3D 가상치매체험 프로그램이 치매에 대한 태도와 인식변화에 미치는 효과

Effects of Dementia Experience using Virtual Reality on Public Awareness and Attitude toward Dementia Patients

  • 정지운 (제주특별자치도 광역치매센터) ;
  • 김현택 (고려대학교 심리학과) ;
  • 박준혁 (제주대학교 의학전문대학원 정신건강의학과)
  • 투고 : 2017.08.23
  • 심사 : 2018.10.02
  • 발행 : 2018.11.30

초록

가상현실 치매체험 프로그램(EDuVR, Empathy for Dementia using Virtual Reality)은 환자가족, 조호자, 일반인들에게 치매환자에 대한 이해와 공감을 유도하기 위해 제주특별자치도 광역치매센터에서 개발한 360도 가상현실 콘텐츠이다. 치매에 대한 인식개선도구 개발의 필요성에 따라, 치매환자가 겪는 기억력, 지남력, 언어능력, 판단력과 같은 인지기능 저하와 이로 인한 일상생활의 어려움을 환자 일인칭 시점으로 체험하도록 하였다. 본 보고의 전반부에서는 EDuVR에 대하여 소개하였고 후반부에서는 EDuVR 체험이 인식개선에 미치는 효과를 기술하였다. 총 66명의 피험자를 EDuVR 집단(34명)과 교육집단(32명)에 할당한 후, 치매태도검사, 치매인식검사를 사전과 사후에 각각 측정하였다. EDuVR 집단은 추가적으로 VR 경험에 따른 멀미감과 현실감 수준을 측정하였다. 그 결과, 치매환자에 대한 태도 및 인식은 EDuVR의 체험에 따라 긍정적으로 변화하였으며, 이러한 변화는 치매교육의 효과와 다르지 않았다. EDuVR의 체험 후 유의한 수준으로 멀미를 느낀 사람은 1명에 불과하였다. 본 결과는 EDuVR은 짧은 체험시간만으로도 교육과 유사한 수준의 인식개선 및 태도변화를 일으키며, 멀미감이 크게 유발되지 않아 일반대중이 체험하기에 용이한 콘텐츠임을 시사한다. 즉, EDuVR은 치매에 대한 이해와 공감수준을 높이는 유용한 인식개선 도구이다.

The Empathy for Dementia using Virtual Reality (EDuVR) system, developed by the Jeju Provincial Dementia Center, is a 3D video system capturing the experience of dementia in a first-person perspective using 360 degree vritual reality (VR) technology. It was developed to create a greater understanding of dementia and to help people empathize with individuals with dementia through an immersive VR experience. The EDuVR shows how a dementia patient has impairments in memory, orientation, language, judgment and problem solving, as well as problems with activities of daily living. The present study reported the effectiveness of the EDuVR experience in changing public awareness of, and attitude toward, dementia. Sixty-six participants were assigned to the EDuVR (n = 34) or the conventional education (n = 32) groups, and two types of questionnaires - attitude and awareness questionnaires - were administered to the subjects before and after the EDuVR experience or education. The simulator sickness and presence questionnaires were administered to the EDuVR group to assess cybersickness and presence of the VR experience. As a results, the attitude and awareness toward dementia patients changed positively in both the EDuVR and the conventional education groups, and these changes did not differ between two groups. Only one person reported a significant level of cybersicness after experiencing the EDuVR system. These results suggest that the EDuVR enhances the level of understanding and empathy for dementia and would be a useful tool for improving awareness in the general public.

