• Title/Summary/Keyword: 임상수행력

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Effectiveness of the Assessment of the Depressive Symptomatology and Social Functioning as Rated by the Client's Significant Other (친지에 의한 클라이언트의 우울증상 및 사회기능 측정의 유효성 연구)

  • Park, Sun-Young
    • Korean Journal of Social Welfare
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    • v.52
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    • pp.143-170
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    • 2003
  • This study investigated the effectiveness of the assessment of psychosocial treatment outcome in symptomatology and social functioning as rated by the depressed client's significant other in explaining the client's symptomatology and social adjustment at 6 and 12 month follow-up period after the 16-week psychosocial treatment was terminated. The data were drawn from the National Institute of Mental Health Treatment of Depression Collaborative Research Program of the U.S. Significant others of depressed clients have rarely participated in the assessment of treatment outcome, although they are major participants of the clients' daily life and have meaningful opportunities to observe the clients' functioning in different social situations. Thus, this study aimed to examine the explanatory power of the significant others' outcome assessment in depressive symptomatology and social functioning for the long-term outcome in symptomatology and social adjustment. The outcome measures used by the significant others were actual performance, expected performance, gap between actual and expected performance, and symptomatology drawn from the Katz Adjustment Scale-Relatives Form. Three major findings were: (1) in general, the posttreatment assessment by the significant other demonstrated stronger explanatory power of the follow-up status than the assessment rated at pretreatment in all of the four outcome domains; (2) the significant other's assessment of actual and expected performance at both pre- and posttreatment demonstrated significant explanatory power of the follow-up status in symptomatology and social/leisure and work adjustment; and (3) the significant other's assessment of social functioning at pretreatment improved the explanatory power over and above the explanation by symptomatology in the follow-up status of social/leisure and work adjustment; however, at posttreatment, symptomatology improved the explanation over and above social functioning more frequently in predicting both symptomatology and social/leisure and work adjustment. These findings suggest the effectiveness of the measures of symptomatology and actual and expected performance as assessed by significant others. The results imply that mental health professionals and researchers need to involve the depressed client's significant other in the treatment and make good use of their contribution in treatment planning and further intervention in the follow-up period to prevent relapse.

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Test-Retest Reliability of Attention Network Test Scores in Schizophrenia (조현병 환자가 시행한 주의력 네트워크 검사 점수의 검사-재검사 신뢰도)

  • Lee, Jae-Chang;Kim, Ji-Eun;Kim, Min-Young;Yang, Jisun;Han, Myung-Hun;Kwon, Hyukchan;Kim, Kiwoong;Lim, Sanghyun;Jung, Eun-eui;Kim, Ji-Woong;Im, Woo-Young;Lee, Sang-Min;Kim, Seung Jun
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.210-217
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    • 2017
  • Objectives : Although the Attention Network Test(ANT) has been widely used to assess selective attention including alerting, orienting, and conflict processing, data on its test-retest reliability are lacking for clinical population. The objective of the current study was to investigate test-retest reliability of the ANT in healthy controls and patients with schizophrenia. Methods : Fourteen patients with schizophrenia and 23 healthy controls participated in the study. They are tested with ANT twice with 1 week interval. Test-retest reliability was analyzed with Pearson and Intra-class correlations. Results : Patients with schizophrenia showed high test-retest correlations for mean reaction time, orienting effect, and conflict effect. Also, they showed moderate to high test-retest correlations for mean accuracy and moderate test-retest correlations for alerting effect and conflict error rate. On the other hand, healthy controls revealed high test-retest correlations for mean reaction time and moderate to high test-retest correlations for conflict error rate. In addition, they revealed moderate test-retest correlations for alert effect, orienting effect, and conflict effect. Conclusions : The mean reaction time, alerting effect, orienting effect, conflict effect, and conflict error rate of ANT showed acceptable test-retest reliabilities in healthy controls as well as patient with schizophrenia. Therefore, the analyses of these reliable measures of ANT are recommended for case-control studies in patients with schizophrenia.

