• Title/Summary/Keyword: 재활심리

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Psychiatric Treatment of Chronic Pain Disorder (만성 통증장애의 정신과적 치료)

  • Rho, Seung-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.256-262
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    • 1999
  • Because chronic pain disorder may has multiple causes or contributing factors, including physical, psychological, and socio-environmental variables, the treatment of patients with the disorder requires biopsychosocial approaches in a multidisciplinary setting. In treating chronic pain, it is important to address functioning as well as pain, and treatment should be to increase functional capacity and manage the pain as opposed to curing it. Therefore treatment goal should be adaptation to pain or minimizing pain with corresponding greater functioning. Treatment begins with the initial assessment, which includes evaluation of psychophysiologic mechanisms, operant mechanisms, and overt psychiatric comorbidity. Psychiatric treatment of the patients requires adherence to sound pharmacologic and behavioral principles. There are four categories of drugs useful to psychiatrist in the management of chronic pain patients : 1) narcotic analgesics, 2) nonsteroidal antiinflammatory drugs, 3) psychotropic medications, and 4) anticonvulsants, but antidepressants are the most valuable drugs in pharmnacotherpy for them. Psychological treatments tend to emphasize behavioral and cognitive-behavioral modalities, which are divided into self-management techniques and operant techniques. Psychodynamic and insight-oriented therapies are indicated to some patients with long-standing interpersonal dysfunction or a history of childhood abuse.

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Structural Analysis on the Path of Problem Gambling among College Students - Using Jacob's General Theory of Addiction- (대학생의 문제도박 발달경로 구조분석 -Jacob의 중독의 일반이론 적용-)

  • Jang, Soomi
    • Korean Journal of Social Welfare
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    • v.65 no.2
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    • pp.231-254
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    • 2013
  • The growth of legal and illegal gambling industry in Korea has increased the gambling accessibility. Actually, the prevalence of gambling addiction in Korea is significantly higher than those in western countries. The problems related to gambling make negative consequences in the individual, familial and socio-economical aspect. Previous studies showed that the prevalence of problem gambling by college students was much higher than that by adolescence and adult due to the nature of psychosocial developmental stage. The purpose of this study is to explore the path of problem gambling among college students based on the Jacob's general theory of addiction. Participants are 366 male college students who have experienced on gambling behavior. The main results are as follows. First, the problem gambling prevalence of participants is 14%. Second, statistical analysis using structural equation modeling shows the significant pathway among psychological vulnerability, needs to escape and problem gambling. Instead, the physiological vulnerability is not significant on the path to problem gambling. On the basis of these findings, the implications for social welfare prevention and intervention to college students are discussed.

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A Study of Psychometric Function Curve for Korean Standard Monosyllabic Word Lists for Preschoolers (KS-MWL-P) (한국표준 학령전기용 단음절어표 (Korean Standard Monosyllabic Word Lists for Preschoolers, KS-MWL-P)의 심리음향기능곡선 연구)

  • Shin, Hyun-Wook;Kim, Jin-Sook
    • The Journal of the Acoustical Society of Korea
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    • v.28 no.6
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    • pp.534-541
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    • 2009
  • Word recognition test (WRT) for the children can be useful for diagnosing the degree of communication disability, prescribing hearing instruments, planning aural rehabilitation and speech therapy, and determination of site of lesions. The Korean standard monosyllabic word lists for preschoolers (KS-MWL-P) were developed considering the criteria given by the literatures. However, the authors of KS-MWL-P suggested more children should be included to verify homogeneity of the lists using psychometric function curve since only 8 children participated in the developing process. The purpose of this study was to explore the homogeneity of KS-MWL-P for supplementing the limitations of the lists employing psychometric analysis. To 23 preschoolers who have normal-hearing, 100 monosyllabic KS-MWL-P words were examined with the pictures. Psychometric function curve with linear slopes of 20% and 80%'s correct rates through accounting recognition scores of each monosyllabic word at variable intensities from -10 to 40 dBHL was obtained and analyzed. As a result, s-shaped psychometric function curve was presented with increasing correct rate depending on intensity and showed no statistical significant differences among each word and list. The congruous graph shapes among lists also indicated good homogeneity and the list 1,2,3,4's average slopes were 4.48, 3.86, 4.65, 4.50. It was verified that the homogeneity was suitable because the analysis of variance showed no statistical significance among lists (p>0.05). However, KS-MWL-P's order of slope according to the order of the number of items, $1{\sim}10$, $1{\sim}20$, $1{\sim}25$ showed no difference with the p-value of 0.93, 0.59, 0.91, 0.70 for the lists 1,2,3, and 4, respectively. Although KS-MWL-P was assumed that the lower-numbered items were easy for testing younger ages, this study's results could not agree with the author's conclusion. Considering this matter, rearranging of the number of items should be performed according to the analysis of slope suggested by this study for testing younger children with easier items. Other than this, in conclusion, KS-MWL-P was proved to be useful for clinical and rehabilitative evaluating and training tools for preschoolers.

