journal_list | How to participate | E-utilities
Song and Lee: Is the SIS 3.0 Valid for Use at a Rehabilitation Setting in Korea for Patients with Stroke?

Abstract

Purpose:

The purpose of this study was to assess psychometric properties of the Korean version of the Stroke Impact Scale 3.0 (K-SIS 3.0) in patients with stroke.

Methods:

Patients with stroke longer than 3 months were invited to participate in the study at specialized rehabilitation centers in Busan. Information on patients was collected using Mini-Mental State Examination (MMSE), Modified Bathel Index (MBI), Beck Depression Index (BDI), WHODAS 2.0-12 item, and K-SIS. Floor and ceiling effects of each domain of K-SIS were examined. The internal consistency of each domain of the K-SIS was calculated using Cronbachโ€™s ฮฑ. Correlation between K-SIS and each scale was assessed using Spearmanโ€™s correlation coefficient.

Results:

Ninety subjects participated in the study. The K-SIS was found to have excellent internal consistency (Cronbachโ€™s ฮฑ=0.93). Each domain of the consistency ranged from 0.86 to 0.94, except the emotion (ฮฑ=0.51). Significant correlations were observed between MMSE and domains of memory and thinking, and communication (r=0.48 and 0.52 respectively). BDI was negatively related to domains of emotion, ADL, mobility, and participation (r=-0.43, -0.49, -0.52 and -0.33 respectively). Specific daily activity (MBI) and general functioning (WHODAS 2.0) were also found to be closely related to the domains of ADL, mobility, and participation (ranging from r=-0.41 to r=-0.59). No ceiling and floor effect was observed.

Conclusion:

Excellent reliability and validity of K-SIS were obtained in the study and it could be suggested that K-SIS may be used for patients with stroke for collection of information on functioning in the clinical context.

์„œ๋ก 

๋‡Œ์กธ์ค‘์€ ์ด๋™ ๋Šฅ๋ ฅ, ์ผ์ƒ์ƒํ™œ๋™์ž‘, ์˜์‚ฌ์†Œํ†ต ๋ฐ ์ธ์ง€๋Šฅ๋ ฅ์„ ํฌํ•จํ•ด ์ผ์ƒ์ƒํ™œ์˜ ์ „๋ฐ˜์— ๊ฑธ์ณ ๋ฌธ์ œ๋ฅผ ์•ผ๊ธฐ์‹œ์ผœ ์‚ถ์˜ ์งˆ์— ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ๋Œ€ํ‘œ์ ์ธ ์‹ ๊ฒฝ์งˆํ™˜์ด๋‹ค.1 ์‚ถ์˜ ์งˆ์€ ๊ฐœ์ธ์˜ ์‹ ์ฒด์ , ๊ธฐ๋Šฅ์ , ์‹ฌ๋ฆฌ์  ๋ฐ ์‚ฌํšŒ์  ๊ฑด๊ฐ•์„ ๋‹ค๋ฃจ๋Š” ๋‹ค์ฐจ์›์  ์ ‘๊ทผ์œผ๋กœ ์ด๋ก ์  ํ”„๋ ˆ์ž„ ์›Œํฌ๋Š” ICF์— ๊ธฐ๋ฐ˜ํ•˜๊ณ  ์žˆ๋‹ค.2,3 ๊ทธ๋Ÿฌ๋ฏ€๋กœ ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ์‚ถ์˜ ์งˆ์— ๋Œ€ํ•œ ํ‰๊ฐ€๋Š” ํ™˜์ž์˜ ๊ธฐ๋Šฅ์ˆ˜ํ–‰๊ณผ ์‚ฌํšŒ์‹ฌ๋ฆฌ์  ์ƒํƒœ์— ๋Œ€ํ•˜์—ฌ ๊ด‘๋ฒ”์œ„ํ•˜๊ฒŒ ์ˆ˜์ง‘ํ•  ์ˆ˜ ์žˆ์œผ๋ฉฐ, ์ ์ ˆํ•œ ์น˜๋ฃŒ๊ณ„ํš๊ณผ ์ ์šฉ ๋ฐ ์น˜๋ฃŒํšจ๊ณผ ์ธก์ •์— ๋„์›€์ด ๋œ๋‹ค.
์‚ถ์˜ ์งˆ์„ ์ธก์ •ํ•˜๋Š” ๋งŽ์€ ๋„๊ตฌ๋“ค์ด ์„ค๋ฌธํ˜•ํƒœ์˜ ํ™˜์ž-๋ณด๊ณ ์‹์œผ๋กœ ๊ฐœ๋ฐœ๋˜์–ด ์‚ฌ์šฉ๋˜๊ณ  ์žˆ๋‹ค. Short Form 36๊ณผ Euro-Qol์€ ์ผ๋ฐ˜์ ์ธ ๊ฑด๊ฐ•๊ด€๋ จ ์‚ถ์˜ ์งˆ(health-related QOL, HRQOL)์„ ์ธก์ •ํ•˜๋Š” ๋„๊ตฌ๋กœ์„œ ๋‡Œ์กธ์ค‘๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ๋‹ค์–‘ํ•œ ๊ฑด๊ฐ•์ƒํƒœ์—์„œ ์‚ฌ์šฉ๋˜๋Š” ์ผ๋ฐ˜ HRQOL๋„๊ตฌ์ด๋‹ค. ๋ฐ˜๋ฉด ๋‡Œ์กธ์ค‘ ์˜ํ–ฅ ์ฒ™๋„(Stroke Impact Scale, SIS), ๋‡Œ์กธ์ค‘ ์‚ถ์˜ ์งˆ(Stroke-Specific Quality of Life) ๋ฐ Stroke Adapted Sickness Impact Profile์€ ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ HRQOL์„ ์ œ๊ณตํ•˜๋Š” ๋„๊ตฌ๋กœ์จ4 ๋‹จ๊ธฐ๊ฐ„ ๋™์•ˆ ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๊ฑด๊ฐ• ์ƒํƒœ ๋ณ€ํ™”๋ฅผ ์ธก์ •ํ•˜๋Š” ๋ฐ ์œ ์šฉํ•˜๋‹ค.5 SIS๋Š” ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ์‚ถ์˜ ์งˆ์„ ํ‰๊ฐ€ํ•˜๋Š” ๋„๊ตฌ๋กœ์„œ ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๊ฑด๊ฐ•๊ณผ ๊ด€๋ จ๋œ ์ƒํ™œ ๊ธฐ๋Šฅ์˜ ๋‹ค์–‘ํ•œ ์ธก๋ฉด์„ ๊ด‘๋ฒ”์œ„ํ•˜๊ฒŒ ์ธก์ •ํ•˜๊ธฐ ์œ„ํ•ด ์‚ฌ์šฉ๋˜๊ณ  ์žˆ๋‹ค.6 SIS๋Š” 8๊ฐœ์˜ ์˜์—ญ 64ํ•ญ๋ชฉ์œผ๋กœ ๊ตฌ์„ฑ๋˜์–ด, ์ „๋ฌธ๊ฐ€์šฉ, ๋Œ€๋ฆฌ์ธ ๋ฐ ์ž๊ฐ€๊ธฐ์ž…์‹์˜ 3๊ฐ€์ง€ ๋ฒ„์ „์œผ๋กœ ๊ฐœ๋ฐœ๋˜์—ˆ๋‹ค.7 ์ •์„œ, ์˜์‚ฌ์†Œํ†ต, ๊ธฐ์–ต๊ณผ ์‚ฌ๊ณ , ์‚ฌํšŒ์  ์—ญํ• , ์ธ์ง€ ๋“ฑ 8๊ฐœ์˜ ์˜์—ญ์—์„œ ๋‡Œ์กธ์ค‘์œผ๋กœ ์ธํ•œ ์‚ถ์˜ ์งˆ์˜ ๋ณ€ํ™”์˜ ์ธก์ •์— ํƒ€๋‹น๋„์™€ ์‹ ๋ขฐ๋„๊ฐ€ ๋†’์€ ๋„๊ตฌ์ด๋ฉฐ7 ๋‡Œ์กธ์ค‘ ์˜ํ–ฅ์˜ ํ‰๊ฐ€๋ฅผ ๋” ํ–ฅ์ƒ์‹œํ‚ค๊ธฐ ์œ„ํ•ด SIS 3.0์œผ๋กœ ๊ฐœ์ •๋˜์–ด ์‚ฌ์šฉ๋˜๊ณ  ์žˆ๋‹ค.8
ํ™˜์ž-๋ณด๊ณ ์‹์˜ ์ธก์ •๋„๊ตฌ๋Š” ์ž„์ƒ๊ฐ€์™€ ๊ด€๋ จ ์—ฐ๊ตฌ์ž๋“ค์— ์˜ํ•ด ์‚ฌ์šฉ๋˜๋ฉฐ ์ž„์ƒ ํ˜„์žฅ์—์„œ๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ํ™˜์ž์˜ ์ผ์ƒ์ƒํ™œ ํ™˜๊ฒฝ์—์„œ ํ™˜์ž๊ฐ€ ์ˆ˜ํ–‰ํ•˜๋Š” ๊ฒƒ์„ ํ‰๊ฐ€ํ•  ์ˆ˜ ์žˆ๊ธฐ ๋•Œ๋ฌธ์— ๋” ๊ฐ€์น˜๊ฐ€ ์žˆ๋‹ค.9 ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ์‚ถ์˜ ์งˆ์„ ๊ฐ๊ด€์ ์œผ๋กœ ์ธก์ •ํ•˜๊ธฐ ์œ„ํ•ด ์„ ํƒ๋˜๋Š” ๋„๊ตฌ๋Š” ์‹ ๋ขฐ๋„์™€ ํƒ€๋‹น๋„๋ฅผ ํฌํ•จํ•˜์—ฌ ์ธก์ •๋„๊ตฌ๋กœ์„œ์˜ ํŠน์„ฑ์ด ํ™•๋ณด๋˜์–ด์•ผ ํ•œ๋‹ค. ์‹ ๋ขฐ๋„๋Š” ๋‚ด์ ์ผ์น˜๋„์™€ ๊ฒ€์‚ฌ-์žฌ๊ฒ€์‚ฌ๋ฅผ ์‚ฌ์šฉํ•˜์—ฌ ํ‰๊ฐ€๋œ๋‹ค. ๋‚ด์ ์ผ์น˜๋„๋Š” ์ธก์ •๋„๊ตฌ์˜ ๋ฌธํ•ญ๋“ค์— ๋Œ€ํ•œ ๋™์งˆ์„ฑ์˜ ์ •๋„๋ฅผ ์˜๋ฏธํ•˜๋ฉฐ, ๊ฒ€์‚ฌ-์žฌ๊ฒ€์‚ฌ ์‹ ๋ขฐ๋„๋Š” ๋ฐ˜๋ณต์ธก์ •์— ์˜ํ•œ ์‹ ๋ขฐ๋„๋กœ์„œ ํ™˜์ž์˜ ์ƒํƒœ๋ณ€ํ™”๊ฐ€ ์—†๋Š” ๊ฒฝ์šฐ ๋‘ ์ธก์ •๊ฐ’์˜ ์ผ์น˜๋„๋ฅผ ๋‚˜ํƒ€๋‚ธ๋‹ค. ํƒ€๋‹น๋„๋Š” ์—ฐ๊ตฌ์ž๊ฐ€ ์ธก์ •ํ•˜๊ณ ์ž ํ•˜๋Š” ๊ฐœ๋…์ด๋‚˜ ์†์„ฑ์„ ์–ผ๋งˆ๋‚˜ ์ •ํ™•ํ•˜๊ฒŒ ์ธก์ •ํ•˜๊ณ  ์žˆ๋Š” ๊ฐ€๋ฅผ ์˜๋ฏธํ•œ๋‹ค.10
์„ ํ–‰๋œ ๋งŽ์€ ๊ตญ๋‚ด ์—ฐ๊ตฌ์—์„œ๋Š” ๋‡Œ์กธ์ค‘ ์ค‘์žฌ ํ›„ ๊ทธ ํšจ๊ณผ๋ฅผ ์ฃผ๋กœ ํ ๊ธฐ๋Šฅ, ์ƒ์ง€ ๊ธฐ๋Šฅ, ๋ณดํ–‰ ๋ฐ ๊ท ํ˜•๊ณผ ๊ฐ™์€ ์‹ ์ฒด ๊ธฐ๋Šฅ์ด๋‚˜ ์ผ์ƒ์ƒํ™œ๋™์ž‘๊ณผ ๊ฐ™์€ ์‹ ์ฒดํ™œ๋™์„ ํ‰๊ฐ€ํ•˜๋Š” ๋„๊ตฌ๋ฅผ ์‚ฌ์šฉํ•˜์˜€๋‹ค.11-14 ๋˜ํ•œ ๋‡Œ์กธ์ค‘ํ™˜์ž์˜ QOL์— ๋Œ€ํ•œ ์—ฐ๊ตฌ๋Š” ์ค‘์žฌ ํšจ๊ณผ์˜ ์ธก์ •๋ณด๋‹ค๋Š” QOL์— ์˜ํ–ฅ์„ ์ฃผ๋Š” ์š”์ธ์„ ๋ถ„์„ํ•˜๋Š” ์—ฐ๊ตฌ๊ฐ€ ๋Œ€๋ถ€๋ถ„์ด์—ˆ๋‹ค.15 ์—ฌ๋Ÿฌ ๋‚˜๋ผ ์–ธ์–ด๋กœ ๋ฒˆ์—ญ๋˜์–ด ๊ฐ€์žฅ ๋งŽ์ด ์‚ฌ์šฉ๋˜๋Š” ์ธก์ •๋„๊ตฌ์ž„์—๋„ ๋ถˆ๊ตฌํ•˜๊ณ  ์šฐ๋ฆฌ๋‚˜๋ผ์˜ ์ž„์ƒ์—์„œ๋Š” ์ž˜ ์‚ฌ์šฉ๋˜์ง€ ์•Š๊ณ  ์žˆ๋Š” ์‹ค์ •์ด๋‹ค.16-19 ๋”ฐ๋ผ์„œ ๋ณธ ์—ฐ๊ตฌ๋Š” ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ์‚ถ์˜ ์งˆ์„ ํ‰๊ฐ€ํ•˜๋Š” SIS 3.0 ํ•œ๊ตญ์–ดํŒ์˜ ํƒ€๋‹น๋„๋ฅผ ๊ฒ€์ฆํ•˜์—ฌ ํ•œ๊ตญ ์ž„์ƒ์—์„œ์˜ ํ™œ์šฉ ๊ฐ€๋Šฅ์„ฑ์„ ํ™•์ธํ•˜๊ธฐ ์œ„ํ•ด ์ˆ˜ํ–‰๋˜์—ˆ๋‹ค.

