• Title/Summary/Keyword: 정신질환자

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ESOPHAGEAL FOREIGN BODY REMOVAL WITH FIBEROPTIC ESOPHAGOSCOPY (식도이물의 굴곡형 내시경을 이용한 치료)

  • 박수헌
    • Korean Journal of Bronchoesophagology
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    • v.2 no.2
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    • pp.182-193
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    • 1996
  • 식도내 이물은 종종 어린이나 식도질환을 가진 환자, 죄수들, 정신박약자 및 정신질환자등의 위험성이 높은 성인에서 흔히 발생한다. 그러나 대부분의 이물은 저절로 위장관을 통과하나 날카롭고 뾰족하며 긴 이물은 위장관의 천공이나 혈관과 누공형성 및 다른 합병증을 초래할 수도 있다. 이물의 섭취는 대개 환자나 다른 목격자에 의하여 복용한 병력으로 진단할 수 있다. 그러나 어린이나 정신박약자는 병력을 얻을 수 없기 때문에 우선 의심하는 것이 중요한 진단방법이 될 수밖에 없다. 연하곤란과 연하통은 식도이물의 통상적인 증상이다. 주변기도의 압박으로 인한 호흡기 증상은 어린이에 흔하며 종종 성인에서도 관찰된다. 식도내 이물을 제거하는데 많이 사용되는 방법은 굴곡형내시경을 사용하여 제거하는 것이다. 이방법은 성인이나 어린이에서 전신마취없이 기존의 진정제 투여방법으로 시술할 수 있다. 이물제거에 사용되는 파지겸자와 올가미는 내시경이물제거술을 가능하게 하였고 굴곡형내시경에 사용되는 overtube는 기존의 강직 형내시경의 장점을 얻을 수 있어 뽀족하거나 날카로운 이물을 제거하는데 사용하게 되었다. 이런 내시경적이물제거 원칙을 잘 지키고 적절한 준비가 된다면 합병증이 거의 없이 98% 정도의 이물을 제거할 수 있다. 내시경을 사용하지 않는 여러 가지 방법은 천공의 위험성이 높고 흡인성폐렴을 유발할 수 있기 때문에 사용하지 않는 것이 낫다. 수술적인 처치는 천공이 되었거나 다른 이물로 인한 합병증이 있는 경우에만 드물게 적용된다.

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Phenomenological Study on the Life of People with Schizophrenia (조현병을 가진 사람의 삶에 대한 현상학적 연구)

  • Park, Mi-Won;Eom, Tae-Wan
    • Journal of Digital Convergence
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    • v.16 no.11
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    • pp.521-533
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    • 2018
  • This study aimed to understand the meaning and essence inherent in the life experiences of people with schizophrenia. We approached with phenomenological method, and the research participants were 10 adults, aged 20 or older, who were diagnosed with schizophrenia. As a result, we found four essential themes. The participants with schizophrenia lived a life with special constraints of being thrown to the reality in which they experienced continuing suffering. Nevertheless, their daily lives were maintained on the basis of their own feelings and needs. In this study, we confirmed that they should be understood and treated in the mental health field with the perspective that they are not 'patients' nor a pathological outcome, but a 'human' with schizophrenia.

Relationship among Dysfunctional Attitudes, Stress Coping Strategies and Depressive Symptoms in Psychiatric Patients (정신질환자들의 역기능적 태도, 스트레스 대처 방식 및 우울증상 간의 관계)

  • Park, Chan-Moo;Seo, Kyung-Ran;Rhee, Min-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.1
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    • pp.31-42
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    • 1997
  • This study was aimed to investigate dysfunctional attitudes, stress coping strategies and depressive symptoms in psychiatric patients. The subjects of this study consisted of 210 patients(138 schizophrenic patients, 29 depression patients, 43 alcohol dependence patients) according to DSM-IV criteria. Futhermore, the instruments were K-BDI(Beck Depression Inventory-Korean version), DAS(Dysfunctional Attitude Scale) and multidimensional coping strategy scale. The results were the following. 1) There were statistically significant correlations between depressive symptoms and dysfunctional attitudes in psychiatric patients. 2) In terms of coping strategies, there were positive correlations between depressive symptoms and focus on and venting emotions, accommodation, active forgetting, self-criticism, positive comparison, fatalism, passive withdrawal. Whereas, there was significant negative correlation between depressive symptom and active coping. 3) In terms of coping strategies, there were significant correlations between dysfunctional attitudes and focus on and venting emotions, active forgetting, self-criticism, positive comparison, fatalism, passive withdrawal. 4) Depression groups reported significantly higher BDI scores than schizophrenia groups. 5) In depression groups, DAS scores were significantly higher than those in schizophrenia groups. 6) In terms of coping strategies according to diagnosis, there were significant differences in venting emotions, active forgetting and self-criticism. As for venting emotions, alcoholic groups were scored significantly higher than schizophrenic groups. As for active forgetting, depression groups were scored significantly higher than schizophrenic groups. In self-criticism, depression groups and alcohol dependence groups reported significantly higher scores than schizophrenic groups.

