• Title/Summary/Keyword: 입원스트레스

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Psychophysiologic Response in Patients with Panic Disorder (공황장애환자의 정신생리적 반응)

  • Chung, Sang-Keun;Cho, Kwang-Hyun;Jung, Ae-Ja;Park, Tae-Won;Hwang, Ik-Keun
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.52-58
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    • 2001
  • Objectives: An Increased level of psychophysiologic arousal and diminished physiologic flexibility would be observed in patients with panic disorder compared with a normal control group. We investigated the differences of psychophysiologic response between patients with panic disorder and normal control to examine this hypothesis. Methods: Ten Korean patients with panic disorder who met the diagnostic criteria of DSM-IV were compared with 10 normal healthy subjects. In psychological assessment, levels of anxiety and depression were evaluated by State-Trait Anxiety Inventory, Beck's Depression Inventory and Hamilton Rating Scale For Anxiety and Depression. Heart rate, respiration rate, electrodermal response, and electromyographic activity were measured by biofeedback system (J & J I-330 model) to determine psychophysiologic responses on autonomic nervous system. Stressful tasks included mental arithmetic, video game, hyperventilation, and talking about a stressful event. Psychophysiologic responses were measured according to the following procedures : baseline(3 min)-mental arithmetic (3 min)-rest (3 min)-video game (3 min)-rest (3 min)-hyperventilation (3 min)-rest (3 min)-talking about a stressful event (3 min). Results: The baseline level of anxiety and depression, electrodermal response (p=.017), electromyographic activity (p=.047) and heart rate (p=.049) of patients with panic disorder were significantly higher than those of the normal subject group. In electrodermal response, patient group had significantly higher startle response than the control group during hyperventilation (p=.001). Startle and recovery responses of heart rate in the patient group were significantly lower than responses in the control group during mental arithmetic (p=.007, p=.002). In electrodermal response of the patient group, startle response was significantly higher than recovery response during mental arithmetic (p=.000) and video game task (p=.021). Recovery response was significantly higher than startle response in respiratory response during hyperventilation. Conclusion: The results showed that patients with panic disorder had higher autonomic arousal than the control group, but the physiologic flexibility was variable. We suggest that it is helpful for treatment of panic disorder to decrease the level of autonomic arousal and to recover the physiologic flexibility in certain stressful event.

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Psychosocial Risk Factors of Postpartum Depression (산후우울증의 심리사회적 위험요인)

  • Park, Si-Sung;Han, Kwi-Won
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.124-133
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    • 1999
  • Objective : Postpartum depression(PPD) was known to be caused by many factors including various psychosocial risk factors. This study was performed to identify the psychosocial risk factors for ppd, preliminarily in Korea. Methods : A group of 119 postpartum women, each of whom was at 6 to 8 weeks after delivery was identified at the time when they visited to the child health clinic or postnatal check-up clinic. The risk factors were surveyed by the self-reported questionnaire. The items of questionnaire were consisted of known risk factors in other studies and other possible stress-related factors. PPD was assessed by the Edinburgh Postnatal Depression Scale(EPDS) and the degree of postpartum depression was determined by its score. Results : 16 women(13.45%) in the high risk group were diagnosed as PPD among the 119 women. Risk factors including past experience of depressive symptoms and low level of marital satisfaction were founded more frequently in women in the high risk group than in the low risk group. The score of EPDS was significantly high in the group who experienced depressive symptoms in the past, anxiety or depression during pregnancy, stressful life event during the period of recent pregnancy and postpartum, and who had low level of marital satisfaction. There was a positive correlation between age and the score of EPDS. However, the postpartum depressive symptoms were not influenced by the level of education, job, retirement due to pregnancy and delivery, wanted or unwanted pregnancy, delivery method, feeding method, the hospitalization of infant, expected and real gender of infant. Conclusion : These results suggest that PPD is quite frequent at postpartum period. Various risk factors contribute to the development of PPD. If clinicians pay attention to the risk factors of PPD and give appropriate psychiatric intervention to the mothers during pregnancy and postpartum, it will be easy for the clinicians to recognize and treat PPD in the early stage.