์—ฐ๊ตฌ ๋ฐฉ๋ฒ•

1. ์—ฐ๊ตฌ ๋Œ€์ƒ

๋ณธ ์—ฐ๊ตฌ๋Š” 2014๋…„ 6์›”๋ถ€ํ„ฐ 12์›”๊นŒ์ง€ ๋ถ€์‚ฐ๊ด‘์—ญ์‹œ ์†Œ์žฌ 8๊ฐœ์˜ ์žฌํ™œ๋ณ‘์›์—์„œ ๋‡Œ์กธ์ค‘์œผ๋กœ ์ง„๋‹จ ๋ฐ›๊ณ  ์ž…์› ์น˜๋ฃŒ ์ค‘์ธ 90๋ช…์˜ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ํ•˜์˜€๋‹ค. ๋Œ€์ƒ์ž ์„ ์ •์กฐ๊ฑด์€ ์œ ๋ณ‘๊ธฐ๊ฐ„์ด ๊ธ‰์„ฑ๊ธฐ๊ฐ€ ์ง€๋‚œ 3๊ฐœ์›” ์ด์ƒ์ธ ํ™˜์ž์™€ ํ•œ๊ตญํ˜• ๊ฐ„์ด์ •์‹  ์ƒํƒœํŒ๋ณ„๊ฒ€์‚ฌ(mini-mental state examination- Korea version; MMSE-K) ๊ฒฐ๊ณผ 24์  ์ด์ƒ์œผ๋กœ ์ธ์ง€๋Šฅ๋ ฅ์— ์†์ƒ์ด ์—†๋Š” ํ™˜์ž์ด๋ฉฐ, ๋ณธ ์—ฐ๊ตฌ์˜ ๋‚ด์šฉ์„ ์ดํ•ดํ•˜๊ณ  ์ž๋ฐœ์ ์œผ๋กœ ์ฐธ์—ฌ์— ๋™์˜ํ•œ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ํ•˜์˜€๋‹ค.

