• Title/Summary/Keyword: 질문법

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A Study of the Depressive Symptoms and the Quality of Life in Patients with Breast Cancer in a University Hospital (일 대학병원 유방암 환자의 우울증상과 삶의 질)

  • Jang, Seung-Ho;Lee, Dae-Bo;Choi, Un Jong;Lee, Kwang-Man;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.11-17
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    • 2013
  • Objectives : This study was designed to investigate the prevalence of depressive symptoms in patients with breast cancer and to identify demographic variables and clinical characteristics impact on depressive symptoms and health related quality of life in patients with breast cancer in a university hospital. Methods : Fourty-one patients with breast cancer were selected, who had visited the department of General surgery of the Wonkwang University hospital with a diagnosis of breast cancer regularly during the period November, 2010-May, 2011. All of subjects were evaluated for the depression, anxiety and the health related quality of life with Beck Depression Inventory(BDI), anxiety subscale of Personality Assessment Inventory(PAI) and Short-Form 36 Health Survey-Korean version(SF-36-K). Patients were divided into depressive symptoms and non-depressive symptoms group according to the BDI score. We compared SF-36-K between two groups, and analized multiple regression with depression and health related quality of life as criterion variables and demographic and clinical characteristics. Results : The prevalence of depression in patients with breast cancer in a University hospital was 36.4%. Compared to the non-depression, depressed patients with breast cancer appeared significantly lower mean scores on six subscales in SF-36-K : Physical function(p<.01), Role-physical(p<.001), General health(p<.05), Social function(p<.001), Role-emotional(p<.001) and Mental health(p<.001). But there was no significant difference between two groups in Vitality and Bodily pain. Anxiety, level of education and presence of enforcement of chemotherapy(63.6%) were significant explanation variables for depressive symptoms. And type of surgery and age(55.8%) were significant explanation variables for health related quality of life. Conclusions : The prevalence of depressive symptoms in patients with breast cancer in a University hospital was 36%. The depressive symptoms had not only negative impact on the health related quality of life but also important explanation variable for health related quality of life. These results suggest that depressive symptoms in patients with breast cancer should be evaluated and treated for improving patient's health related quality of life.

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The Influence of Urinary Incontinence and Depression in Elderly on the Quality of the Life (노인의 요실금과 우울증이 삶의 질에 미치는 영향)

  • Kim, Jihyun;Lee, Joongsuk;Nam, Beomwoo;Choi, Jin-Yong;Yang, Sang-Kuk;Yim, Hyeon Woo;Jo, Sun-jin;Jeong, Hyunsuk
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.129-135
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    • 2017
  • Objectives : Little is known about the influence of urinary incontinence and depression on individual's QOL(Quality of life). We aimed to clarify how the interaction between urinary incontinence and depression influences one's QOL. Methods : A total of 1262 patients were enrolled in this study from April, 2011 to July, 2011. We estimated the severity of depressive symptoms and QOL, using SGDS-K, EQ-5D. We also investigated the morbidity of urinary incontinence for each patient in person or by questionnaire. Comparisons of QOL between groups with or without depression, with or without urinary incontinence were established using t-test, ANOVA and Scheffe's post hoc analysis. The interaction between urinary incontinence and depression was analyzed by each domain of QOL, using multiple regression analysis. Results : Patients with depression and urinary incontinence showed significantly higher EQ-5D scores on every domain of QOL than other patients, which means significantly lower QOL. Patients with depression, no urinary incontinence reported lower QOL, especially in the domain of 'usual activity', 'anxiety' and 'visual analogue scale(VAS)', whereas those with urinary incontinence, no depression showed lower QOL in 'motility', 'usual activities' and 'pain' domain. Statistically significant interaction effects of two diseases were observed in the domain of 'VAS', 'self care' and 'anxiety'. Conclusions : Comorbidity of urinary incontinence and depression showed significantly lower QOL of patients, compared with urinary incontinence or depression respectively, which implies additive interaction effects of the two diseases. Optimal diagnosis and treatment of depression should be emphasized for patients with urinary incontinence.

