• 재활복지
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• v.22 no.2
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• pp.83-102
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• 2018

The purpose of the this study was to investigate the association of self-stigma, quality of life, and self-esteem and analyze the mediating role of self-esteem in the relationship between self-stigma and quality of life among people with mental disabilities. For this purpose, the data were collected from 254 people with mental disabilities who utilize the community mental health centers located in D and K regions. Findings of the study indicated that there were statistically significant relationships among self-stigma, quality of life and self-esteem. In addition, self-esteem had partial mediating effects on the relationships between self-stigma and the quality of life domains such as physical, psychological, and environmental areas, while self-esteem was a full mediator in the relationships between self-stigma and social relationship in the quality of life. Based on the findings of, possible practice implications for improving the quality of life among people with mental disabilities by reducing self-stigma along with empowering their self-esteem and recommendation for further study were provided.

• Korean Journal of Social Welfare Studies
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• v.47 no.3
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• pp.85-111
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• 2016

This study aims to analyse major changes of Mental Health Promotion and Welfare Service Support Act(MHPWSSA) and critically discuss these changes based on the major discourses on Mental Health Act revision. For this purposes this study reviewed literatures and government reports to understand human rights discourses, welfare discourses, and prevention discourses. Secondly, the major changes of MHPWSSA were analysed and discussed based on those discourses. This study found that MHPWSSA defined the concept of people with mental disorders narrowly, tightened the involuntary admission procedures, introduced welfare service support provisions and mental health promotion provisions. But this study shows that the new legislation may well be criticised due to neglect of the concept of disability and people with psychiatric disability, involuntary admission without mental capacity assessment, neglect of the basic values and principles of self determination and independent living common in welfare of the persons with disability. And the new legislation may be criticised due to overuse of the concept of mental health promotion as encompassing promotion, prevention, treatment and rehabilitation.

• 재활복지
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• v.20 no.1
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• pp.65-86
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• 2016

The purpose of this study is to verify the moderating effects of social supports in the relationship between stigma and self-esteem of the mental disabled's family. For this research, 190 family of the mental disabled were asked to complete some scales for this study. The results of this study are as follows. First, stigma of the mental disabled's family is positively correlated to self-esteem and social supports. Second, social support is positively correlated to self-esteem. Third, social supports have moderating effect the relationship between stigma and self-esteem of the mental disabled's family. This study verify that for the purpose of decreasing the stigma and improving the self-esteem, it is important to supply the mental disabled's family with social supports. This study have implication that stigma of the mental disabled family impair their self esteem and social supports delivered to the mental disabled's family improve family's self esteem. In accordance to the results of this study, the authors suggest some strategy to supply social support to the family. The authors suggest some direction to solve the problems related this study questions and describe the limitation of this study.

• 재활복지
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• v.16 no.3
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• pp.165-192
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• 2012

This study aims to develop a valid self-report scale for the community integration of persons with psychiatric disabilities. To this end, conducted were in-depth interviews with individuals with psychiatric disabilities, consultation with experts, and a survey. First, literature review and the in-depth interview with individuals with psychiatric disabilities were collected questionnaires regarding the community integration of persons with psychiatric disabilities. Second, preliminary research 1 focused on the selection and modification of the items collected in the first research. Final 44 items were selected by the verification of the importance and content-validity of items under the advices of professionals. Lastly, preliminaty research 2 applied cross-validation method to the data from 524 cases in order to verify the factor structure and concept-validity of the items. The result of exploratory factor analysis shows that 5 factor structures are the most appropriate, and the confirmatory factor analysis suggests that the Self-reporting Scale of Community Integration for the person with psychiatric disabilities consists of 27 questionnaires which compose 5sub-concepts such as'psychological integration','physical integration', 'social support', 'social integration', 'independence/self-actualization'. Moreover, this scale was significantly related to the 'Life Satisfaction scale for the person with psychiatric disabilities'. This proved concurrent validity of the scale.

• Journal of Korean Neuropsychiatric Association
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• v.57 no.3
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• pp.235-243
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• 2018

Treatment of schizophrenia has as its ultimate goals, the functional recovery of the patients and improvement of their quality of life. While antipsychotic medication is the fundamental method for treating schizophrenia, it has certain limitations in terms of treating the illness beyond its positive symptoms. Therefore, psychosocial intervention should be used in tandem with pharmacological methods in treating schizophrenia. The efficacy of several modes of psychosocial intervention for improving outcomes in schizophrenia is well attested. Approximately 10 modes of psychosocial intervention have been recommended based on existing evidence, including family intervention, cognitive behavioral therapy, supported employment, early intervention services, lifestyle intervention for physical health enhancement, treatment of comorbid substance abuse, assertive community treatment, cognitive remediation, social skills training, and peer support. Ideally, these interventions are offered to patients in combination with one another. Over the last decade, increased emphasis has been placed on early detection and intervention, with particular focus on long-term recovery. Early intervention with comprehensive psychosocial interventions should be enacted promptly from the initial detection of schizophrenia.

