경도치매 환자를 위한 그림책 활용 시각화 기억훈련 프로그램의 임상 유용성 연구

주유미,Ju, Yumi 중소기업융합학회 2021 융합정보논문지 Vol.11 No.4

This study aims to develop a protocol for the visualized memory training program using the picture book and evaluate its clinical utility. A total of 5 sessions were conducted for 5 elderly people with mild dementia. Rey-Kim II, GDS-Short, word test were conducted to observe its effectiveness before and after the program. As a results overall memory was improved but was not statistically significant. Overall depression was also improved and statistically significant. The effect of word memory varies depending on individuals' degenerative conditions. In conclusion, the visualized memory training program using the picture book is effective in improving the memory to some extent and had an emotional effect of reducing depression in mild dementia. In the future it is necessary to research its effects in larger population.

치매 환자를 대상으로 하는 가상현실 재활치료에 관한 체계적 고찰

주유미 ( Ju Yumi ) 대한인지재활학회 2020 대한인지재활학회지 Vol.9 No.1

Objective: This study aims to systematically review the methods of virtual reality(VR) based rehabilitation and its effectiveness for dementia. Methods: The articles were searched through the database such as PubMed, CINAHL, Riss from 2000, January to 2020, May with key words of ‘Dementia’, ‘Virtual reality’, ‘Rehabilitation/Intervention. Total 13 were selected among 160 articles which were searched from database and went through scrutinizing. Result: As a result of analyzing, 5 (38.5%) articles which were the most frequent were level III one group comparison study. 2 (15.4%) articles were applied immersive VR devices and other 11 (84.6%) were applied non-immersive VR. Relating to VR contents, VR based exercise(38.5%) were most frequently applied, then ADL tasks (23.1%) were followed next. Besides, navigation task, stimulus-response game, watching scenary were used for intervention. The various types of VR were all effective on physical function, cognition, frontal lobe function, affective symptoms and so on. Conclusion: VR based rehabilitation is cost effective and ecologically more valid. It is technologically available to produce virtual therapeutic environment at any place and it motivates patients to engage more in rehabilitation. As a results, VR based rehabilitation for dementia is very early stage of introduction and pilot trials. In the future study, it is necessary to establish more clinical evidences by applying them to the larger group of patients.

그림책을 활용한 기억력 향상 프로그램 사례연구 : 노니 호그로지안의 ‘꼬리를 돌려주세요’ 활용

주유미 ( Ju Yumi ) 대한인지재활학회 2019 대한인지재활학회지 Vol.8 No.1

Objective: The purpose of this study was to develop the picturebook based memory enhancement program protocol and it applied to small group of the elderly. The improvement of cognitive function and changes in depression were focused through this program. Methods: The picturebook. ‘One Fine Day’ by Nonny Hogrogian was used in memory enhancement program. 3 elderly people with long-term care insurance were participated in the program, it runs through 4 sessions, the contents were repeated every week. K-MoCA was used to test pre- and post- cognitive function and short-form of GDS was used to evaluate the level of depression before and after the program. The word recognition questionnaire was also conducted in order to check that th learning would happen though the program. Result: There were no significant changes in cognitive function and depression level after the 4 sessions of program comparing to the baseline. However, the participant memorized the more word in the picturebook at the 4^th session than 1^st session. The learning of words were happened through the program. Conclusion: The picturebook based memory enhancement program was developed and it applied to the elderly to evaluate its clinical utility. It was not possible to statistically scrutinize its effectiveness. However, we could get an idea that the literature and art combined program well fitted especially in community based cognitive rehabilitation.

노인낙상안심마을 만들기 프로그램의 개발 및 효과

주유미 ( Ju Yumi ) 대한인지재활학회 2018 대한인지재활학회지 Vol.7 No.1

Objective: Fall-Free Village Project was designed for the elderly over 65 year-old which lives in rural area. It is community based fall prevention program consisted of 8 weeks group program and 4 weeks individual intervention. This study aimed to evaluate how much the program is effective for the elderly in rural area. Methods: According to literatures relating to fall and fall prevention program, the intrinsic and extrinsic factors to cause fall were extracted and applied throughout our program sessions. The effectiveness of the program was evaluated from two aspects, which were fall-related behaviors and environmental hazard of fall. The Falls Behvioural Scale for the Older Person (FaB) and Home Falls and Accidents Screening Tool (HOME-FAST) was used to assess the effectiveness. The Wilcoxon’s signed-rank test was applied to analyze statistical significance. Result: The fall related behaviors were decreased and it was statistically significant before and after the program. The environmental hazards were eliminated to some extent and it was also statistically significant before and after the program. Conclusion: Fall-Free Village Project is effective to prevent falls for the elderly over 65 year old which are living in rural area. The protocol of the fall prevention program which was developed in this study would be useful to be used in community-based occupational therapy.