The Effect of Therapeutic Listening on Occupational Performance, Auditory Problem Behavior, and Attention in Children With Sensory Modulation Disorder (감각조절 장애 아동에게 치료적 듣기가 작업수행, 청각행동문제, 주의집중에 미치는 영향)

  • Park, Mi-Young;Kim, Hee;Cha, Tae-Hyun;Kim, Soo-Kyung
    • The Journal of Korean Academy of Sensory Integration
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    • v.18 no.3
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    • pp.14-26
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    • 2020
  • Objective : The purpose of this study was to investigate the effect of therapeutic listening on task performance, auditory behavior problems, and attention in children with sensory modulation disorder. Methods : Sixteen children aged four to seven years who were classified as children with sensory modulation disorder were randomly assigned to either the experimental group (n = 8) or the control group (n = 8). From July 1 to October 18, 2017, both groups participated in sensory integration programs, while therapeutic listening training was administered only to the experimental group. Sensory integration therapy was conducted in two sessions per week for six weeks (12 sessions); each session consisted of 40 minutes of therapy and 10 minutes of parent education. Therapeutic listening was conducted in three thirty-minute sessions per week for six weeks (18 sessions). We used the Canadian Occupation Performance Measure (COPM) to evaluate changes in the participants' occupational performance between pre- and post-intervention. We used Fisher's Auditory Problems Checklist (FAPC) to observe changes in behavioral problems related to hearing. The Child Attention Scale for Teacher (CAST) was used to evaluate changes in attention. Results : No significant differences pre- and post-intervention between the two groups were observed. The participants' auditory behavioral problems improved significantly in the experimental group, but no significant difference was found between the two groups. There was no significant difference in attention between the two groups, but there was a significant difference between the two groups in the "adaptability" and "emotion" domains (p < .05). Conclusion : The results suggest that therapeutic listening training has a positive effect on reducing problematic behaviors related to hearing and improving the occupational performance of children with sensory modulation disorder. This study provides a basis for improving the sensory processing ability of children with sensory modulation disorder by applying listening training in the clinical field and at home.

Clinical Manifestations of Pulmonary Infection Due to Rapidly Growing Nontuberculous Mycobacteria (신속발육 비결핵항산균에 의한 폐감염의 임상상)

  • Kim, Eun Kyung;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang Do;Koh, Younsuck;Kim, Woo Sung;Kim, Won Dong;Kim, Dong Soon
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.283-294
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    • 2003
  • Introduction : Rapidly growing nontuberculous mycobacteria (RGM) can produce numerous types of manifestations including a pulmonary infection. Managing a pulmonary infection due to RGM is unusually difficult to treat because the organism is invariably resistant to traditional antituberculous drugs and has a varying susceptibility to other antibiotics. The experiences of treatments for a RGM pulmonary infection with various antibiotics are also limited. This study evaluated the clinical manifestations, treatment, and the therapeutic outcomes of a RGM pulmonary infection. Subjects and method : Fifty-four cases with RGM from respiratory specimens were identified between November of 1996 and September of 2002 in the Asan medical center. The medical records and radiographic findings in 20 patients who fulfilled the diagnostic criteria of nontuberculous mycobacteria (NTM) pulmonary disease by ATS guidelines. The clinical, laboratory, and radiological parameters between subgroups. Results : Of the 20 patients, 15 were female. The mean age was 57.7 yrs (${\pm}7.5$), and all of the patients had a history of pulmonary tuberculosis. Most (90%) had an underlying lung disease. The majority of the isolates (80%) were M. abscessus. Chest radiography showed bilateral involvement in 80% of the patients. Bronchiectasis and multiple nodules were the main findings. Cavitation was present in 35% of the patients. Even though 70 % of the patients received antituberculous drugs prior to the correct diagnosis, all of the patients eventually received antibiotics. A mean of 3.5 antibiotics were given for an average of 439 days(${\pm}168$). After completing treatment, nine patients showed improvement after a mean 591(${\pm}311$) days of treatment, whereas the antibiotic treatment was unsuccessful in 2 patients. Conclusion : Many patients with a RGM pulmonary infection show an atypical pattern of radiological findings (bronchiectasis and multiple centrilobular nodules). It is very important to differentiate between M. tuberculosis and NTM and to identify the causative organisms among the NTM because a misdiagnosis can lead to an inappropriate and prolonged treatment. Combined antibiotic treatment yielded promising results, and is recommended for treating patients with a RGM pulmonary infection.