2. ์‹คํ—˜๋ฐฉ๋ฒ•

1) ์ธก์ •๋„๊ตฌ ๋ฐ ๋ฐฉ๋ฒ•

(1) ๊ฐ„์ด์ •์‹ ์ƒํƒœ ํŒ๋ณ„๊ฒ€์‚ฌ(Mini-Mental State Examination, MMSE)
์น˜๋งค ์ง„๋‹จ๊ณผ ์ธ์ง€๊ธฐ๋Šฅ ์žฅ์•  ์œ ๋ฌด๋ฅผ ํŒ๋ณ„ํ•˜๊ธฐ ์œ„ํ•ด ๊ฐœ๋ฐœ๋œ MMSE๋Š” ์‹ ๋ขฐ๋„์™€ ํƒ€๋‹น๋„๊ฐ€ ๋†’์€ ์ธก์ •๋„๊ตฌ์ด๋‹ค. ์ด 12๋ฌธํ•ญ์œผ๋กœ ์ง€๋‚จ๋ ฅ, ๊ธฐ์–ต๋“ฑ๋ก, ๊ธฐ์–ตํšŒ์ƒ, ์ฃผ์˜ ์ง‘์ค‘ ๋ฐ ๊ณ„์‚ฐ, ์–ธ์–ด ๊ธฐ๋Šฅ, ์ดํ•ด ๋ฐ ํŒ๋‹จ ๋“ฑ 6๊ฐœ ์˜์—ญ์œผ๋กœ ๊ตฌ์„ฑ๋˜์–ด ์žˆ์œผ ๋ฉฐ ์ด 30์ ์œผ๋กœ 24์  ์ด์ƒ์„ โ€˜ํ™•์ •์  ์ •์ƒโ€™, 19์  ์ดํ•˜๋ฅผ โ€˜ํ™•์ •์  ์น˜๋งคโ€™, ๊ทธ๋ฆฌ๊ณ  20-23์ ์€ โ€˜์น˜๋งค ์˜์‹ฌโ€™์œผ๋กœ ํŒ๋ณ„๋œ๋‹ค. ์ž„์ƒ์—์„œ ๋‡Œ์†์ƒ ํ™˜์ž์˜ ์ธ์ง€์ˆ˜์ค€์„ ํ‰๊ฐ€ํ•˜๋Š” ๋„๊ตฌ๋กœ ๋„๋ฆฌ ์‚ฌ์šฉ๋˜๊ณ  ์žˆ๋‹ค. ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ํ•œ๊ธ€ํŒ MMSE๋ฅผ ์‚ฌ์šฉํ•˜์˜€๋‹ค.20
(2) ์ˆ˜์ •๋ฐ”๋ธ์ง€์ˆ˜(Modified Barthel Index)
์ผ์ƒ์ƒํ™œ๋™์ž‘์˜ ์ž๋ฆฝ๋„๋ฅผ ํ‰๊ฐ€ํ•˜๊ธฐ ์œ„ํ•ด ๊ฐœ๋ฐœ๋œ ๋ฐ”๋ธ์ง€์ˆ˜๋Š” ์ด 5ํšŒ์˜ ๊ฐœ์ •์ด ์žˆ์—ˆ๊ณ  ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” 5ํŒ์„ ํ•œ๊ธ€ํŒ ์ˆ˜์ •๋ฐ”๋ธ์ง€์ˆ˜๋ฅผ ์‚ฌ์šฉํ•˜์˜€๋‹ค.21 ํ™˜์ž์˜ ๊ธฐ๋Šฅํ˜ธ์ „ ๋ณ€ํ™”๋ฅผ ์ฆ‰๊ฐ์ ์œผ๋กœ ๋ฐ˜์˜ํ•˜๋Š” ํ‰๊ฐ€๋„๊ตฌ๋กœ ์ผ์ƒ์ƒํ™œ๋™์ž‘ ์ˆ˜ํ–‰์ˆ˜์ค€์„ ๋‚˜ํƒ€๋‚ด๋Š” ์‹ ๋ขฐ๋„์™€ ํƒ€๋‹น๋„๊ฐ€ ๋†’์€ ๋„๊ตฌ์ด๋‹ค. ๊ฐœ์ธ์œ„์ƒ, ๋ชฉ์š•ํ•˜๊ธฐ, ์‹์‚ฌํ•˜๊ธฐ, ์šฉ๋ณ€์ฒ˜๋ฆฌ, ๊ณ„๋‹จ ์˜ค๋ฅด๊ธฐ, ์˜ท์ž…๊ธฐ, ๋Œ€๋ณ€/์†Œ๋ณ€ ์กฐ์ ˆ, ๋ณดํ–‰ ๋˜๋Š” ์˜์ž์ฐจ ๋ฐ ์˜์‚ฌ-์นจ๋Œ€ ์ด๋™์˜ 10๊ฐœ ํ•ญ๋ชฉ์„ ์ˆ˜ํ–‰ํ•˜๋Š” ๋™์•ˆ ์ง์ ‘์ ์ธ ๊ด€์ฐฐ๊ณผ ๋ฉด์ ‘์„ ํ†ตํ•˜์—ฌ ์˜์กด ์ •๋„๋ฅผ ๊ฐ ํ•ญ๋ชฉ ๋ณ„๋กœ 5๋‹จ๊ณ„์˜ ์ ์ˆ˜๋กœ ํ‘œ์‹œํ•˜์˜€๋‹ค. 100์ ์„ ๋งŒ์ ์œผ๋กœ 0-24์ ์€ ์™„์ „ ์˜์กด์„ฑ, 25-49์ ์€ ์ตœ๋Œ€ ์˜์กด์„ฑ, 50~74์ ์€ ๋ถ€๋ถ„ ์˜์กด์„ฑ, 75-90์ ์€ ์•ฝ๊ฐ„ ์˜์กด์„ฑ, 91-99์ ์€ ์ตœ์†Œ ์˜์กด์„ฑ, 100์ ์€ ์™„์ „ ๋…๋ฆฝ์„ ๋‚˜ํƒ€๋‚ธ๋‹ค
(3) Beck ์šฐ์šธ์ฒ™๋„ (Beck Depression Index, BDI)
์šฐ์šธ์ฆ์„ ์„ ๋ณ„ํ•˜๊ธฐ ์œ„ํ•ด ๊ฐœ๋ฐœ๋œ BDI๋Š” ์‹ ๋ขฐ๋„์™€ ํƒ€๋‹น๋„๊ฐ€ ๋†’์€ ์ž๊ฐ€๊ธฐ์ž…์‹ ์ธก์ •๋„๊ตฌ์ด๋‹ค. ๊ฐ ๋ฌธํ•ญ์—์„œ 0์ ์—์„œ 3์ ๊นŒ์ง€ ์ด 63์ ๊นŒ์ง€ ๋ถ„ํฌํ•˜๋ฉฐ ์šฐ์šธ์ฆ์˜ ์ธ์ง€์ , ์ •์„œ์ , ๋™๊ธฐ์  ๋ฐ ์‹ ์ฒด์  ์ฆ์ƒ ์˜์—ญ์˜ 21๋ฌธํ•ญ์œผ๋กœ ๊ตฌ์„ฑ๋˜์–ด ์žˆ์œผ๋ฉฐ ์ฆ์ƒ์˜ ์ •๋„๋ฅผ ํ‘œํ˜„ํ•˜๋Š” ๊ตฌ์ฒด์ ์ธ ํ•ญ๋ชฉ์— ๋Œ€ํ•œ ๋‹ต๋ณ€์œผ๋กœ ์ ์ˆ˜ํ™” ํ•œ๋‹ค. ์ ์ˆ˜๊ฐ€ ๋†’์„์ˆ˜๋ก ์šฐ์šธ ์ฆ์ƒ์ด ์‹ฌํ•จ์„ ์˜๋ฏธํ•œ๋‹ค. ํ•œ๊ธ€ํŒ Beck ์šฐ์šธ์ฒ™๋„๋ฅผ ์‚ฌ์šฉํ•˜์˜€๋‹ค.22
(4) ์„ธ๊ณ„๋ณด๊ฑด๊ธฐ๊ตฌ์žฅ์•  ํ‰๊ฐ€ ๋ชฉ๋ก 2.0 (WHODAS 2.0)
ICF ํ”„๋ ˆ์ž„์›Œํฌ์— ๊ธฐ์ดˆํ•˜์—ฌ ๋งŒ๋“ค์–ด์ง„ ํ‰๊ฐ€๋„๊ตฌ์ธ WHODAS 2.0๋Š” ์ธ์ง€, ์ด๋™, ์ž๊ธฐ ๊ด€๋ฆฌ, ์–ด์šธ๋ฆฌ๊ธฐ, ์ผ์ƒ ํ™œ๋™ ๋ฐ ์ง€์—ญ์‚ฌํšŒ ์ฐธ์—ฌ์˜ 6๊ฐ€์ง€ ์˜์—ญ์—์„œ ๊ธฐ๋Šฅ์ˆ˜ํ–‰ ์ •๋„๋ฅผ ํ‰๊ฐ€ํ•  ์ˆ˜ ์žˆ์œผ๋ฉฐ ์žฅยท๋‹จ๊ธฐ ๊ฑด๊ฐ•์ƒํƒœ์™€ ์—ฐ๊ด€๋œ ์ผ์ƒ์ƒํ™œ์ˆ˜ํ–‰๋Šฅ๋ ฅ์„ ์ธก์ •ํ•  ์ˆ˜ ์žˆ๋‹ค. ์ตœ๊ทผ 30์ผ๋™์•ˆ ๋Œ€์ƒ์ž๊ฐ€ ๊ฐ ํ•ญ๋ชฉ์„ ์ˆ˜ํ–‰ํ•˜๋Š” ๋ฐ ๊ฒช์€ ์–ด๋ ค์›€์— ๋Œ€ํ•ด 5๋‹จ๊ณ„๋กœ ๊ธฐ์ž…ํ•˜์˜€๋‹ค. ์–ด๋ ค์›€์ด ์—†์œผ๋ฉด 0์ , ๊ทน๋„๋กœ ์–ด๋ ต๊ฑฐ๋‚˜ ์ˆ˜ํ–‰ํ•  ์ˆ˜ ์—†์œผ๋ฉด 4์ ์œผ๋กœ ์ตœ๊ณ  ์ ์ˆ˜๋Š” 60์ ์ด๊ณ  ์ ์ˆ˜๊ฐ€ ๋‚ฎ์„์ˆ˜๋ก ๊ธฐ๋Šฅ ์ˆ˜ํ–‰ ์ •๋„๊ฐ€ ์ข‹์€ ๊ฒƒ์„ ์˜๋ฏธํ•œ๋‹ค.23 WHODAS 2.0๋Š” ์ตœ๊ทผ ํ•œ๊ธ€๋กœ ๋ฒˆ์—ญ๋˜์—ˆ์œผ๋ฉฐ, ํ•œ๊ธ€๋„๊ตฌ์— ๋Œ€ํ•œ ๋†’์€ ์‹ ๋ขฐ๋„์™€ ํƒ€๋‹น๋„๊ฐ€ ํ™•๋ณด๋˜์–ด์žˆ๋‹ค.24
(5) ๋‡Œ์กธ์ค‘ ์˜ํ–ฅ ์ฒ™๋„ 3.0 (Stroke Impact Scale 3.0)
SIS 3.0์€ ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ์‚ถ์˜ ์งˆ์„ ํ‰๊ฐ€ํ•˜๊ธฐ ์œ„ํ•œ ์‹ ๋ขฐ๋„์™€ ํƒ€๋‹น๋„๊ฐ€ ๋†’์€ ์ž๊ฐ€๋ณด๊ณ ์‹ ํ‰๊ฐ€ ๋„๊ตฌ์ด๋‹ค. ๋‡Œ์กธ์ค‘์˜ ์ „๋ฐ˜์ ์ธ ํšŒ๋ณต์„ ์ธก์ •ํ•˜๊ธฐ ์œ„ํ•ด ๊ทผ๋ ฅ, ์†์˜ ๊ธฐ๋Šฅ, ์ผ์ƒ์ƒํ™œ๋™์ž‘, ์ด๋™, ์˜์‚ฌ์†Œํ†ต, ์ •์„œ, ๊ธฐ์–ต๊ณผ ์‚ฌ๊ณ  ๋ฐ ์‚ฌํšŒ์  ์ฐธ์—ฌ์˜ 8๊ฐœ ์˜์—ญ์˜ 59ํ•ญ๋ชฉ์œผ๋กœ ๊ตฌ์„ฑ๋˜์–ด ์žˆ๋‹ค. ์„ค๋ฌธ์ง€๋ฅผ ์ž‘์„ฑํ•˜๊ธฐ์— ์•ž์„œ ๊ฒ€์‚ฌ์ž๋Š” ๋Œ€์ƒ์ž์—๊ฒŒ ์ง€๋‚œ ํ•œ ์ฃผ ๋™์•ˆ ๋Š๊ผˆ๋˜ ๊ฒƒ์„ ๊ทผ๋ ฅ์— ๋Œ€ํ•œ ํ•ญ๋ชฉ์€ ๊ทผ์œก์˜ ๊ฐ•ํ•œ ์ •๋„๋ฅผ ๋‹ตํ•˜๊ฒŒ ํ•˜๊ณ  ๊ธฐ์–ต๊ณผ ์‚ฌ๊ณ , ์˜์‚ฌ์†Œํ†ต, ์ผ์ƒ์ƒํ™œ๋™์ž‘, ์ด๋™ ๋ฐ ์†์˜ ๊ธฐ๋Šฅ ํ•ญ๋ชฉ์€ ์–ด๋ ค์›€์˜ ์ •๋„๋ฅผ ๋‹ตํ•˜๊ฒŒ ํ•˜์˜€์œผ๋ฉฐ ์ •์„œ์™€ ์‚ฌํšŒ์  ์ฐธ์—ฌ๋Š” ๋นˆ๋„์˜ ์ •๋„๋กœ ๋‹ตํ•  ๊ฒƒ์„ ์„ค๋ช…ํ•˜์˜€๋‹ค. ์ ์ˆ˜๋Š” 5 (์ „ํ˜€ ~์—†๋‹ค), 4 (์•ฝ๊ฐ„ ~์žˆ๋‹ค), 3 (๋‹ค์†Œ ~์žˆ๋‹ค), 2 (๋งค์šฐ ~์žˆ๋‹ค), 1 (๊ทน๋„์˜ ~์žˆ๋‹ค)์ ์œผ๋กœ ์ „์ฒด ์ ์ˆ˜๊ฐ€ ๋†’์„์ˆ˜๋ก ์‚ถ์˜ ์งˆ์ด ๋†’์€ ๊ฒƒ์„ ๋‚˜ํƒ€๋‚ธ๋‹ค. ์ •์„œ ์˜์—ญ์—์„œ 6๋ฒˆ (์ด์ „๊ณผ ๊ฐ™์ด ๋ญ”๊ฐ€๋ฅผ ์ฆ๊ธธ ์ˆ˜ ์žˆ์Œ), 8๋ฒˆ (์‚ถ์ด ๊ฐ€์น˜๊ฐ€ ์žˆ๋‹ค๊ณ  ๋Š๋‚Œ), 9๋ฒˆ (์ ์–ด๋„ ํ•˜๋ฃจ์— ํ•œ ๋ฒˆ ์ด์ƒ ๋ฏธ์†Œ ์ง“๊ธฐ) ํ•ญ๋ชฉ์€ ๋‹ค๋ฅธ ํ•ญ๋ชฉ์˜ ๋‹ต๋ณ€๊ณผ ๋ฐ˜๋Œ€์˜ ์ฒ™๋„๋กœ ๊ตฌ์„ฑ๋˜์–ด ์žˆ์–ด ์ ์ˆ˜๋ฅผ ์—ญ์œผ๋กœ ๊ณ„์‚ฐํ•˜์—ฌ์•ผ ํ•œ๋‹ค.8,25 ๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” ์šฐ๋ฆฌ๋‚˜๋ผ ์‹ค์ •์— ๋งž๊ฒŒ ๋ฒˆ์—ญํ•œ ํ•œ๊ธ€ํŒ SIS 3.0์„ ์‚ฌ์šฉํ•˜์˜€๋‹ค.26