키워드

참고문헌

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV(4th ed.). Washington, DC: American Psychiatric Association. 1994.
  2. Kim, K. W., Park, J. H., Kim M. H., Kim, M. D., Kim, B. J., Kim, S. k., Kim, J. L., Moon, S. W., Bae, J. N., Woo, J. I., Ryu, S. H., Yoon, J. C., Lee, N. J., Lee, D. Y., Lee, D. W., Lee, S. B., Lee, J. J., Lee, J. Y., Lee, C. U., Chang, S. M., Jhoo, J. H. and Cho, M. I. A nationwide survey on the prevalence of dementia and mild cognitive impairment in South Korea. Journal of Alzheimer's Disease. 23(2). Amsterdam: IOS press. pp. 282-291. 2011.
  3. Jhoo, J. H., Kim, K. W., Huh, Y., Lee, S. B., Park, J. H., Lee, J. J., Choi, E. A., Han, C, Choo, I. H., Youn, J. C., Lee, D. Y. and Woo, J. I. Prevalence of dementia and its subtypes in an elderly urban Korean population: Results from the Korean Longitudinal Study of Health and aging (KLoSHA). Dementia and Geriatric Cognitive Disorders. 26(3). Basel: Karger Publishers. pp. 270-276. 2008. https://doi.org/10.1159/000160960
  4. 보건복지부. 2012 전국 치매유병률 조사. 세종: 보건복지부. 2012.
  5. 보건복지부. 치매노인 실태조사. 세종: 보건복지부. 2011.
  6. 김아영, 채원석, 장규호, 최하림, 김백섭, 이준우. 가상현실 동향분석. 전자통신동향분석. 31(4). 한국전자통신연구원. pp. 23-35. 2016. https://doi.org/10.22648/ETRI.2016.J.310403
  7. Witmer, B. and Singer, M. Measuring presence in virtual environments: A presence questionnaire. Presence: Teleoperators and Virtual Environments. 7(3). Cambridge, MA: MIT Press. pp. 225-240. 1998. https://doi.org/10.1162/105474698565686
  8. Bowman, D. A. and McMahan, R. P. Virtual reality: how much immersion is enough? Computer. 40(7). Washington, DC: IEEE Computer Society. pp. 36-43. 2007.
  9. Sanchez-Vives, M. V. and Slater, M. From presence to consciousness through virtual reality. Nature Reviews Neuroscience. 6(4). London: Nature Publishing Group. pp. 332-339. 2005. https://doi.org/10.1038/nrn1651
  10. 현정우. 의료 분야에서의 가상현실 기술 동향. 주간기술동향. 1751호. 정보통신기술진흥센터. pp. 2-15. 2016.
  11. Emmelkamp, P. M., Krijn, M., Hulsbosch, A. M., de Vries, S., Schuemie, M. J. and van der Mast, C. A. Virtual reality treatment versus exposure in vivo: a comparative evaluation in acrophobia. Behaviour Research and Therapy. Amsterdam: Elsevier. 40(5). pp. 509-516. 2002. https://doi.org/10.1016/S0005-7967(01)00023-7
  12. Rothbaum, B. O., Hodges, L. F., Kooper, R., Opdyke, D., Williford, J. S. and North, M. Effectiveness of computer-generated (virtual reality) graded exposure in the treatment of acrophobia. The American Journal of Psychiatry. 152(4). Philadelphia, PA: American Psychiatric Association. pp. 626-628. 1995. https://doi.org/10.1176/ajp.152.4.626
  13. North, M. M., North, S. M. and Coble, J. R. Effectiveness of virtual environment desensitization in the treatment of agoraphobia. Presence: Teleoperators and Virtual Environments. 5(3). Cambridge, MA: MIT Press. pp. 346-352. 1996. https://doi.org/10.1162/pres.1996.5.3.346
  14. Vincelli, F., Anolli, L., Bouchard, S., Wiederhold, B. K., Zurloni, V. and Riva, G. Experiential cognitive therapy in the treatment of panic disorders with agoraphobia: a controlled study. Cyberpsychology and Behavior. 6(3). Larchmont, NY: Mary and libert, Inc. pp. 321-328. 2003. https://doi.org/10.1089/109493103322011632
  15. Rothbaum, B. O., Hodges, L. F., Smith, S., Lee, J. H. and Price, L. A controlled study of virtual reality exposure therapy for the fear of flying. Journal of Consulting and Clinical Psychology. 68(6). Washington, DC: American Psychological Association. pp. 1020-1026. 2000. https://doi.org/10.1037/0022-006X.68.6.1020
  16. Wiederhold, B. K., Jang D. P., Kim, S. I. and Wiederhold, M. D. Physiological monitoring as an objective tool in virtual reality therapy. Cyberpsychology and Behavior. 5(1). Larchmont, NY: Mary and libert, Inc. pp. 77-82. 2002. https://doi.org/10.1089/109493102753685908
  17. Difede, J. and Hoffman, H. J. Virtual reality exposure therapy for World Trade Center post-traumatic stress disorder: a case report. Cyberpsychology and Behavior. 5(6). Larchmont, NY: Mary and libert, Inc. pp. 529-535. 2002. https://doi.org/10.1089/109493102321018169
  18. Rizzo, A., Pair, J., McNerney, P. J., Eastlund E., Manson B., Gratch, J., Hill, R. and Swartout, B. Development of a VR therapy application for Iraq war military personnel with PTSD. Studies in Health Technology and Informatics. 111. Amsterdam: IOS press. pp. 407-413. 2005
  19. Rothbaum, B. O., Hodges, L. F., Alarcon, R., Ready, D., Shahar, F., Graap, K., Pair, J., Hebart, P., Gotz, D., Wills, B. and Baltzell, D. Virtual reality exposure therapy for PTSD Vietnam veterans: a case study. Journal of Traumatic Stress. 12(2). Hoboken, NJ: Wiley-Blackwell. pp. 263-271. 1999. https://doi.org/10.1023/A:1024772308758