Adoption and Efficacy of ISO 15189 in Medical Laboratories for Diagnostic and Research (메디컬시험기관에서 ISO 15189 도입의 필요성과 시행의 효용성)

  • Yang, Man-Gil;Lee, Won Ho;Jun, Jin Hyun
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.2
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    • pp.158-167
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    • 2016
  • The requirements for medical laboratories ISO 15189 is examined in organization and a quality management system, stressing the importance of evidence, document control, and control of records and clinical material. Medical services are provided from the areas of resource management, and pre-examination, examination and post-examination processes. The main goal of ISO 15189 accreditation is to improve the quality of laboratory services provided for patients and clinical users not only through compliance with consensually developed and harmonized requirements but also by adopting the philosophy of continual improvement using the Plan-Do-Check-Act cycle. Laboratory quality should be evaluated and improved in all steps of the testing process as the state-of-the art indicates that the pre- and post-analytical phases are more vulnerable to errors than the intra-analytical phase. The Korea Laboratory Accreditation Scheme (KOLAS), a national accreditation body, provides medical laboratory accreditations for appropriate approaches to evaluating the competence of a medical laboratory in providing effective services to its customers and clinical users. Adoption of ISO 15189 in 2010s as a government policy has been delayed, and only 5 laboratories have been accredited to date in Korea. The medical laboratories should seek the adoption of ISO 15189 with a positive attitude for quality improvement and strengthening of international competitiveness.

The Clinical Features of Pertussis in Infancy (영아 백일해의 임상 양상)

  • Kim, Soon Ju;Kim, Sang-Eun;Kim, Jong-Hyun;Lee, Jung-Hyun;Oh, Jin Hee;Koh, Dae Kyun;Sung, Hwa Young;Yu, Jae-Yon
    • Pediatric Infection and Vaccine
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    • v.16 no.2
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    • pp.167-174
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    • 2009
  • Purpose : Pertussis was very common in the past, but reported cases have dramatically decreased. The improvement of vaccination programs and unreadiness of laboratory confirmation seems to have developed this situation. This study investigated the frequency of pertussis among infants with a paroxysmal cough and compared the clinical characteristics between infants with and without pertussis. Methods : Between June and November 2006, 27 infants admitted to the hospital that were 15-90 days old with a history of a cough for more than seven days were enrolled. The cough was described as: paroxysmal, whooping, and post-tussive vomiting. PCR and cultures for Bordetella pertussis with nasopharyngeal aspirates were obtained. The patients were divided into two groups: (1) the pertussis group that had positive results by PCR or culture; (2) the control group that had negative results by PCR and culture. Clinical and laboratory characteristics were compared between the two groups. Results : Among the 27 cases, five (18.5%) were finally diagnosed with pertussis. Only one out of the five pertussis cases was initially diagnosed with a pertussis-like syndrome on admission. Compared to the group without pertussis, the pertussis group had a significantly higher frequency of: no fever (P =0.043), a paroxysmal cough (P =0.040), cyanosis (P =0.001), non-immunized status for DTaP (P =0.047), normal auscultation (P =0.028), normal chest X-ray findings (P =0.027), high absolute lymphocyte count (P =0.039), and low CRP (P =0.046). The patients with the diagnosis of pertussis had a significantly longer duration of coughing (27.2${\pm}$10.6 vs. 12.6${\pm}$5.6 days, P =0.039). Conclusion : Pertussis should be suspected in any infant with typical symptoms of pertussis in addition to: a persistent cough without fever, accompanied by paroxysms or cyanosis prior to the age of DTaP immunization. Active laboratory confirmation should be carried out to confirm more cases with pertussis.