2) ์ž๋ฃŒ์ˆ˜์ง‘๋ฐฉ๋ฒ•

๋ณธ ์—ฐ๊ตฌ์— ์ฐธ์—ฌํ•œ ๋Œ€์ƒ์ž๋“ค์—๊ฒŒ ์—ฐ๊ตฌ์— ๋Œ€ํ•œ ์˜์˜๋ฅผ ์„ค๋ช…ํ•˜์˜€์œผ๋ฉฐ, ๋Œ€์ƒ์ž ๋ณธ์ธ์ด๋‚˜ ๋Œ€๋ฆฌ์ธ์œผ๋กœ๋ถ€ํ„ฐ ์—ฐ๊ตฌ์— ๋Œ€ํ•œ ๋™์˜๋ฅผ ๋ฐ›์•˜๋‹ค. ๋ฐ์ดํ„ฐ ์ˆ˜์ง‘์€ ์ž„์ƒ๊ฒฝํ—˜ 3๋…„ ์ด์ƒ์˜ ์‹ ๊ฒฝ๊ณ„ ๋ฌผ๋ฆฌ์น˜๋ฃŒ์‚ฌ๊ฐ€ ์‹ค์‹œํ•˜์˜€์œผ๋ฉฐ, ๋ณธ ์—ฐ๊ตฌ๋ฅผ ์œ„ํ•˜์—ฌ ์ƒ๊ธฐ์˜ ์ธก์ •๋„๊ตฌ ์‚ฌ์šฉ์— ๋Œ€ํ•ด ๊ต์œก์„ ์‚ฌ์ „์— ์‹ค์‹œํ•˜์˜€๋‹ค. ๋Œ€์ƒ์ž๋“ค์˜ ์ดํ•ด๋„๋ฅผ ๋†’์ด๊ธฐ ์œ„ํ•ด ๋ฌผ๋ฆฌ์น˜๋ฃŒ์‚ฌ๊ฐ€ ์ธก์ •๋„๊ตฌ ํ•ญ๋ชฉ์„ ์ฝ๊ณ  ํ™˜์ž์˜ ๋‹ต๋ณ€์„ ๊ธฐ๋กํ•˜๋Š” ๋ฐฉ์‹์œผ๋กœ ์ง„ํ–‰๋˜์—ˆ๋‹ค.

