The Journal of the Korea Contents Association (한국콘텐츠학회논문지)

The Korea Contents Association (한국콘텐츠학회)
권호 표지
DOI QR코드

DOI QR Code

Necessity of Community-Based Rehabilitation System after Stroke

뇌졸중 환자에 대한 지역사회 재활시스템의 필요성

  • 원종임 (전주대학교 대체의학대학 물리치료학과)
  • Published : 2008.01.28
Download PDF
⟨ Previous Next ⟩

Abstract

Despite intensive therapy, a large proportion of stroke survivors are left with significant disabilities. To improve the disable condition, a major component of stroke management is aimed at facilitating functional independence and community reintegration. There are many evidences that community-based rehabilitation after stroke is most effective when provided by a well-organized multidisciplinary team. Key to the implementation of community-based rehabilitation(CBR) is that the disabled person, their family and their community decide on what the priorities of the service should be. The stroke patients in the community need a wide range of services, including the traditional rehabilitation services of physiotherapy, occupational therapy, speech therapy, social workers, orthotists, nurses and so on. The purpose of this research was to investigate necessity and methods of community-based rehabilitation system in Korea.

노인인구의 증가와 더불어 뇌졸중 환자들이 증가하고 있다. 치료에도 불구하고 대부분의 뇌졸중 환자들은 장애를 갖게 된다. 이런 장애를 개선하기 위한 뇌졸중 치료의 주요 목적은, 환자들의 기능적 독립을 촉진시키고, 지역사회에 통합하도록 하는 것이다. 지역사회재활 적용시 중요한 점은 장애인과 그들의 가족 그리고 지역사회가 서비스의 우선순위가 무엇인지를 결정하는 것이다. 지역사회 뇌졸중 환자는 물리치료, 작업치료, 언어치료, 보장구, 간호 등 포괄적인 서비스를 필요로 한다. 본 논문의 목적은 우리나라 뇌졸중 환자들에 대한 지역사회재활의 필요성에 대해 논구하는 것이다.