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NORMOBARIC OXYGEN($O_2$) ADMINISTRATION EFFECT ON ATTENTION AND MEMORY FUNCTION IN TEENAGE ADOLESCENTS (10대 청소년의 주의력과 기억능력에 미치는 정상기압 산소흡입 효과)

  • Kim, Byung-Hyo;Kim, Young-Mi;Cho, Soo-Churl;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.76-84
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    • 2002
  • Objectives:This study was conducted to investigate the effect of oxygen on attention and memory functions in healthy adolescents. Methods:The participant subjects were recruited from local advertisement. All subjects are students attending ordinary middle and high school. Their degree of achievement was average or below average. Before the study, its nature and purpose were fully explained to the patients and their parents, and a written informed consent was obtained from each child's parent and a written assent from each child for entire the procedure. The Ethics Committee and Clinical Research Committee of Gyeongsang National University Hospital approved the protocol. For baseline assessment, all subjects received tests for attention and memory. All tests were conducted by a certified psychologist. Stroop test, continuous performance test and trail making test A and B were used for evaluation of attention. As memory tests, we used memory assessment scale(MAS), standardized memory assessment tools. Ten to fourteen days after initial assessments, same tests was applied to the same subjects after prior 5 minute oxygen inhalation. Results:1) Attention test:Improved performances in trail making part B, and stroop test were found in normobaric oxygen inhalation group compared to air inhalation group. Improved reaction time in those tests seemed to reflect the enhanced executive prefrontal activity. 2) Memory test:More words and digits memorization were found in short-term memory subscale score in MAS in oxygen inhalation group compared to air inhalation group. This finding suggested the improved working memory function after oxygen inhalation. Conclusion:Though interpreted cautiously, these results suggested that normobaric oxygen inhalation could enhance executive function and working memory of prefrontal lobe. Further study, however, should be performed to investigate the mechanism of effects of oxygen on cognitive enhancement.

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A Study for the Improvement Subjects of the Korean Dental Hygienists' Licensing Examination (치과위생사 국가시험 개선을 위한 조사연구)

  • Kim, Sook-Hyang;Jang, Jong-Hwa;Oh, Sang-Hwan
    • Journal of dental hygiene science
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    • v.9 no.3
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    • pp.353-360
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    • 2009
  • The purpose of this study was to investigate the recognition for improvement of the Korean Dental Hygienists' Licensing Examination(KDHLE). The subjects were 1,048 dental hygienists were surveyed. either in person or through mail. Data was collected using a self administrated questionnaire from July 1 to July 20, 2008. The data were analysed with frequency and $x^2$-test using the SPSS 15.0 windows. For the inquiry where adequacy of subjects of the KDHLE regarding to evaluation of standard duty achievement ability in the real field was asked, 404(39.5%) answered 'Yes', and 680(66.9%) was answered 'Yes' for necessity of changing current subjects of the KDHLE. For the inquiry about the number of questions in the KDHLE, 353(34.6%) answered that current number of questions is 'Inappropriate' and advisable way of improving KDHLE subjects, 463 (45.4%) answered 'enhancing problem solving ability through unifying subjects', the highest of all. About practical examination methods, 647(67.3%) was answered 'Should be modified'. For methods of dental hygienist practical examination, 'clinical demonstration on patients' received the highest number of votes 628(63.6%). According to the above results, most of active dental hygienists at presence expect the alteration of current KDHLE and new items which are reliable for globalization by testing problem solving ability through unified subjects must be introduced.

