가정환경 수정과 과제기반 중재의 융복합 접근이 지역사회 뇌졸중 환자의 낙상 효능감 및 활동 수준에 미치는 영향
The Effect of a Convergence Approach of Home Environment Modification and Task-oriented Intervention on Fall Efficacy and Activity Level of Person with Stroke in the Community
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초록
본 연구의 목적은 보조공학 기술을 적용한 가정환경 수정과 낙상 안전 체크리스트를 이용한 과제기반 중재를 함께 적용하는 융복합 접근법이 뇌졸중 환자의 낙상 효능감과 활동 수준에 미치는 효과를 확인하는 것이다. 뇌졸중 환자 41명 대상자(실험군 21명, 대조군 20명)는 실험군과 대조군으로 나누어졌다. 실험군에는 환경수정과 낙상 안전 체크리스트를 활용한 과제기반 중재를 4주간 적용하였다. 대조군에는 가정환경 수정만 실시하였다. 중재 전과 후에 한국형 활동분류카드(Korean Activity Card Sort, KACS), 한국형 낙상효능감 측정도구(Falls Efficacy Scale-Korean version, FES-K)를 이용하여 평가하였다. 실험군과 대조군의 낙상효능감과 활동수준의 변화량은 유의한 차이가 없었다. 실험군과 대조군은 모두 중재 이후에 낙상효능감과 활동 수준이 유의하게 향상되었다. 이러한 연구의 결과를 임상 현장에 적용하여 뇌졸중 환자가 지역사회에서 안전하게 생활하고 적극적으로 참여하는 삶을 유지할 수 있도록 지원할 수 있을 것이다.
Abstract
The purpose of this study is to determine the effect of a convergence approach, which applies both home environment modification applied with assistive technology and task-oriented intervention using a fall safety checklist, on the fall efficacy and activity level of stroke patients. 41 persons with stroke(21 experimental groups and 20 control groups) were divided into experimental and control groups. The experimental group was applied environmental modification and the task-oriented intervention using the fall safety checklist for 4 weeks. The control group was provided only the environmental modification. Before and after the intervention, the Korean Activity Card Sort (KACS) and the Korean Falls Efficacy Scale-Korean version (FES-K) were used for evaluation. There was no significant difference in fall efficacy and activity level change between the experimental group and the control group. Both the experimental group and the control group significantly improved the fall efficacy and activity level after the intervention. By applying the results of this study to the clinical field, it will be possible to support stroke patients to live safely and actively participate in the community.
참고문헌 (33)
- Julie K. Tilson, "Characterizing and Identifying Risk for Falls in the LEAPS Study", Stroke, 43(2), pp.446~452 (2012), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Laura M Wagner, "Falls among community-residing stroke survivors following inpatient rehabilitation: a descriptive analysis of longitudinal data", BMC Geriatrics, 9(1) (2009), Springer Science and Business Media LLC[DOI]
- Vivian Weerdesteyn, "Falls in individuals with stroke", The Journal of Rehabilitation Research and Development, 45(8), pp.1195~ (2008), Journal of Rehabilitation Research & Development[DOI]
- Sander Pouwels, "Risk of Hip", Femur Fracture After Stroke, 2009, pp.40(10), 3281~3285[DOI]
- Lisa A. Simpson, "Effect of Stroke on Fall Rate, Location and Predictors: A Prospective Comparison of Older Adults with and without Stroke", PLoS ONE, 6(4), pp.e19431~ (2011), Public Library of Science (PLoS)[DOI]
- Tianma Xu, "Risk Factors for Falls in Community Stroke Survivors: A Systematic Review and Meta-Analysis", Archives of Physical Medicine and Rehabilitation, 99(3), pp.563~573.e5 (2018), Elsevier BV[DOI]
- J. E. Harris, "Relationship of balance and mobility to fall incidence in people with chronic stroke", Physical Therapy, 85(2), pp.150~158 (2005)[DOI]
- Dorit Hyndman, "Fall events among people with stroke living in the community: Circumstances of falls and characteristics of fallers", Archives of Physical Medicine and Rehabilitation, 83(2), pp.165~170 (2002), Elsevier BV[DOI]
- Beliz Belgen, "The Association of Balance Capacity and Falls Self-Efficacy With History of Falling in Community-Dwelling People With Chronic Stroke", Archives of Physical Medicine and Rehabilitation, 87(4), pp.554~561 (2006), Elsevier BV[DOI]
- Ferhan Soyuer, "The effect of spasticity, sense and walking aids in falls of people after chronic stroke", Disability and Rehabilitation, 29(9), pp.679~687 (2007), Informa UK Limited[DOI]
- Briana Moreland, "Trends in Nonfatal Falls and Fall-Related Injuries Among Adults Aged ≥65 Years — United States, 2012–2018", MMWR. Morbidity and Mortality Weekly Report, 69(27), pp.875~881 (2020), Centers for Disease Control MMWR Office[DOI]
- Wenjun Li, "Outdoor Falls Among Middle-Aged and Older Adults: A Neglected Public Health Problem", American Journal of Public Health, 96(7), pp.1192~1200 (2006), American Public Health Association[DOI]
- Lesley D Gillespie, "Interventions for preventing falls in older people living in the community", Cochrane Database of Systematic Reviews, 2021(6) (2012), Wiley[DOI]
- Julie K. Tilson, "Characterizing and Identifying Risk for Falls in the LEAPS Study", Stroke, 43(2), pp.446~452 (2012), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Stijn Denissen, "Interventions for preventing falls in people after stroke", Cochrane Database of Systematic Reviews (2019), Wiley[DOI]
- 권미지, "뇌졸중 환자의 낙상 형태와 낙상 관련요인", 대한물리치료학회지, 20(3), pp.19~28 (2008), 대한물리치료학회
- 이미지, "신경계 재활에서의 작업기반중재(occupation based intervention)에 관한 고찰", 재활치료과학, 6(2), pp.29~36 (2017), 대한신경계작업치료학회
- Lynn Legg, "Therapy-Based Rehabilitation for Stroke Patients Living at Home", Stroke, 35(4), pp.1022~1022 (2004), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Joan P. Toglia, "Anatomy of Cognitive Strategies: A Therapist's Primer for Enabling Occupational Performance", Canadian Journal of Occupational Therapy, 79(4), pp.225~236 (2012), SAGE Publications[DOI]
- T. Heather, "Occupation-Based Activity Analysis" (2012), SLACK
- Beverly P. Horowitz, "Use of the <i>Home Safety Self-Assessment Tool (HSSAT)<", i> within Community Health Education to Improve Home Safety, 2016, pp.30(4), 356~372[DOI]
- 박상기, "한국어판 가정안전 자가 평가도구(K-HSSAT)의 타당도 및 신뢰도 연구", 대한작업치료학회지, 25(3), pp.117~130 (2017), 대한작업치료학회
- Machiko R. Tomita, "Psychometrics of the Home Safety Self-Assessment Tool (HSSAT) to Prevent Falls in Community-Dwelling Older Adults", The American Journal of Occupational Therapy, 68(6), pp.711~718 (2014), AOTA Press[DOI]
- B. P. Horowitz, "Occupational therapy community practice and home assessments: Use of the Home Safety Self-Assessment Tool(HSSAT)to support aging in place", Occupational Therapy in Health Care, 27(3), pp.216~227 (2013)[DOI]
- C. M. Baum, "Activity Card Sort(ACS): Test-Manual", Washington University, ~ (2001)
- 안승헌, "뇌졸중 환자의 한국판 Falls Efficacy Scale의 신뢰도와 타당도", 특수교육재활과학연구, 51(3), pp.363~381 (2012), 특수교육재활과학연구소
- B. Hooper, "Willard, & Spackman’s occupational therapy", pp.43~55 (2019), Wolters Kluwer
- Joan Toglia, "Spatial exploration strategy training for spatial neglect: A pilot study", Neuropsychological Rehabilitation, 32(5), pp.792~813 (2020), Informa UK Limited[DOI]
- K. Forsyth, "Willard & Spackman’s occupational therapy", pp.601~621 (2019), Wolters Kluwer
- 조희은, "낙상예방 프로그램이 노인의 체력, 낙상효능감 및 낙상예방행위에 미치는 효과", 재활간호학회지, 20(1), pp.22~32 (2017), 한국재활간호학회[DOI]
- Hsuei-Chen Lee, "Effects of a Multifactorial Fall Prevention Program on Fall Incidence and Physical Function in Community-Dwelling Older Adults With Risk of Falls", Archives of Physical Medicine and Rehabilitation, 94(4), pp.606~615.e1 (2013), Elsevier BV[DOI]
- Christina Ziebart, "The Efficacy of Fall Hazards Identification on Fall Outcomes: A Systematic Review With Meta-analysis", Archives of Rehabilitation Research and Clinical Translation, 2(3), pp.100065~ (2020), Elsevier BV[DOI]
- Y. Huang, "The Correlation Between Fall Prevention Knowledge and Behavior in Stroke Outpatients", Journal of Neuroscience & Nurse, 52(2), pp.61~65 (2020)[DOI]