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Psychophysiologic Responses to Event Imagery in Traffic Accident Related Patients (교통사고관련 환자에서 사건상상에 대한 정신생리반응)

  • Chung, Sang-Keun;Choi, Myong-Su;Hwang, Ik-Keun
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.45-51
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    • 2001
  • Objectives: The experience of traffic accident is a kind of the psychosocial stressors to person. The traffic accident-related patients may show the psychophysiologic hyperarousal. So we examined the differences of psychophysiologic response between patients with and without the memory of experienceing a traffic accident. Methods: Twenty-four traffic accident-related patients were divided into two groups according to ther memory of a traffic accident. In psychological assessment, levels of anxiety and depression were evaluated by State-Trait Anxiety Inventory, Beck's Depression Inventory, and Hamilton Rating Scales For Anxiety and Depression. Heart rate, electrodermal response (EDR), and electromyographic activity (EMG) were measured by biofeedback system, and systolic and diastolic blood pressure by automated vital sign monitor during baseline, task, and rest periods. We utilized script-driven imagery technique as a stressful task. The patients listened to the script describing their own traffic accident experience and were instructed to imagine the event during the task period. Statistically analytic data were obtained from the differences of psychological and psychophysiologic data between two groups. Results: The memory group did not show significantly higher EDR than the none memory group, but showed higher tendency during baseline, imagery, and rest periods. The memory group showed significantly lower EMG than the none memory group during rest period. However, there were no differences in other psychophysiologic reponses between the two groups. Conclusion: Our results showed that the memory group had higher tendency in autonomic arousal level such as electrodermal response than the none memory group. We suggest that physicians need to minimize repetitive imagery of traffic accident (reexperience), and decrease the autonomic hyperarousal in the treatment of traffic accident-related patients.

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Lymphocyte Subpopulations and Proliferation of T cells, Phagocytic Activity of Leukocytes on Alcoholics (알코올중독자의 백혈구탐식능, 림프구아형 및 증식능)

  • 김용호;서병배;이정녀;김영훈
    • Biomedical Science Letters
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    • v.2 no.2
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    • pp.167-174
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    • 1996
  • Alcoholics increased susceptibility to microbial infection that is associated with decreased immunity. but there has been little experimental evidence to support alcoholics-induced increase of microbial infection directly in non-specific immunity. Therefore, we were used the method of phagocytic-plaque including all the stimulating factors for the phagocytosis, subtypes of lymphocytes and T-lymphocyte proliferation. The experimental groups were divided into 3 groups: (1) alcoholics who were hospitalized less than 1 week (newly hospitalized alcoholics), (2) alcoholics who were hospitalized more than 2 weeks (old hospitalized alcoholics), (3) healthy blood donors. We have studied 98 alcoholics and 35 healthy blood donors and control groups. A physician has checked the biological markers and diagnosed the body-condition alcoholics. The immunity and non-specific immunity on the alcoholics were analyzed by using the simultest kit and flow cytometry. Proliferation of the lymphocytes was analyzed by the phytohemmagglutinine mitogen. Phagocytosis and migration properties of leukocytes were identified on the layer formed by Staphylococcus aureus Cowan I strain. Biological markers of alcoholics and control groups, by such as blood glucose, ${\gamma}$-glutamyl transpeptidase and mean corpuscular volumes of red blood cells, were determined by biochemical and hematological methods. Compared with control groups, cluster of differentiation (CD)3+, CD8+ and CD19+ in alcoholic were more decreased except CD4+/CD8+ ratio. Proliferation of the T-lymphocytes, phagocytosis and migration properties of the leukocytes in alcoholics were decreased compared with those of control groups. According to the results observed in our experiment, they can be summerized as follows: 1, Cellular, humoral and non-specific immunities, are markedly decreased in alcoholics than those in control groups. 2. It is inferred that Phagocytic plaque formation is a very useful method to evaluate phagocytosis and migration properties of the alcoholic leukocytes 3. It is thought that the subtypes of lymphocytes, especially CD4+/CD8+ ratio, are essential methods to analyzed the alcoholic immunity. 4. Specific and non-specific immunity on the old hospitalized alcoholics was slightly increased, which depends upon the alcoholic medication.

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A Study on the Nutritional Assessment and the Effects of Enteral Nutritional Supports of Tube Feeding In-patients (경관급식 중인 입원환자의 영양상태 평가와 영양 보충제 투여의 영향에 관한 연구)

  • 윤숙영;김성미
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.25 no.5
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    • pp.855-864
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    • 1996
  • The purpose of this study is to evaluate nutritional status of tube feeding patients, and to investigate the effects of giving enteral nutritional support to them. 83 in-patients have been examined for their nutritional status. The mean caloric density was 0.77kca1/m1. 36.1% to 75.9% of them were malnourished in terms of biochemical assessment. The energy intake showed the significant and positive correlation in all biochemical parameters. And the protein intake showed the significant and positive correlation in total protein, serum albumin, serum iron, hemoglobin, hematocrit and TLC. But age was correlated negatively to serum albumin and transferrin. The amount of energy and protein intake has been significantly increased as the tube feeding duration became longer. Also the effect of enteral nutritional support for 6 weeks has been investigated. Case group(n=8) was administered 250kca1 of polymeric formula in addition to their usual diet, while control group(n=8) kept the amount of their original intake. When comparing the biochemical changes of the case group and those of control group at week 0 and week 6 respectively, it showed significant differences in total protein, serum transferrin and TLC. This study suggests that the malnourished status of tube feeding patients can be improved and even prevented if nutritional support is properly administered.

