• Title/Summary/Keyword: 인지행동치료

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Increase of Spoken Number of Syllables Using MIT(Melody Intonation Therapy) : Case Studies on older adult with stroke and aphasia (MIT(Melodic Intonation Therapy) 중심의 음악활동을 이용한 실어증을 가진 뇌졸중 노인의 음절 수 증가에 대한 사례 연구)

  • Hong, Do Kyoung
    • Journal of Music and Human Behavior
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    • v.2 no.2
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    • pp.57-67
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    • 2005
  • Most of stroke patients have not only physical difficulty but speech and neurological disorder because of hemiplegia and such unexpected changes cause psychologic disadaptability and absent-mindedness. Particularly, lowering of physical ability can lead to serious emotional problem from failure or frustration in daily life. Generally, treatment of patient with stroke put emphasis on physical rehabilitation but actually this patient had considerable speech disorder such as aphasia or articulation disorder. Moreover, failing of recognition function, mental disorder as hypochondria, and even visual and auditory disorder are represented. So it is effective to integrate verbal remediation and other treatments in medical care environment. In particular, patients with language disorder very often wither psychologically therefore it is efficient to use of music therapy that gives opulent emotion to aphasia patients. And primarily to investigate the effects of 10 sessions treatments; change in spoken total number of syllables, to confirm their own value by success of given task and reassure about themselves ability. All of 10 sessions stages were scored by MIT manual and its improvement were measured, that is, accomplishment was analyzed within each level in order to prove detail change of spoken total number of syllables. The result of this program organized from 2 syllables to 4 syllables is summarized as follows. Subject A completed in preliminary stage Level I, in 2 syllables case advanced to Level III in fifth session and to Level IV in seventh session, in 3 syllables case advanced to Level III in seventh session and to Level IV in ninth session, and in 4 syllables case showed 8% low success rate in first session but after repeated practice increased considerably in sixth session and in advanced to Level III in eighth session to Level IV in tenth session. Subject B also completed in preliminary stage Level I, in 2 syllables case advanced to Level III in forth session and to Level IV in sixth session, in 3 syllables case advanced to Level III in fifth session and to Level IV in seventh session, and in 4 syllables case showed 10% low success rate in first session and increased considerably in fifth session and in advanced to Level III in seventh session but could not reach to Level IV until tenth session. As a result, it was shown that music therapy using MIT was not statistically meaningful but improved spoken total number of syllables and success rate of task had improved as a whole. Therefore, music intervention using MIT it has positive affect on verbal ability of patients with Broca's Aphasia and their language rehabilitation.

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Somatic Symptoms after Psychological Trauma (심리외상 이후의 신체증상)

  • Park, Joo Eon;Ahn, Hyun-Nie;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.43-53
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    • 2016
  • Objectives : Somatic symptoms after the exposure of psychological trauma frequently developed. However, the somatic symptoms are not covered under the diagnostic criteria of posttraumatic stress disorder(PTSD) in detail, although they are often associated with social and occupational functioning and patient-doctor relationships. The aim of this article is to highlight the potential mechanisms, the common manifestations, and the treatment of the somatic symptoms. Methods : This article studied the somatic symptoms searched using academic search engines like PubMed, Scopus, Google Scholar, KoreaMed and KISS from the earliest available date of indexing to March 31, 2016. Results : The mechanism of somatic symptoms after the exposure was described as psychological and physiological aspects. Psychological mechanism consisted of psychodynamic theory, cognitive behavioral theory, and others. Physiological mechanism involved changes in neuroendocrine and immune system, autonomic nervous system and central nervous system. Somatization associated with psychological trauma manifested various health conditions on head and neck, chest, abdominal, musculoskeletal, and dermatological and immune system. Few studies described the standardization of treatment for the somatic symptoms. Conclusions : Clinicians and disaster behavioral health providers should think of the accompanying somatic symptoms during intervention of psychological trauma and PTSD. Further studies are needed on the somatic symptoms seen in psychological trauma and PTSD.

