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A Study for Developing Music Therapy Activity Program for Development of Rudimentary Movement Phase of Spastic Cerebral Palsied Infant : Applying the techniques of Neurological Music Therapy (경직형 뇌성마비 유아의 초보운동단계 발달을 위한 음악치료활동 프로그램 개발 - 신경학적 음악치료의 기법을 활용하여)

  • Lee, Yoon Jin
    • Journal of Music and Human Behavior
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    • v.4 no.2
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    • pp.84-105
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    • 2007
  • Cerebral palsy is a collection of motor disorders resulting from damage to the central nervous system that arise in multiple handicaps including cognitive disorders, speech disorders, epilepsy, perception disorders, and emotion disorders. Today spastic cerebral palsy has become more prevalent because intensive care for newborns has resulted in higher survival rates for very small premature babies. Since the children grow the fastest in order for a development during one year after birth, the therapeutic intervention is provided as early as possible to the children with cerebral palsy. After seven year old, there is no effect of intervention. So, the necessity of early intervention to spastic cerebral palsied infants is increasing. The purpose of this study is to develop the music therapy activity program using the techniques of neurological music therapy(NMT), the therapeutic application of music to dysfunctions due to neurologic disease of the human nervous system, for rudimentary movement phase of spastic cerebral palsied infant. This music therapy activity program was developed on the basis of the major developmental tasks of the rudimentary movement phase, the period that children can acquire the most basic movement function at the 0 to 2. Then the developmental characteristics of spastic cerebral palsy were applied to this music therapy activity program. This music therapy activity program was classified to three domains, those are stability, locomotion, and manipulation. This study has been consisted of three steps, those are the development of the activities, the evaluation of the activities by th panels, and the adjustment and complement of the activities. Reviewing literatures and interviews were done for the development of the activities, and the evaluation the activities was done by seven music therapists. In the evaluation steps, the questionnaire was used for estimating the content validity and application efficiency. The adjustment and complement of the activities were evaluated by the panels who were participating in the music therapy for cerebral palsied children in the clinical setting, and the results of the adjustment and complement were confirmed by the panels. The evaluation was presented in a mean value with the comment of the panels. In conclusion, the music therapy activity program for the spastic cerebral palsied infants using the techniques of NMT was developed on the basis of the major developmental tasks of the rudimentary movement phase. The program is comprised of 38 activities, those are 14 activities for developing the stability, 10 activities for developing the locomotion, and 14 activities for developing the manipulation. The programed activities would bring out the answers in the affirmative for the conformance with infants' development phase, the harmony between the objective and the activity, the conformance with the cerebral palsied infants, the properness of the music and the instruments, and the utility in the clinic field. This results mean that this developed music activity program is appropriate to help spastic cerebral palsied infants progress their movement development by stages.

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Comparison of Reliability and Validity of Three Korean Versions of the 20-Item Toronto Alexithymia Scale (TAS-20의 한국판 3종간의 신뢰도 및 타당도 비교)

  • Chung, Un-Sun;Rim, Hyo-Deog;Lee, Yang-Hyun;Kim, Sang-Heon
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.1
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    • pp.77-88
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    • 2003
  • Objectives: The purpose of this study was to compare reliability and validity of three Korean versions of the 20-item Toronto Alexithymia scale and to confirm the most reliable and validated Korean translation of the 20-item Toronto Alexithymia Scale for both clinical and research purpose in Korea. The first one was a Korean version of the 20-Item Toronto Alexithymia Scale developed by Lee YH et al in 1996 which was designated as TAS-20K(1996) in this study. This scale had a problem with one item due to the cultural difference regarding the word 'analyzing' between western culture and Korean culture. The second one was the revised version of TAS-20K(1996) on that point by Lee YH et al in 1996 without validation which was designated as TAS-20K(2003) in this study. The third one was a 23-item Korean version developed by Sin HG and Won HT in 1997, which was somewhat different from the 20-item Toronto Alexithymia Scale(TAS-20) in the number of total item, the content of some items and the scoring method. This scale was designated as S-TAS here. Methods: 408 medical students were tested with one scale composed of all the different items randomly arranged from the three versions. We evaluated goodness-of-fit and Cronbach $\alpha$ coefficients of three scales for reliability. We used confirmatory factor analysis to compare validity. Results: TAS-20K(2003) showed that it had better internal consistency than TAS-20K(1996), which implied that the cultural difference should be considered in the Korean translation. Both TAS-20K(2003) and S-TAS replicated three-factor structures and had adequacy of fit, good internal consistency and acceptable validity. However, S-TAS had one item with poor item-factor correlation and didn't show high correlation between item 2 and factor 1 as before in 1997. Conclusion: Although S-TAS had added 3 items and changed the content of two items, it didn't show better reliability and validity than TAS-20K(2003). Therefore it is proposed to use TAS-20K (2003) as the Korean version of the 20-item Toronto Alexithymia Scale(TAS-20K) for international communication of results of Alexithymia research. It has good internal consistency and validity and maintains original items, the same construct and scoring method as the 20-item Toronto Alexithymia Scale.