  20. Kandalaft, M. R., Didehbani, N., Krawczyk, D. C., Allen, T. T. and Chapman, S. B. Virtual reality social cognition training for young adults with high-functioning autism. Journal of Autism and Developmental Disorders. 43(1). Berlin: Springer. pp. 34-44. 2013. https://doi.org/10.1007/s10803-012-1544-6
  21. Rizzo, A. A., Buckwalter, J. G., Bowerly, T., Van Der Zagg, C., Humphrey, L., Neumann, U., Chua, C., Kyriakakis, C., Van Rooyen, A. and Sisemore, D. The virtual classroom: a virtual reality environment for the assessment and rehabilitation of attention deficits. CyberPsychology and Behavior. 3(3). Larchmont, NY: Mary and libert, Inc. pp.483-499. 2000. https://doi.org/10.1089/10949310050078940
  22. Wang, M. and Reid, D. Virtual reality in pediatric neurorehabilitation: attention deficit hyperactivity disorder, autism and cerebral palsy. Neuroepidemiology. 36(1). Basel: Karger Publishers. pp. 2-18. 2010. https://doi.org/10.1159/000320847
  23. da Costa, R. M. E. M. and de Carvalho, L. A. V. The acceptance of virtual reality devices for cognitive rehabilitation: a report of positive results with schizophrenia. Computer Methods and Programs in Biomedicine. 73(3). Amsterdam: Elsevier. pp. 173-182. 2004. https://doi.org/10.1016/S0169-2607(03)00066-X
  24. Park, K. M., Ku, J., Choi, S. H., Jang, H. J., Park, J. Y, Kim, S. I. and Kim, J. J. A virtual reality application in role-plays of social skills training for schizophrenia: a randomized, controlled trial. Psychiatry Research. 189(2). Amsterdam: Elsevier. pp. 166-172. 2011. https://doi.org/10.1016/j.psychres.2011.04.003
  25. Sorkin, A., Weinshall, D., Modai, I. and Peled, A. Improving the accuracy of the diagnosis of schizophrenia by means of virtual reality. American Journal of Psychiatry. 163(3). Philadelphia, PA: American Psychiatric Association. pp. 512-520. 2006. https://doi.org/10.1176/appi.ajp.163.3.512
  26. Beville, P. K. Virtual Dementia Tour helps sensitize health care providers. American Journal of Alzheimer's Disease and Other Dementias. 17(3). Thousand Oaks, CA: SAGE Publishing. pp. 183-190. 2003. https://doi.org/10.1177/153331750201700301
  27. 오봉욱. 사이버대학생들의 치매에 대한 지식과 태도, 영향요인에 관한 연구. 복지상담교육연구. 5(1). 한국복지상담교육학회. pp. 111-127. 2016.
  28. 조현오. 치매에 대한 일반인의 지식과 태도 조사연구. 석사학위논문. 한양대학교 행정대학원. 대한민국: 서울. 1999.
  29. Kennedy, R. S., Lane, N. E., Berbaum, K. S. and Lilienthal, M. G. Simulator sickness questionnaire: An enhanced method for quantifying simulator sickness. The International Journal of Aviation Psychology. 3(3). Abingdon: Taylor & Francis. pp. 203-220. 1993. https://doi.org/10.1207/s15327108ijap0303_3
  30. 장은희, 서대일, 김현택, 유병현. 사이버멀미 통합모델: 가상현실 사용자의 불편감 현상 연구. 정보과학회논문지. 45(3). 한국정보과학회. pp. 251-279. 2017.
  31. 황인재, 김석찬, 장은희, 전현진, 천예슬, 박창훈, 김현택. 가상환경에서 사이버멀미 경감을 위한 독립적 시각 전경효과. 한국심리학회지: 인지 및 생물. 24(3). 한국심리학회. pp. 251-263. 2012.
  32. Henrique, G. D., Eray, M., Bruno, H. and Ronan, B. Characterizing embodied interaction in first and third person perspective viewpoints. In proceeding of 2015 IEEE symposium on 3D user interfaces (3DUI). Arles. pp. 23-24. 2015.
  33. Bronfenbrenner, U. Toward an experimental ecology of human development. American Psychologist. 32(7). Washington, DC: American Psychological Association. pp. 513-531. 1997. https://doi.org/10.1037/0003-066X.32.7.513
  34. LaViola, J. J. A discussion of cybersickness in virtual environment. ACM SIGCHI Bulletin. 32(1). New York, NY: ACM. pp. 47-56. 2000. https://doi.org/10.1145/333329.333344
  35. Kober, S. E. Effect of age on the subjective presence experience in virtual reality. In Proceedings of the International Society for Presence Research. Vienna. pp.149-157. 2004
  36. Stanney, K., Mourat, R. and Kennedy, R. Human factors issues in virtual environments: A review of the literature. Presence: Teleoperators and Virtual Environments. 7(4). Cambridge, MA: MIT Press. pp. 327-351. 1998. https://doi.org/10.1162/105474698565767
  37. Gleen, N. O. Values, attitudes, and beliefs. In O'Brim, O. G. and Kagan, J. (Ed.) Constancy and cnage in human development. Cambridge, MA: Harvard Press, 1980.
  38. Serrani Azcurra, D. J. A reminiscence program intervention to improve the quality of life of long-term care residents with Alzheimer's disease: a randomized controlled trial. Revista Brasileira de Psiquiatria. 34(4). Rio de Janeiro: Brazilian Association of Psychiatry. pp. 422-433. 2012. https://doi.org/10.1016/j.rbp.2012.05.008
  39. Subramaniam, P. and Woods, B. The impact of individual reminiscence therapy for people with dementia: systematic review. Expert Review of Neurotherapeutics. 12(5). Abingdon: Taylor & Francis. pp. 545-555. 2012. https://doi.org/10.1586/ern.12.35