근로자 역할인식 면담도구(Worker Role Interview)를 이용한 인간작업모델(Model of Human Occupation)의 임상적용

국문 초록 (Abstract)

본 논문의 목적은 인간작업모델(The Model of Human Occupation: MOHO)을 이론적 틀로 하여 개발된 근로 자역할인식 면담도구(Worker Role Interview: WRI)를 소개하고, 향후 국내에서의 적극적인 사용을 제안하기 위한 것이다. WRI를 이용한 면담조사를 준비하기 위하여 2006년 9월부터 12월까지 WRI Version 9.0의 매뉴얼을 한국어로 1차 번역을 실시하였고, 감수와 수정 과정을 통하여 면담조사 권장질문지와 점수표, 판정기준을 마련하였다. 면담조사를 위하여 작업치료실이 있는 3곳의 산재전문병원을 방문하여 연구의 취지를 설명하였고, 그 중 한 곳에서 직업복귀 가능성이 있고 연구의 취지에 동의하는 산재 환자를 소개받아 2007년 2월 27일 면담조사를 실시하였다. WRI의 평가결과는 최소 17점에서 최대 68점으로 점수화 할 수 있는 데, 클라이언트의 평가 결과 총점 48점으로 전체적으로 직업복귀에 부정적인 측면 보다는 긍정적인 측면이 더 큰 것으로 나타났다. 특히 개인적 사유나 자신의 직업에 대한 가치, 흥미와 관련되어 있는 의지 영역에서 직업복귀를 강하게 지지하는 반응을 보였는데, 이는 클라이언트의 직업복귀에 대한 동기가 강하므로 직업복귀에 성공할 가능성이 높다는 전제 하에 재활서비스가 제공되어야 함을 의미한다. 인간작업모델이라는 새로운 작업치료의 패러다임을 임상에서 적용할 수 있는 간편한 면담평가도구로써 WRI는 심리적, 사회적, 환경적 변인을 통한 직업복귀의 가능성을 예측한다는 점에서 의미가 있으며, 작업치료사가 환자의 기능적 손상이나 장해에만 관심을 두는 것이 아니라 보다 폭넓은 관점에서 환자를 이해하고 접근하여 성공적인 재활프로그램을 계획하는데 도움이 되리라 기대된
다.

다국어 초록 (Multilingual Abstract)

The aims of this article were to introduce the Worker Role Interview (WRI) that was developed on the basis of the Model of Human Occupation (MOHO) and to suggest the application of the WRI and the MOHO in clinical practice. As a preparation process of a client interview the WRI Version 9.0 was translated into Korean between September and December in 2006 and the recommended questions, scoring sheet, and rating criteria were specified through editorial supervision and revision. The first author visited three occupational therapy clinics in general hospitals for the work-related injuries and explained the purposes of the study to the staff. She interviewed a client who agreed to participate in the study implementing the WRI on February 27th in 2007. The WRI scores can be ranged from 17 to 68 and the client scored 48 which indicated positive
qualities outweighed negative qualities supporting his returning to job. In particular, he reported high scores in volition area that is related to personal causation, values toward his job, and interests suggesting that a rehabilitation program should be provided based on the fact that in was highly probable that the positive aspects of this item would benefit him in returning to previous employment. The WRI, based on the MOHO as a new paradigm in occupational therapy, is a powerful evaluation tool in determining the psycho-social and environmental variables influencing work success. The WRI is expected to guide occupational therapists
toward a holistic perspective on their clients' conditions, rather than merely focusing on their functional impairment, for successful rehabilitation programs.

목차 (Table of Contents)

• 국문초록
• Ⅰ. 서 론
• Ⅱ. 본 론
• 1. 인간작업모델의 개념
• 2. 근로자 역할인식 면담도구의 개요
• 3. 근로자 역할인식 면담도구와 관련된 연구
• 4. 근로자 역할인식 면담도구의 적용 사례
• Ⅲ. 결 론
• 참고문헌

참고문헌 (Reference)