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Factors Affecting the Parental Stress of Children and Adolescents with Epilepsy (뇌전증 소아청소년 환아의 부모 스트레스에 영향을 주는 요인)

  • Jung, Byu Lee;Kim, Ga Eun;Lee, Hyang Woon;Kim, Eui-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.63-71
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    • 2020
  • Objectives : The aim of this study was to investigate the impact of clinical and psychological factors on the parental stress of children and adolescents with epilepsy. Methods : Children and adolescents with epilepsy (n=90, age range=6-17 years) completed questionnaires on epilepsy-related variables, children's depressive symptoms (Children's Depression Inventory, CDI), children's anxiety (Revised Children's Manifest Anxiety Scale, RCMAS) and performed the scale for children's intelligence (IQ). Parents who have children and adolescents with epilepsy completed questionnaires on parental stress (Questionnaire on Resources and stress, QRS), parental anxiety (State-Trait Anxiety Inventory, STAI), children's attention problems (Abbreviated Conners Parent Rating Scale Revised, CPRS), and children's behavioral problems (Korean Child Behavior Checklist, K-CBCL). Stepwise regression analysis was performed to determine the significant predictive variables that affect parental stress. Results : In the correlational analysis, duration of seizure treatment (r=0.253, p=0.016), children's IQ (r=-0.544, p<0.001), children's attention problems (r=0.602, p<0.001), children's depressive symptoms (r=0.335, p=0.002), children's anxiety (r=0.306, p=0.004), children's behavioral problems (r=0.618, p<0.001), and parental anxiety (r=0.478, p<0.001), showed a significant correlation with parental stress. Children's behavioral problem (β=0.241, p=0.010), children's IQ (β=-0.472, p<0.001), and parental anxiety (β=0.426, p<0.001) were significantly related to the parental stress (Adjusted R2=0.619). Conclusions : Clinicians should pay attention to children's intelligence and behavioral problems and parental anxiety, which affect parental stress with children and adolescents with epilepsy.

Brain F-18 FDG PET for localization of epileptogenic zones in frontal lobe epilepsy: visual assessment and statistical parametric mapping analysis (전두엽 간질에서 F-18-FDG PET의 간질병소 국소화 성능: 육안 판독과 SPM에 의한 분석)

  • Kim, Yu-Kyeong;Lee, Dong-Soo;Lee, Sang-Kun;Chung, Chun-Kee;Yeo, Jeong-Seok;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.3
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    • pp.131-141
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    • 2001
  • Purpose: We evaluated the sensitivity of the F-18 FDG PET by visual assessment and statistical parametric mapping (SPM) analysis for the localization of the epileptogenic zones in frontal lobe epilepsy. Materials and Methods: Twenty-four patients with frontal lobe epilepsy were examined. All patients exhibited improvements after surgical resection (Engel class I or II). Upon pathological examination, 18 patients revealed cortical dysplasia, 4 patients revealed tumor, and 2 patients revealed cortical scar. The hypometabolic lesions were found in F-18 FDG PET by visual assessment and SPM analysis. On SPM analysis, cutoff threshold was changed. Results: MRI showed structural lesions in 12 patients and normal results in the remaining 12. F-18 FDG PET correctly localized epileptogenic zones in 13 patients (54%) by visual assessment. Sensitivity of F-18 FDG PET in MR-negative patients (50%) was similar to that in MR-positive patients (67%). On SPM analysis, sensitivity decreased according to the decrease of p value. Using uncorrected p value of 0.05 as threshold, sensitivity of SPM analysis was 53%, which was not statistically different from that of visual assessment. Conclusion: F-18 FDG PET was sensitive in finding epileptogenic zones by revealing hypometabolic areas even in MR-negative patients with frontal lobe epilepsy as well as in MR-positive patients. SPM analysis showed comparable sensitivity to visual assessment and could be used as an aid in the diagnosis of epileptogenic zones in frontal lobe epilepsy.

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