Therapeutic Science for Rehabilitation (재활치료과학)

Korean Society of Neurological Occupational Therapy (대한신경계작업치료학회)
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Phenomenological Qualitative Research of Social Admission in Rehab hospitals: Occupational Therapists' Perspectives

요양·재활병원 환자의 사회적 입원과 지역사회 복귀 어려움에 대한 작업치료사의 관점: 현상학적 연구

  • Received : 2019.12.31
  • Accepted : 2020.02.25
  • Published : 2020.08.31
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Abstract

Objective : This study aims to understand the phenomenon of social admission in Korea's rehabilitation system by analyzing the perspectives of occupational therapists. Methods : We developed a written questionnaire based on RSAT and, in August 2019, distributed it to occupational therapists with more than three years of experience at the time. Data were analyzed using the van Kaam's method. Further, high frequency words were analyzed by word cloud in order to extract significant statements. Results : Forty-six written interviews were collected from various areas of Korea. We analyzed the data into 2 categories, 4 themes, 13 sub-themes. The two categories were 'hospital system' and 'external factors of occupational therapy practice'. The themes according to 'hospital system' were 'difficulties in implementing multidisciplinary approach' and 'inadequate discharge planning system'. The themes according to 'internal and external factors of occupational therapy' were analyzed as 'difficulties of occupational therapists' and 'difficulties in occupational therapy practice'. Conclusion : Occupational therapists in rehabilitation hospitals recognize that the reason for social admission is insufficient insurance systems related to occupational therapy services in rehab hospitals. This leads to difficulties in occupational therapy practice. We need to develop the insurance systems that can meet patient needs for social recovery.

목적 : 본 연구는 재활·요양병원 환자의 사회적 입원이 증가하고 있는 현상에 대해 작업치료사의 관점에서 분석하고자 하였다. 연구방법 : 작업치료사들의 관점을 확인하기 위하여 재활 서비스 평가 도구 RSAT를 기반으로 주관식 설문지를 구성하였고, 2019년 8월 전국 3년차 이상의 작업치료들에게 설문지를 배포 및 수거하였다. 설문지의 응답자료를 van Kaam의 현상학적 연구 방법을 통해 분석하였고, 유효 세부서술에 대해 Word cloud로 다빈도 단어를 분석하였다. 결과 : 배포한 설문지는 수도권, 충청권, 경상권에서 46명의 작업치료사들로부터 응답을 받았다. 설문지의 응답자료는 2개의 범주(categories)와 4개의 주제(theme), 13개의 하위주제(subtheme)로 분석되었다. 2개 범주는 '병원의 체계'와 '작업치료 임상의 내·외부적 요인'으로 나타났으며 '병원의 체계'에 따른 주제는 '다학제 팀 접근의 어려움'과 '퇴원계획 체계의 미흡'으로 나타났다. '작업치료 임상의 내·외부적 요인'에 따른 주제로는 '작업치료사의 어려움'과 '작업치료 실시의 어려움'으로 분석되었다. 결론 : 작업치료사들은 재활·요양병원 환자들의 지역사회 복귀가 어려운 가장 큰 원인이 합리적이지 못한 작업치료 관련 요양급여체계에 있다고 지적하였다. 퇴원 및 지역사회 적응을 위한 작업치료 서비스 체계의 미흡함 역시 환자들로 하여금 퇴원하지 못하고 결국 다시 병원으로의 입원을 하게 만드는 주요 원인의 하나로 인식하고 있었다. 향후 작업치료 처방 및 의료 급여 체계를 환자의 재활 목적에 맞도록 다면화할 필요가 있음을 제언한다.

Keywords

References

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