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A Study of Awareness and Implementation of OBP(Occupation-Based Practice)

작업기반 중재(Occupation-Based Practice)에 대한 인식 및 실행 조사연구

  • 장기연 (우송대학교 작업치료학과)
  • Received : 2017.07.13
  • Accepted : 2017.08.20
  • Published : 2017.08.30

Abstract

Objective : This study was to learn the Korean Occupational Therapists' awareness and current state of implement of Occupation-Based Practice and to use it as a baseline data. Methods : After 300 Korean clinical occupational therapists were conveniently sampled, the structured 293 questionnaires were released, the answered 293 questionnaires were analyzed. Results : Awareness of OBP was 5.7 points on average and the awareness, increased with age and clinical experience. The opportunity that Occupational Therapists know OBP was through major subjects, articles & seminars, through peers and so on. The differences depended on age, level of education, location of work, clinical experience. 152 Occupational therapists(52.8%) answered that they apply OBP in their clinical work. There was no significant difference in the use of OBP based on gender, age, clinical experience, education background with exception of work location. It was shown that during practice,The most frequently used OBP was as follow in order: interview, practice, goal setting, assessment and documentation. The goal of using OBP was to find out a meaningful occupation for client's living, to promote client's participation in family or community, to treat for function recovery of clients. The biggest difficulty faced during OBP was lack of understanding of OBP for the clients and their guardian. Other difficulties were limitations of treatment environment, lack of occupational instruments, related knowledge, utilization method, preparation time and difficulty in handling insurance and medical expenses in order. Conclusion : Level of awareness of OBP was at intermediate level and it was related to education level and treatment environment. Based on this result, it is need to support institutional and academical discusstion in order to promote OBP.

목적 : 본 연구는 국내 작업치료사들의 작업기반 중재에 대한 인식도와 실행현황을 알아보고 이를 작업기반 중재 관련 기초자료로 사용하고자 시행하였다. 연구방법 : 국내 임상작업치료사 300명을 편의 표집하여 구조화된 293부의 설문지를 배포하였고 응답한 288부의 설문지를 분석하였다. 결과 : 작업기반 중재에 대한 인식도는 평균 5.7점으로 남자가 여자보다, 연령과 임상경력이 많을수록 인식도가 높았으나 성별을 제외하고는 유의하지 않았다. 작업기반 중재를 접하게 된 계기는 전공수업, 논문 및 세미나, 동료의 소개 및 기타 등이었으며 연령과 학력, 기관소재지, 임상경력에 따라 관련성에 유의한 차이가 있었다. 작업기반 중재를 임상에서 사용한다고 응답한 인원은 152명(52.8%)으로 사용하지 않는 경우보다 많았다. 사용여부는 근무지를 제외하고 성별, 연령, 임상경력, 학력에 따른 관련성의 차이가 모두 유의미하지 않았다. 작업치료 전체 과정 중 상담, 중재, 목표설정, 평가와 문서화 순으로 작업기반 중재를 사용하는 빈도가 높은 것으로 나타났다. 작업기반 중재를 사용하는 목적은 클라이언트의 삶에서 의미있는 작업을 찾기, 클라이언트의 가정이나 지역사회활동에 참여를 촉진, 클라이언트 기능회복을 위한 치료 등의 순으로 나타났다. 작업기반 작업치료를 시행하는 동안 어려움을 느꼈던 부분은 클라이언트 및 보호자의 작업에 대한 이해 부족이 가장 많았고 작업치료실 환경의 제약 및 도구의 부족, 관련 지식 및 활용방법 이해의 부족, 치료 준비 시간 부족, 치료비/보험 수가 적용의 어려움 등의 순으로 높은 응답을 보였다. 결론 : 작업기반 중재의 인식도와 실행 정도는 중간 수준으로 나타났으며 교육수준 및 치료환경과 관련이 있음을 알 수 있었다. 본 연구결과를 토대로 작업기반 중재를 현재보다 활성화하기 위한 교육의 시행과 임상 환경의 조성을 위해 제도적, 학술적 논의와 지원이 선행되어야 할 것이다.

