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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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본 연구는 뇌성마비 아동을 대상으로 다감각 스토리텔링을 적용한 활동중재가 신체기능과 활동참여에 미치는 영향을 알아보기 위해 단일눈가림,두 집단 사전-사후검사로 설계한 유사실험연구이다.
연구 대상자는 경직형 뇌성마비로 의학적 진단을 받은 대동작기능분류체계 Ⅰ~Ⅲ단계에 속하는 7~8세 아동 24명으로 실험군과 대조군에 각 12명씩 무작위로 배정한 후 아동과 보호자는 집단이 어느 군에 속하는지 알 수 없도록 하였다. 두 집단 모두 회기당 60분, 주 2회, 8주간, 총 16회기 동안 실험군은 다감각 스토리텔링을 적용한 활동중재를 하였고, 대조군은 구조화된 신체활동을 실시하였다.
뇌성마비 아동의 중재 전과 후에 신체기능과 활동참여의 변화를 알아보기 위해 대동작기능, 시지각, 활동참여도, 또래관계기술을 측정하였다. 수집된 자료는 SPSS 25.0 for windows(IBM Corp, USA) 프로그램을 이용하여 분석하였고, 통계적 검증을 위한 유의수준(α)은 0.05로 하였다. 실험군과 대조군의 신체기능과 활동참여에 대한 집단 내 변화는 윌콕슨부호순위검정(Wilcoxon Signed-Rank test)을 실시하였고, 두 집단 간 변화량 차이 비교는 맨휘트니검정(Mann-Whitney U test)으로 분석하였다.
연구 결과 대동작기능은 실험군과 대조군 모두 중재 전후에 유의한 차이가 있었고, 두 집단 간 변화량에서도 유의한 차이가 나타났다. 시지각의 경우 실험군에서 눈-손 협응, 공간 위치, 공간 관계의 유의한 차이가 있었고, 대조군은 공간 위치에서만 유의한 차이가 있었다. 두 집단 간 변화량은 눈-손 협응과 공간 관계에서 유의한 차이가 나타났다. 활동참여도와 또래관계기술은 실험군과 대조군 모두 중재 전후에 유의한 차이가 있었고, 두 집단 간 변화량에서도 유의한 차이가 나타났다.
뇌성마비 아동을 대상으로 다감각 스토리텔링을 적용한 활동중재를 실시하고 대동작기능, 시지각, 활동참여도, 또래관계기술에 유의한 향상을 확인하였다. 그러므로 다감각 스토리텔링을 적용한 활동중재는 뇌성마비 아동의 신체기능과 활동참여 향상을 위한 효과적인 중재방법으로 제안할 수 있다.
연구 대상자는 경직형 뇌성마비로 의학적 진단을 받은 대동작기능분류체계 Ⅰ~Ⅲ단계에 속하는 7~8세 아동 24명으로 실험군과 대조군에 각 12명씩 무작위로 배정한 후 아동과 보호자는 집단이 어느 군에 속하는지 알 수 없도록 하였다. 두 집단 모두 회기당 60분, 주 2회, 8주간, 총 16회기 동안 실험군은 다감각 스토리텔링을 적용한 활동중재를 하였고, 대조군은 구조화된 신체활동을 실시하였다.
뇌성마비 아동의 중재 전과 후에 신체기능과 활동참여의 변화를 알아보기 위해 대동작기능, 시지각, 활동참여도, 또래관계기술을 측정하였다. 수집된 자료는 SPSS 25.0 for windows(IBM Corp, USA) 프로그램을 이용하여 분석하였고, 통계적 검증을 위한 유의수준(α)은 0.05로 하였다. 실험군과 대조군의 신체기능과 활동참여에 대한 집단 내 변화는 윌콕슨부호순위검정(Wilcoxon Signed-Rank test)을 실시하였고, 두 집단 간 변화량 차이 비교는 맨휘트니검정(Mann-Whitney U test)으로 분석하였다.
연구 결과 대동작기능은 실험군과 대조군 모두 중재 전후에 유의한 차이가 있었고, 두 집단 간 변화량에서도 유의한 차이가 나타났다. 시지각의 경우 실험군에서 눈-손 협응, 공간 위치, 공간 관계의 유의한 차이가 있었고, 대조군은 공간 위치에서만 유의한 차이가 있었다. 두 집단 간 변화량은 눈-손 협응과 공간 관계에서 유의한 차이가 나타났다. 활동참여도와 또래관계기술은 실험군과 대조군 모두 중재 전후에 유의한 차이가 있었고, 두 집단 간 변화량에서도 유의한 차이가 나타났다.
뇌성마비 아동을 대상으로 다감각 스토리텔링을 적용한 활동중재를 실시하고 대동작기능, 시지각, 활동참여도, 또래관계기술에 유의한 향상을 확인하였다. 그러므로 다감각 스토리텔링을 적용한 활동중재는 뇌성마비 아동의 신체기능과 활동참여 향상을 위한 효과적인 중재방법으로 제안할 수 있다.
목차
요 약 ····································································································ⅰ표 목 차 ····································································································ⅴ그림목차 ····································································································ⅵI. 서 론 ········································································································ 11. 연구의 필요성 ·················································································· 12. 연구의 목적 ······················································································ 5II. 이론적 배경 ··························································································· 61. 뇌성마비 ···························································································· 61) 뇌성마비 아동의 운동발달과 감각 ········································· 62) 뇌성마비 아동의 활동과 참여 ················································· 72. 활동중재 ···························································································· 83. 다감각 스토리텔링 ·········································································· 91) 스토리텔링 ···················································································· 92) 다감각 스토리텔링 ···································································· 10III. 연구 방법 ··························································································· 121. 연구 설계 ························································································ 122. 연구 대상자 ···················································································· 143. 연구 절차 및 중재 프로그램 ······················································ 151) 연구 절차 ··················································································· 152) 중재 프로그램 ··········································································· 164. 측정 도구 ························································································ 221) 대동작기능평가(GMFM) ·························································· 222) 시지각발달평가(K-DTVP-2) ····················································· 233) 아동용활동참여평가(APA) ······················································· 244) 또래관계기술척도(PRSS) ························································· 255) 질적 평가 ··················································································· 265. 자료 분석 ························································································ 27IV. 연구 결과 ························································································· 281. 연구 대상자의 일반적 특성 ······················································ 282. 대동작기능 ······················································································ 293. 시지각 ······························································································ 324. 활동참여도 ···················································································· 365. 또래관계기술 ·················································································· 406. 질적 평가 ························································································ 42V. 고 찰 ·································································································· 44Ⅵ. 결 론 ································································································· 54참고문헌 ·································································································· 55Abstract ····································································································· 65
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