Therapeutic compliance and its related factors in pediatrics patients (소아 환자의 치료 순응도 및 이에 영향을 미치는 요인)

  • Park, Ki Soo;Kam, Sin;Kim, Heung Sik;Lee, Jeong Kwon;Hwang, Jin-Bok
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.584-596
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    • 2008
  • Purpose : This study was conducted to investigate treatment compliance and related factors in pediatric patients. Methods : Three hundred and fifty-five patients diagnosed with various acute diseases at a teaching hospital or clinic in October 2003 were enrolled. Data were analyzed using the Health Belief Model, which includes items on self-efficacy and family assistance. Results : The study found that 62.9% of pediatric patients adhered faithfully to agreed-upon hospital revisits, 41.6% complied with dose timings instructions, 65.8% precisely took medication, and 27.2% complied with all of these requirements. According to ${\chi}^2$ test analysis, the factors found to be related to therapeutic compliance (the taking of medicines requested) were; susceptibility, severity, benefit, barriers, mother's self-efficacy, and family assistance (P<.05). Multiple logistic analysis and path analysis showed that susceptibility, severity, barriers, and mother's self-efficacy were related to therapeutic compliance (P<.05). Moreover, mother's self-efficacy was identified as the most important factor. Conclusion : To improve therapeutic compliance among pediatric patients, parental education is necessary, and a health care professional must take a thorough history of how the medication was taken before it is assumed that treatment failure is attributable to the medication prescribed. Furthermore, the type of device recommended for dosing should be determined by clinicians. In addition, it is important that pediatric medications be discussed in relation to their palatability and internal acceptability.

Analysis of Coexistence Rates of Attention Deficit/Hyperactivity Disorder Symptoms in Patients with Depression (우울감을 주소로 내원한 환자들에서 주의력 결핍/과잉행동장애 증상의 공존율 분석)

  • Jeong, Mi Young;Park, Seo Young;Kim, Jung Ho;Im, Woo Young;Lee, Yeon Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.147-154
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    • 2019
  • Objectives : Cognitive dysfunction, including inattention, is often observed in patients with depression. Inattentive symptoms in patients with depression is similar to those among attention deficit/hyperactivity disorder (ADHD) patients. It is important to diagnose the two diseases accurately, because the treatment varies depending on the cause of inattention. This study aimed to investigate the coexistence rate of ADHD and the correlation between ADHD symptoms and depression in patients with depression. Methods : Participants in this study were 158 outpatients presenting with depression, who visited the psychiatric department from March 2015 to July 2018. Participants divided into a depression and a non-depression group according to the Korean version of the Center for Epidemiological Studies-Depression Scale (CES-D) score and were administered the following : a sociodemographic variables form (age, sex, academic background, occupation), the self-reporting test for adult ADHD (Adult Attention Deficit/Hyperactivity Disorder self-report scale-V 1.1; ASRS V1.1), and the Korean version of the Connors adult ADHD rating scale (K-CAARS). Descriptive statistical analysis, crossover analysis, t-tests, and Pearson's correlation coefficient were conducted on the data. Results : The coexistence rate of adult ADHD symptom was as high as 36.7% in patients with depression (p<0.001). In K-CAARS, the depression group (Inattention=1.80, Hyperactivity=1.92, Impulsivity=1.56, Self-concept=2.06) showed higher average scores on ADHD symptoms than the non-depressive group (Inattention=1.28, Hyperactivity=1.25, Impulsivity=1.09, Self-concept=1.42, p<0.001). Conclusions : This study confirmed that ADHD symptoms coexist in the depression group. When evaluating the symptoms of patients who complain of depression, it is suggested that they should be accurately diagnosed and appropriately treated with interest to the coexistence of ADHD symptoms and the possibility for ADHD diagnosis.

Changing Trends in the Occurrence and Management of Delirium for 5 Years in a University Hospital (일 대학병원에서 5개년간 섬망의 발생 및 치료 경향의 변화)

  • Bae, Jae Ho;Kang, Won Sub;Paik, Jong Woo;Kim, Jong Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.112-119
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    • 2012
  • Objectives : Delirium is a disorder defined as a sudden disturbance in thinking, speaking, acting and sleep pattern due to altered level of consciousness and cognitive function. The objective of this study is to analyze characteristics and therapeutic methods of the delirious patients during the recent 5 years, and provide basic data for further studies and investigation regarding delirium in the occurrence and treatment. Methods : We retrospectively reviewed medical records of 475 patients who were consulted for delirium in Kyunghee University Medical Center from January 2007 to December 2011. Results : During the 5 years, among the 475 patients who were diagnosed as delirium, men were more common(61.7%). The most commonly consulted reason and cause were sleep disturbance(80.8%) and post-operational delirium(30.9%), respectively. The medication prescription percentage was 76.6% and was significantly increased year after year. Ratio of using antipsychotics were 76.4% among prescribed medication and the most frequently prescribed antipsychotic drug was quetiapine(46.8%). Other specialists commonly misdiagnosed delirium when the patient was previously diagnosed as dementia(6.8%). Conclusions : In our study, post-operational delirium was the most commonly referred reason and the percentage of medication prescription tended to increase. Patients with history of dementia were more easily misdiagnosed as diseases other than delirium. Our study suggests that we should evaluate symptoms, causes, reasons of consultation, management tendency of delirium. We should also closely observe changes in sleep patterns and establish the prevention strategies for post-operational delirium and therapeutic bases for pharmacotherapy.

