뇌졸중 작업치료 지침 개발
Development of Occupational Therapy Guidelines for Stroke
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목적 : 뇌졸중 환자를 치료하는 작업치료사들에게 객관적이고 명확한 근거 중심의 표준을 제시하고, 의사결정 과정에 도움이 되는 임상 지침을 개발하고자 하였다. 연구방법 : 개발 과정은 수용 개작 방식에 따라 진행하였으며, 기존의 개발된 지침들을 평가하여 수용하기에 적절한 지침을 선정하였다. 이에 최신성을 더하기 위해 문헌 고찰을 통해 지침에 포함하기에 적절한권고사항을 포함하였다. 결과 : 미국 작업치료사협회에서 개발한 지침을 수용 개작을 위한 지침으로 선정하였으며, 권고사항 재분류 과정을 통해 81개의 권고사항이 도출되었다. 이에 추가적인 문헌 고찰을 통해 최신의 권고사항을 추가하여 최종적으로 149개의 권고안이 도출되었다. 권고사항은 감각 및 지각에는 21개, 인지에는 24개, 운동에는 54개, 정신사회적 기능에는 16개, 작업 수행 영역에는 34개가 포함되어 있다. 가장 많은 권고안을 포함하고 있는 것은 상지 기능을 위한 중재였으며, 그 다음으로 많은 권고안을 포함하고 있는 것은기본적 일상생활활동을 위한 중재였다. 결론 : 본 연구에서 개발한 뇌졸중 작업치료 지침은 뇌졸중 환자를 치료하는 작업치료사에게 근거 기반 치료적 접근과 직무에 대한 역할 확립에 도움이 되는 자료가 될 것이다.
Abstract
Objective : This study aimed to present objective and clear evidence-based standards for occupational therapists treating patients with stroke and to develop clinical guidelines to assist in decision-making. Methods : The development process was conducted using the adaptation method, and suitable guidelines were selected by evaluating existing guidelines. Appropriate recommendations were included in the guidelines through an additional literature review. Results : The guidelines developed by the American Occupational Therapy Association were selected for adaptation, and 81 recommendations were included through the recommendation reclassification process. Finally, 149 recommendations were obtained by adding the latest recommendations through a literature review. There are 21 recommendations for sensory and perception, 24 for cognition, 54 for motor function, 16 for psychosocial function, and 34 for task performance. Most recommendations concerned upper extremity function, followed by interventions for basic activities of daily living. Conclusion : The occupational therapy guidelines for stroke developed in this study will help occupational therapists establish an evidence-based therapeutic approach and role in treating patients with stroke.
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