Psychometric Charateristics of Occupational Low Back Pain Patients (일부 재해성 요부손상 환자의 심리적 특성)

  • Ha, Mi-Na;Cho, Soo-Hun;Kweon, Ho-Jang;Han, Sang-Hwan;Joo, Young-Soo;Pack, Nam-Jong
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.3 s.51
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    • pp.715-725
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    • 1995
  • This study was done for identifying the factors which affect psychologic symptoms of low back(LBP) patients. The study subjects were 43 work-related low back pain patients, 28 work-related non-low back pain patients and 47 general low back injury patients. The study materialis SCL 90-R for checking psychologic symptoms and questionnaire for obtaining general information about the subjects. The data were analyzed by model of analysis of covariance adjusted by several variables such as gender, age, education and marital status and then compared the least square means of symptom score between groups. To identify the factors that affect psychologic symptom, duration of suspension, return to work and interaction factor of these two variables were analyzed by multivariate model and we calcuated partial correlation coefficient of these variables. As a result, work-related LBP patients showed higher score of symptoms in somatization, depression and psychosis than work-related non-LBP and non-work-related LBP. Duration of suspension and return to work were significant explanatory variables for psychologic symptom score of work-related LBP. Then, we may conclude that the treatment and rehabilitation programe for work-related LBP should cover the strategy of early return to work.

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The Effect of Psychotherapy Using Forest Environment on Depressive Symptoms in Patients with Major Depressive Disorder : a Preliminary Study (산림활동 심리프로그램이 우울증 환자들의 우울감에 미치는 영향 : 예비적 연구)

  • Kim, Won;Woo, Jong-min;Lim, Seong Kyeon;Chung, Eun Joo;Yoo, Rhee Hwa
    • Journal of Korean Society of Forest Science
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    • v.98 no.1
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    • pp.26-32
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    • 2009
  • The use of natural environments to change lifestyle and health has been long recognized. In particular, forests, trees, and open space have been shown to promote mental health. In this study, we examined the effectiveness of the structured psychotherapeutic program using forest environment ("forest activity program") to improve the symptoms of nine patients with Major Depressive Disorder (MDD) who were taking variable doses of antidepressants. We assessed the depressive symptoms, quality of life, and autonomic nerve regulation among the MDD patients. Hamilton Rating Scales for Depression (HRSD) scores significantly decreased after the forest therapy (13.56 vs. 5.56, p=0.003), and some subscores of Short Form 36 health survey questionnaire (SF-36) and heart rhythm coherence are improved as well. Combined with antidepressant pharmacotherapy, the structured psychotherapeutic program using forest environment showed an improved health status for MDD patients and thus has potential as an adjuvant treatment for MDD, especially for rehabilitation and relapse prevention.

The Quality Evaluation Methods of Medical Serious Game (의료용 기능성게임의 품질평가 방법)

  • Yoon, Seon-Jeong
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2013.01a
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    • pp.39-40
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    • 2013
  • 의료용 기능성게임의 효과가 입증되면서 다양한 분야의 투자와 주목을 받고 있다. 이에 따라 사용자를 위하여 의료용 기능성게임의 품질평가가 중요한 이슈가 되었다. 품질평가는 객관적인 기준과 평가요소 개발이 중요하다. 기능성게임의 특성 상 품질평가는 기술적인 영역과 비기술적인 영역으로 나누어 진행된다. 본 연구에서는 의료용 기능성게임의 비기술적인 영역의 품질평가 요소를 개발하기 위한 방법을 제안한다. 제안한 방법을 사용하여 심리 치료와 헬스케어 및 재활치료 2개 분야에 대해 각각 5개의 평가 요소를 추출하였다. 추출 결과는 전문가에 의해 내용 타당도 검사로 신뢰성을 확보했다. 본 연구는 다양한 분야의 기능성게임 품질평가 모델 개발의 가이드라인이 될 것이다.