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Space Usage and Satisfaction with Privacy in General Hospital Inpatients (종합병원 입원환자의 공간사용 및 프라이버시 만족도)

  • Choi, In Young;Park, Hey Kyung
    • Korea Science and Art Forum
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    • v.36
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    • pp.391-400
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    • 2018
  • To ensure a user-centered treatment environment, hospital construction needs an approach that is not centered on functional aspects such as efficiency or economic feasibility but on the consideration of needs as reflected in user psychology and behavior. Patients who are physically and psychologically vulnerable experience psychological pressure when they are placed in an unfamiliar environment. Most of existing studies however focus on the evaluation of the physical environment, without paying attention to the psychological or behavioral approach to anxiety and stress that patients may experience in a special environment that a hospital may be to them. This study examines general hospital inpatients to understand the usage of major space available and their satisfaction with privacy. This study provides useful primary information needed for the user-centered design of general hospital for improved patient health and welfare. For the purpose of the study, literature review, site investigation, and survey were conducted. Major functional space and privacy in general hospitals were studied, and the site investigation was performed to identify the plans and their status. Survey was also performed to understand the usage of functional space and satisfaction with such space usage as well as satisfaction with privacy. The findings were as follows: (1) Space usage was rated as average in general. It was found that patients used their rooms and lobby on a daily basis. By age, the usage was highest in the group in their 40s; the usage was relatively lower in the groups in their 30s or younger. (2) Space satisfaction was above average, indicating that patients were fairly satisfied. Satisfaction was highest in the lobby space designed with distinct features. By case, satisfaction was highest in Case B, characterized by its wide horizontal space in the rural settings. (3) Satisfaction with privacy in hospital was average, indicating that the demand for privacy was relatively higher but what patients receive in return was lower than their expectation. It was also found that satisfaction with privacy was a crucial element that affected the overall satisfaction with hospital.

Prevalence and Etiology of Molar Incisor Hypomineralization in Children Aged 8 - 9 Years (8 - 9세 어린이의 Molar-Incisor Hypomineraization의 원인 및 유병률에 대한 조사연구)

  • Kim, Taehyoung;Jeong, Ilyong;Lee, Daewoo;Kim, Jaegon;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.4
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    • pp.410-418
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    • 2016
  • This study examined the prevalence of MIH and severity of hypomineralization exhibited by MIH-affected tooth based on the clinical examination of 950 children between age 8 and 9 in the city of Jeonju. The etiology was also studied utilizing a questionnaire on the MIH risk factors. The prevalence of MIH was 7.1%. The examined MIH-affected teeth showed statically significant difference in the degree of their hypomineralization (p < 0.05). The permanent first molar showed greater frequency of MIH compared to the permanent incisor, and the MIH code 2a and 3 were only observed in the permanent first molar (p < 0.05). From the questionnaire, showed the significant relationship between the occurrence of MIH and risk factors such as stress and antibiotics intake during pregnancy, low birth weight and events like hospital admission, frequent respiratory infection, high fever and long-term antibiotics intake within the three years of children's lives (p < 0.05). Among all the possible risk factors, the antibiotics intake during pregnancy only showed high correlation with the incidence of MIH (p < 0.05).

Gender Differences in Behavioral Psychological Symptoms of Dementia in Patients with Alzheimer's Disease (알츠하이머병 환자에서 행동심리증상의 성별차이)

  • Lee, Ji Young;Im, Woo-Young;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.71-78
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    • 2014
  • Objectives : Behavioral and psychological symptoms of dementia(BPSD) represent significant clinical problems, resulting in functional decline, caregiver distress, institutionalization and increased mortality. A recent study showed gender differences have important role in the development of BPSD, but relationship between BPSD and gender has never been studied in Korea. This study was designed to examine whether patients with Alzheimer's disease show gender differences in behavioral and psychological symptoms of dementia(BPSD). Methods : Ninety-eight subjects with Alzheimer's disease were included in this study. We carried out history taking and cognitive assessment for the diagnosis of Alzheimer's disease based on DSM-IV. Cognitive impairment and BPSD were measured using the Mini Mental State Examination(MMSE), Global Deterioration Scale (GDS), Clinical Dementia Rating(CDR) and the Korean Neuropsychiatric Inventory(K-NPI). Independent samples t-test was used to examine the differences across gender in BPSD. Correlation analysis between MMSE, CDR, GDS and NPI was performed using Pearson's correlation coefficient. Results : There were no significant gender differences between the gender in BPSD. We found statistically significant negative correlations between MMSE with NPI total score, and with scores of several sub-domains such as hallucination. Conclusions : This study showed that gender differences in BPSD are not significant. Further research is necessary to identify whether BPSD affect gender differences or individual differences.