• 대한예방의학회:학술대회논문집
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• 2002.05a
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• pp.73-83
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• 2002

우리 사회에서 일정 정도 이상의 사회와 가정에서의 기능상의 부적응을 초래하는 정신적 문제는 경제활동인구에 있어 가장 흔한 보건의료상의 문제일 것으로 추측되고 있으나, 현재까지는 정신보건제도 마련에 있어 가장 극심한 부적응을 보이는 정신적 장애를 지닌 환자를 위주로 수용시설과 지역사회에서의 재활과 관리에 그 초점을 두어 왔다. 즉 직업스트레스와 같은 일시적인 사회심리적 갈등으로 인한 신체증상의 호소나 알을 및 약물중독으로 인한 사고의 발생으로부터 일생동안 관리되어야 하는 지능저하나 학습장애와 같은 만성적인 문제에 이르기까지 다양한 스펙트럼을 보이는 사업장과 지역사회에서의 정신적 문제들 중 그 일부만이 제도적으로 관리되어 왔다. 실제 그 동안 직장 내 정신보건문제에 대한 행정적 관심은 일부 장애인의 취업 문제를 제외하고는 없었다고 하여야 할 것이다. 그러나 한편으로 우리 사회의 산업구조와 경제사회적 조건의 변화에 따른 노동내용과 조건상 유연화의 증대가 많은 직장에서 노동강화로 이어진다는 점, 그리고 가족 및 교류집단을 비롯한 전통적인 사회적 지지구조가 와해되고 있다는 점과 정신적 문제로 인한 기능상 부적응의 척도가 한편으로 사회적 가치관의 변화에 따라 계속 그 영역이 넓어지는 방향으로 변화하고 있다는 점등에서 직장 내 정신보건 문제는 앞으로 더욱 그 비중이 커질 것으로 판단되고 있다. 문제의 심각성에 대한 관심이 요구되는 현재의 시점에서 제도적 접근에 대한 검토 또한 시작되어야 할 것으로 판단되고 있다. 현재까지 기업 내에서 이루어지고 있는 정신보건관리의 현황을 단편적으로 파악해 보았을 때, 단지 일부 기업에서 취업시 내지는 부서 배치시 성격검사를 비롯하여 적성검사를 실시하고 있으며, 기업윤리확보 차원에서 비정규적으로 사기앙양을 주목적으로 하는 집단적인 교육이나 단체훈련이 이루어지고 있으나, 정신심리적 문제를 개인적 차원에서 그리고 또한 조직적 차원에서 체계화된 프로그램으로 관리하고 있는 사례는 아직 없다. 앞으로 직장 내 정신보건문제에 대하여 제도적인 접근을 하기 위하여서는 다음과 같은 세가지 조건들이 구비되어야 할 것으로 판단된다. 첫 번째로 문제점 그 자체의 내용과 그 규모에 대한 정확한 파악과 예측이 가능하여야 한다. 즉 제도 전체의 운영을 객관적으로 평가하고 개선할 수 있는 기제가 함께 있어야 제도가 실제적인 기능을 할 수 있다는 최소한의 목적이 달성될 수 있다. 두 번째로 문제점의 관리를 위한 효과적인 개입내용 및 개입지점의 확보가 가능하여야 한다. 특히 직장 내에서 수행할 수 있는 프로그램이 개발되어야 하며, 이는 시범사업과 시장을 통한 소비자, 즉 사업주들의 자발적인 선택을 통하여 검토되고 걸려져야만 한다. 마지막으로 제도 운영의 대상, 특히 정신보건문제를 안고 있는 노동자들의 자발적인 동의가 확보될 수 있어야 한다. 이는 정신적 문제가 안고 있는 편견과 그로 인한 차별이 가져다주는 문제를 함께 고려하면서 제도가 운영되어야 하며, 이에 있어 제도 운영상 노동자들의 주체적인 참여가 필요하기 때문이다. 이상 고려되는 직장 내 정신보건문제에 대한 제도적 접근을 담기 위하여서는 프로그램 개발이나 전문가 집단의 양성과 같은 단순한 기술적 접근과 이들의 인허가 및 사업화에 따른 적용기준 및 의무의 설정과 같은 제도적 접근에 그쳐서는 그 실효성을 담보하지 못할 것으로 판단된다. 보다 중요한 것은 이러한 정신보건문제에 대한 노사의 공감대를 이루어 내는 것이며, 사회 전반적인 인식의 확산과 더불어 바람직한 관리모습에 대한 사회적 가치관을 도출해 내는 것이 제도적인 접근의 성공을 보장할 수 있는 기반 조건이 될 것이다. 이러한 점에 있어 정신보건문제를 바라보는 기존의 가치관이 부정적이고 고착화된 모습만을 강조하였으나, 이제는 점차 긍정적이 사회활동에 수반되는 역동적인 모습으로서 비추어지는 것이 많아진다는 측면에서 그 전망을 밝게 하여 주고 있다.