1 "조선소근로자들의 근골격계 질환 양상의 중재적 보건관리 효과" 14 (14): 468-477, 2002

2 "작업에 복귀한 요통산재근로자에 대한 작업강화 프로그램의 효과" 2006

3 "인간의 작업성 모델(The Model of Human Occupation)이 작업치료학에 미친 영향" 9 : 163-171, 2001

4 "우리나라에서 근골격계 질환의 발생 현황 및 증가 요인" 41 (41): 155-163, 2002

5 "산업재해 근로자의 직장복귀 예측요인" 2002

6 "and future-The work programs special interest section national work-hardening outcome study. American Journal of Occupational Therapy" rey (rey): 327-339, 1994

7 "Worksite physical activity interventions" 15 : 344-361, 1998

8 "Validity of the Swedish version of the worker role interview" 4 : 23-29, 1997

9 "The model of human occupation: Understanding the worker who is injured or disabled" 12 : 3-11, 1999

10 "The model of human occupation and prediction of return to work: A review of related empirical research" 12 : 13-23, 1999

11 "The dominant role of psychosocial risk factors in the development of chronic low back pain disability" 20 : 2702-2709, 1995

12 "The Worker Role Interview: A powerful tool in Icelandic work rehabilitation" 22 : 21-26, 2004

13 "The Worker Role Interview-Preliminary data on the predictive validity of return to work of clients after an insurance medicine investigation" 14 (14): 131-141, 2004

14 "Respecting both the ＂occupation＂ and the ＂therapy＂ in our field" 61 : 479-482, 2007

15 "Psychometric properties of the Worker Role Interview" 27 : 313-318, 2006

16 "Prevention strategies for occupational low back pain" 13 : 33-45, 1998

17 "Occupational therapy in industrial rehabilitation. American Journal of Occupational Therapy" 314-321, 1985

18 "Model of human occupation: Theory and application. (4th ed.)" Philadelphia: Lippincott Williams & Wilkins

19 "Model of human occupation: Theory and application. (3rd ed.)" Philadelphia: Lippincott Williams & Wilkins 2002

20 "Effects of body mechanics training on performance of repetitive lifting" 54 : 166-175, 2000

21 "Administration and application of the Worker Role Interview: Looking beyond functional capacity" 12 : 13-24, 1999

22 "Absence resulting from low back pain trouble can be reduced by psychosocial intervention at the work place" 20 : 2738-2745, 1995

23 "A systematic review of controlled clinical trials on the prevention of back pain in industry" 54 : 841-847, 1997

24 "A review of the scientific evidence on prevention after disability begins." 21 : 2918-2929, 1996

25 "A literature review of low back disorder surveillance measures and risk factors" 12 : 211-226, 1997

26 ". Using work simulation to treat adults with back injuries. American Journal of Occupational Therapy" 12-18, 1986

27 ". The management of work-related back pain. American Journal of Occupational Therapy" 112-117, 1987

28 ". The effectiveness of four interventions for the prevention of low back pain. Journal of the American Medical Association" 1286-1291, 1994

29 ". Reliability of the Worker Role Interview. American Journal of Occupational Therapy" 797-803, 1993

30 ". Psychosocial factors at work and musculoskeletal disease. Scandinavian Journal of Work and Environmental Health" 297-312, 1993

31 ". Predictors of low back pain disability. Clinical Orthopedics" 89-98, 1987

32 ". Perceptions of disability and occupational stress as discriminators of work disability in patients with chronic pain. Journal of Occupational Rehabilitation" 1991185-195.

33 ". A user's guide to the Worker Role Interview The Model of Human Occupation Clearinghouse Department of Occupational Therapy University of Illinois at Chicago." Chicago: The Model of Human Occupation Clearinghouse, Department of Occupational Therapy, University of Illinois at Chicago 1998

34 ". A new clinical model for the treatment of low back pain. Spine" 632-644, 1987

35 ". A multidisciplinary approach to the prevention evaluation and management of work disability. Journal of Occupational Rehabili- tation" 5-12, 1991

36 ". A model of human occupation Part 4. Assessment and intervention. American Journal of Occupational Therapy" 777-788, 1980

37 ". A model of human occupation Part 3. Benign and vicious cycle. American Journal of Occupational Therapy" 731-737, 1980b

38 ". A model of human occupation Part 2. Ontogenesis from the perspective of temporal adaptation. American Journal of Occupational Therapy" 657-663, 1980a

39 ". A model of human occupation Part 1. Conceptual framework and content. American Journal of Occupational Therapy" 572-581, 1980