3. ์ž๋ฃŒ๋ถ„์„

์—ฐ๊ตฌ๋Œ€์ƒ์ž์˜ ์ผ๋ฐ˜์ ์ธ ํŠน์„ฑ ๋ฐ ๊ฐ ์ธก์ • ๋ณ€์ˆ˜๋Š” ๊ธฐ์ˆ ํ†ต๊ณ„๋กœ ๋ถ„์„ํ•˜์˜€๋‹ค. ๋‚ด์ ์ผ์น˜๋„๋Š” Cronbachโ€™s ฮฑ ๊ฐ’์œผ๋กœ ๋ถ„์„ํ•˜์˜€์œผ๋ฉฐ, ํƒ€๋‹น๋„๋Š” ์Šคํ”ผ์–ด๋งŒ ์ƒ๊ด€๋ถ„์„์„ ์ด์šฉํ•˜์—ฌ SIS์˜ ๊ฐ ์˜์—ญ๊ณผ K-MMSE, K-MBI, K-BDI ๋ฐ K-WHODAS๊ณผ์˜ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ์ธก์ •ํ•˜์˜€๋‹ค. ๋˜ํ•œ K-SIS 3.0์˜ ๊ฐ ์˜์—ญ์— ๋Œ€ํ•œ ๋ฐ”๋‹ฅํšจ๊ณผ์™€ ์ฒœ์ •ํšจ๊ณผ๋ฅผ ๊ด€์ฐฐํ•˜์˜€๋‹ค. ํ†ต๊ณ„ํ”„๋กœ๊ทธ๋žจ์€ IBM SPSS 21๋ฒ„์ „์„ ์‚ฌ์šฉํ•˜์˜€์œผ๋ฉฐ, ํ†ต๊ณ„ํ•™์  ์œ ์˜์ˆ˜์ค€์€ 0.05๋กœ ํ•˜์˜€๋‹ค.

๊ฒฐ๊ณผ

1. ๋Œ€์ƒ์ž์˜ ์ผ๋ฐ˜์  ํŠน์„ฑ

๋ฐœ๋ณ‘์ด 3๊ฐœ์›” ์ด์ƒ์ธ 90๋ช… (๋‚จ์„ฑ 60๋ช…, ์—ฌ์„ฑ 30๋ช…)์˜ ๋‡Œ์กธ์ค‘ ์ž…์›ํ™˜์ž๊ฐ€ ๋ณธ ์—ฐ๊ตฌ์— ์ฐธ์—ฌํ•˜์˜€๋‹ค. ๋Œ€์ƒ์ž ์—ฐ๋ น์˜ ํ‰๊ท ์€ 52.7ยฑ15.6์„ธ์˜€๋‹ค. ๋‡Œ์กธ์ค‘์˜ ์œ ํ˜•์€ ๋‡Œ์ถœํ˜ˆ์ด 46๋ช…, ๋‡Œ๊ฒฝ์ƒ‰์ด 44๋ช…์œผ๋กœ ๊ตฌ์„ฑ๋˜์—ˆ์œผ๋ฉฐ, ๋งˆ๋น„ ์ธก์€ ์˜ค๋ฅธ์ชฝ์ด 45๋ช…, ์™ผ์ชฝ์ด 45๋ช…์œผ๋กœ ๊ตฌ์„ฑ๋˜์—ˆ๋‹ค.

2. K-SIS์˜ ๊ฐ ์˜์—ญ๊ณผ ๊ธฐ์กด ๋„๊ตฌ์˜ ๊ธฐ์ˆ ํ†ต๊ณ„๋Ÿ‰

K-SIS์˜ ๊ฐ ์˜์—ญ๊ณผ K-MMSE, K-MBI, K-BDI ๋ฐ K-WHODAS 2.0์˜ ๊ธฐ์ˆ ํ†ต๊ณ„๋Ÿ‰์€ Table 1์— ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค.
Tableย 1
The means and standard deviations of measured scales
Scale meanยฑstandard deviation
K-SIS Strength 9.48ยฑ3.52
Memory & Thinking 29.21ยฑ5.89
Emotion 30.70ยฑ5.52
Communication 31.42ยฑ4.97
Activity 34.46ยฑ9.62
Mobility 28.61ยฑ10.07
Hand Function 9.61ยฑ5.35
Participation 20.90ยฑ9.50
Total 194.17ยฑ38.05
K-MMSE 28.02ยฑ3.82
K-MBI 70.23ยฑ24.30
K-BDI 40.86ยฑ12.15
K-WHODAS 2 82.97ยฑ46.46

K-SIS, Korean version of Stroke Impact Scale 3.0; K-MMSE, Korean version of Mini-Mental State Examination; K-MBI, Korean version of Modified Barthel Index; K-BDI, Korean version of Beck Depression Index; K-WHODAS 2.0, Korean version of World Health Organization Disability Assessment Schedule.

3. K-SIS์˜ ์ฒœ์ •ํšจ๊ณผ์™€ ๋ฐ”๋‹ฅํšจ๊ณผ

์ž„์ƒ์ธก์ •๋„๊ตฌ๋Š” ์ตœ๋Œ€์ ์ˆ˜์™€ ์ตœ์†Œ์ ์ˆ˜์˜ ๋น„์œจ์ด ์ „์ฒด 15%๋ฅผ ๋„˜์ง€ ์•Š์•„์•ผ ํ•œ๋‹ค. ๊ธฐ์–ต๊ณผ ์‚ฌ๊ณ  ๋ฐ ์˜์‚ฌ์†Œํ†ต์˜์—ญ์—์„œ๋Š” ์ฒœ์ •ํšจ๊ณผ๊ฐ€ ๊ด€์ฐฐ๋˜์—ˆ์œผ๋ฉฐ, ์ด๋ฅผ ์ œ์™ธํ•œ ์˜์—ญ๊ณผ K-SIS์˜ ์ด์ ์—์„œ๋Š” ์ฒœ์ •ํšจ๊ณผ์™€ ๋ฐ”๋‹ฅํšจ๊ณผ๋Š” ๊ด€์ฐฐ๋˜์ง€ ์•Š์•˜๋‹ค(Figure 1).
Figureย 1
Ceiling and floor effect of each domain of K-SIS 3.0.
JKPT_27_252_fig_1.tif

4. K-SIS์˜ ๋‚ด์ ์ผ์น˜๋„

๊ฐ์ •์˜์—ญ์„ ์ œ์™ธํ•œ ์˜์—ญ์—์„œ ๋งค์šฐ ๋†’์€ ๋‚ด์ ์ผ์น˜๋„๊ฐ€ ๊ด€์ฐฐ๋˜์—ˆ๋‹ค. ์ •์„œ์˜์—ญ์„ ๊ตฌ์„ฑํ•˜๋Š” ํ•ญ๋ชฉ ๊ฐ„์˜ ๋™์งˆ์„ฑ์ด ๋‚ฎ์€ ๊ฒƒ์œผ๋กœ ๊ด€์ฐฐ๋˜์—ˆ๋‹ค(ฮฑ=0.56) (Table 2).
Tableย 2
The internal consistency of K-SIS of each domain
Domain of K-SIS Cronbachโ€™s ฮฑ
Strength 0.84
Memory & Thinking 0.92
Emotion 0.56
Communication 0.91
Activity 0.91
Mobility 0.95
Hand Function 0.94
Participation 0.91
Total 0.82

K-SIS, Korean version of Stroke Impact Scale 3.0.

5. K-SIS์™€ ๊ธฐ์กด ๋„๊ตฌ์˜ ์ƒ๊ด€์„ฑ

K-SIS์˜ ๊ฐ ์˜์—ญ๊ณผ K-MMSE, K-MBI, K-BDI ๋ฐ K-WHODAS 2.0์˜ ์ƒ๊ด€๊ด€๊ณ„ ๊ฒฐ๊ณผ๋Š” Table 3์— ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค. ๊ธฐ์–ต๊ณผ ์‚ฌ๊ณ  ์˜์—ญ ๋ฐ ์˜์‚ฌ์†Œํ†ต์˜์—ญ์—์„œ๋Š” K-MMSE์˜ ํ•ญ๋ชฉ๊ณผ ํ™œ๋™์˜์—ญ ๋ฐ ์ด๋™์˜์—ญ์€ K-MBI์™€ ๋†’์€ ์—ฐ๊ด€์„ฑ์ด ๊ด€์ฐฐ๋˜์—ˆ๋‹ค. K-BDI๋Š” ์ •์„œ์˜์—ญ๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ํ™œ๋™์˜์—ญ ๋ฐ ์ด๋™์˜์—ญ์—์„œ๋„ ์„œ๋กœ ๋†’์€ ์Œ์˜ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ๋‚˜ํƒ€๋‚ด์—ˆ๋‹ค. ํ™œ๋™์˜์—ญ ๋ฐ ์ด๋™์˜์—ญ์€ ๋˜ํ•œ ์ „๋ฐ˜์ ์ธ ๊ธฐ๋Šฅ์ˆ˜ํ–‰ ์ •๋„๋ฅผ ๋‚˜ํƒ€๋‚ด๋Š” K-WHODAS 2.0์™€ ๋งค์šฐ ๋†’์€ ์Œ์˜ ์ƒ๊ด€๊ด€๊ณ„๊ฐ€ ๊ด€์ฐฐ๋˜์—ˆ๋‹ค(Table 3).
Tableย 3
Correlation between each domain of K-SIS 3.0 and MMSE, MBI, BDI & WHODAS 2.0
K-SIS K-MMSE K-MBI K-BDI K-WHODAS 2.0
Strength 0.19 0.34** -0.36** -0.43**
Memory & Thinking 0.49** 0.41** -0.35** -0.28**
Emotion 0.22* 0.34** -0.43** -0.44**
Communication 0.52** 0.29** -0.31** -0.27**
Activity 0.34** 0.61** -0.50** -.060**
Mobility 0.28** 0.66** -.052** -.062**
Hand Function 0.17 0.37** -0.35** -0.42**
Participation 0.18 0.40** -0.40** -0.46**

* p<0.05;

** p<0.01.

K-SIS, Korean version of Stroke Impact Scale 3.0; K-MMSE, Korean version of Mini-Mental State Examination; K-MBI, Korean version of Modified Barthel Index; K-BDI, Korean version of Beck Depression Index; K-WHODAS 2.0, Korean version of World Health Organization Disability Assessment Schedule.