발달장애아동을 위한 태블릿기반 사회성평가 항목 컨텐츠 개발 : 델파이 예비연구

주유미(Yumi Ju),김정호(Jung-ho Kim),정서원(Seo-won Jung),조선영(Sun-young Cho) 한국콘텐츠학회 2021 한국콘텐츠학회 종합학술대회 논문집 Vol.2021 No.8

노인의 인지기능과 낙상유발 행동요인과의 상관분석

주유미(Ju, Yumi),이헌주(Lee, Heon-Joo) 대한신경계작업치료학회 2018 재활치료과학 Vol.7 No.2

목적: 본 연구는 노인의 인지수준이 낙상을 유발하는 위험 행동요인과 어떤 상관관계를 갖는지 알아보 기 위하여 진행되었다. 연구방법: 2017년 10월부터 12월까지 3개월 간 4개의 도시에 거주하고 있는 65세 이상 인지장애가 있 는 노인 및 인지장애가 없는 노인 43명을 대상으로 인지기능 평가(K-MoCA) 및 낙상행동요인척도 (FaB)를 실시하여 자료를 수집하였다. 두 평가의 총점 결과간의 상관관계를 SPSS 22를 사용하여 분 석하였고, 각각의 낙상행동요인과 인지수준과의 상관관계를 분석하였다. 결과: 노인의 인지수준과 낙상행동요인 간에 통계적으로 유의미한 양의 상관관계가 있는 것으로 나타 났다(p<.01). 노인 낙상행동요인 척도의 총 30개의 문항 중 9개의 문항이 K-MoCA의 총점과 통계적 으로 유의미한 상관관계를 보였다. 결론 : 노인의 인지수준이 높을수록 낙상위험 행동요인이 적고, 인지수준이 낮을수록 낙상위험 행동요 인을 인식하지 못하고 낙상관련 위험행동을 하는 양상을 보인다. 특히 일부 낙상위험 행동요인은 인 지수준과 상관관계가 있어 관련 중재를 제공할 시 고려해주는 것이 필요하다. Objective: This study was conducted to investigate the correlation of cognitive function and fall-risk behavioral factors. Methods: The elderly over than 65 year-old with and without cognitive impairment were recruited in four different regional areas. Total 43 data of K-MoCA and FaB were collected. Pearson correlation of total scores of K-MoCA and FaB was analyzed using SPSS 22. Correlation between total score of K-MoCA and each item of FaB which describes the fall-risk behaviors was analyzed as well. Results: The cognitive function was statistically positive correlated with the fall-related behaviors in pearson correlation analysis (p<.01). Nine items of total 30 items of FaB was significantly correlated with total score of K-MoCA. Conclusion: Fall-risk behaviors were decreased as the cognitive level was improved. If the cognitive function was vulnerable, the insight to fall-risk behaviors deficits and various fall-related behavioral factors exits. The high fall-risk behaviors were correlated with cognitive function, so that the cognitive level should be considered in fall prevention intervention in Occupational Therapy.

쉼터 노숙인의 직업재활 후 직업 유지기간과 만족도에 영향을 미치는 요인 : 설문지 문항 예비조사

주유미 ( Ju Yumi ) 대한인지재활학회 2016 대한인지재활학회지 Vol.5 No.2

Objective: This study aims to construct survey items in order to identify factors related to job satisfaction and duration of job for homeless people. Methods: 5 homeless people were participated in survey, they answered and rated each items in 7 category factors which is considered as influencing factors to job satisfaction and duration of job. 7 categories are followings: Basic Information, Physical Condition, Neuropsychological Condition, Abuse dependency, Characteristics of homeless life, Social relationship. Statistic analysis were conducted by SPSS 22.0 and Spearman analysis was used for correlation analysis. Result: Intimacy to people within shelter, depression, frequency of leave away from shelter, physical condition of lower extremities were significantly correlated to job satisfaction. Self-esteem, recent personality changes, monthly income were significantly correlated to duration of job that they are working now. Conclusion: For the successful vocational rehabilitation for the homeless people, physical, cognitive, and affective factors should be considered within the program. Especially, not only specific job skills but their stable life and social relationship in the shelter is significantly important to their job satisfaction and long duration of job.