Analysis of Communication of Dental Hygienist in Oral Hygiene Instruction during Scaling (치과위생사의 스케일링시 구강보건교육의 의사소통분석)

  • Kang, Su-Kyung;Bae, Hyun-Sook;Lim, Soon-Ryun
    • Journal of dental hygiene science
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    • v.14 no.4
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    • pp.546-553
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    • 2014
  • The purpose of this study was to investigate the actual condition of communication of dental hygienist in oral hygiene instruction during scaling. The research was intended for 67 dental hygienists who worked dental hospitals and clinics. Oral hygiene instruction during scaling was audiotaped. Pearson correlation analysis, t-test, one-way ANOVA, and chi-squared test were conducted. The results gained by the research were as follows. An analysis of 67 dental hygienists has found that 63 dental hygienists (94%) educated the patients with dentiform and 65 of them (97%) did rolling method. Thirty-three of them (49.3%) recommended oral care products to the patients. Only 14 of all educators (21%) said simple greetings and educated importance of care of subjects' teeth, side effect of scaling, when they finished all the scaling stage. The average time of oral hygiene education was 161.3 seconds. In detail, the dental hygienists told 155.0 seconds, the patients did 6.3 seconds on average. The percentage of education time without patients' comments and dialogue each other were 35.8% and 37.3% respectively. The conversation frequency according to the education level of dental hygienist showed significant difference (p<0.05). There was a negative correlation between total education time and patients coming for scaling per day and there was a positive correlation between total number of questions and patient talking time. The result of chi-squared test showed that there was significant difference on asking regards depending on setting a limitation of scaling time (p<0.05). The research showed that the dental hygienists seem to educate the patients mechanically, uniformly rather than educate them according to their oral hygiene condition.

Defense Style and Insomnia (방어유형과 불면증)

  • Joo, Sun-Sik;Cho, Seong-Jin;Lee, Yu-Jin;Lee, So-Jin;Kim, Seog-Ju
    • Sleep Medicine and Psychophysiology
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    • v.19 no.1
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    • pp.42-46
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    • 2012
  • Introduction: The objective of the present study was to investigate the defense style of insomnia patients and to grasp the differences in defense style between primary insomnia patients and insomnia patients with history of major depressive disorder. Methods: Forty three subjects with insomnia (11 subjects with primary insomnia and 32 subjects with major depressive disorder) and 138 control subjects participated in this study. To diagnose insomnia and major depressive disorder, interviews including structured clinical interview for DSM-IV (SCID-IV) were done. To assess the defense style, self-reported Korean version of Defense Style Questionnaire (K-DSQ) were completed by the participants. Results: Compared to normal controls, subjects with insomnia used more acting out (t=3.25, p<0.01), consumption (t=2.66, p<0.01), fantasy (t=3.51, p<0.001), resignation (t=5.42, p<0.001), suppression (t=3.28, p<0.01), projection (t=3.92, p<0.01), splitting (t=4.31, p<0.01), undoing (t=2.66, p<0.01), withdrawal (t=6.72, p<0.001) and isolation (t=3.80, p<0.001), and less omnipotence (t=4.08, p<0.001) and humor (t=3.20, p<0.01). Compared to normal controls, subjects with primary insomnia used more undoing and withdrawal. Compared to subjects with primary insomnia, subjects with insomnia with history of major depressive disorder used more resignation and withdrawal, and less humor. Conclusion: In the current study, there were differences in defenses between primary insomnia patients and insomnia patients with major depressive disorder history. To evaluate the pattern of defenses through the K-DSQ might provide important clues to differentiate these two conditions.