๊ณ ์ฐฐ

๋ณธ ์—ฐ๊ตฌ๋Š” ๋‡Œ์กธ์ค‘ํ™˜์ž์˜ ์‚ถ์˜ ์งˆ์„ ๋‹ค์ฐจ์›์ ์œผ๋กœ ์ธก์ •ํ•˜๋Š” ๋„๊ตฌ์ธ K-SIS 3.0์˜ ํ•œ๊ตญ ์ž„์ƒ์˜์—ญ๊ณผ ๊ด€๋ จ ์—ฐ๊ตฌ์˜์—ญ์—์„œ ๊ทธ ํ™œ์šฉ๊ฐ€๋Šฅ์„ฑ์„ ํ™•์ธํ•˜๊ธฐ ์œ„ํ•ด ์ˆ˜ํ–‰๋˜์—ˆ๋‹ค. K-SIS 3.0์— ๋Œ€ํ•œ ํŠน์„ฑ๋ถ„์„์„ ์œ„ํ•˜์—ฌ ๊ฐ ์˜์—ญ์˜ ํ•ญ๋ชฉ ๊ฐ„ ๋‚ด์ ์ผ์น˜๋„์™€ K-MMSE, K-MBI, K-BDI ๋ฐ K-WHODAS 2.0๊ณผ์˜ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ์ด์šฉํ•œ ํƒ€๋‹น๋„ ๋ถ„์„์„ ์‹ค์‹œํ•˜์˜€๋‹ค.
๋ณธ ์—ฐ๊ตฌ์— ์ฐธ์—ฌํ•œ ๋Œ€์ƒ์ž๋Š” ์ „๋ฌธ์žฌํ™œ๋ณ‘์›์— ์ž…์›ํ•˜์—ฌ ์น˜๋ฃŒ๋ฅผ ๋ฐ›๊ณ  ์žˆ๋Š” ๋งŒ์„ฑ ๋‡Œ์กธ์ค‘ ํ™˜์ž๋“ค๋กœ์„œ ์ธ์ง€๊ธฐ๋Šฅ์˜ ์†์ƒ์ด ์—†๊ณ  ์˜์‚ฌ์†Œํ†ต์ด ์›ํ™œํ•œ ์ˆ˜์ค€์˜ ํ™˜์ž๋“ค๋กœ ๊ตฌ์„ฑ์ด ๋˜์—ˆ๋‹ค. ์ฐธ์—ฌํ•œ ํ™˜์ž๋“ค์˜ ๊ธฐ๋Šฅ์ˆ˜ํ–‰์ˆ˜์ค€์€ ์„ ํ–‰์—ฐ๊ตฌ์—์„œ์™€ ์œ ์‚ฌํ•˜์˜€๋‹ค.16,18 ๋ณธ ์—ฐ๊ตฌ์—์„œ ๊ฐ์ •์˜์—ญ์—์„œ์˜ ํ•ญ๋ชฉ๊ฐ„ ๋‚ฎ์€ ๋‚ด์ ์ผ์น˜๋„๋Š” SIS ์›์ €๋ฅผ ํฌํ•จํ•œ ์„ ํ–‰์—ฐ๊ตฌ์—์„œ ๋ณด๊ณ ๋œ ๊ฒฐ๊ณผ์™€ ๋น„์Šทํ•˜๋‹ค.8,16,18 ์ด๋Š” ์ •์„œ ์˜์—ญ์€ 3๊ฐœ์˜ ๊ธ์ •์  ์ฒ™๋„์™€ 4๊ฐœ์˜ ๋ถ€์ •์  ์ฒ™๋„ ํ•ญ๋ชฉ์ด ํ˜ผํ•ฉ๋˜์–ด ๊ตฌ์„ฑ๋˜์–ด ๋Œ€์ƒ์ž๋“ค์˜ ๋‹ต๋ณ€ํ•˜๋Š”๋ฐ ํ˜ผ๋ž€์ด ์•ผ๊ธฐ๋  ์ˆ˜ ์žˆ๋Š” ๊ฒƒ์œผ๋กœ ์‚ฌ๋ฃŒ๋˜๋ฉฐ ์ด๋Ÿฌํ•œ ์ธก๋ฉด์ด ๋‚ฎ์€ ๋‚ด์ ์ผ์น˜๋„์— ์˜ํ–ฅ์„ ๋ฏธ์นœ ๊ฒƒ์œผ๋กœ ์ƒ๊ฐ๋œ๋‹ค.
์ž„์ƒ์ธก์ •๋„๊ตฌ์—์„œ ์ตœ๋Œ€์ ์ˆ˜์™€ ์ตœ์ €์ ์ˆ˜์˜ ๋น„์œจ์ด ์ „์ฒด์˜ 15%๋ฅผ ๋„˜์œผ๋ฉด ์ฒœ์ •ํšจ๊ณผ์™€ ๋ฐ”๋‹ฅํšจ๊ณผ์˜ ์กด์žฌ๋ฅผ ์˜๋ฏธํ•œ๋‹ค. ์ฒœ์žฅํšจ๊ณผ๊ฐ€ ์žˆ๋‹ค๋ฉด ํ™˜์ž์˜ ์ƒํƒœ๊ฐ€ ๋” ํ˜ธ์ „๋˜๋”๋ผ๋„ ์ธก์ •ํ•˜์ง€ ๋ชปํ•˜๋ฉฐ, ๋ฐ”๋‹ฅํšจ๊ณผ๋Š” ํ™˜์ž์˜ ์ƒํƒœ๊ฐ€ ์•…ํ™”๋˜๋”๋ผ๋„ ๊ทธ ์ •๋„๋ฅผ ์ธก์ •ํ•˜์ง€ ๋ชปํ•œ๋‹ค. ๋ณธ ์—ฐ๊ตฌ ๊ฒฐ๊ณผ ๊ธฐ์–ต๊ณผ ์‚ฌ๊ณ ์˜์—ญ ๋ฐ ์˜์‚ฌ์†Œํ†ต์˜์—ญ์—์„œ ์ฒœ์ •ํšจ๊ณผ๊ฐ€ ๊ด€์ฐฐ๋˜์—ˆ๋‹ค. ์„ ํ–‰์—ฐ๊ตฌ์—์„œ๋„ ๋น„์Šทํ•œ ๊ฒฐ๊ณผ๋ฅผ ๋ณด๊ณ ํ•˜๊ณ  ์žˆ๋‹ค.16 ๊ธฐ์–ต๊ณผ ์‚ฌ๊ณ ์˜์—ญ ๋ฐ ์˜์‚ฌ์†Œํ†ต์˜์—ญ์—์„œ ๋‚˜ํƒ€๋‚œ ์ฒœ์ •ํšจ๊ณผ๋Š” ์ธ์ง€๊ธฐ๋Šฅ๊ณผ ์˜์‚ฌ์†Œํ†ต์— ๋ฌธ์ œ๊ฐ€ ์—†๋Š” ๋Œ€์ƒ์ž ์„ ์ •์œผ๋กœ ์‚ฌ๋ฃŒ๋œ๋‹ค. ์†๊ธฐ๋Šฅ ์˜์—ญ์—์„œ์˜ ๋ฐ”๋‹ฅํšจ๊ณผ ๋˜ํ•œ ์„ ํ–‰๋œ ์—ฐ๊ตฌ์˜ ๊ฒฐ๊ณผ์™€ ์œ ์‚ฌํ•˜๋‹ค.16 ์ด๋Š” ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ํšŒ๋ณต๊ณผ์ •์—์„œ ์†๊ธฐ๋Šฅ์˜ ํšŒ๋ณต์ด ๋Š๋ฆฌ๊ณ  ๋ถˆ์™„์ „ํ•˜๊ฒŒ ์ผ์–ด๋‚˜๋Š” ๊ฒƒ์„ ๋ฐ˜์˜ํ•œ ๊ฒƒ์œผ๋กœ ์‚ฌ๋ฃŒ๋˜๋ฉฐ ์†์˜ ๊ธฐ๋Šฅ์ˆ˜ํ–‰์— ๋Œ€ํ•œ ์ •๋ณด๋ฅผ ์ •ํ™•ํ•˜๊ฒŒ ํŒŒ์•…ํ•˜๊ณ  ์‹ถ๋‹ค๋ฉด ์†์˜ ๊ธฐ๋Šฅ์ˆ˜ํ–‰์— ๋Œ€ํ•ด ํŠนํ™”๋œ ๋„๊ตฌ๋ฅผ ์‚ฌ์šฉํ•˜๋Š” ๊ฒƒ์ด ํƒ€๋‹นํ•  ๊ฒƒ์œผ๋กœ ์ƒ๊ฐ๋œ๋‹ค.
