반신마비 뇌졸중 환자의 심리와 정서적 재활에 대한 원예작업치료 효과 Effects of Horticultural Occupational Therapy on the Physical and Psychological Rehabilitation of Patients with Hemiplegia after Stroke원문보기
반신마비 뇌졸중 환자의 심리적 정서적 재활에 대한 원예작업치료의 효과를 확인하고자 40명의 반신마비 뇌졸중 환자 가운데 20명을 대상으로 원예치료와 작업치료를 시행하였다(치료군). 나머지 20명을 대상으로 작업치료만을 실시하였다(대조군). 원예치료 프로그램은 다양한 실내원예활동으로 구성되었으며 1주일을 기본으로 4주 단위로 3단계 즉 3개월 동안 실시하였다. 선정된 원예작업은 동기유발, 적응, 사회성, 관계와 소통의 4개의 단위로 구성되었다. 원예작업치료의 효과 분석을 위해 손기능척도(GPT), 노인우울척도(GDS), 일상생활동작검사(FIM)를 실시하였다. 그 결과 대조군과 달리 원예작업 치료를 받은 처리군에서 재활 효과가 우수하였으며 GPT, GDS, FIM 모두 통계적으로 고도로 유의한 결과를 나타냈다. 또한 원예작업치료를 통해 환자들의 재활치료에 대한 동기부여는 물론 FIM의 하부요소인 의사소통, 사회인지도, 자기보호 항목도 크게 향상되었다. 본 연구를 통해 원예작업치료가 반신마비 뇌졸중 환자에 대한 작업치료 프로그램으로 활용될 수 있다는 것을 확인 가능하였다.
반신마비 뇌졸중 환자의 심리적 정서적 재활에 대한 원예작업치료의 효과를 확인하고자 40명의 반신마비 뇌졸중 환자 가운데 20명을 대상으로 원예치료와 작업치료를 시행하였다(치료군). 나머지 20명을 대상으로 작업치료만을 실시하였다(대조군). 원예치료 프로그램은 다양한 실내원예활동으로 구성되었으며 1주일을 기본으로 4주 단위로 3단계 즉 3개월 동안 실시하였다. 선정된 원예작업은 동기유발, 적응, 사회성, 관계와 소통의 4개의 단위로 구성되었다. 원예작업치료의 효과 분석을 위해 손기능척도(GPT), 노인우울척도(GDS), 일상생활동작검사(FIM)를 실시하였다. 그 결과 대조군과 달리 원예작업 치료를 받은 처리군에서 재활 효과가 우수하였으며 GPT, GDS, FIM 모두 통계적으로 고도로 유의한 결과를 나타냈다. 또한 원예작업치료를 통해 환자들의 재활치료에 대한 동기부여는 물론 FIM의 하부요소인 의사소통, 사회인지도, 자기보호 항목도 크게 향상되었다. 본 연구를 통해 원예작업치료가 반신마비 뇌졸중 환자에 대한 작업치료 프로그램으로 활용될 수 있다는 것을 확인 가능하였다.
To examine the effects of horticultural occupational therapy (HOT) on the physical and psychological rehabilitation of stroke patients with paralysis on one side of the body, a horticultural therapy (HT) program was implemented along with occupational therapy (OT) in 20 patients with hemiplegia afte...
To examine the effects of horticultural occupational therapy (HOT) on the physical and psychological rehabilitation of stroke patients with paralysis on one side of the body, a horticultural therapy (HT) program was implemented along with occupational therapy (OT) in 20 patients with hemiplegia after stroke (treatment group). In the control group, another 20 patients with hemiplegia after stroke received OT but no HT. The HOT program consisted of various indoor horticultural activities that proceeded stepwise on a weekly basis over the course of four weeks. The selected horticultural occupations were organized into four-phases: motivation, adaptation, sociality, and interpersonal relationships and communication. The grooved pegboard test (GPT), geriatric depression scale (GDS), and functional independent measure (FIM) were tested to the patients in this study. Unlike control group, the treatment group showed statistically significant differences in GPT, GDS, and FIM ($p$<0.001). In addition, communication, social cognition, and self-care scores as FIM subordinate factors were improved significantly by HOT program which motivated patients to engage in rehabilitation therapy. This finding suggests that HOT has the potential to be used as an OT program for stroke patients with hemiplegia.