Keywords

References

  1. Arbesman, M., & Mosley, L. J. (2012). Systematic Review of Occupation- and Activity-Based Health Management and Maintenance Interventions for Community-Dwelling Older Adults. The American Journal of Occupational Therapy, 66(3), 277-283. https://doi.org/10.5014/ajot.2012.003327
  2. Arbesman, M., & Lieberman, D. (2012). Methodology for the Systematic Reviews on Occupation- and Activity-Based Intervention Related to Productive Aging. The American Journal of Occupational Therapy, 66(3), 271-276. https://doi.org/10.5014/ajot.2012.003699
  3. Estes, J., & Pierce, D. E. (2012). Pediatric therapists' perspectives on occupation-based practice. Scandinavian Journal of Occupational Therapy, 19, 17-25. https://doi.org/10.3109/11038128.2010.547598
  4. Fisher, A. G. (2014). Occupation-centred, occupationbased, occupation-focused: Same, same or different? Scandinavial Journal of Occupational Therapy, 21, 96-107. https://doi.org/10.3109/11038128.2014.952912
  5. Hooper, B., Mitcham, M. D., Taff, S. D., Price, P., Krishnagiri, S., & Bilics, A. (2015). Energizing Occupation as the Center of Teaching and Learning. The American Journal of Occupational Therapy, 69(Supplement 2), 1-5.
  6. Japanese Association of Occupational Therapy. (2009) from http://www.jaot.or.jp/science/MTDLP.html. (accessed 20 June, 2017).
  7. Johonson, J. J., & Schkade, J. K. (2001). Effects of an Occupation-Based Intervention On Mobility Problems Following a Cerebral Vascular Accident. Applied Gerontology, 20(1), 91-110. https://doi.org/10.1177/073346480102000106
  8. Korean Association of Occupational Therapy. (2017). from https://www.kaot.org/start.asp. (accessed 20 June, 2017).
  9. Krishnagiri, S., Hooper, B., Price, P., Taff, S. D., & Bilics, A. (2017). Explicit or Hidden? Exploring How Occupation Is Taught in Occupational Therapy Curricula in the United States. The American Journal of Occupational Therapy, 71(2), 1-9.
  10. Lee, H. S., Chang, K. Y., Jung, M. Y., Ku, I. S., & Woo, H. S. (2014). Job Analysis of Occupational Therapists for 2013. Journal of Korean Society of Occupational Therapy, 22(2), 89-112. https://doi.org/10.14519/jksot.2014.22.2.07
  11. Oh, S. I. (2015). The Effects of Improved Quality of Daily Life Activities through a Occupation-Based Intervention on the Depression of Stroke Patient. Department of Occupational Therapy, The Graduate School Hanseo University. Master's thesis.
  12. Orellano, E., Colon, W. I., & Arbesman, M. (2012). Effect of Occupation- and Activity-Based Interventions on Instrumental Activities of Daily Living Performance Among Community-Dwelling Older Adults: A Systematic Review. The American Journal of Occupational Therapy, 66(3), 292-300. https://doi.org/10.5014/ajot.2012.003053
  13. Polatajko, H. J. (2001). National perspective: The evolution of our occupational perspective: The journey from diversion through therapeutic use to enablement. Canadian Journal of Occupational Therapy, 68, 203-207.
  14. Polatajko, H. J., Davis, J. A., Hobson, S., Landry, J. E., Mandich, D., Street, S. L., Yee, S., et al. (2004). Meeting the responsibility that comes with the privilege Introducing a taxonomic code for understanding occupation. Canadian Journal of Occupational Therapy, 71(5), 261-264. https://doi.org/10.1177/000841740407100503
  15. Price, P., & Miner, S. (2007). Occupation Emerges in the Process of Therapy. The American Journal of Occupational Therapy, 61(4), 441-450. https://doi.org/10.5014/ajot.61.4.441
  16. Rogers, S. L. (2007). Occupation-Based Intervention in Medical-Based Settings. OT Practice, 12(15), 10-16.
  17. Saito, Y., Tomori, K., Uezu, S., & Sawada, T. (2015). Case report from Occupation- How to write an occupational therapy outline- Igaku-shoin.
  18. Schell, B. A. B., Gillen, G., & Scaffa, M. E. (2014). Willard & Spackman' 12th ed. Lippincott Williams & Wilkins, Baltimore.
  19. Sim, J. H., Cha, T. H., & Oh, D. W. (2009). A Study on Empowerment, Job Satisfaction and Organizational CommitmentPerceived by Clinical Occupational Therapists. Journal of Korean Society of Occupational Therapy, 17(3), 111-120.
  20. The American Occupational Therapy Association(2014). Occupational therapy practice framework: Domain & process 3rd edition. The American Journal of Occupational Therapy, 68, S1-S48.
  21. Tomori, K., Nagayama, H., Ohno, K., Nagatan, R., Saito, Y., Takahashi, K., et al. (2014). Comparison of occupation-based and impairment-based occupational therapy for subacute stroke: A randomized controlled feasibility study. Clinical Rehabilitation, 1-11.
  22. Tomori, K., Uezu, S., Kinjo, S., et al. (2012). Utilization of the iPad application: aid for decision-making in occupation choice. Occupational Therapy International. 19, 88-97. https://doi.org/10.1002/oti.325
  23. Townsend, E. A., & Polatajko, H. J. (2008). Enabling occupation II: Advancing an occupational therapy vision for health, well-being, and justice through occupation. ON: CAOT Publications ACE.
  24. Wasmuth, S., Pritchard, K. & Kaneshiro, K. (2016). Occupation-Based Intervention for Addictive Disorders: A Systematic Review. Journal of Substance Abuse Treatment, 62, 1-9. https://doi.org/10.1016/j.jsat.2015.11.011
  25. Wolf, T. J., Chuh, A., Floyd, T., McInnis, K., & Williams, E. (2015). Effectiveness of Occupation-Based Interventions to Improve Areas of Occupation and Social Participation After Stroke: An Evidence-Based Review. The American Journal of Occupational Therapy, 69(1), 1-3A.
  26. World Federation of Occupational Therapists: Definition of Occupational Therapy, 2014. from Available at: http:// www.wfot.org/AboutUs/AboutOccupationalTherapy/Definition of Occupational Therapy. aspx.(accessed 20 June, 2017).
  27. World Health Organization. International classification of functioning, disability and health (ICF). Geneva, Switzerland; 2001.
  28. Yoo, H. J., Yoo, T. Y., Chung, T. I., Bae, S. H., & Jo, A. R. (2014). Scale Development of Occupational Identity and Testing Model of Antecedents and outcome variables of Occupational Identity. Korean Psychological Association, 27(4), 617-624.

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