• Korean Journal of Social Welfare
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• v.54
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• pp.123-147
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• 2003

It is well known that one of essential features of psychiatric disability is vocational impairment. Since the year of 2000 when psychiatric disability was declared as one of disability categories in Korea, vocational rehabilitation programs have been actively administered. At this point, it is compelling that vocational evaluation serves as a means of screening out the most promising candidates, identifying their vocational deficits and strengths, designing the individualized vocational interventions, and evaluating vocational outcomes. Still, vocational evaluation for people with psychiatric disabilities has been more problematic than for any other group with disabilities. The authors argued that vocational evaluation for people with psychiatric disabilities should be based on a certain vocational rehabilitation model to address those problems. It is because there exists an indispensible relationship between the vocational rehabilitation model and vocational evaluation. In other words, the main purposes, measurement time points, and focus of vocational evaluation may depend on which of vocational rehabilitation models to make a choice of. In addition, the vocational rehab model(i.e., vocational readiness model or graduation model) underlying traditional vocational evaluation does not seem to work for people with psychiatric disabilities. Authors argued that accelerating model fits for psychiathric characteristics which are often unpredictable and turbulent. As a preliminary step of developing vocational functioning instrument incorporating the demand characteristics of the accelerating model, post-hoc analyses were done on data from a vocational functioning measure and the results were critically examined from viewpoints of accelerating model. For these purposes, discussions were made about a) general functioning of vocational evaluation, (b) relation between vocational rehabilitation model and vocational evaluation, (c) the reasons why the accelerating model is more appropriate to the characterstics of psychiatric clients than the graduation model, (d) post-hoc analytic results reviewed from viewpoints of accelerating model-based vocational evaluation This study is significant in that it attempted model-based, model-specific vocational evaluation as a preliminary step for developing vocational functioning assessment instruments ill future.

• 재활복지
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• v.21 no.2
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• pp.113-137
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• 2017

In this study, we explore whether and how the experience of discrimination and social support affects physical health and mental health through disability identity among the disabled aged 50 and over. We also examine such relationship differs by the degree of disability. For the empirical test, we utilized the data from the Panel Survey for the Disabled conducted by our research team in 2016. According to structural equation model analysis, social support has a direct effect on disability identity. It also has a direct effect on physical health. As for the mental health, there are found direct effects of discrimination experience, social support, disability identity, and physical health, Furthermore, social support influences the mental health through disability identity. This finding suggests that social support for the disabled in old age increases disability identity and, in turn, it contributes their mental health. In the meanwhile, multiple group comparison analysis reveals the effect of discrimination experience on disability identity is found for those with lower level of disability but not for their counterparts. This seems to result from that the level of common ground which constitutes disability identity is low for the severely disabled. Thus, it requires our efforts to enhance disability identity focusing on common ground for the severe disabled.

• Korean Journal of Social Welfare Studies
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• v.40 no.3
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• pp.299-326
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• 2009

The purpose of this study was to find out some factors affecting the social prejudice perceived by people with psychiatric disability(PPD) and to present some useful explanations for those effects based on theories from symbolic interactionism. The hypotheses were as follow. First, the higher the symptoms, the higher will be the perceived social prejudice of PPD. Second, if PPD have vocational roles, the perceived prejudice will be lower. Third, if PPD want more services or supports for vocational rehabilitation, the perceived prejudice will be higher. Fourth, the higher the perceived prejudice of family members, the higher will be the perceived prejudice of PPD. The results show that the major hypotheses were supported. Based on the results some theoretical and clinical implications are discussed. First, this study made a little contribution to the study of perceived social prejudice of PPD providing some useful theoretical basis and empirical evidences. Secondly, due to the limitation of the data and cross-sectional research the results of this study need to be duplicated under more rigorous experimental or quasi-experimental study. Concerning the clinical intervention, it should be stressed to provide valued social roles to help PPD protect themselves from social prejudices. Secondly, rehabilitation professionals need to help PPD cope with increasing perceived prejudice while pursuing valued social roles such as employee. Third, rehabilitation professionals should assess the perceived prejudice of family members and to help them resist social prejudices through education, self-help groups, and other advocating strategies. Lastly, professionals should be carful not to blame family members for the adverse effects of their perceived prejudice on PPD.

• Therapeutic Science for Rehabilitation
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• v.9 no.2
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• pp.87-98
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• 2020

Objective : The purpose of this study was to verify the effectiveness of home-visit occupational therapy in stroke patients. Methods : Two patients with stroke who applied for home-based occupational therapy services at a health center in Seoul were enrolled. The home-visit occupational therapy program evaluates the subject's daily living, task performance, cognitive, and emotional functions, sets occupational therapy goals and plans interventions based on a client-centered approach. Occupational therapy programs consisted of 12 sessions based on the client's major problems. Results : COPM scores improved in both cases, there was an improvement in COPM scores, and in Case 2 there were improvements in MBI and K-MMSE scores. There was also an improvement in KGDS scores in Case 1. Conclusion : Home-visit occupational therapy was found to be effective in improving daily activities, cognition, and mental function of stroke patients. During home and community integration, continuous and continuous rehabilitation services need to be activated from institutional rehabilitation to community-based rehabilitation. Active home-visit occupational therapy is needed to promote physical, cognitive, mental and social access in stroke patients discharged from hospitals.