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Electroencephalographic Changes Induced by a Neurofeedback Training : A Preliminary Study in Primary Insomniac Patients (뉴로피드백 훈련에 의한 뇌파 변화 연구 : 일차성 불면증 환자에 대한 예비 연구)

  • Lee, Jin Han;Shin, Hong-Beom;Kim, Jong Won;Suh, Ho-Suk;Lee, Young Jin
    • Sleep Medicine and Psychophysiology
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    • v.26 no.1
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    • pp.44-48
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    • 2019
  • Objectives: Insomnia is one of the most prevalent sleep disorders. Recent studies suggest that cognitive and physical arousal play an important role in the generation of primary insomnia. Studies have also shown that information processing disorders due to cortical hyperactivity might interfere with normal sleep onset and sleep continuity. Therefore, focusing on central nervous system arousal and normalizing the information process have become current topics of interest. It has been well known that neurofeedback can reduce the brain hyperarousal by modulating patients' brain waves during a sequence of behavior therapy. The purpose of this study was to investigate effects of neurofeedback therapy on electroencephalography (EEG) characteristics in patients with primary insomnia. Methods: Thirteen subjects who met the criteria for an insomnia diagnosis and 14 control subjects who were matched on sex and age were included. Neurofeedback and sham treatments were performed in a random order for 30 minutes, respectively. EEG spectral power analyses were performed to quantify effects of the neurofeedback therapy on brain wave forms. Results: In patients with primary insomnia, relative spectral theta and sigma power during a therapeutic neurofeedback session were significantly lower than during a sham session ($13.9{\pm}2.6$ vs. $12.2{\pm}3.8$ and $3.6{\pm}0.9$ vs. $3.2{\pm}1.0$ in %, respectively; p < 0.05). There were no statistically significant changes in other EEG spectral bands. Conclusion: For the first time in Korea, EEG spectral power in the theta band was found to increase when a neurofeedback session was applied to patients with insomnia. This outcome might provide some insight into new interventions for improving sleep onset. However, the treatment response of insomniacs was not precisely evaluated due to limitations of the current pilot study, which requires follow-up studies with larger samples in the future.

Ontology Components for the Depression Management based on Context (상황기반의 우울증 관리를 위한 온톨로지 구성요소)

  • Kang, Yun-Jeong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.20 no.9
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    • pp.1785-1790
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    • 2016
  • There is exhibit a degree of pain in the occurrence and course of treatment levels or oral, pain rating scale actions, such as illness, for example, the discomfort scale because of the pain "annoying", "unpleasant" "annoyed am", "painful" represents a pain scale of the order of "painful", "hard to bear", "very difficult to bear". Depression is recognized based on the premise of the situation, because it is difficult to recognize themselves. In this paper we define the components of the depression can be seen lifestyle which can lead to depression or through a biological signal. The depression index was derived from the ontology modeling to understand the state of depression. Depression ontology components and depression index will be aware of the situation based information services for depression. Combined with the situational awareness based devices and can be synchronized to verify the results of the depression index. It will be applied to improve lifestyle factors that of depression.

Psychological Characteristics in Oral Malodor Patients (구취 환자의 심리학적 특징에 관한 연구)

  • Lee, Seung-Ryeul;Kim, Hyung-Suk;Kim, Young-Ku
    • Journal of Oral Medicine and Pain
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    • v.26 no.3
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    • pp.225-241
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    • 2001
  • 구취에 대한 환자의 주관적 감각은 다양한 심리학적 요소들에 의하여 영향을 받을 가능성이 있다. 본 연구에서는 구취 환자의 심리학적 특징을 살펴보기 위하여, 구취를 주소로 내원한 환자 446명과 일반적인 치과 치료를 위하여 내원한 환자 63명을 대상으로 간이정신진단검사 (SCL-90-R), 구취 설문검사, 구취 측정 검사를 시행하여 분석한 결과 아래와 같은 결론을 얻었다. 1. 남성 구취 환자와 여성 구취 환자의 연령분포는 통계학적으로 유의한 차이를 보였다 (p<0.001). 남성에서는 20대, 30대, 40대에 고르게 분포한 반면, 여성에서는 20대와 30대에 집중되어 분포하였다. 2. 구취의 인식 유형은 남녀간에 통계학적으로 유의한 차이를 보였다 (p<0.01). 구취 인식 유형 중 타인에 의한 지적이나 타인의 행동으로 인한 추측 없이 스스로 구취를 인지하는 유형은 여성 구취 환자에서만 관찰되었다. 3. 구취 환자는 대조군에 비하여 강박증, 불안, 적대감, 전체심도지수에서 높은 수치를 보였다 (p<0.05). 4. 여성 구취 환자는 남성 구취 환자에 비하여 강박증(p<0.05), 불안 (p<0.05), 편집증 (p<0.001)에서 높은 수치를 보였다. 5. 남성 구취 환자에서는 표출증상합계를 (p<0.05) 제외한 모든 간이정신진단검사 항목에서 고농도 VSC군과 저농도 VSC군간에 유의한 차이를 보이지 않았다. 여성 구취 환자에서는 저농도 VSC군이 신체화를 제외한 모든 간이정신진단검사 항목에서 고농도 VSC군에 비하여 높은 수치를 보였다 (p<0.05). 6. 여성 구취 환자에서 주관적 구취심도는 강박증, 대인예민성, 불안, 적대감, 공포불안, 전체심도지수, 표출증상심도지수 들과 유의한 상관관계를 보였고 (p<0.05), 주관적 구취불편감은 모든 간이정신진단검사 항목들과 유의한 상관관계를 보였다 (p<0.05).