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Effects of Nurses' Attitudes toward Mental Illness Patient, Psychiatric Nursing Competency and Nursing Work Stress on Burnout of Nurses in General Ward (정신질환자에 대한 태도, 정신간호역량, 정신질환자 간호업무 스트레스가 일반 병동간호사의 소진에 미치는 영향)

  • Lee, Sunmi;Yun, Jung Sook;Shin, Sung Hee
    • Journal of East-West Nursing Research
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    • v.28 no.1
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    • pp.31-40
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    • 2022
  • Purpose: The purpose of this study was to identify factors affecting burnout of nurses caring for people with mental illness in general hospital wards. Methods: This study conducted a survey targeting 186 nurses in general wards with more than one year of clinical experience working at three general hospitals in Seoul, Korea. The collected data were analyzed using t-test, one-way ANOVA, Pearson's correlation coefficient, and multiple linear regression analysis with SPSS 21.0. Results: The factors influencing burnout were nursing work stress (β=.30, p<.001), attitude towards people with mental illness (β=-.25, p<.001), religion (β=-.21, p=.001), psychiatric nursing competency (β=-.16, p=.016), experience of nursing for people with mental illness (β=.14, p=.023), and gender (β=.14, p=.026), explaining 33.5% of the total variance (F=16.53, p<.001). Conclusion: The findings suggest that it is necessary to develop and apply an education program to lower nurses' work stress, to create positive attitude towards people with mental illness, and to enhance psychiatric nursing competency for prevention and mitigation of burnout of nurses caring for people with mental illness.

Association Between Lifestyle and Medical Expenses of Older Adults With Mental Illness: Using Korea Older Adults' Cohort Database (노인 코호트 DB를 이용한 정신과 질환 동반 노인의 생활 습관과 의료비 지출 크기의 연관성 분석 연구)

  • Jeong, Jiin;Bae, Suyeong;Yoo, Eun-Young;Hong, Ickpyo
    • Therapeutic Science for Rehabilitation
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    • v.12 no.1
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    • pp.51-63
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    • 2023
  • Objective : This study aimed to analyze the association between lifestyle and medical expenses of older adults with mental illness using claims data. Methods : We conducted secondary data analysis using the older adult cohort database provided by the Korea National Health Insurance Service. The lifestyle and medical expense variables were extracted from the cohort database. We used a generalized linear model to examine the association between lifestyle and medical expenses. Results : In total, 32,853 records were extracted. The results showed that smokers had medical expenses (estimate = -218,255, p = .037). As the number of days of walking increased, medical expenses significantly decreased (estimate = -58,843, p < .0001). Furthermore, as the number of days of drinking decreased, medical expenses increased (estimate = 692,289, p < .0001). Conclusion : This study analyzed the estimates of medical expenses according to lifestyle among older adults with mental illness. Smoking and exercise were negatively associated with medical expenses. These results suggest the importance of a healthy lifestyle for older adults with mental illness. In addition, this study can be used as clinical evidence for lifestyle management programs to improve physical and mental health.

Suicide in Jeonbuk region: Psychological autopsy study (심리적 부검을 통한 전북지역 자살 실태에 관한 연구)

  • Man Seok Lee;Myung Shig Kim;Hoin Kwon
    • Korean Journal of Culture and Social Issue
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    • v.21 no.2
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    • pp.119-130
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    • 2015
  • This study is aimed to analyse the causes and characteristics of suicide in jeonbuk region using psychological autopsy. Psychological autopsy is a technique to get comprehensive analysis on suicidal death by collecting data from interviewing suicide victim's family, relatives, and friends added with additional data of police report, hospital records, and suicide victim's lifetime records for objective evidence. For the data from 42 cases(male 24, female 18) of suicides that occurred between May 2013 and April 2014 with agreement for psychological autopsy, we analyzed a survey that recorded by interviewers who had a consultation based on half-structured psychological interview panel. As the result, out of 42 cases, 30(71%) had previous suicidal attempts and 21(50%) had a family history of suicides. Psychiatric disorders(38%) was the most common cause of suicide followed by interpersonal problems(31%). Among psychiatric problems, depressive disorder was the most common. many suicide victims had previously received psychiatric treatments but discontinued the therapy later on. The results showed that suicide is strongly related to mental disorders and psychiatric therapy should be continued until full recovery. Preventive efforts should focus on persons who have a history of previous suicidal attempts and have a family history of suicide. Implications of these findings are discussed and directions for future research are advanced.