To examine the effects of horticultural occupational therapy (HOT) on the physical and psychological rehabilitation of stroke patients with paralysis on one side of the body, a horticultural therapy (HT) program was implemented along with occupational therapy (OT) in 20 patients with hemiplegia after stroke (treatment group). In the control group, another 20 patients with hemiplegia after stroke received OT but no HT. The HOT program consisted of various indoor horticultural activities that proceeded stepwise on a weekly basis over the course of four weeks. The selected horticultural occupations were organized into four-phases: motivation, adaptation, sociality, and interpersonal relationships and communication. The grooved pegboard test (GPT), geriatric depression scale (GDS), and functional independent measure (FIM) were tested to the patients in this study. Unlike control group, the treatment group showed statistically significant differences in GPT, GDS, and FIM ($p$<0.001). In addition, communication, social cognition, and self-care scores as FIM subordinate factors were improved significantly by HOT program which motivated patients to engage in rehabilitation therapy. This finding suggests that HOT has the potential to be used as an OT program for stroke patients with hemiplegia.
* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.
문제 정의
However, horticultural occupations or activities therapy has not widened its range of application. This study examines the effects of HOT on the psychological and physical rehabilitation of stroke patients compared with existing OT.
제안 방법
A test of statistical independence was conducted before the interventions in order to verify the homogeneity of the general characteristics between the control and treatment groups. The results showed no significant differences in the GPT, GDS and FIM results before the intervention between the control and treatment groups at 1% significant level, which also suggested that the two groups were homogeneous(Table 3).
In the pre- and post-tests, grooved pegboard test (GPT), geriatric depression scale (GDS), and functional independent measure (FIM) were administered to the both groups in order to evaluate the effects of the HOT intervention. The evaluation of horticultural activities was administered only to the patients in the treatment group to evaluate their satisfaction with the horticultural occupations.
It also showed horticultural occupations are effective in improving hand dexterity of the non-paralyzed hand in stroke patients with hemiplegia. Limitations of this study include the inability to generalize because of small sample size, and the fact that researchers could not completely control the influence of external factors on the results. Patients in the treatment group were patients with late-stage stroke (3.
The phases were implemented stepwise over the course of 4 weeks, 1 week for each phase (Table 2). This four-phase HOT program was carried out with different horticultural occupations each month for three months (three stages). The program was group-based, and there were 5-10 patients in each group.
Similar to people enjoying the peace and healing effects while they are involved in horticultural occupations, or as a leisure activity (Kim, 1999), it is expected that stroke patients with hemiplegia also can improve their physical health, raise self-confidence, and increase their quality of life by participating in horticultural activities as a leisure or a therapy. This study examined effects of HOT on improving hand function and psychological rehabilitations of stroke patients with hemiplegia, and provided evidence that the HOT program was effective as a rehabilitation therapy. It also showed horticultural occupations are effective in improving hand dexterity of the non-paralyzed hand in stroke patients with hemiplegia.
대상 데이터
Forty stroke patients with hemiplegia who were hospitalized at three hospitals in Seoul and scored 20 or more on the mini-mental state examination (MMSE-K) and 10 or more on the geriatric depression scale (GDS) participated in this study (Table 1). The MMSE-K is a Korean standard cognition ability test introduced by Folstein et al.
Screening processes were used to select patients who had the ability to understand instructions from a therapist and to perform simple activities. The control group included 20 patients (11 men, nine women, average age 66 years). Twelve patients had left-sided hemiplegia, and the other eight patients had right-sided hemiplegia.
Demographic characteristics of 40 stroke patients with hemiplegia in this study. The patients were selected on the basis of 20 points or more on the mini-mental state examination (MMSE-K)z and 10 points or more on the geriatric depression scale (GDS)y among those who were hospitalized at three hospitals in Seoul.
Eleven patients had been paralyzed for less than six months, two for less than 12 months, one for less than 24 months, and the remaining six had been paralyzed for more than 25 months. The treatment group included 15 men and five women, with an average age of 58 years. Thirteen patients had left-sided hemiplegia, and the other seven were had right-sided hemiplegia.
데이터처리
Frequency analysis was used to examine the demographic characteristics of the control and treatment groups. Independent t-tests and paired t-tests were used to verify the homogeneity and effectiveness of the program, respectively.
성능/효과
Unlike GPT, the GDS score showed a statistically significant difference in the two groups all by the intervention. In comparison to the control group (decreased 11.5% in GDS score from 16.95 to 15.10), change in GDS score showed a more marked decrease of about 48.3% in the treatment group, suggesting that there was a greater reduction in depression in the treatment group. In addition, both groups showed significant improvement in total FIM score, from 73.
The patients’ medical histories, experience with horticultural occupations, rejection of horticultural occupations or activities, cognitive ability and ability to endure 30 minute of engagement in horticultural occupations were examined.
