• 의료법학
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• 제17권1호
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• pp.209-279
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• 2016

최근 정신건강증진법의 전면 개정을 계기로 하여 정신장애인의 인권과 지역사회통합의 관점에서 개정 전 정신건강증진법의 문제점과 개정 정신건강증진법의 주요 개정 내용을 검토하고 평가하였다. 1995년 정신건강증진법의 제정과 다섯 차례의 개정은 정신장애인들을 사회로부터 분리 배제하는 과정이었으며 이를 정당화하고 제도적으로 뒷받침한 것이 정신보건법을 지배하는 의료적 관점이었음을 확인할 수 있었다. 정신장애인을 오직 치료의 대상으로만 접근하는 것은 정신장애인을 뚜렷한 효과 없는 치료를 명목으로 장기간 정신병원에 입원시키는 것을 정당화하고 그 속에 감추어져 있는 사회방위의 목적 또는 장신장애인의 부양의 목적을 은폐하는 역할을 하였음을 확인할 수 있었다. 그리고 이를 제도적으로 뒷받침한 것이 정신보건법상의 보호의무자에 의한 입원제도이다. 이러한 보호의무자에 의한 입원은 정신장애인의 입원 결정에 관여하는 부양의무를 가진 보호의무자와 정신의료기관 소속 전문의의 공공연한 이해충돌의 가능성 때문에 그 객관성과 공정성에 대하여 의심을 받아 왔을 뿐 아니라 강제입원이 신체의 자유를 구속하는 기본권제한에 요청되는 기본권 제한의 과잉금지 원칙이나 적법절차 원칙에 저촉되어 위헌적이라는 것이 평가를 받고 있다. 이러한 상황에서 개정된 개정 정신건강증진법은 강제입원의 대상인 정신질환자의 범위를 축소하고, 보호의무자에 의한 입원에 있어서 정신과 전문의 2인의 진단과 입원적합성심사위원회의 심사를 추가하는 등 강제입원의 요건과 절차를 강화하였다. 이점에 있어서 입원적합성심사위원회는 강제입원을 규제하고 입원장기화를 축소하는 데에 부분적으로 기여할 것으로 평가할 만하다. 그러나 개정된 보호의무자에 의한 입원제도도 장애인의 자유와 안전에 관한 유엔장애인권리협약 제14조 위반의 문제점을 극복하지는 못하였다. 뿐만 아니라 지역사회로 복귀할 정신장애인의 사회통합을 위한 복지서비스의 지원은 다양한 항목 설정에도 불구하고 규범적으로 약화된 형태의 규정에 머물고 있는 반면, 적절한 복지서비스의 지원의 실현에 긴요한 국가나 지방자치단체의 예산확보 방안 등에 있어서 불확실성이 크다. 향후 제도나 정책에 있어서 정신장애인의 인권과 사회통합을 위한 각별한 관심과 노력이 필요하다.

• 보건행정학회지
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• 제31권4호
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• pp.518-530
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• 2021

Background: This study examined the effect of having a usual source of care on the degree of patient-centered communication among persons with disability. The role of the usual source of care has been emphasized to improve patient experience, especially for patients with complex health conditions. Methods: This study used the 2017-2018 Korean Health Panel data, and the final study observations were 22,475 (20,806 people without disability and 1,669 people with disability). We applied generalized estimating equation model to show the effect of having a usual source of care on patient-centered communication, and subgroup analysis considering the types and severity of disabilities. Results: Persons who have disabilities, compared with ones without it, significantly had more usual sources of care (32.4% vs. 24.6%). By type of disability, persons with mental (51.4%), internal organ (43.8%), visual (37%), and physical disabilities (31.6%) had more usual sources of care than hearing/speech (26.6%), and developmental disabilities (18.6%). The average score of patient-centered communication was higher among who had a usual sources of care (3.2 vs. 2.7), and the regression analysis showed that having a usual sources of care was positively associated with higher patient-centered communication score (𝛽=0.476, p<0.05). However, the positive effects of usual sources of care was not observed among persons with severe hearing/speech, developmental, and mental disabilities. Conclusion: This study showed that role of patient-centered communication was limited in persons with severe hearing/speech disabilities, developmental, and mental disabilities. The education programs and supports are needed to improve communication skills between medical staff and persons with specific types of disabilities.