PRELIMINARY STUDY OF MENTAL REPRESENTATIONS OF PRESCHOOL CHILDREN EXPERIENCING SINGLE, SEVERE TRAUMA (심한 정신적 외상 경험을 한 학령 전기 아동의 정신적 표상에 대한 예비연구)

  • Eon, So-Yong;Song, Won-Woung;Oh, Kyung-Ja;Choi, Eui-Gyum;Shim, Eun-Ji;Shin, Yee-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.1
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    • pp.61-74
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    • 2004
  • Objectives:This study was performed to introduce a psychoeducational family therapy model for the families of schizophrenic patient and to investigate the effect of this model on the changes in coping style and depressive symptoms of the family members, and in perception of emotional support by families and depressive symptoms of patients. Methods:Nine preschool children, 3-5 years old, experiencing physical injuries caused by attack from a psychotic patient at kindergarten, were evaluated for psychological assessments;Intelligence test, MSSB(MacArthur Story-Stem Battery), H-T-P test(House-Tree-Person test). And their parents completed rating scale, KPI-C(Korean Personality Inventory for Children about children’s psychological conditions). Results:With respects to the contents and emotional reactions of MSSB, 9 preschool children showed generally high levels of anxiety, depression, avoidance, aggression, probably related to the traumatic experiences. Even though children couldn't verbally report directly about their traumatic experiences, in both MSSB, structured play narrative assessment tool, and HPT, free drawing and association test, they demonstrated psychiatric problems through reenactment plays, regardless of clinical diagnoses. Conclusion:Present study allowed us the chance to see beyond the outer pathological behaviors of PTSD in preschool children, through deeper evaluations of their mental representation. These preliminary data suggest deep understanding of internal representation would be of help for thorough evaluations and treatment plan for preschool children, experiencing severe trauma.

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THE CHARACTERISTICS OF CHILD AND ADOLESCENT INPATIENTS WITH SEVERE OBSESSIVE-COMPULSIVE DISORDER (심각한 소아 ${\cdot}$ 청소년 강박장애로 입원한 환아들의 특징)

  • Hwang, Jun-Won;You, So-Young;Chang, Jun-Hwan;Shin, Min-Sup;Cho, Soo-Churl;Hong, Kang-E;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.143-151
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    • 2004
  • Objectives : Child and adolescent onset obsessive compulsive disorder(C-OCD) is known to be associated with poor drug response, high comorbid rate and strong genetic tendencies. Till now studies for C-OCD have been very rare in Korea. We conducted this study to investigate the informations about clinical features, familial psychiatric loading, treatment profiles and course of server C-OCD from the retrospective analysis of inpatient data of Seoul National University Children's Hospital. Method : Retrospective chart review and data analysis was performed. Twenty(male 16 : female 4) patients with final C-OCD diagnosis by DSM-IV at discharge from 1994 to 2002 were found and their medical chart, psychological data, family interview data and nursing reports were collected and analyzed. Results : 1) The sex ratio of C-OCD was male dominant(4:1). 2) Phenomenological, most common obsession was pathologic doubt, contamination fear, followed by aggressive obsession, need for symmetry, sexual obsession, most common compulsion was checking and washing, followed by breathing, movement, symmetry, repetitive asking, hoarding, mental compulsion. 3) Most common comorbid diagnosis was depression. Other axis-I diagnosis associated OCD were anxiety disorder, tic disorder, conduct and oppositional defiant disorder and psychosis. 4) Regarding psychiatric familial loadings, 17 patients(85%) had relatives with psychiatric disorders, OC-spectrum disorders(OCD or OCPD) were found in 9 patients(45%). 5) The majority of patients(75%) have received SSRI and antipsychotics treatment. The response rate above 'moderate improved" by CGI was 75%. 6) During follow-up period in outpatient clinic, five patients(25%) showed continuous complete remission, 10 patients (50%) did residual symptoms with chronic course. Conclusion : This seems to be the first systemic investigation of severe pediatric OCD patients in Korea. The children & adolescents with severe OCD in inpatient-setting showed the high comorbid rate, familial psychiatric loading, and combined pharmacotherapy with antipsychotics, As for symptoms, high rate of aggressive-sexual obsession and atypical compulsions like breathing and moving was reported in this study. Severe pediatric OCD patients, however, responded well to the combined SSRI and antipsychotics regimen.

