by public. This study shows that even the occupational therapists including the students in college in 2000 itself are over-estimated and over-supplied already under the current system of legislation, even though the estimation on manpower needed in this field shows lack of. In this point of view, this study proposes the measures against the problems expected as follow. 1. Legislative specification In spite of the varieties of the occupational therapy, only 4 categories of therapy -simple therapy, complex therapy, special therapy, activities of daily living adjustment training method - are specified in the insurance category of the law. Moreover, the law stipulates that special therapy and ADL adjustment training method shall be prescribed by the rehabilitation medicine. Thus the occupational therapy could not be requested from neurosurgery and orthopedic surgery at all. Nevertheless, it is strongly requested that patients from pediatrics, psychiatric, geriatrics, neurology, orthopedics as well as rehabilitation medicine shall be regarded as the subjects of the special therapy in the law. 2. Certification of psychiatric health care supplier According to the clause 7 of the psychiatric health law, only 3 groups of psychiatric health specialists including clinical psychologist, nurse, and social welfare specialist can supply a psychiatric health care. Anyhow the job descriptions on the clause 2 of the PH law implementation regulation such as ADL adjustment training, occupational and recreational therapy, etc should be classified as the job of occupational therapist. The psychiatric health care courses including the practices are established for the curriculum of the department of occupational therapy in college. And considering that the development of independent ADL ability for the patients is one of the most critical areas of the occupation therapy discipline, the occupational therapist shall supply the psychiatric health care services, 3. Short of facilities and the alternatives The number of occupational therapy clinics in Korea, 98, is not sufficient. Moreover many of the clinics are at big hospitals in big cities, and only 32 clinics are in regional areas. It is required to inform the government agencies and public opinion leaders that occupational therapy clinics shall not be limited to the big hospitals, rather than health offices managed by government should accept the clinics at first. The ultimate purpose of health services, promoting personal health status and help him to return to the society, is likely accorded with that of occupational therapy. Therefore it is requested that the occupational therapy clinics shall be opened in psychiatric resorts, health offices, special institute for disabled, rehabilitation institutes, and the facilities for old aged persons as well as in hospitals.

Since occupational therapy was introduced into Korea, over fifty years have passed. But the Korean Occupational Therapy. is still below the level. Therefore I surveyed the present condition and problems of occupational therapy in Korea, and planned its alternatives. The conclusions are as follows: 1. The absolute number of occupational therapist is not enough. So, the department of Occupational Therapy should be urgently established in university or college. 2. The medical insurance premium of Occupational Therapy is very low. So, it should be highly raised, and the item of that should be made various and detailed. 3. People do not understand and concern about Occupational Therapy So. we should give wider publicity about Occupational Therapy to people. 4. Occupational Therapist should improve themselves for the higher quality of treatment.