• 한국엔터테인먼트산업학회논문지
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• 제13권6호
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• pp.287-295
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• 2019

본 연구는 지체장애인의 성별에 따른 정신적 건강상태에 미치는 요인을 파악하여 그들의 건강한 삶을 도모하고자 시도되었다. 제6차 국민노후보장패널을 이용하여 지체장애인 333명을 연구 대상으로 하였다. 도구적 일상생활 수행능력, 물질적 지지, 우울, 삶의 만족도, 정신적 건강상태를 알아보기 위하여 기술통계, t-test를 사용하였고, 정신적 건강상태에 미치는 영향요인을 알아보기 위하여 다중회귀분석을 이용하였다. 지체장애인의 정신적 건강상태에 영향을 주는 요인을 성별로 구분하여 알아본 결과 남성의 경우 도구적 일상생활 수행능력, 물질적 지지, 우울, 삶의 만족도가 영향을 주었고 여성의 경우 배우자 여부, 우울, 삶의 만족도가 영향을 주었다. 본 연구결과를 토대로 지체장애인들을 이해하고 정신건강 증진 프로그램 개발에 기초자료로 사용될 수 있을 것이다.

• 인간식물환경학회지
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• 제22권3호
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• pp.279-287
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• 2019

This study carried out a horticultural program for people with mental disabilities to determine suitability of the horticultural activity program and to actually apply to vocational rehabilitation. The program was carried out in 16 sessions from April 12 to June 7, 2018 with nine people with a strong will to participate in vocational rehabilitation at a health center for persons with mental disabilities. The tools used were the Horticultural Activity Performance Assessment (psychological behavior) and Purdue Pegboard Test that examines functions of hands and arms. The subjects sold the products they made during class time and obtained the profits. After the program, the scores increased with a significant difference (p = .000) in the psychological behavior area of the Horticultural Activity Performance Assessment. Hand and arm movement also showed continuous improvement along the program with a significant difference (p = .000), as well as finger dexterity also with a significant difference (p = .018). The net profit was 314,000 KRW (subtracting cost of goods 314,000 KRW from total sales 628,000 KRW). The profit was shared equally among the nine subjects, each receiving 34,900 KRW. Therefore this study proved horticultural activity class is suitable for vocational rehabilitation of people with mental disabilities proved by the positive effects. We also expect that the subjects will be able to make more profits if they learn more skills, since they are interested the process of making such profits.

• 한국콘텐츠학회논문지
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• 제12권6호
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• pp.303-316
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• 2012

본 연구는 정신장애인의 평생계획수립을 위한 주관적인 경험을 깊이있게 알아보기 위해서 질적연구방법으로 접근하여 분석하였다. 연구대상자는 독립취업 후 6개월이상 직업을 유지하고 있는 정신장애인 12명을 대상으로 평생계획수립을 위한 주관적 경험을 심층인터뷰를 통해 분석하였다. 자료수집 기간은 2011년 1월 11일부터 2011년 2월 10일까지 조사하였다. 연구참여자들이 진술한 내용을 분석한 결과 최종적으로 38개의 구성된 의미가 도출되었다. 이들 구성된 의미들을 유사한 내용으로 묶고 분류한 결과 17개의 주제와 7개의 주제묶음으로 범주화되었다. 평생계획수립을 위한 경험으로 나타난 7개의 주제묶음은 안정적인 직업유지, 자기자신의 역량계발, 사회적 지지, 건강관리, 미래대비를 위한 인식갖기, 희망적인 사고, 다양한 사회활동으로 나타났다. 이러한 연구결과를 중심으로 실천적 함의를 제시하였다.