SIS๋Š” ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ๊ฑด๊ฐ•์ƒํƒœ์™€ ๊ด€๋ จํ•˜์—ฌ ์‚ถ์˜ ์งˆ์„ ํ‰๊ฐ€ํ•˜๊ธฐ ์œ„ํ•ด ์—ฌ๋Ÿฌ ์˜์—ญ์—์„œ์˜ ๊ธฐ๋Šฅ์ˆ˜ํ–‰ ์ˆ˜์ค€์„ ์ธก์ •ํ•˜๋Š” ๋ฐ ์‚ฌ์šฉ๋˜๊ณ  ์žˆ๋‹ค.2,16,17,27 K-SIS์˜ ํ™œ๋™์˜์—ญ ๋ฐ ์ด๋™์˜์—ญ์˜ ํ•ญ๋ชฉ๋“ค์€ ์ผ์ƒ์ƒํ™œ๋™์ž‘์„ ํ‰๊ฐ€ํ•  ์ˆ˜ ์žˆ๋Š” ๊ฐœ๋…์„ ํฌํ•จํ•˜๊ณ  ์žˆ์œผ๋ฉฐ, ๊ธฐ์–ต๊ณผ ์‚ฌ๊ณ  ์˜์—ญ ๋ฐ ์˜์‚ฌ์†Œํ†ต ์˜์—ญ์€ ํ™˜์ž์˜ ์ธ์ง€๊ธฐ๋Šฅ์˜ ์ •๋„๋ฅผ ํ‰๊ฐ€ํ•  ์ˆ˜ ์žˆ๋Š” ๊ฒƒ์œผ๋กœ ๋ณธ ์—ฐ๊ตฌ์—์„œ ํ™•์ธํ•˜์˜€๋‹ค. ์ •์„œ์˜์—ญ์€ ์šฐ์šธ ์ •๋„๋ฅผ ์ธก์ •ํ•˜๋Š” ํ•ญ๋ชฉ์œผ๋กœ ๊ตฌ์„ฑ๋œ K-BDI์™€ ๋†’์€ ์ƒ๊ด€๊ด€๊ณ„๋ฅผ ํ†ตํ•˜์—ฌ ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ์ •์„œ์ƒํƒœ์— ๋Œ€ํ•œ ์ •๋ณด๋ฅผ ํ™•์ธํ•˜๋Š” ๋ฐ ์œ ์šฉํ•  ์ˆ˜ ์žˆ์„ ๊ฒƒ์œผ๋กœ ์‚ฌ๋ฃŒ๋œ๋‹ค.16,18 ํฅ๋ฏธ๋กญ๊ฒŒ๋„ ํ™œ๋™์˜์—ญ ๋ฐ ์ด๋™์˜์—ญ์—์„œ๋„ K-BDI์™€ ๋†’์€ ์ƒ๊ด€๊ด€๊ณ„๊ฐ€ ๊ด€์ฐฐ๋˜์—ˆ๋‹ค. ์ด๋Š” ์ •์„œ์ ์ธ ์ธก๋ฉด์ด ์‹ ์ฒดํ™œ๋™์— ๋ถ€์ •์ ์œผ๋กœ ์˜ํ–ฅ์„ ๋ฏธ์น˜๋Š” ๊ฒƒ์„ ์˜๋ฏธํ•œ๋‹ค.22
ํ™œ๋™์˜์—ญ, ์ด๋™์˜์—ญ ๋ฐ ๊ทผ๋ ฅ์€ ์ „๋ฐ˜์ ์ธ ๊ธฐ๋Šฅ์ˆ˜ํ–‰ ์ •๋„๋ฅผ ํ‰๊ฐ€ํ•˜๊ธฐ ์œ„ํ•œ ํ•ญ๋ชฉ์œผ๋กœ ๊ตฌ์„ฑ๋˜์–ด ์žˆ๋Š” ๊ฒƒ์„ ๊ด€์ฐฐํ•  ์ˆ˜ ์žˆ์—ˆ์œผ๋ฉฐ, ์ฐธ์—ฌ์˜์—ญ์€ ๊ฐ ๋„๊ตฌ๋“ค๊ณผ ์—ฐ๊ด€์„ฑ์ด ๋‚˜ํƒ€๋‚˜ ์ฐธ์—ฌ ์ •๋„๋ฅผ ๋†’์ด๊ธฐ ์œ„ํ•ด์„œ๋Š” ์ธ์ง€๊ธฐ๋Šฅ, ์ •์„œ, ์ด๋™ ๋ฐ ํ™œ๋™๋Šฅ๋ ฅ ๋“ฑ์˜ ์ˆ˜ํ–‰๋ ฅ์„ ํ–ฅ์ƒ์‹œํ‚ค๋Š” ๊ฒƒ์ด ์ค‘์š”ํ•˜๋‹ค๋Š” ๊ฒƒ์„ ์•Œ ์ˆ˜ ์žˆ์—ˆ๋‹ค.28 ๋ณธ ์—ฐ๊ตฌ์˜ ๊ฒฐ๊ณผ K-SIS๊ฐ€ ๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ์ •๋ณด๋ฅผ ๊ทผ๋ ฅ๊ณผ ์ธ์ง€๊ธฐ๋Šฅ์„ ํฌํ•จํ•œ ์‹ ์ฒด๊ธฐ๋Šฅ๋ฟ๋งŒ ์•„๋‹ˆ๋ผ ํ™œ๋™ ๋ฐ ์ฐธ์—ฌ ์˜์—ญ๊นŒ์ง€ ๋‹ค๋ฉด์  ์ธก๋ฉด์œผ๋กœ ์ธก์ •ํ•˜๊ธฐ์— ์ ์ ˆํ•œ ๋„๊ตฌ์ž„์„ ๋‚˜ํƒ€๋‚ธ๋‹ค. ๋ณธ ์—ฐ๊ตฌ๋Š” ์—ฐ๊ตฌ ์ง„ํ–‰์˜ ์šฉ์ด์„ฑ์„ ์œ„ํ•ด ์ธ์ง€๊ธฐ๋Šฅ๊ณผ ์˜์‚ฌ์†Œํ†ต์˜ ์†์ƒ์ด ์‹ฌ๊ฐํ•˜์ง€ ์•Š์€ ์œ ๋ณ‘๊ธฐ๊ฐ„์ด 3๊ฐœ์›” ์ด์ƒ์ธ ๋งŒ์„ฑ ๋‡Œ์กธ์ค‘ ์ž…์›ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ์‹ค์‹œ๋˜์–ด ์—ฐ๊ตฌ์˜ ๊ฒฐ๊ณผ๋ฅผ ์ผ๋ฐ˜ํ™” ํ•˜๋Š”๋ฐ ์ œํ•œ์ ์ด ์žˆ๋‹ค. ์•ž์œผ๋กœ์˜ ์—ฐ๊ตฌ๋Š” K-SIS๊ฐ€ ๊ด€๋ จ ๋ถ„์•ผ์—์„œ ๋ณดํŽธ์ ์œผ๋กœ ์‚ฌ์šฉํ•  ์ˆ˜ ์žˆ๋„๋ก, ๋งŒ์„ฑ๊ธฐ ๋‡Œ์กธ์ค‘ ์™ธ๋ž˜ํ™˜์ž, ์ง€์—ญ์‚ฌํšŒ์žฌํ™œ ๋Œ€์ƒ ๋‡Œ์กธ์ค‘ ํ™˜์ž ๋ฐ ์žฅ์• ์ธ, ์‹œ์„ค์ˆ˜์šฉ ๋‡Œ์กธ์ค‘ ์žฅ์• ์ธ ๋“ฑ ๋‹ค์–‘ํ•œ ํŠน์„ฑ์˜ ๋Œ€์ƒ์ž์™€ ๋‹ค์–‘ํ•œ ์˜์—ญ์—์„œ ์—ฐ๊ตฌ๊ฐ€ ํ•„์š”ํ•  ๊ฒƒ์œผ๋กœ ์‚ฌ๋ฃŒ๋œ๋‹ค.
๋‡Œ์กธ์ค‘ ํ™˜์ž์˜ ์‚ถ์˜ ์งˆ์„ ๋‹ค์ฐจ์›์ ์œผ๋กœ ์ธก์ •ํ•˜๊ธฐ ์œ„ํ•ด ๊ฐœ๋ฐœ๋œ ๋‡Œ์กธ์ค‘์˜ํ–ฅ์ฒ™๋„ 3.0์˜ ํ•œ๊ธ€ํŒ(K-SIS 3.0) ๋˜ํ•œ ํ•ญ๋ชฉ๊ฐ„์˜ ๋†’์€ ๋‚ด์ ํƒ€๋‹น๋„์™€ ๊ธฐ์กด์˜ ํ‘œ์ค€ ์ž„์ƒ์ธก์ •๋„๊ตฌ์™€ ๋†’์€ ์ƒ๊ด€๊ด€๊ณ„๊ฐ€ ๊ด€์ฐฐ๋˜์–ด ํ•œ๊ตญ์˜ ์ž„์ƒํ˜„์žฅ์—์„œ ํ™˜์ž์˜ ์‚ถ์˜ ์งˆ๊ณผ ๊ด€๋ จ๋œ ๊ธฐ๋Šฅ์ •๋ณด ์ˆ˜์ง‘์„ ์œ„ํ•ด ํ™œ์šฉํ•˜๋Š”๋ฐ ์ ์ ˆํ•œ ๋„๊ตฌ๋ผ๊ณ  ์ œ์•ˆํ•œ๋‹ค.

