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뇌졸중 환자를 위한 일상생활활동 평가도구에 관한 체계적 고찰

A Systematic Review of Assessment Tools of Activities of Daily Living for Stroke Patients

박지혁|강재원
대한신경계작업치료학회 (Korean Society for Neurological Occupational Therapy)|2017.08|재활치료과학 (Therapeutic Science for Rehabilitation)|제6권 제2호|pp. 11-28

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뇌졸중Systematic reviewStroke일상생활활동체계적 고찰평가도구Activities of daily livingAssessment tool작업치료Occupation therapy

초록

목적: 본 연구는 뇌졸중 환자를 위한 일상생활활동 평가도구에 관해 체계적 고찰함으로써 임상 및 연구에서 자료로활용되고자 하였다. 연구방법: 2001년부터 2016년까지 학회지에 게재된 논문을 검색하기 위하여 Pubmed, Embase, Cochrane, NDSL 데이터베이스를 사용하여“stroke AND activities of daily living AND occupational therapy AND assessment OR evaluation OR measurement”를 검색하여 체계적 고찰을 하였다. 평가도구의 종류와 사용빈도를 분석한 후 이에 대한 경향을 파악하였다. 또한 국제 기능·장애·건강 분류(International Classification of Functioning, Disability and Health; ICF) 모델의 분류기준에 맞추어 활동과 참여에 대한 평가도구를 분류하였다. 결과: 총 111개의 논문이 최종적으로 분석되었으며, 30개의 평가도구가 확인되었다. 최근 들어 뇌졸중 환자를 대상으로 한 연구 게재편수가 증가함에 따라 평가도구의 종류와 사용빈도가 증가하였다. 가장 많이 사용되는 평가도구는기능적 독립성 측정(Functional Independence Measure; FIM), 바델 지수(Barthel Index; BI)와 캐나다작업수행측정(Canadian Occupational Performance Measure; COPM)이었다. ICF 모델의 분류 기준에 따라 분석한 결과 대부분의 도구는 활동에 대한 평가도구로 참여에 대한 평가도구 수는 매우 적었다. 결론: 본 연구는 뇌졸중 환자의 일상생활활동 수행능력을 측정하기 위해 사용된 평가도구를 체계적으로 고찰하였다. 연구 결과 FIM, BI와 같은 특정한 도구가 많이 사용되었다. 앞으로는 평가도구의 특성에 맞춰 적절한 평가가 이루어 질 수 있도록 다양한 평가도구를 사용한 연구가 진행되어 근거기반의 작업치료를 뒷받침 해 주어야 한다. 또한ICF 모델의 분류 기준 중 참여에 대한 평가도구의 개발이 이루어져야 할 것이다.

Abstract

Objective: The purpose of this study was conducted to systematic review about assessment tools for Activities of Daily Living (ADL) for stroke patients. Methods: Studies tools was administered by using four electronic databases (Pubmed, Embase, Cochrane and NDSL). For the main key words,“stroke AND activities of daily living AND occupational therapy AND assessment OR evaluation OR measurement”was used. We analyzed the types and frequency of evaluation tools. In addition, the evaluation tools for activities and participation were classified based on the classification criteria of International Classification of Functioning, Disability and Health (ICF). Results: In this study, 111 studies were analyzed and 30 assessment tools were identified. As the number of studies on stroke patients has been increased recently, the types and frequency of evaluation tools have been also increased. The most commonly used evaluation tools were Functional Independence Measure (FIM), Barthel Index (BI) and Canadian Occupational Performance Measure (COPM). In addition, according to classification based on ICF, we found that the types of assessment tools which assess participation were few. Conclusion: Although there were many kinds of assessment tools, the types of evaluation tools which were used in the research or field were very limited. Using various assessment tools, more research should be conducted to support evidence-based occupational therapy. Evaluation tools for participation also should be developed.

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