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Self-care Status of the Aged Diabetic Patients with Noncompliance (일개 종합병원에서의 치료 미순응 노인 당뇨병 환자의 자가관리 실태)

  • Kim, So-Mi;Hwang, Tae-Yoon;Nah, Min-Ah;Lee, Kyeong-Soo;Yeom, Seog-Heon
    • Journal of agricultural medicine and community health
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    • v.42 no.4
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    • pp.226-233
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    • 2017
  • Objective: The purpose of this study was to describe and understand self-care status of the aged diabetic patients with noncompliance after hospital discharge. Methods: A qualitative research method was used for the study design. The participants were 15 diabetic patients aged 65 or older who had been admitted more than two times for hyperglycemia in the past 1 year in a general hospital in Daegu. Data were collected from November 1 2015 to March 1 2016 through in-depth personal interview. Results: Patients' knowledge level on causes and symptoms of diabetes was low. Most participants rarely and irregularly checked blood sugar at home. They were under a lot of stress from their family. Due to old age and illness they did not have sufficient physical activity and they have had rarely regular meals. They considered the self-care education program unnecessary and there was limitations of accessibility for education. Conclusions: The aged diabetic patients who had the repeat admission did not perform self-care activities properly and had problems especially in blood glucose check, support from their family, and health education after returning home. More personalized and community-based self-management education programs will be necessary.

A Study on Efficiency of Case Management Practical Model for Industrial Injury Inpatients (산업재해 입원환자를 위한 사례관리실천모형의 효과성에 관한 연구)

  • Baek, Eun-Joo
    • Korean Journal of Occupational Health Nursing
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    • v.10 no.1
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    • pp.24-40
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    • 2001
  • This study is to observe the effectiveness of the applied model and to present the improvement plan and directions for development for the case management practical model suitable for the actual condition of Korea Labor Welfare Co. and needs of the industrial injury patients. The concrete purpose of this study is: First, observe the difference of stressor experience and experience degree between the experimental group and the comparative group. Second, observe the difference of stress of the experimental group and the comparative group. Third, find out how the stress affects the support degree and satisfaction degree. Fourth, present the improvement plan of case management model, which can promote the psychosocial rehabilitation of the industrial injury patient based on the research results. The outline of the main research results identified in this study is as follows. The stressors the industrial injury patients perceived are health problems, family matters, the problems concerning hospital recuperation (hospital staff and environmental problems), economical problems, problems of coming back to society, problems with companies, problems with Korea labour Welfare Co. and other problems. And the experience of stressor was prominently lower in experimental group than comparative group in the whole problem, health problem, problems with Korea Labour-Welfare Co. and other problems. The stressor experience degree was conspicuously lower in experimental group in the whole problem experience degree, health problem experience degree, problem with Korea Labour Co. experience degree and other problem experience degree. Besides whether or not the case management is applied is having a prominent affect on the primary factor affecting the stressor experience degree, therefore the patients applied with case management has less stressor than the patient who didn't. The difference of degree of tension experienced by the stressor in both groups, the degree of stress, was not conspicuous in statistics so it shows that the application of case management in this research has not affected the degree of tension. The field which had been the most help was emotional support in help level the experimental group perceived through applying case management about industrial accident patients and recuperation, compensation problem, medical treatment problem, family matters has been helpful in this order. The help level of the whole problem was in higher level than the middle value. The stress factor which affects the case management problem settlement is the whole body of stress. The satisfaction level of help through applying case management was highest in emotional support and family matters, recuperation problem, company problem, compensation problem, and medical treatment problem was the next highest. The satisfaction level of the whole problem was higher than the middle value. The stress factor affecting the satisfaction level of help is the whole body of stress. Therefore to reduce the stress level of industrial accident patients and for them to come back to local societies, we need to reinforce the continuance and responsibility of case management model, increase staff, reinforce the role of counsel and medical treatment, intervene in the patient's plan of leaving the hospital, develop social support system and the need to establish After Care Center.

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