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Development of Problem-based learning module for Bioterrorism (생물테러재난안전교육을 위한 문제중심학습개발)

  • Kim, Jee-Hee;Moon, Tae-Young;Park, Jeong-Hyun
    • Proceedings of the KAIS Fall Conference
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    • 2009.12a
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    • pp.774-777
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    • 2009
  • 2001년 9 11 테러 이후 미국에서 탄저균을 이용한 생물테러가 발생한 이래 미국을 비롯한 여러 나라에서는 생물무기 및 생물테러에 대한 대응방안들이 준비되고 있다. 따라서 이런 대응방안과 더불어 생물무기를 쓰는 테러리스트의 행동과 위협에 대비를 할 필요가 있다. 생물테러 전염병은 치명률이 높고, 인간 상호간에 전염이 용이하며 치료하기가 어려우므로, 인명의 손실을 최소화하기 위해서는 보건의료기관 등에서 근무하는 보건의료인이 생물테러로 의심되는 병원체 및 전염병을 조기에 인지하는 것이 가장 중요하다. 따라서 보건분야 전문가들은 환자나 일반 대중, 그리고 다른 보건전문가들에게 생물무기와 생물테러에 의해 퍼질 가능성이 있는 질병들에 대해 신중하게 대응할 수 있는 방법들을 교육해야 한다. 질병이 발생했을 때 보건전문가들은 조사에 착수할 역학자들과 협조를 해야 하고, 임상 또는 연구소에 일하는 보건전문가들은 생물무기로 사용될 수 있는 병원체나 생물무기를 생산하는데 사용되는 시설에 접근하는 것을 제한하도록 도울 수 있다. 2005년 질병관리본부 생물테러대응팀에서는 의료인, 다중시설이용 근무자, 보건요원을 대상으로 생물테러 인식도를 조사한 바 있다. 조사결과, 의료인에 대한 생물테러 교육 및 교육훈련의 필요성에 대해 94.2%가 필요하다고 응답하였다. 이런 자료를 바탕으로 하여 국내에서도 생물테러교육의 필요성이 대두되기 시작하였다. 본 연구는 미국, 영국에서 진행되고 있는 생물테러 관련 교육에 대한 관련 자료와 사례를 문헌 분석을 통해 우리나라에 맞는 생물테러 교육에 대한 방향을 제시하고 문제중심학습모듈을 개발하고자 하는데 그 목적이 있다.

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Effect of Occupational Therapy Volunteering on Self-esteem and Self-efficiency in University Students (대학생의 전공관련 자원봉사가 자존감, 자기효능감에 미치는 영향)

  • Park, So-Yeon;Kim, Jin-Kyung;Lee, Taek-Young
    • The Journal of the Korea Contents Association
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    • v.11 no.2
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    • pp.376-384
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    • 2011
  • This study was conducted to determine the effect of major-related volunteering on self-esteem and self-efficiency in fifty three university students who are majoring in occupational therapy. Students volunteered for 20 days in the geriatric service center for dementia from July 27, 2009 to August 21, 2009. Questionnaire survey was conducted to determine the difference in, self-efficiency, career awareness before and after the volunteering. Student showed satisfaction to volunteer program in general, and self-esteem and self-efficiency improved from $29.43{\pm}2.51$ point and $30.45{\pm}3.41$ point to $31.66{\pm}2.63$ point and $33.26{\pm}3.93$ point, respectively. In addition, subjects expressed comfort toward occupational therapy and were able to recognize how to prepare the role of occupational therapist after graduation. These results indicates that occupational therapy-related volunteering was effective in understanding occupational therapy and improving career awareness.