Keywords

References

  1. 보건복지부, 2007년 등록장애인 현황, 보건복지부, 2007.
  2. 보건복지부, 장애등급 판정기준, 보건복지부, 2003.
  3. 한국보건사회연구원, 2005년 장애인 실태조사, 한국보건사회연구원, 2005.
  4. 김병식, 뇌손상환자를 위한 낮병원 시범사업 보고서, 국립재활병원, 2001.
  5. E. Helander, The management of community -based rehabilitation, World Health Organization, 1983.
  6. C .L. Sudlow and C. P. Warlow, Comparable stydies on the incidence of stroke and its pathological types: results from an international collaboration, International Stroke Incidence Collaboration, Stroke, Vol.28, No.3, pp.491-499, 1997. https://doi.org/10.1161/01.STR.28.3.491
  7. C. P. Warlow, Epidemiology of stroke, Lancet, Vol.352, suppl.3:SIIII1-4, 1998.
  8. L. W. Pedretti, Occupational Therapy, The C. V. Mosby Company, 1985.
  9. C. A. Trombly, Occupational Therapy for Physical Dysfunction, Williams & Wilkins, 1977.
  10. R. M. Scully and M. R. Barnes, Physical Therapy, J. B. Lippincott Company, 1988.
  11. 지제근, 의학용어 큰사전, 아카데미아, 2004.
  12. D. A. Umphred, Neurological Rehabilitation. The C. V. Mosby Company, 1990.
  13. American Physical Therapy Association, Guide to Physical Therapist Practice, Physical Therapy, Vol.81, No.1, pp.9-749, 2001.
  14. 전세일, 재활치료학, 계측문화사, 1998.
  15. 박옥희, 장애인 의료재활서비스 개선 방안 연구, 한국보건사회연구원, 1993.
  16. 박희찬, 장애인 직업, 인간과 복지, 1994.
  17. J. A. Delisa and B. M. Gens, Rehabilitation Medicine: Principles and Practice, Lippincott-Raven Publishersa, 1998.
  18. 김진호, 한태륜, 재활의학, 군자출판사, 1997.
  19. F. J. Kottke, G. K. Stillwell, and J. F. Lehmann, Krusen's Handbook of Physical Medicine and Rehabilitation, W.B. Saunders Company, 1982.
  20. J. Carod-Artal, J. A. Egido, and J. L. Gonzalez, Quality of life among stroke survivors evaluated 1 year after stroke, Stroke, Vol.31, No.12, pp.2995-3000, 2000. https://doi.org/10.1161/01.STR.31.12.2995
  21. P. Kim, S. Warren, and H. Madill, Quality of life of stroke survivors, Quality of Life Research, Vol.8, No.4, pp.293-301, 1999. https://doi.org/10.1023/A:1008927431300
  22. World Health Organization (WHO), Health for all, series no 2. Strategies for health for all by year 2000, Geneva, WHO, 1979.
  23. ILO, UNESCO and WHO, Community-based rehabilitation for and with people with disabilities, WHO, 1994.
  24. http://www.who.int/disabilities/cbr/en/
  25. R. G. Robinson, Poststroke depression: prevalence, diagnosis, treatment, and disease progression, Biological Psychiatry, Vol.54, No.3, pp.376-387, 2003. https://doi.org/10.1016/S0006-3223(03)00423-2
  26. J. I. Won, The effect of a community-based group exercise in chronic stroke, Physical Therapy Korea, Vol.12, No.4, pp.1-6, 2005.
  27. P. Enerby and D. T. Wade, Community rehabilitation in the United Kingdom, Clinical Rehabilitation, Vol.15, No.6, pp.577-581, 2001. https://doi.org/10.1191/0269215501cr450oa
  28. N. E. Mayo, S. Wood-Dauphine, and R. Cote, There is no place like home: an evaluation of early supported discharge for stroke, Stroke, Vol.31, No.5, pp.1016-1023, 2000. https://doi.org/10.1161/01.STR.31.5.1016
  29. L. von Koch, A. W. Wottrich, and L, Widen-Holmqvist, Rehabilitation in the home versus the hospital: the importance of context, Disability and Rehabilitation, Vol.20, No.10, pp.367-372, 1998. https://doi.org/10.3109/09638289809166095
  30. T. M. McMillan, and H Ledder, A survey of services provided by community neurorehabilitation teams in South East England, Clinical Rehabilitation, Vol.15, No.6, pp.582-588, 2001. https://doi.org/10.1191/0269215501cr541oa
  31. J. Gladman, A. Forster, and J. Young, Hospital- and Home-based rehabilitation after discharge from hospital for stroke patients: analysis of two trials, Age and Ageing, Vol.24, No.1, pp.49-53, 1995. https://doi.org/10.1093/ageing/24.1.49
  32. L. A. Hale, Community-based or home-based stroke rehabilitation: confusion or common sense? New Zealand Journal of Physiotherapy, Vol.32, No.3, pp.131-139, 2004.
  33. C. Ballinger, A. Ashburn, and J. Low, Unpacking the black box of therapy-a pilot study to describe occupational therapy and physiotherapy interventions for people with stroke, Clinical Rehabilitation, Vol.13, No.4, pp.301-309, 1999. https://doi.org/10.1191/026921599673198490
  34. V. A. Wood and R. L. Hewer, The prevention and management of stroke, Journal of Public Health Medicine, Vol.18, No.4, pp.423-431, 1996. https://doi.org/10.1093/oxfordjournals.pubmed.a024540
  35. 국립재활원, 2005 지역사회중심재활사업 거점보건소 사업보고서, 2005.
  36. H. Rodgers, J. Soutter, and W. Kaiser, Early supported ospital discharge following acute stroke: pilot study results, Clinical Rehabilitation, Vol.11, No.4, p.280, 1977.
  37. 보건복지부, 장애인복지법령집, 2000.
  38. 이충휘, 농촌 재가장애인의 가정방문 재활서비스 욕구도 분석, 보건복지부, 2000.
  39. J. R. F. Gladman and N. B. Lincoln, Follow-up of a controlled trial of domiciliary stroke rehabilitation, Age and Aging, Vol.23, No.1, pp.9-13, 1994. https://doi.org/10.1093/ageing/23.1.9
  40. L. Widen-Holmqvist, L. von Koch, and V. Kostulas, A randomized controlled trial of rehabilitation at home after stroke in southwest Stokholm, Stroke, Vol.29, No.5, pp.591-597, 1998. https://doi.org/10.1161/01.STR.29.3.591
  41. D. T. Wade, F. M. Collen, and G. F. Robb, Physiotherapy intervention late after stroke and mobility, British Medical Journal, Vol.304, No.6827, pp.609-613, 1992. https://doi.org/10.1136/bmj.304.6827.609
  42. P. Duncan, L. Richards, and D. Wallace, A randomized, controlled pilot study of a home-based exercise program for individuals with mild and moderate stroke, Stroke, Vol.29, No.10, pp.2055-2060, 1998. https://doi.org/10.1161/01.STR.29.10.2055
  43. A. A. Rodriquez, P. O. Black, and K. A. Kile, Gait training efficacy using a home-based practice model in chronic hemiplegia, Archives of Physical medicine and Rehabilitation, Vol.77, No.8, pp.801-805, 1996. https://doi.org/10.1016/S0003-9993(96)90260-9
  44. 김은영, 최정현, 김창엽, 뇌졸중 환자에 대한 지역사회 중심 사례관리 효과, 지역사회간호학회지, 제15권, 제1호, pp.18-28, 2004.
  45. 원종임, 지역사회 뇌졸중 환자를 위한 근력강화 운동과 보행훈련의 효과, 한국전문물리치료학회지, 제13권, 제3호, pp.18-23, 2006.
  46. 박창일, 이상건, 김미정, 일부 도시지역의 뇌졸중 재가 장애인의 기초 요구도 조사, 대한재활의학회지, 제26권, 제3호, pp.254-257, 2002.
  47. 양산시 보건소, 지역사회중심재활사업 활동사례집, 2003.
  48. 최규철, 나은우, 윤승현, 재가 중증 뇌졸중 환자를 돌보는 주 보호자의 삶의 질, 대한재활의학회지, 제29권, 제6호, pp.568-577, 2005.
  49. 이규범, 임재영, 김완호, 지역사회 장애인의 보건의료 재활서비스 이용 실태, 대한재활의학회지, 제28권, 제2호, pp.175-181, 2004.
  50. M. Pohl, J. Mehrholz, and C. Ritschel, Speed-dependent treadmill training in ambulatory hemiparetic stroke patients: a randomized controlled trial, Stroke, Vol.33, No.2, pp.553-558, 2002. https://doi.org/10.1161/hs0202.102365

Cited by

  1. Effect of Community-based Rehabilitation on Patients with Brain Injury: Meta-analysis Based on the ICF Model vol.14, pp.3, 2014, https://doi.org/10.5392/JKCA.2014.14.03.203