목적: 물리 치료사의 업무 중 근골격계 장애를 유발하는 환경 적 요인 및 자세 요인에 대한 실태 조사 및 결과를 분석하고 산업안전공단 근골격계 질환 예방 메뉴얼에 따른 개선 방안을 제시하고 그 결과를 알아보기 위해 실시하였다.
방법: 본 연구에서는 신경계 치료 분야 종사자 30 명, 근골격 치료 분야 종사자 30명, 총 60명을 대상으로 하였다. 측정 방법은 물리 치료사의 치료 영상을 30 분 동안 촬영했다. 작업 자세는 2분 간격으로 15번 절단하여 분석하였다. 평가 도구는 OWAS 및 REBA를 사용한 자세 분석을 사용하였다. 근골격계 및 신경계 대상자들은 문제점을 파악하고 그에 맞는 산업안전공단 근골격계 질환 예방 매뉴얼을 통해 2주간 중재 후 변화를 측정하였다.
결과: 신체 부위 별 유병률과 특징적 분포는 신경계와 근골격계에서 허리 통증의 비율이 가장 높았다. OWAS 기준에 따른 작업 자세 분포는 신경계 분야에서 신체, 다리, 체중, 활동에서 유의한 감소를 보였으며(p <0.05), 근골격계 분야에서 다리와 활동에서 유의한 감소를 보였다(p <0.05). REBA 평가 기준에 따른 근무 태도 분포는 모두 유의한 감소를 보였다(p <0.05).
결론: 본 연구에서는 작업 관련 근골격계 증상 예방을 위한 부적절한 작업 자세 예방 교육의 중요한 기초 자료로 활용될 수 있다. 근골격계 예방 교육을 마련하고 질병을 줄이기위한 환경 적 요인과 자세 요인을 바꾸는 것이 가능할 것으로 보인다.
Background: Pregnancy-related low back pain (PLBP) has fewer systematic guidelines than pregnancy-related pelvic girdle pain, previous studies have not evaluated physical therapy for this ailment in Korea.
Objects: We aimed to provide a detailed account of clinical decision making by Korean physiotherapists while treating PLBP.
Methods: In total, 955 questionnaires were distributed mainly in places of continuing education held by the Korean Physical Therapy Association from April to July 2019. The same questionnaire was posted on a website used by physiotherapists. We collected subject information, a specific Vignette typically represent symptoms of PLBP, and responses to multiple questions about decision making, subjective recognition and interest level in the field of women’s health physiotherapy (WHPT).
Results: The overall response rate was 56% (n = 537); of these, responses to 520 questionnaires were analyzed. Most respondents chose various combinations of physical therapy methods. There were significant differences in subjective recognition levels of WHPT according to gender (p < 0.05), age (p < 0.01), education level (p < 0.01), and clinical experience (p < 0.05). There were significant differences in interest according to gender (p < 0.01) and education level (p < 0.01). With respect to the types of treatment, significant differences were noted in selective rates for “manual therapy”, “pain control”, and “supportive devices” based on gender. Manual therapy tended to be chosen more with increasing age and clinical experience. With increased education level, there were fewer choices for the use of pain control.
Conclusion: This is the first data on how Korean physiotherapists manage PLBP patients using the vignette method. We were able to recognize the Korean physical therapist's decision on PLBP patients, and observed statistically significant correlations. This may aid in developing future research and education plans in the WHPT field.
목적 : 정부는 2013년부터 ‘보호자 없는 병동’으로 지칭되는 포괄간호서비스 제도를 시범적으로 실시하고 있으며 이것을 2018년까지 모든 병원으로 확대할 계획이다. 이 제도는 입원환자에 대해 가족 구성원이 간병을 해야 한다거나 혹은 사설간병인을 고용해야 한다는 사회ㆍ경제적 부담을 줄이기 위함이 목적이 다. 하지만 보호자가 상주하지 않는다는 측면에서 환자의 낙상과 같은 안전사고에 대한 우려가 제기되고 있다. 따라서 본 연구에서는 이러한 우려를 해결하기 위한 대안을 조사해보고자 한다.
연구방법 : 이미 선진국에서는 오래전부터 포괄간호서비스 제도를 시행하고 있고 낙상예방을 위하여 병원 안내지침(guideline)을 제작하여 활용하고 있다. 이러한 낙상예방 안내지침이 우리나라에 적용 가능한지 를 알아보기 위해 미국, 영국 그리고 호주의 병원 내 낙상예방 안내지침을 분석하였다.
결과 : 미국, 영국 그리고 호주의 병원 낙상예방 안내지침에 의하면 병원 내 환자의 안전한 생활을 위하여 다학제간 보건 인력팀을 구성하여 역할을 분담하고 있다. 각 전문 인력들은 낙상의 요인들을 분야별로 접근하여 중재를 제공한다. 특히 물리치료사와 작업치료사는 노인 환자의 병원 입원에 있어서 낙상을 예 방하고, 안전한 생활을 하는데 있어 매우 중요한 역할을 하고 있다.