• 대한소아치과학회지
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• 제27권1호
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• pp.146-150
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• 2000

장애인은 일반적으로 구강관리에 대한 인식과 수행능력의 부족으로 구강위생상태가 불량하며, 치과질환의 발생빈도가 높고 그 정도가심한 편이다. 장애인의 치과치료시 많은 어려움이 따르는 행동조절은 장애의 종류와 정도에 따라 심리적 물리적, 약물적 방법 및 전신마취 등을 선택할 수 있으나, 여러 가지 이유로 인하여 일반적인 방법으로 치료가 불가능할 경우 전신마취를 이용하게 된다. 장애인 환자에 있어서 보철치료는 정상인에서와 다를 바가 없으나 장애정도에 따라 치과의사의 세심한 주의가 필요하며, 수복후에도 철저한 구강위생관리를 위해 환자 스스로나 보호자의 각별한 노력이 요구된다. 본 증례는 경도의 장애를 가지고 있으나 치과치료에 대한 불안과 공포가 심하고, 다수치아의 수복을 위하여 장시간의 치과 치료가 요구된 경우로서 전신마취를 이용한 보존 외과적 처치 및 보철치료를 시행하여 비교적 양호한 결과를 얻었다.

• 재활간호학회지
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• 제4권2호
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• pp.240-247
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• 2001

The history of rehabilitation of disabilities in Korea began with the foreigners and missionaries who were interested in it after Korean War. In 1981, Disabled Persons Welfare Act was enacted and the 88 Paralympics brought the nations attention to the welfare and rehabilitation of persons with disabilities. Since then, the facilities and the services for the disabled persons have expanded rapidly and the rehabilitation treatment and nursing intervention are drawing more attention. Against this background, the survey on the current status of disabilities, welfare service, facilities, and rehabilitation nursing was conducted. The results of this survey are as follows. 1. According to the 2000 census of disabilities, the number of persons with disabilities in Korea is estimated at 1,449,500, or 3.09% of the entire Korean population, 0.74% up from 2.35% in 1995. 2. Disability Types in 2000 The 2000 census showed that the persons with disabilities numbered 1,449,496 out of the total population and 1,024,371 persons are registered for disability, making up 70.7% of the estimated disabled population. Among them, physically disabled persons accounted for the largest 41.7% (605,127) and mentally retarded persons stood at the smallest 9% (13,481). 3. Percentage of Disability Presence The survey showed that more than 90% of disability were acquired. However, 44.8% of mental disability and 61.4% of hearing/speaking disability were not acquired after birth. This means that these disabilities happened by congenital cause or birth accident. 4. Yearly Figure of Registered Disabled Persons In 1989, 218,601 persons registered for disability and, in 2000, the number increased by 4.7 times to 1,024,371. These figures are different from the actual number of disabled persons. According to the 1995 census, 1,053,486 were disabled persons but only 378,323registered for disability. And, in the 2000 census, 1,024,371 out of the 1,449,496 of disabled persons registered for disability. 5. Welfare Service for Persons with Disability 62.6% of the total disabled people are registered and physically disabled persons accounted for the highest percentage of 96.7%. 26.5% of non-registered disabled people said that they didnt know the registration procedure. The rest of them replied that they didnt think they were disabled or that registration didnt seem to give any benefits. 6. Welfare Policies for Disabled Persons The welfare benefits given to the disabled are as follows: Issuance of disabled sign for car drivers, Permission to use LPG fuel, Communication fee reduction, Tax exemption related to cars, Reduction of public facility fees, Household allowance, Tax reduction or exemption, Medical allowance and education subsidy for children, and Housing. 7. Current Condition of Welfare Facilities by Disability Type The welfare institutions for disabilities numbered 188 in total and they can accommodate 16,823 persons. Categories of these institutions are physical disability(37), visual disability(10), hearing/speaking disability(14), mental retardation(59), and sanatoriums(68). 8. Human Resource of Rehabilitation of Disabilities Advanced education programs include rehabilitation nursing in its curriculum and this was selected as the program of Korean Academic Society of Nursing in 1990. In November 1997, Korean Academic Society of Rehabilitation Nursing was launched and many academic meeting and seminars were held. This organization is also making efforts to develop the education program for qualified rehabilitation nursing professionals and to develop the standards of rehabilitation nursing practice. In the professionals of the rehabilitation, there are rehabilitation specialist, physical therapist, speech therapist, occupational therapist. It is needed to come up with the measures to supply stable human resources following the demand of disabled persons and to recognize the private certificates for rehabilitation professionals as official ones after reviewing the education and training programs of private institutions. 9. Rehabilitation Nursing 1) Rehabilitation nursing was taught as an independent subject in 11 undergraduate programs and 9 graduate programs. 2) Research on rehabilitation nursing in Korea were 24 experimental research and 11 non-experimental research. The intervention of experimental research were mostly education and exercise rehabilitation programs. 3) In the three rehabilitation hospitals, nursing is divided into two categories, direct nursing and education & counseling. Direct nursing includes tracheostomy or nasogastric tube care, urination and defication, skin care, pain control, complication prevention and care, prevention of injury from a fall, etc.