발달장애 아동 부모의 인지재활 경험에 대한 질적 연구: 워드 클라우드 분석과 현상학적 연구 방법 혼합설계

주유미(Yumi Ju),김영근(Young-geun Kim),이희령(Hee-Ryoung Lee),홍승표(Seung-Pyo Hong),한대성(Dse Sung Han) 대한신경계작업치료학회 2024 재활치료과학 Vol.13 No.1

목적 : 본 연구의 목적은 현상학적 방법론과 워드 클라우드 분석을 통해 발달장애 아동 부모의 인지재활경험에 대한 인식을 알아보기 위함이다. 연구방법 : 인지재활에 대한 부모 인식을 알아보기 위하여 발달장애 아동의 부모 5명을 심층 인터뷰하였다. 아울러 Python을 사용하여 워드 클라우드 분석을 하였고, 출현 빈도 수가 높은 단어를 중심으로 5명의 연구자가 의미 단위와 주제를 현상학적 방법으로 분석하였다. 결과 : 인지재활의 현상에 대한 의미 단위 43개 및 구성요소 9개를 도출하였고, 이로부터 총 3개의 주제를 최종 도출하였다. 도출된 중심 주제는 인지재활의 정의, 인지재활의 문제점, 인지재활 기관 선택 시 고려사항이었다. 인지재활은 발달장애 아동의 학습, 일상생활 기능, 인지기능 향상을 목적으로 하는치료라는 인식이 있었다. 인지재활의 문제점으로는 치료방식, 치료사의 전문성, 치료비용에 관한 문제인식이 있었다. 마지막으로, 인지재활 기관 선택 시 고려사항으로는 치료사의 전문성, 입소문, 비용과 시간의 적정성이 있었다. 결론 : 발달장애 아동의 부모는 인지재활을 통해 아동의 실질적인 기능 향상을 기대하고 있었고, 이와 더불어 임상에는 현실적인 문제들이 존재하고 있었다. 본 연구는 부모가 인식하는 문제점들을 보완한 보다 나은 인지재활 서비스로 발전되는 데 기초자료가 될 것이다. Objective : The purpose of this study was to investigate parental perspectives on cognitive rehabilitation using a combination of phenomenological research methodology and word cloud analysis. Methods : Interviews were conducted with five parents of children with developmental disabilities. Word cloud analysis was conducted using Python, and five researchers analyzed the meaning units and themes using phenomenological methods. Words with high frequency were considered as a heuristic tool. Results : A total of 43 meaning units and nine components related to the phenomenon of cognitive rehabilitation were derived, and three themes were finalized. The main themes encompassed the definition of cognitive rehabilitation, challenges associated with cognitive rehabilitation, and factors influencing the selection of a cognitive rehabilitation institute. Cognitive rehabilitation emerged as a treatment focused on improving learning, daily functioning, and cognitive abilities in children with developmental disabilities. The perceived issues with cognitive rehabilitation pertained to treatment methods, therapist expertise, and associated costs. In addition, parents highlighted the importance of therapist expertise, humane personality, and affordability of cost and schedule when choosing a cognitive rehabilitation institute. Conclusion : Parents expressed expectations for substantial improvements in their children's daily functioning through cognitive rehabilitation. However, challenges were identified in clinical practices. Going forward, we expect that cognitive rehabilitation will evolve into a better therapeutic support service addressing the concerns raised by parents.

한국어로 번안한 노인 낙상행동요인 척도(The Falls Behavioural (FaB) Scale)의 타당도 및 신뢰도 연구

주유미(Yumi Ju),장종식(Jongsik Jang) 인문사회과학기술융합학회 2018 예술인문사회융합멀티미디어논문지 Vol.8 No.4

본 연구는 낙상을 예방할 수 있는 낙상행동 요인 척도를 임상에 적용하기 위하여 타당도와 신뢰도를 확인하였다. FaB을 번역-역번역 과정을 통해 한국어로 번안 후 내용타당도를 확인하기 위해 델파이 기법을 사용하였다. 전문가 집단 30명(교수 13명, 지역사회 7명, 병원 10명)의 적합도를 CVR값을 통해 제시 하였다. 한국어로 번안된 노인 낙상행동요인 척도를 지역사회 거주 노인 107명에게 실시하여 내적일치도를 확인하였다. 낙상행동 요인 척도 30문항 중 11개 문항은 한국문화에 적합하지 않았으CVR=-0.20~0.80), 가장 부적합한 항목은 ‘나는 우리 집에서 나가는 길목에 있는 잡초나 나무들을 관리해주고 있다’였다. 내적일치도는 총점을 기준으로 Cronbach’s ɑ=0.78로 높은 값을 나타내었으나, 전체-항목 간 상관성에서 6개의 항목에서 음의 상관성을 보였다. FaB을 한국어로 번안하여 한국노인들에게 적용하였을 시 신뢰도는 높게 유지되는 편으로써 임상사용에 유용한 것으로 나타났다. 국내에서 FaB의 사용 시 19개의 항목만을 사용하는 것이 추천되며 한국문화를 반영한 한국형 낙상행동요인 항목을 추가적으로 개발하는 것이 필요할 것으로 사료된다. The aim of this study FaB was translated into Korean by systematic translation process. The content validity and the reliability were tested with Korean version of FaB. The translation was performed using direct and backward translation process. The content validity was tested with the 30 expert panels by Delphi method. The translated Korean version of FaB was performed to 109 community dwelling elderly person with and without disability. The FaB was translated in Korean. 11 items among total 30 items were judged as culturally inappropriate(CVR=-0.20~0.80). The internal consistency of Korean version of FaB was 0.78 (Cronbach’s ɑ). The reliability of Korean version of FaB is relatively high to be used in clinic. However, the 11 items over total 30 items was judged culturally inappropriate to apply Korean elderly by expert Delphi method. FaB is the assessment to evaluate behavioral factors related to falls, the behaviors are highly influenced by social and cultural context. Therefore, it is necessary to develop new items on Korean version of FaB which are culturally valid in the future study.