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Associations of Communication Skills, Self-Efficacy on Clinical Performance and Empathy in Trainee Doctors (전공의 의료커뮤니케이션 능력과 진료수행 자기효능감, 공감능력과의 상관관계)

  • Kim, Doehyung;Kim, Min-Jeong;Lee, Haeyoung;Kim, Hyunseuk;Kim, Youngmi;Lee, Sang-Shin
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.49-57
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    • 2021
  • Objectives : This study evaluated the medical communication skills of trainee doctors and analyzed the relationship between medical communication skills, self-efficacy on clinical performance (SECP) and empathy. Methods : A total of 106 trainee doctors from a university hospital participated. The questionnaire comprised self-evaluated medical communication skills, modified SECP and the Korean version of the Jefferson Scale of Empathy-Health Professionals version. The mean difference in medical communication skills scores according to gender, age, division (intern, internal medicine group or surgery group) and position (intern, first-/second- and third-/fourth-year residents) were analyzed. Pearson correlation coefficients were determined between medical communication skills, modified SECP and empathy. The effects of each variable on medical communication skills were verified using the structural equation model. Results : There were no statistically significant mean differences in self-evaluated medical communication skills according to gender, age, division or position. Medical communication skills had a significant positive correlation with modified SECP (r=0.782, p<0.001) and empathy (r=0.210, p=0.038). Empathy had a direct effect on modified SECP (β=0.30, p<0.01) and modified SECP had a direct effect on medical communication skills (β=0.80, p<0.001). Empathy indirectly influenced medical communication skills, mediating modified SECP (β=0.26, p<0.05). Conclusions : Medical communication skills are an important core curriculum of residency programs, as they have a direct correlation with SECP, which is needed for successful treatment. Moreover, the medical communication needs a new understanding that is out of empathy.

Development of Needs Assessment Instrument for the Patients with Cancer (암환자의 요구 조사 도구 개발)

  • Kim, Gi-Yon;Choi, Sang-Soon;Pak, So-Mi;Song, Hee-Young;Hur, Hea-Kung
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.136-145
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    • 2002
  • Purpose : This study was designed to develop an instrument that could be used for comprehensive and effective need assessment for patients with cancer. Methods : In the first phase, a conceptual framework for the instrument was established by Wingate & Lackey (1989). In the second phase, the preliminary instrument was drawn up through a review of the literature and in consultation with three professors in Nursing. In the third phase validity and reliability of the preliminary instrument were tested as follows; 1) an expert validity test of the preliminary instrument was done by nine head nurses and charge nurses who had over ten years experience caring for patients with cancer at Wonju Christian Hospital. 2) A construct validity test and reliability test was done for the instrument by 116 staff nurses selected by convience sampling from hospitals located in Kang-Won, Kyoung-Ki, and Choong-Chung Provinces. The collected data were analyzed using SPSS 10.0 WIN program. For the factors of the instrument, factor analysis was used. The reliability of the scale was analyzed by Cronbach's alpha. Results : The results of the experts' test of validity, showed that, of 32 items, only one item had less than 55.4%. It was then deleted and a total of 31 items was selected. On the basis of the results of the factor analysis, the following six components were identified: physiological, informational, spiritual, and emotional needs, available resources, and legal/financial needs. These factors explained 61.8% of the variance. In the factor analysis, the first factor (physiological needs) and the second factor (informational needs) explained 25.4% and 10.9% of the variance respectively, which were major factors for the needs of patients with cancer in Korea. Cronbach' alpha for the scale was .90 indicating internal reliability. Conclusion : This instrument can be effectively utilized for assessment of needs of patients with cancer in Korea. Use of the needs assessment instrument developed in this study will allow nurses to develop nursing interventions that provide comprehensiveness and continuity in meeting the needs of patients with cancer.