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The Effect of Education Program by Illness on Perception of Illness and Knowledge of Medication in Psychiatric Inpatients (질환별 교육프로그램이 정신질환자의 질병인식 및 약물지식에 미치는 효과)

  • Jun, Won-Hee;Park, Jeong-Soon;Jeong, An-Soon
    • Journal of East-West Nursing Research
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    • v.17 no.2
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    • pp.110-116
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    • 2011
  • Purpose: This study aimed to examine the effects of education program by illness on perception of illness and knowledge of medication in psychiatric inpatients. Methods: The research design was a non-equivalent and non-synchronized control group design. For this research, a total of 50 subjects was selected at a psychiatric unit of C university hospital in U-city. The experimental group consisted of 24 subjects and they received education program by illness 1 session per a week for 4 weeks. The remaining 26 subjects were assigned to the control group and they received standard services except the education program by illness. In data analysis, SPSS/WIN 15.0 program was used. Results: The experimental group significantly improved compared to the control group in perception of illness and knowledge of medication. Conclusion: This study results suggest that education program by illness could be effective to improve perception of illness and knowledge of medication in psychiatric inpatients.

A Comparison of the Effects between Eye-Mask and Light-Off Conditions on Psychiatric Patient Sleep (야간 조명 하 안대와 소등의 수면에 대한 효과 비교)

  • Shin, Juyong;Lim, Kyoung-Ok;Cho, Seongnam;Jang, Soyeong;Cha, Seung-Min;Han, Songyi;Kim, Moojin
    • Sleep Medicine and Psychophysiology
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    • v.28 no.1
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    • pp.27-33
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    • 2021
  • Objectives: The purpose of this study is to investigate the difference in the effects of eye-mask and light-off on sleep status according to a commercial fitness tracker and a sleep diary of psychiatric in-patients in correctional facilities where nocturnal light is compulsory. Methods: This study was conducted over 3 consecutive nights. In-patients of the National Forensic Psychiatric Hospital (n = 29) were assigned random subject numbers and slept as usual in the light-on condition on the first night. The subjects slept with eye-masks in the light-on condition on another night and without an eye-mask in the light-off condition on the other night. Subjects were asked to sleep wearing a commercial fitness tracker and to keep a sleep diary. The order of these changes in bedroom lighting condition on the second and third nights was assigned randomly to participants. Results: In comparison of the sleep variables between the light-on condition and the eye-mask condition, the Wakefullness After Sleep Onset (WASO) was shorter and sleep satisfaction was higher in the latter.(respectively, Z = 3.66, p < 0.017 ; Z = 2.69, p < 0.017) In comparison of the sleep variables between the light-on and light-off conditions, the WASO was shorter and sleep efficiency and sleep satisfaction were higher in the latter (respectively, Z = 2.40, p < 0.017 ; Z = 3.02, p < 0.017 ; Z = 3.88, p < 0.017). However, there were no differences in the sleep variables between the eye-mask condition and the light-off condition. Conclusion: Subjective improvements in sleep variables were noted in sleep diaries of institutionalized psychiatric patients under either the 'eye-mask' or 'light-off' condition. However, there were no significant differences between the 'eye-mask' and 'light-off' conditions. Therefore, we suggest that psychiatric patients in correctional facilities use eye-masks when sleeping.

Rechtsvergleichende $\ddot{U}$berpr$\ddot{u}$fungen $\ddot{u}$ber zwangsunterbringung der psychischen Patienten (정신질환자의 비자발적 입원에 관한 비교법적 검토 - 독일법을 중심으로 -)

  • Yi, Jae-Kyeong
    • The Korean Society of Law and Medicine
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    • v.10 no.2
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    • pp.183-201
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    • 2009
  • Im Allgemeinen auch psychische Patienten k$\ddot{o}$nnen sich daruber selbst entscheiden, $\ddot{a}$rztliche Behandlung zu nehmen und ins Krankenhaus aufgenommen zu werden. Im S$\ddot{u}$dkorea bei der zwangsweisen Unterbringung wird kein KBGB des privatlichen Rechts, sondern Gesetz $\ddot{u}$ber psychisch Gesundheitspflege des $\ddot{o}$ffentlichen Rechts vorz$\ddot{u}$glich verwandt. Aber das noch kann ein selbst Bestimmungsrecht von der psychischen Patient verletzen. Im Deutschland regelt BGB $\S$ 1906 Zwangsunterbringung der psychische Patienten, die Gef$\ddot{a}$hr des Selbstmord oder der Eigengef$\ddot{a}$hrdung haben. Au$\ss$erdemhat jedes Land eigen Gesetz $\ddot{u}$ber psychischen Kranken, das $\ddot{o}$ffentliche Vorschrift f$\ddot{u}$r Zwangsunterbringung regelt. Im Fall der Zwangsunterbringung im Deutschland BGB $\S$ 1906 wird prim$\ddot{a}$rer als $\ddot{o}$ffentlich Rechts verwandt, um die Selbstbestimmungsrecht der Patienten zu unterstutzen. Auch im Korea KBGB (koreanisches B$\ddot{u}$rgerliches Gesetzbuch) Ver$\ddot{a}$nderungen f$\ddot{u}$r die Einf$\ddot{u}$hrung des Betreuungsrechts, die sich mit der Zwangsunterbringung befassen, sollten diskutiert werden, damit die Selbstbestimmung sch$\ddot{a}$tzen.

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