가정환경개선 서비스가 지역사회 치매 노인의 낙상 위험성과 일상생활 독립성에 미치는 영향

주유미(Ju, Yumi),박주연(Park, Ju-Yeon),한효진(Han, Hyo-Jin),유제광(Ryu, Jeh-Kwang) 한국노인작업치료학회 2021 한국노인작업치료학회지 Vol.3 No.2

목적 : 본 연구는 지역사회 거주 치매 환자를 대상으로 가정환경개선 서비스를 제공하고 효과성을 검증하기 위함이다. 연구방법 : 태안군 치매안심센터에서 총 16명의 치매 진단을 받은 노인을 연계 받아 총 8주간 가정환경개선 서비스를 진행하였다. 각 대상자 개인별로 1주일에 1회씩 총 6회기의 재가방문 서비스를 제공하였다, 사전-사후 평가를 포함하여 개인 행동평가, 가정환경 컨설팅, 가정환경개선, 일상생활 훈련, 및 인지 전략 교육 등을제공하였다. 서비스 전후 효과를 알아보기 위하여 가정환경평가 프로토콜(HEAP)과 추가로 활동-특정 균형 자신감 척도(ABC), 낙상 행동요인 척도(FaB), 한국판 일상생활활동 평가(K-ADL)과 수단적 일상생활활동 평가(K-IADL)의 독립성 변화를 평가하였다. 사전-사후 점수 비교는 Jamovi 2.2.2를 통해 분석하였다. 결과 : 중재 결과 가정 내 위험환경, 적응, 시각적 단서, 관찰에서는 통계적으로 유의미한 환경변화가 있었다(p<.001). 단, 가정환경의 편안함은 통계적으로 유의한 개선이 없었던 것으로 나타났다. 또한, 중재 후 균형자신감, 낙상 행동요인, 수단적 일상생활의 독립성에 통계적으로 유의한 변화가 있었던 것으로 나타났다(p<.001). 반면 일상생활의 독립성에는 변화가 없었다(p=.186). 전반적 서비스 만족도는 10점 만점에 9.6점으로 매우 높게 나타났다. 결론 : 지역사회 거주 치매 환자를 대상으로 하는 가정환경개선 서비스는 가정 내 생활 환경의 개선뿐만 아니라노인의 낙상을 예방하고 수단적 일상생활의 독립성을 향상하는데 효과적인 것으로 나타났다. 추후 더 많은모집단을 통해 서비스를 제공하고 서비스의 효과성을 체계적으로 분석해볼 필요가 있다. Objective : The aim of this study was to provide a home modification service for elderly people with dementia living in the community and to verify its effectiveness. Methods : Sixteen elderly people diagnosed with dementia participated in the home modification service provided in this study. Six home visits were provided for each individual subject. Including pre-and post-evaluation, personal behavior evaluation, home environment consulting, home environment modification, daily activities training, and cognitive strategy education were provided. To examine the effects before and after the service, changes in the environment, balance confidence, fall behavioral factors, and independence of ADL and IADL were evaluated. The preand post-score comparisons were analyzed using Jamovi 2.2.2. Results : The intervention showed statistically significant environmental changes in home hazards, adaptation, visual cues, and observation (p<.001). However, there was no statistically significant improvement in the comfort of the home environment. Also, there were statistically significant changes in activity-specific balance confidence, fall behavioral factors, and independence in IADL after intervention (p<.001). On the other hand, there was no change in independence in ADL (p=.186). Overall satisfaction with the service was very high at 9.6 out of 10. Conclusion : The home modification service for the elderly with dementia living in the community was found to be effective not only in improving the living environment at home, but also in preventing falls and improving the independence of IADL. In the future, it will be necessary to provide services to a larger population and investigate its effectiveness.