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ASSESSMENT OF DENTAL ANXIETY IN THE CHILD PATIENT BY THEIR DRAWINGS (환아의 그림을 통한 치과치료시 불안도 평가)

  • Choi, Seo-Jung;Park, Ho-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.3
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    • pp.354-362
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    • 2003
  • The aim of the present study was to establish validity for Dental Anxiety Scale in children by their drawings. Dental treatment was provied for 35 children in the ages of 4 to 8, using the quadrant approach. The children's anxiety arising during dental treatment was measured by Modified Sheskin's Criteria(Dental Anxiety Scale, DAS). After reliability analysis of Dental Anxiety Score, it was compared with Faces Pain Scale and was tested for their correlation. Thereafter the several factors having an effect on Dental Anxiety Scale were examined. A significant correlation(r=0.2610) was found between the two scales and Dental Anxiety Scale was high significantly in 4-6 score of Faces Pain Scale. The findings suggested that the Dental Anxiety Scale is a valid means of assessing child dental anxiety status in a clinical context and the Dental Anxiety Scale can be affected by 'Age', 'Gender' and 'Reaction in the past'.

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Development of a Korean Version of the Levels of Emotional Awareness Scale(LEAS-K) (한국판 감정자각 수준 척도의 개발)

  • Lee, Jung-Jae;Kim, Sang-Heon;Rim, Hyo-Deog
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.1
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    • pp.60-68
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    • 2003
  • Objectives: The purpose of this study was to develop a Korean version of the Levels of Emotional Awareness Scale(LEAS-K) and to examine its validity and reliability. Methods: LEAS-K was developed from translating original LEAS into Korean. The subjects were 476 Korean medical students(322 males and 154 females). The internal consistency was evaluated with the Cronbach's alpha coefficients and 40 protocols were independently scored by two raters to confirm interrater reliability. Additionally, a Korean version of 20-item Toronto Alexithymia Scale(TAS-20K), Korean versions of the Openness to Experience Inventory(OE), the Marlowe-Crowne Scale (MCS), the Bendig short form of the Taylor Manifest Anxiety Scale(TMAS) and the Emotional Expressivity Scale(EES) were rated to evaluate concurrent validity. Results: The internal consistency measured by Cronbach's alpha was 0.81 and interrater reliability was high{r(40)=0.99}. Correlation coefficients for concurrent validity were nonsignificant with TMAS and EES. LEAS-K correlated significantly with TAS-20K{r(476)=-0.10, p<0.05}, OE {r(476)=0.10, p<0.05} and MCS {r(476)=0.10, p<0.05}. Conclusion: LEAS-K was demonstrated to have high reliability and validity.

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Behavioral Variant Frontotemporal Dementia Phenocopy Syndrome (행동증상 아형 전측두엽 치매 표현형모사 증후군)

  • Cheon, Jin Sook
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.3-11
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    • 2017
  • Objectives : The aim of this study was to draw attention toward so called 'behavioral variant frontotemporal dementia(bvFTD) phenocopy syndrome', which is difficult to discriminate with the primary psychiatric disorders, showing poor response to conventional therapeutic drugs, leading to higher risk to misdiagnoses and legal problems. Furthermore, the author insisted that our interest and study on them must be continued. Methods : English articles published during 2000 thru 2016 had been searched by internet with the combination of words such as 'frontotemporal', 'phenocopy' and 'behavioral', and reviewed. Besides, two clinical vignettes were described. Results : Precise diagnosis is important because patients' behavioral symptoms can influence on their families and community. However, disease-modifying treatment for bvFTD are not developed until now, and recent therapeutic drugs are only good for specific symptoms, while deterioration progresses in spite of proper psychiatric management. The possible bvFTD patients are not progressed into probable bvFTD clinically, showing no decline of cogntive and social function, no decrease of activity function, longer survival time, and normal neuroimaging for several years. Conclusions : Rather than expected, there are much more patients having clinical symptoms, course and diagnostic findings including neuroimaging, which are atypical to classical frontotemporal dementia and primary psychiatric disorders. If our knowledge and discriminating ability is improved, discovery rate of that cases will be increased. However, the identity of these atypical features are not clarified until now, it must be further actively investigated.