결론 : 정부는 포괄간호서비스의 확대와 더불어 환자의 안전한 병원생활을 위해서 물리치료사와 작업치료사 가 포함된 낙상예방을 위한 안내지침을 연구 및 개발해야 할 것이다.
Background: The International Classification of Functioning, Disability, and Health-core set (ICF-core set) for children and youth (CY) with cerebral palsy (CP) provides a useful conceptual framework and a guide for health care planning and measuring the changes brought by interventions across a multitude of dimensions from body functions to personal activities, social participation, and environmental factors for them. Objects: This single case study was reported to illustrate the use of a goal directed approach in applying the ICF-core set for CY with CP from a physical therapist perspective. Methods: An eleven year old boy with spastic CP, Gross Motor Function Classification System (GMFCS) level V, and his mother participated in an evaluation of his functioning state. The intervention goal was set through an interview using the ICF-core set, Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS). Physical therapy was carried out on an outpatient basis using a goal directed approach for 30 min, 1 time/week during 12 weeks and the boy’s gross motor function was assessed using the Gross Motor Function Measure (GMFM)-66 version (item set 2) before and after the intervention. Results: As measured by the boy’s mother, the COPM score showed a meaningful clinical change (performance=mean 3.5, satisfaction=mean 2.5) and the T-score of GAS changed 34.4 after the goal directed approach. The GMFM-66 (item set 2) score changed from 31.8 to 38.7 and evaluation using the ICF-core set displayed improvement in 6 items of activity level between before and after the intervention. Conclusion: The ICF-core set for CY with CP is useful for understanding the overall functioning of CY with this condition and provides an opportunity to share and integrate information and opinions from different disciplines. We consider it as a useful tool in the universal language for the therapy and education of CY with CP.
Importance of the work-related musculoskeletal disorders (WMSDs) has been increasing in the hospital industry such as health care industry and financial industry. This study investigated in order to identify the factors like general, occupational and ergonomically characteristics of the subjects related to musculoskeletal disorders (MSDs) of physical therapists (PTs). Ergonomic tools of rapid upper limb assessment (RULA) were used for evaluation workload of the tasks. Prevalence of MSDs were 13 PTs (26.0%) for neck, 31 PTs (62.0%) for shoulder, 9 PTs (18.0%) for arm/elbow, 27 PTs (54.0%) for hand/wrist, 28 PTs (56.0%) for back, 14 PTs (28.0%) for leg/foot. The analysis of the rate of the pain intensity showed that 53.5% subjects experience moderate pain and 14.0% subjects experience severe pain. Factors which were general characteristics, for example, height, ergonomically characteristics such as 'Posture Score A' were related musculoskeletal subjective symptoms in logistic analysis (p<.05). Among physical therapists, action level of RULA were action level 2 (6.0%), action level 3 (52.0%), action level 4 (42.0%). Physical therapists were estimated one of the highest risk factor in this study. This study suggested that the need of preventive education and program for PTs (physical therapists). Comprehensive and systematic management plans should be established to include both ergonomic and sociopsychological aspects.
목적 : 본 연구는 작업·물리치료사들의 근골격계질환 유해인자를 확인하고 이에 따른 근골격계질환 예방프로그램의 적용이 통증 및 직무스트레스에 미치는 효과에 대해 알아보고자 하였다.연구방법 : 2010년 5월부터 동년 7월까지 경남 창원에 위치하는 C병원에 근무하는 21명의 작업·물리치료사들을 대상으로 근골격계질환 유해인자를 Quick Exposure Checklist(QEC)를 통해 확인한 후, 이에 따른 근골격계질환 예방프로그램을 8주간 적용하였다. 대상자들의 중재 전·후의 통증과 스트레스 변화를 측정하기 위해 시각적 상사척도(Visual Analogue Scale; VAS)와 한국인 직무스트레스 측정도구를 각각 사용하였다.결과 : QEC를 통해 작업·물리치료사들의 업무환경은 개선이 필요한 수준임을 알 수 있었고, 중재를 적용 후 중재 전에 비해 VAS와 한국인 직무스트레스 측정도구의 결과가 유의하게 감소함을 알 수 있었다(p<.05). 또한 VAS와 한국인 직무스트레스 측정도구의 상관관계 분석을 통해 통증변화와 직무스트레스변화 간에 양의 상관관계가 있음을 확인하였다(p<.05). 결론 : 본 연구는 작업·물리치료사의 업무환경 분석을 통한 근골격계질환 예방프로그램을 적용함으로써 근골격계질환 예방활동이 작업·물리치료사의 통증 및 직무스트레스 감소에 긍정적인 효과가 있음을 제시하였다.