• 대한치과의사협회지
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• 제49권12호
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• pp.749-757
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• 2011

In the welfare law for the disabled in Korea, the disabled is defined as "the persons sho have significant limitations of daily or social life due to physical or mental disabilities over a long period." The number of registered domestic disabled person in 2008 survey was approximately 2.1 million. 90% of the disabled was caused by the aposteriori illness or accidents. So, in this aging society, the number of people with disabilities will increase even more. In general, people with physical and mental disabilities tend to have more oral diseases, but, are difficult to get treated. Therefore, a thorough oral care through individualized prevention is more important than ever. In this article, we review the oral care methods in dental office and home and in the hospital for the elderly and finally focus on a denture care method. According to this article, the dental professionals can be able to select and apply the oral care method in agreement with the characteristics of the disabilities. Particularly, it is important to prevent the aspiration pneumonia in the elderly in hospital.

• 디지털융복합연구
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• 제10권6호
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• pp.349-359
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• 2012

본 연구에서는 현재 우리나라의 지적장애인 대상의 디지털 성교육 콘텐츠 프로그램과 현황을 살펴보고, 이에 따른 디지털 성교육 콘텐츠 구성에 대한 연령별 제안과 피셔의 성교육에 관한 정보 동기 행동 스킬 모형을 인적자원 개발에서 흔히 논의되는 역량(competency)이라는 개념의 모형을 적용 확장하여 성적역량(sexual competency) 이라는 목표 하에서 모형을 제시해 보았다. 또한 이러한 모형과 현황조사를 바탕으로 적절한 디지털 성교육 프로그램 개발을 위한 과제를 제시해 보았다.

• 인간식물환경학회지
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• 제23권1호
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• pp.67-75
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• 2020

The purpose of this study was to develop an effective horticultural activity program for the vocational rehabilitation of people with mental disabilities. The subjects of this study were seven persons with mental disabilities in the vocational rehabilitation team of a public health center located in G city, Gyeongsangbuk-do. A total of 10 horticultural programs were held from October 10 to December 11, 2018. Five programs were selected among those that were easy for the persons with mental illness to handle and their preference was high. In each session, the same task was repeated 10 times and finally changes in hand functions and working speed were measured. As a result, the assembly task of the Purdue Pegboard test was 23.6 (SD = 10.5) before the program, 26.6 (SD = 11.5) after planting, 27.7 (SD = 12.2) after wrapping pots, and 28.0 (SD = 13.9) after making mini flower baskets, 26.9 (SD = 12.0) after wrapping a single flower, and 29.1 (SD = 11.9) after making corsages. There was a significant difference between the five programs (p = .016). As a result of measuring the time taken to produce the same 10 products, the average planting time was 9.9 (SD = 4.0) minutes in the first class and 6.0 (SD = 2.3) minutes in the second class (p = .018), and making mini flower baskets was reduced from 35.2 (SD = 10.1) minutes to 21.0 (SD = 7.7) minutes (p = .018), wrapping a single flower from 23.3 (SD = 7.9) minutes to 16.2 (SD = 7.3) minutes (p = .043), and making corsages from 53.6 (SD = 15.9) to 40.8 (SD = 16.8) minutes (p = .043). The working time was significantly shortened in the second class compared to the first class. The class for wrapping pots was shortened from 52.7 (SD = 11.7) to 49.6 (SD = 17.8) minutes, but there was no significant difference (p = .398).