Factors Influencing on Social Participation in Patients with Stroke (뇌졸중 환자의 사회 참여에 영향을 미치는 요인)

  • Song, Ye-Won;Kim, Su-Kyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.6
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    • pp.165-170
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    • 2017
  • This study aims to provide important data for community-centered rehabilitation by examining factors influencing community participation after the onset of stroke. The study subjects were 100 patients with a stroke for more than six months. Korean Craig Handicap Assessment and Reporting Technique (K-CHART) was conducted to determine the level of participation of subjects, and Korean-Modified Barthel Index (K-MBI) was conducted to examine the factors influencing the community participation of the subjects to determine the level of independence of activities of daily living. As a result, the relevant factors of community participation in stroke patients were as follows. Physical independence, cognitive independence, mobility, work, and social integration of stroke patients showed higher explanatory power than engagement in activities of daily living, age, and employment. Also, physical independence, cognitive independence, mobility, work, and social integration were factors that affected participation. All items were statistically significant (p <.01). It is considered that this study will contribute to providing information for focusing on occupational therapy for increasing the social participation of stroke patients, and proper evaluation and intervention will work as essential rehabilitation factors for improving participation with respect to the influential factors of participation.

Development of Elements of Horticultural Therapy Evaluation Indices (HTEI) through Delphi Method (전문가 델파이 조사를 통한 원예치료 평가지표 구성요소 개발)

  • Im, Eun-Ae;Son, Ki-Cheol;Kam, Jeong-Ki
    • Horticultural Science & Technology
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    • v.30 no.3
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    • pp.308-324
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    • 2012
  • The aim of this study is to develop and construct the elements of a new evaluation tool to assess the effectiveness of a horticultural therapy. Delphi method was applied to classify the realms of evaluation and specify their components and constituting items. Delphi process was performed through three rounds and 24 professionals attended all the rounds as panel members. Some of the items were revised or removed according to the results of such tests as content validity ratio, agreement rate, convergency and stability of each item. On the contrary, a few new items were added by accepting the opinions of the professional panels. Previous to the Delphi, the realms of evaluation were classified into physical, cognitional, psycho-emotional and social ones on the basis of literature review, professionals' consultation and in-depth interview with practitioners. At the first round, 112 items constituting four realms were reviewed. The numbers of items to be reviewed were reduced to 107 at the second round and to 102 at the third round. As a result, 98 items in 4 realms were decided as proper evaluation points of horticultural therapy. The compositions of the four respective realms are as follows: 5 components and 27 items in physical realm; 4 components and 25 items in cognitional realm; 2 components and 24 items in psycho-emotional realm; and 4 components and 22 items in social realm. These realms, components and specific items derived from this study constitute indices to evaluate the effectiveness of horticultural therapy. In addition, they might be utilized as good guidelines for planning horticultural therapy programs.

APPLICATION OF THE MODIFIED-MOUTHGUARD TO PREVENT SELF-INJURIOUS BEHAVIORS IN A CHILD WITH CEREBRAL PALSY : A CASE REPORT (뇌성마비 환아의 자해 방지를 위한 변형된 마우스가드의 적용)

  • Pak, Eun-Kyung;Kim, Kwang-Chul;Choi, Sung-Chul;Park, Jae-Hong
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.351-356
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    • 2008
  • Cerebral palsy, a range of non-progressive syndromes of posture and motor impairment, is a common cause of disability in childhood. Self-injurious behavior(SIB) is deliberate harm to the body without suicidal intend, often involving repetitive actions that cause tissue damage. One of the most common orofacial self-injurious behavior is chewing tongue, lip or oral mucosa. This kind of SIB in children is not common in normal children. High occurrence rates are observered in cases of syndromatic, mentally retarded children, and children with congenital disease. Various methods such as behavior modification, behavior control by drugs, body restraints, application of dental appliance, surgery and extraction of teeth have been suggested to control those self-injurious behavior. Using mouthguard as one of dental applainaces is the most conservative and appropriate method in terms of reducing oral self-injurious habits and protection of tissue. This case report describes a child with cerebral palsy who presented with self-injurious ulceration of lip and buccal mucosa. A modified mouthguard was effective in preventing self-injurious oral trauma in a child with cerebral palsy.

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