This study purposed to analyze difference in the perception of service quality between physical therapy patients and physical therapists and to provide basic materials for maintaining high service quality that meets patients' expectation in each service area. For this study, we conducted a questionnaire survey with physical therapy patients and physical therapists in Jeju from the 6 to 30 of January, 2010. In the survey, we received 133 questionnaires from patients and 125 from physical therapists, and used them in analysis. The instrument used in this study to measure service quality was prepared by the researcher through adapting and supplementing the SERVQUAL model developed by Parasuraman et al (1991). For our physical therapy environment, and it consisted of a total of 23 questions in five areas, namely, tangibility, reliability, responsiveness, assurance, and empathy. Patients' perception of service quality was high in order of reliability, assurance, empathy, responsiveness, and tangibility. In four areas with exception of reliability, quality perceived by patients was lower than that perceived by physical therapists, and particularly in responsiveness(t=2.82, p=.00) and empathy(t=2.02, p=.04), the difference between patients and physical therapists was statistically significant. In order to reduce the difference in the perception of service quality between patients and physical therapists, it is considered necessary to enhance physical therapists' perception of service quality and to prepare measures for improving service equality so that services would be provided through respectful communication with maintaining the dignity of patients, rather than focusing on disease.
This study investigated the relationships between Work-related musculoskeletal disorders (WMSDs), contributing factors, and the occupational stress of physical therapists. Self-reported questionnaires were given to 180 physical therapists in Gangwon Province. Variables examined included the prevalence of pain sites related to WMSDs; pain intensity; pain pattern; and job stress, which is thought to involve the physical environment; job demand; insufficient job control; interpersonal conflict; job insecurity; organizational system; reward system; and occupational culture. Among physical therapists, work-related musculoskeletal pain commonly affected the low back (30.1%), shoulder (29.3%), and wrist (12.2%). The sites of work-related musculoskeletal pain treated medically were the low back (22.8%), shoulder (19.8%), neck (12.7%), and wrist (12.1%). "Repeating the same work constantly" was suggested to be the major cause of the pain. The younger therapists were significantly more likely to feel high job stress due to the physical environment (p<.05), job demand (p<.05), and organizational system (p<.01). Women were more likely to feel greater job stress related to job demand, insufficient job control, the organization system, and job rewards. Men were more likely to feel greater job stress related to job insecurity. Weak positive relationships were observed between work-related musculoskeletal pain and job stress, which is thought to involve the physical environment; job demand; insufficient job control; interpersonal conflict; job insecurity; organizational system; reward system; and occupational culture. Physical therapists appear to be at higher risk of WMSDs because 80.1% of the physical therapists studied experienced work-related musculoskeletal pain. To reduce the risk, we need intervention strategies such as preventive education, ergonomically designed medical equipment, a psychosocial approach to work conditions, improved mechanical conditions related to therapeutic patterns, and an institutional infrastructure with sufficient personnel and scheduling.
The aim of the study was to analyze the relationship between empowerment, job satisfaction, and organizational commitment among physical therapists. Currently, healthcare is changing very rapidly with developments in science and technology. In response to these rapid and uncontrollable changes, organizational members are often empowered. Through the empowerment process, feelings of powerlessness and frustration can be reduced and factors promoting work performance, such as job satisfaction and organizational commitment could be enhanced. One said this term popularly, there was a lack of study. There have been few studies on physical therapy administration. Data was collected from 352 therapists from many hospitals from February 1 to February 28, 2008, and analysis of variance, Pearson's correlation, etc., were performed. The results were as follows: Of all the characteristics of empowered subjects, gender (p<.05) and age were observed to be significantly different (p<.01). Educational background, working pattern, marriage status, and the period of duty were observed to be different among empowered therapists (p<.001). The degree of empowerment as perceived by therapists was 58.72. Empowerment was correlated with job satisfaction and organizational commitment (p<.01). The study on empowerment was significant from the aspect of strategies to increase work performance. To elucidate the optimal strategy to effectuate empowerment in clinical practice, we studied various aspects of empowerment. Further studies on the relationship between empowerment and organizational commitment are warranted.
목적 : 재활치료사들의 근무지향-직무만족도와 조직몰입도-에 영향을 미치는 요인들을 파악하여 가장 효과적인 조직 문화 유형을 구축하고자 함에 그 목적이 있다.
연구방법 : 연구는 작업치료사와 물리치료사 340명을 대상으로 자기기입식 질문지를 사용하여 자료를 수집하였다. 측정도구는 근무지향에 대한 문항으로 구성되었으며, 확인적 요인분석을 통하여 타당도 검증을 실시하였다. 또한 신뢰도 검증을 위하여 Cronbach α 계수를 통해서 확인하였다. 근무지향에 영향을 미치는 요인들의 인과성을 검증하기 위하여 공변량구조분석을 통하여 분석하였다.