A test of statistical independence was conducted before the interventions in order to verify the homogeneity of the general characteristics between the control and treatment groups. The results showed no significant differences in the GPT, GDS and FIM results before the intervention between the control and treatment groups at 1% significant level, which also suggested that the two groups were homogeneous(Table 3).
참고문헌 (24)
Folstein, M.F., L.N. Robins, and J.E. Helzer. 1983. The mini-mental state examination. Arch. Gen. Psychiatry 40:812-820.
Folstein, M.F., S.E. Folstein, and P.R. McHugh. 1975. Mini-mental state a practical method for grading cognitive state of patients for the clinicians. J. Psychiatric Res. 12:189-198.
Getz, D.A., A. Karrow, and J.J. Kielbaso. 1982. Inner city preferences for trees and urban forestry programs. J. Arboriculture 8:258-263.
Granger, C.V., B.B. Hamilton, R.A. Keith, M. Zielesky, and F.S. Sherwin. 1986. Advance in functional assessment for medical rehabilitation. Topics in Geriatric Rehabilitation 1:59-74.
Han, T.R. 2004. Changes in function of the non-paralyzed hand over time in stroke patients with one-sided paralysis. J. Kor. Acad. Rehabilitation Medicine 28:13-19.
Han, T.R., J.H. Kim, and S.J. Lee. 1992. Importance of evaluating hand function of patients with one-sided paralysis. J. Kor. Acad. Rehabilitation Medicine 16:420-430.
Health Insurance Review and Assessment Service. 2006. Peoples making health. Proc. Health Rev. and Assessment 71:5-7.
Jeong, S.A. 2004. Effects of a horticultural therapy program applied in accordance with psychological adaptation stages on psychological and physical rehabilitation of stroke patients. Master's Diss., Konkuk Univ. Seoul, Korea.
Jeong, S.H., M.R. Huh, B.H. Lee, and J.C. Park. 2006. Effects of horticultural therapy on self-esteem in patients with senile diseases. J. Kor. Soc. Plant People and Environ. 9:79-87.
Kim, E.K. 2000. Effects of horticultural therapy on rehabilitation of stroke patients. Master's Diss., Konkuk Univ. Seoul, Korea.
Kim, H.Y. 1999. Horticultural therapy. p. 52-58. Hyosung Catholic Univ., Press. DaeGu, Korea.
Kim, M.Y. 1994. Study on upper limb function after stroke. J. Kor. Soc. Occupational Therapy 3:19-26.
Kim, S.Y. 2001. Effects of horticultural therapy on rehabilitation of stroke patients with one-sided paralysis. Master's Diss., Konkuk Univ. Seoul, Korea.
Kwon, Y.C. and J.H. Park. 1989. Standardization of Korean old person in mini-menta1 state examination (MMSE-K). Kor. J. Neuropsychiatric Asso. 28:508-513.
Kwon, Y.H. 2006. Effects of horticultural therapy on psychology and sociality of people with mentally retarded disabilities. Master's Diss., Univ. of Seoul, Seoul, Korea.
Lee, T.Y., J.G. Oh, H.Y. Kim, G.S. Lee, and M.H. Kim. 1999. Effects of upper limb function of the paralyzed side on hand dexterity of the non-paralyzed side. J. Kor. Soc. Occupational Therapy 7:56-67.
Nakayama, H., H.S. Jorgenson, and H.O. Raschou. 1994. Compensation in recovery of upper extremity function after stroke. Arch. Physical Medicine and Rehabilitation 75:853-857.
Patten C., J. Lexell, and H.E. Brown. 2004. Weakness and strength training in persons with poststroke hemiplegia: Rationale, method, and efficacy. J. Rehabilitation Res. Dev. 41:293-312.
Pedretti, L.W. and M.B. Early. 2001. Occupational therapy practice skills for physical dysfunction. Mosby, Missouri.
Relf, P.D. 1981. Dynamics of horticultural therapy. Rehabilitation Literature 42(5-6):147-150.
Seo, J.G. 2005. Seoul horticultural fair 2005: Horticulture and Human care. p. 89-109. Kor. Soc. Hort. Sci. Suwon, Korea.
Son, G.C., S.G. Park, H.O. Bu, G.Y. Bae, and G.Y. Baek. 2002. Horticultural therapy. Joongang Publishing Company, Seoul, Korea.
Tereshkovieh, G. 1973. Horticultural therapy. HortScience 8:460. (Abstr.)
Yesavage, J.A., T.L. Brink, T.L. Rose, O. Lum, V. Huang, M.B. Adey, and V.O. Leirer. 1986. Development and validation of a geriatric depression screening scale: A preliminary report. J. Psychiatric Res. 17:37-49.
※ AI-Helper는 부적절한 답변을 할 수 있습니다.