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Difference of Functional Outcome Measurements between Total Knee Arthroplasty and Knee Amputation (슬관절 절단과 슬관절성형술간의 가능 수행 측정)

  • Sung, Paul S.
    • Physical Therapy Korea
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    • v.4 no.2
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    • pp.89-99
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    • 1997
  • 임상 결과의 측정에서 새로운 관점을 갖는 것은 중요하다. 의료 재활은 심리적 측정의 질들(표준화, 신뢰도, 타당도)에서 충분한 노력에 수행되어지지 않아 왔기 때문에 환자와 프로그램 사이에 일반화된 기능적인 평가 범위가 부족하다. 장애의 적절한 측정을 위한 요구는 기능적인 상태에서 변화들을 알리고 치료의 필요성을 평가하고 치료를 계획하고 결과를 예측하고 보상 방법을 측정하기 위한 환자의 치료와 임상 연구에서 모두 나타난다. 세계적으로 사용되어지고 있는 기능 평가 도구인 FIM으로부터 이 연구는 신체적 측정의 기대되어진 것에 유사한 비율로 기능적 평가 측정들을 구성한다. 노인 재활에서 기능적인 결과의 측정은 중요한 몇 가지 점이 있다. 첫째는 접근에 기초한 기능적인 결과는 치료 목표 설정에 필요하다. 둘째는 도구는 기능적인 향상을 예상하는데 유용해야 한다. 셋째는 기능 평가는 적절한 타당도와 신뢰도와 함께 고려되어져야만 한다. 넷째는 다른 기능적 도구들이 함께 평가되어져야 할 필요가 있다는 것이다. FIM의 목록의 어려운 접들은 손상을 입은 집단에서는 다소 다양하다. 가장 중요한 부분이기 때문에 하나의 운동범위는 요통과 화상을 입은 환자를 제외한 모든 손상을 입은 집단들에게 적용되어 질 수 있다. 기능의 운동과 인지적인 면은 구분되어지는 것이 중요하였고 분리되어져서 치료되어 졌다. 어려운 목록들은 손상을 입은 집단에서 다양하였고, 다양한 손상의 종류의 독특한 영향을 반영하였다. FIM은 기능적인 장애를 측정하기 위해 고안되어진 또 다른 도구이다. 그리고 다른 것들은 의료 재활을 위한 국제적 자료 체계를 만들기 위한 것이다. FIM의 목적은 의료 재활의 결과를 확인하고 장애의 정도의 측정을 포함한다. FIM은 7가지 수준에서 사회적 인지, 의사 소통, 이동, 움직임 (mobility), 소변 관리, 자조 활동을 평가한다. 범위는 총체적 도움의 비율로부터 완전하게 독립적인 것까지의 범위이고 도움, 감독, 도구의 사용의 범위를 고려한다. 27,009의 환자를 조사한 최근 검사 기록들은 FIM이 움직임(motor)과 인지 기능을 평가하는 것이라는 것을 보여준다(Hinemann, 1993). FIM의 저자들은 자료가 프로그램 평가의 시도에서 즉각적으로 적용 할 수 있기를 기대한다. FSI은 어떤 과제의 수행에서 어려움에 관계된 정보를 제공하는 것을 나타내고 과제를 수행하기 위한 환자를 위한 변경된 전략들을 발달시키기 위해 노력하는 임상가들에게 유용할 수 있다. 두 도구 모두는 전통적인 범위들보다 고관절 골절을 동반한 장애의 좀더 정확한 정보를 모으도록 할 수 있다. 고찰된 모든 연구의 결과들은 골절 후에 남아 있는 잔여 장애의 중요한 수준을 강조한다. 골절 전의 보행으로 회복된 사람은 매우 드물었다. 대부분은 기본적인 움직임 혹은 옷입기, 개인 위생에 관계된 활동들에서 의존적이었다. 많은 사람들은 사회에서 활동을 할 수 없었다. 장애의 적절한 측정의 요구는 환자 치료와 기능적인 상태에서 변화를 알고 치료의 요구도를 측정하고 치료를 계획하고 결과를 예상하고 보상 수단을 결정하는 임상적 연구에서 모두 나타난다. 물리치료 분야는 분야의 다른 영역에서 기능적인 결과를 충족시키고 발달시키는 것이 필요하다.