결과 : 분배정의는 조직몰입에 대해서 유의미한 영향을 미치는 것으로 분석되었지만 직무만족에 대해서는 유의미하지 않았다. 절차정의는 외생변인 중에서 가장 강하게 직무만족과 조직몰입에 유의미한 영향을 미쳤다. 직업결사가 강할수록 직무만족와 조직몰입에 유의미한 영향을 미쳤다. 자율성이 높을수록 직무만족에는 유의미한 영향력을 나타냈지만 조직몰입에는 유의미하지 않았다.
결론 : 조직몰입도를 설명하는 가장 중요한 요인은 직무만족도였으며, 그 다음으로는 절차정의, 직업결사, 분배정의, 교육수준 순으로 중요한 설명요인인 것으로 조사되었다.
Participants of this 1998 survey included 100 physical therapists working in hospitals located in Andong City. 77.7% of the participants were in their twenties and 20.2% in their forties. 46.4% of the participants were 3rd year students at a junior college, and 1.0% were college graduates. 67.6% of the participants had less than 5 years experience and 1.0% 16 years experience in their field. 59.6% of the participants were married. Regarding questions about occupational satisfaction, many of the participants replied "normal" for the first and third questions, and few answered "very much". Most of the participants answered "normal" for all the questions concerning their work environment with few replying "very much". With regards to awareness of the physical signs of fatigue, "occasionally, yes" were the most frequent answers. Regarding awareness of the psychological signs of fatigue, the similar proportions of participants answered "occasionally, yes" as that for "feeling nothing". Similarly, with regard to awareness of the neuro-sensitive signs of fatigue, there was a similar ratio of participants answering "occasionally, yes" and "feel nothing". It can be concluded that there are many causes of fatigue amongst physical therapists. Improvements in daily nutrition, mental health and general well-being are important in tackling these problems. It appears that fatigue amongst physical therapists may be cumulative and due to prolonged working hours To promote better daily functioning and early recovery from fatigue, appropriate assignments of working and resting hours are necessary. They would also benefit the prevention of symptomatic problems in the waist and shoulder.
The purposes of this study were to research the current state of evaluation of children with delayed development and cerebral palsy and determine pediatric physical therapists' knowledge of assessment tools and their use. The subjects were 130 pediatric physical therapists (general hospitals, university-related hospitals, rehabilitation centers, etc.). Data was obtained from August 24, 1999 to October 18, 1999 by means of a survey questionnaire. The results were as follows: 1. The current state of pediatric physical therapist evaluation of children with delayed development and cerebral palsy. 1) Tools used to assess functional areas of children with cerebral palsy were: subjective description format-128 (47.1%); the GMFM-58 (21.3%); facility-generated tool-51 (18.8%); and DDST-15 (5.5%). 2) Tools used to assess developmentally delayed children were: subjective description format-121 (50.6%); the GMFM-43 (18.0%); facility-generated tool-41 (17.2%); and DDS T-14 (5.9%). 3) After their college or university study, therapists who had attended lectures on evaluation were 113 (86.9%); 13 (10.0%) therapists had not attended any lectures on evaluation 2. Test scores of physical therapists' professional knowledge of evaluation procedures: high (more than 36 points)-74 (56.9%); moderate (18~35 points)-39 (30.0%); and low (below 17 points)-none. 1) For therapists treating cerebral palsied children, 73 (65.2%) were in the high range, 39 (34.8%) were in the moderate range and none were in the low range. 2) For therapists treating children with delayed development, 71 (65.7%) were in the high range, 37 (34.3%) were in the moderate range and none were in the low range. Although the general degree of professional knowledge of evaluation was quite high, there was a lack of variety in the assessment tools used With a large number of therapists depending on subjective description. Possible reasons for the low rate of objective asses sment tool use: 1) Poor clinical environment: too many clients and lirnited treatment time. 2) Lack of any medical insurance fee category for specific assessment tools. 3) Lack of continuing education opportunities in pediatric evaluation skills during or after either college-based (3 year) or university-based (4 year) education programs. Based on the study results, provision of more extended educational opportunities would promote the use of a greater variety of objective assessment tools by pediatric physical therapists.
This study analysed national data of manpower supply for physical therapists in Korea. Based on the comparative analysis results of the future demand and supply, as of May 1998, it is estimated that there was already an oversupply of physical therapists in Korea. This oversupply is expected to continue even though there would be an increase in hospital beds, rehabilitation facilities for the elderly, and nursing homes. Thus it would be desirable to cut down the number of students admitted to physical therapy schools each year. Our estimation shows that the Ministry of Health and Welfare must take measures to reduce the supply of physical therapist as soon as possible.