REFERENCES

1. Jรถnsson AC, Lindgren I, Hallstrรถm B, et al. Determinants of quality of life in stroke survivors and their informal caregivers. Stroke. 2005; 36(4):803โ€“8. DOI: 10.1161/01.STR.0000160873.32791.20. PMID: 15761203.
[CrossRef] [Google Scholar]
2. Duncan PW. Issues in selecting outcome measures to assess functional recovery after stroke. NeuroRx. 2006; 3(4):505โ€“24. DOI: 10.1016/j.nurx.2006.07.009. PMID: 17012065. PMCID: PMC3593403.
[CrossRef] [Google Scholar]
3. Song J, Lee H. Investigating functional level in patients with stroke using icf concept. J Kor Phys Ther. 2014; 26(5):315โ€“57.
[Google Scholar]
4. Kranciukaite D, Rastenyte D. Measurement of quality of life in stroke patients. Medicina (Kaunas, Lithuania). 2006; 42(9):709โ€“16.
[Google Scholar]
5. Vellone E, Savini S, Fida R, et al. Psychometric evaluation of the stroke impact scale 3.0. J Cardiovascular Nursing. 2015; 30(3):229โ€“41. DOI: 10.1097/JCN.0000000000000145. PMID: 24695074.
[CrossRef] [Google Scholar]
6. Salter KL, Moses MB, Foley NC, et al. Health-related quality of life after stroke: What are we measuring? Int J Rehab Res. 2008; 31(2):111โ€“7. DOI: 10.1097/MRR.0b013e3282fc0f33. PMID: 18467925.
[CrossRef] [Google Scholar]
7. Duncan PW, Wallace D, Lai SM, et al. The stroke impact scale version 2.0. Evaluation of reliability, validity, and sensitivity to change. Stroke. 1999; 30(10):2131โ€“40. DOI: 10.1161/01.STR.30.10.2131. PMID: 10512918.
[CrossRef] [Google Scholar]
8. Duncan PW, Bode RK, Min Lai S, et al. Rasch analysis of a new stroke-specific outcome scale: The stroke impact scale. Arch Phys Med Rehabil. 2003; 84(7):950โ€“63. DOI: 10.1016/S0003-9993(03)00035-2.
[CrossRef] [Google Scholar]
9. Dawson J, Doll H, Fitzpatrick R, et al. Routine use of patient reported outcome measures in healthcare settings. BMJ (Online). 2010; 340(7744):464โ€“7. DOI: 10.1136/bmj.c186.
[CrossRef] [Google Scholar]
10. Portney L, Watkins M. Foundations of clinical research: Applications to practice. 2009. 3rd. New Jersey: Pearson Education.
11. Kim J. Relationship between gait symmetry and functional balance, walking performance in subjects with stroke. J Kor Phys Ther. 2014; 26(1):1โ€“8. DOI: 10.1589/jpts.26.1. PMID: 24567664. PMCID: PMC3927016.
[CrossRef] [Google Scholar]
12. Yang D, Park S, Kang J, et al. Effects of changes in postural alignment on foot pressure and balance of patients with stroke. J Kor Phys Ther. 2014; 26(4):226โ€“33.
[Google Scholar]
13. Yoon M, Choi H, Shin W. Effects of the abdominal drawing-in maneuver and the abdominal expansion maneuver on grip strength, balance and pulmonary function in stroke patients. J Kor Phys Ther. 2015; 27(3):147โ€“53.
[ScienceCentral] [CrossRef] [PDF] [Google Scholar]
14. Kim Y, Lee D. Effects of dance sports in virtual reality on balance, depression and adl in stroke patients. J Kor Phys Ther. 2013; 25(5):360โ€“36.
[Google Scholar]
15. Kim H, Hwang Y, Yu J, et al. The correlation between depression, motivation for rehabilitation, activities of daily living, and quality of life in stroke patients. J Korean Soc Occ Ther. 2009; 17(3):41โ€“53.
[Google Scholar]
16. Carod-Artal FJ, Coral LF, Trizotto DS, et al. The stroke impact scale 3.0: Evaluation of acceptability, reliability, and validity of the brazilian version. Stroke. 2008; 39(9):2477โ€“84. DOI: 10.1161/STROKEAHA.107.513671. PMID: 18635846.
[CrossRef] [Google Scholar]
17. Vellone E, Savini S, Barbato N, et al. Quality of life in stroke survivors: First results from the reliability and validity of the italian version of the stroke impact scale 3.0. Annali di Igiene. 2010; 22(5):469โ€“79. PMID: 21381542.
[Google Scholar]
18. Geyh S, Cieza A, Stucki G. Evaluation of the German translation of the stroke impact scale using rasch analysis. Clin Neuropsychologist. 2009; 23(6):978โ€“95. DOI: 10.1080/13854040802665782. PMID: 19235632.
[CrossRef] [Google Scholar]
19. Mohammad AH, Al-Sadat N, Siew Yim L, et al. Reliability and validity of the Nigerian (Hausa) version of the stroke impact scale (SIS) 3.0 index. BioMed Res Int 2014. 2014; 302097.
[CrossRef] [PDF] [Google Scholar]
20. Kwon Y, Park J, No I. Standardization of Korean of the mini-mental state examination (mmse-k) for use in the elderly. Part II. Diagnostic validity. Neuropsychiatric assoc. 1989; 28(3):508โ€“13.
[Google Scholar]
21. Jung H, Park B, Shin H, et al. Development of the Korean version of Modified Barthel Index (K-MBI): Multi-center study for subjects with stroke. J Kor Acad Rehabil Med. 2007; 31(3):283โ€“97.
[Google Scholar]
22. Hahn H, Yum T, Shin Y, et al. A standardization study of beck depression inventory in Korea. J Korean Neuropsychiatry Assoc. 1986; 25:487โ€“502.
[Google Scholar]
23. Garin O, Ayuso-Mateos JL, Almansa J, et al. Validation of the โ€œWorld Health Organization Disability Assessment Schedule, WHODAS-2.0โ€ in patients with chronic diseases. Health and Quality of Life Outcomes. 2010; 8.
[Google Scholar]
24. Lee H, Kim D. Internal consistency and concurrent validity of korean language version of whodas 2.0:12 item-self administered. J Kor Phys Ther. 2011; 23(6):23โ€“9.
[Google Scholar]
25. Duncan PW, Lai SM, van Culin V, et al. Development of a comprehensive assessment toolbox for stroke. Clin Geriatric Med. 1999; 15(4):885โ€“915. PMID: 10499941.
[CrossRef] [Google Scholar]
26. Lee H, Song J. The Korean language version of stroke impact scale 3.0: Cross-cultural adaptation and translation. J Kor Soc Phys Med. In press.
[CrossRef] [PDF] [Google Scholar]
27. Hamza AM, Al-Sadat N, Loh SY, et al. Predictors of poststroke health-related quality of life in nigerian stroke survivors: A 1-year follow-up study. BioMed Res Int 2014. 2014; 350281. DOI: 10.1155/2014/350281. PMID: 24982864. PMCID: PMC4058476.
[CrossRef] [PDF] [Google Scholar]
28. Salter K, Jutai JW, Teasell R, et al. Issues for selection of outcome measures in stroke rehabilitation: Icf participation. Dis & Rehabil. 2005; 27(9):507โ€“28. DOI: 10.1080/0963828040008552. PMID: 16040555.
[CrossRef] [Google Scholar]
Formats:
Article | 
PDF LinksPDF(515K) | PubReaderPubReader | EpubePub | 
Download Citation
Share  |
         
METRICS
1,601
View
32
Save
1
Cited-By
In This Page: