워크북 프로그램이뇌졸중 환자의 인지기능에 미치는 영향
The Effect of Pencil and Paper Activities Based Workbook Program for Stroke Patients
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초록
본 연구는 뇌졸중 후 인지장애를 가진 환자를 대상으로 지역사회 거주 환경에서 워크북 프로그램이 인지기능에 미치는 영향을 알아보고자 실시하였다. 연구 대상자는 가정 내에서 워크북을 적용한 실험군 7명과 요양병원에서 과제활동 위주의 전통적인 인지훈련(작업치료)을 적용한 대조군 7명으로 총 14명이 참여하였다. 중재는 6주 동안 주 3회, 50분씩 각각 시행하였고, 한국판 몬트리올 인지평가(Montreal cognitive assessment-Korea; MoCA-K)와 노인용 전산화 인지평가도구(computer cognitive senior assessment System; COSAS)를 사용하여 중재 전과 중재 후의 인지기능을 평가하였다. 실험군은 MoCA-K의 총점과 하위항목인 집중력, 추론능력의 점수에서 유의한 향상을 보였다. 집단 간 변화량에서 MoCA-K 총점 및 하위항목인 집중력에서도 유의한 차이를 보였다. 또한 COSAS 평가에서는 하위항목인 지남력에서 각 집단 간 변화량에 유의한 차이를 보였다(p<.05). 워크북 프로그램은 지역사회 거주하는 뇌졸중 환자의 지남력, 집중력, 추론능력에 유의한 효과를 보였다. 만성 뇌졸중 환자를 대상으로 한 워크북 프로그램은 인지기능 증진을 위한 효과적인 중재가 될 수 있을 것으로 기대된다.
Abstract
This study was to evaluate the effect on cognitive function after conducting the workbook program in a community living environment to a patient who got a cognitive impairment after diagnosed with stroke in a community living environment. This study consists of 14 stroke patients, and were divided into two groups-seven people who conducted workbook program in a community living environment; and seven people who conducted traditional occupational therapy, mainly about task activity. Workbook program was conducted for fifty minutes, three times a week for six weeks. Pre and post evaluation was conducted before and after intervention. Montreal cognitive assessment-Korea (MoCA-K) and computer cognitive senior assessment system (COSAS) were used to test cognitive function. The identify between experimental and control group was verified, and after the workbook mediation the score of attention and abstract ability significantly improved in total score and subcategories of MoCA-K. In the change of each group, The total score of MoCA-K showed significant difference; and the attention, which is subcategory, also showed significant difference. In addition, in COSAS evaluation, orientation, which is subcategory, showed significant difference between the change in each group. Workbook program showed a significant effect on orientation, attention, abstract abilities of stroke patients living in the community. This research suggests that if you apply the mediation of remedial approach for an improvement of cognitive function of community-living stroke patient, the workbook program can be an effective way.
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