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Reality Orientation Therapy and Spaced Retrieval Therapy of the applied of CERAD-K type cognitive rehabilitation programs effects: for Mild Alzheimer's dementia (현실감각(ROT)과 시간차 회상 훈련(SRT)을 적용한 CERAD-K형 인지재활 프로그램의 효과 : 경증 알츠하이머 치매를 중심으로)

  • Hwang, Jung-Hee;Lee, Kyoung-Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.9
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    • pp.6201-6213
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    • 2015
  • The purpose of this study was to investigate the effect of Reality Orientation Therapy and Spaced Retrieval Therapy of the applied of CERAD-K type cognitive rehabilitation program for mild Alzheimer's patients. The tool used to this study was CERAD-K neuropsychological test consists of Boston Naming, a simple mental status, the word list recall, and configure behavior. A non-equivalent control group pretest-posttest design was used. The participants were 85 mild Alzheimer's patients (experimental group: 32, control group: 53) who registered G Health Center, in Gyeonggi province. Those Data were collected from 10:00 to 11:00, 14:00 to 15:00, twice a week on Tuesday and Friday, 8 session, from September 1 to September 30, 2014. Control group was participated daily routine program only in the G public health center.The data were analyzed using SPSS WIN 21.0 program. The results of this study were as follows;Boston Naming(F=3.22, p<.001), simple mental status(F=5.92, p<.001), and configure behavior(F=4.67, p<.001) were accepted, but word list recall(F=.75 p>.05) was not accepted. The study findings indicate that the Reality Orientation Therapy and Spaced Retrieval Therapy of the applied of CERAD-K type cognitive rehabilitation program is effective and can be recommended as intervention for mild Alzheimer's patients.

A Study on the Implementation Level and Improvement of Incheon Strategy of Korea (한국의 인천전략 이행수준과 개선방안 연구)

  • Na, Woon Hwan
    • 재활복지
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    • v.21 no.2
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    • pp.1-27
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    • 2017
  • The purpose of this study is to evaluate the level of implementation of the Incheon Strategy and to develop measures for effective implementation. This research method used literature review and monitoring method. The results of the study are summarized as follows: First, 9 key indicators and 7 supplementary indicators, which are classified into implementation and non-implementation, 3 key indicators have been implemented, one indicator has been partially implemented, 5 indicators have not yet been implemented, Also, In the case of supplementary indicators, five were implemented and two were not. Second, the ten target areas are lacking in implementation, but the objective of 7 is to ensure the comprehensive disaster risk reduction and management, the ratification and implementation of the Convention on the Rights of Persons with Disabilities and the harmonization of the Convention with the domestic law, Also, it is analyzed that the level of implementation is in the order of improving the reliability and comparability of the data of goal 8, ensuring gender equality of goal 6 and strengthening the capacity of women. Based on these results, we propose an improvement plan for implementation. First, it is necessary to formulate policy issues and implement measures for the implementation of Incheon Strategy. Second, it is necessary to establish a system to implement and monitor for Incheon strategy. Third, Korean standards for goals and targets, key indicators and supplementary indicators are needed. Fourth, it is necessary to prioritize the target implementation and to take preemptive action. Lastly, it is necessary to educate and publicize for the Incheon strategy.

The Effects of Cognitive Training Using Application Games of Smart Device on Cognitive Function in Patients With Mild Traumatic Brain Injury (스마트기기 애플리케이션 게임을 이용한 인지훈련이 경미한 손상이 있는 외상성 뇌손상 환자의 인지기능에 미치는 영향)

  • Kang, Seon-Hwa;Kim, Young-Sil;Kang, So-La;Moon, Jong-Hoon
    • Journal of Korean Society of Neurocognitive Rehabilitation
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    • v.10 no.2
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    • pp.9-18
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    • 2018
  • The research has sought to examine the effect of cognition training using smart device application games on the cognition function of traumatic brain injury patients. The research was conducted to the seventeen traumatic brain injury patients with slight symptoms who were treated with occupational therapy. The patients were divided into the two groups, nine for the experimental group and eight for the control group. The experimental group was assigned to conduct cognition training using smart device application games and traditional cognition training for fifteen minutes each, and the control group has conducted the traditional cognition training for 30 minutes. All arbitrations were conducted for 30 minutes a day, five times a week and for four weeks. To assess the cognitive function, Korean Mini-Mental State Examination (K-MMSE), Lowenstein Occupational Therapy Cognitive Assessment (LOTCA) and visual memory 1 and 2 of Motor-free Visual Perception Test-3 (MVPT-3) were measured before and after the intervention. In the comparison of the change between the two groups, the experimental groups showed a significant improvement in the visual memory of Motor-free Visual Perception Test-3 and remembrance section of the Korean Mini-Mental State Examination (p<.05). The result of this research has confirmed that the cognition training using the smart device application game can make the positive change to the visual memory of the traumatic brain injury patients more than the traditional cognition training.