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The Status of Nursing Ethics Education in Korea 4-year-College of Nursing (간호윤리 교육현황 - 4년제 대학교육을 중심으로 -)

  • Han Sung-Suk;Kim Yong-Soon;Um Young-Rhan;Ahn Sung-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.2
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    • pp.376-387
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    • 1999
  • Purpose : To provide fundamental data to present further direction of education on Nursing Ethics by investigating the status of Nursing Ethics education performed at 4-year-Colleges of Nursing. Korea. Methods : A descriptive survey study The data collected from 28 universities through a questionnaire to examine the status of Nursing Ethics education in Korea. Results : I. Teaching Nursing Ethics class as a independent subject-6(21.4%) universities. 1) The average of 23.67 hours(2 credits) in the total educational hours. 2) Teaching method-theoretical class, discussion of case study, discussion of related issues, presentation of video tapes and discussion, team education, role play, and submission of reports. 3) Education contents-Nursing profession and ethics, the dignity of human life, necessity of bioethics, ethical theory and refutation, code for nurses, ethical issues between nurses and patients, nurses and co-workers, and nurses and nurses 6 universities 4) 5 universities-Included ethical decision making, artificial insemination, external insemination, artificial abortion, organ transplantation, brain death, human subject of study suicide, and euthanasia. II. Teaching Nursing Ethics as an inclusive theme in other subjects-22 (78.57%) universities. 1) Educated in Introduction of Nursing (14 universities), Nursing Management, Nursing Ethics and Philosophy, Special Nursing, Nursing and Law, and Professional Nursing. 2) Educational course-Taught in freshman level at 14 universities, average 9.32 education hours. Conclusion: Showed not only that universities, not operating Nursing Ethics as a independent class, unreasonably operate and assign too many contents in comparing with its education hours and are likely to become only a cramming education but also professors whose major is not Nursing Ethics presently in charge need to take a chance to supplement their knowledge and teaching method.

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Long-term outcomes of infantile spasms (영아 연축 환아의 장기적 예후에 관한 고찰)

  • Oh, Seak Hee;Lee, Eun-Hye;Joung, Min-Hee;Yum, Mi-Sun;Ko, Tae-Sung
    • Clinical and Experimental Pediatrics
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    • v.53 no.1
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    • pp.80-84
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    • 2010
  • Purpose : The aims of this study were to investigate the long-term outcomes in children with infantile spasms (IS) and to identify the prognostic factors influencing their neurodevelopment. Methods : We retrospectively evaluated seventy two children over five years old who were treated for IS at Asan Medical Center, Seoul, Korea, between 1994 and 2007. Forty-three children were contacted by telephone or medical follow-up to assess their current neurodevelopmental status. Multiple logistic regression was used to calculate odds ratios (ORs) and 95% confidence interval (95% CIs) of risk factors for unfavorable outcomes.Results : The mean follow-up duration for these 43 children was $7.2{\pm}1.5$ years (range, 4.5 to 13.0 years). Of these, 13 (30.2%) had cryptogenic and 30 (69.8%) had symptomatic IS. Eleven (25.6%) children were initially treated with adrenocorticotrophic hormone (ACTH) therapy, with a mean treatment lag of $1.3{\pm}1.9$ months (range; 0.1 to 7.0 months). Eighteen (41.8%) children clinically responded to initial treatment, as shown by EEG response. Overall, 22 (51.2%) children had at least moderate neurodevelopmental disorders and 2 (4.8%) died. In univariate analysis, etiology (symptomatic) and poor electroclinical response to initial treatment were related to long-term unfavorable outcomes. In multivariate analysis, response to primary treatment was the sole significant independent risk factor with a high OR. Conclusion : Overall prognosis of children with IS was poor. Electroclinical non-responsiveness to initial treatment was related to unfavorable long-term outcomes, indicating that initial control of seizures may be important in reducing the likelihood of poor neurodevelopment.

Parental Survey for Children with Feeding Problems (섭취 문제가 있는 영유아 아동에 대한 부모설문조사)

  • Kim, Hye-Jin;Chung, Kyong-Mee;Park, Mi-Jung;Choe, Yon-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.179-186
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    • 2008
  • Purpose: Feeding problems are common for typically developing children and have negative effects on physical, behavioral, and cognitive development. The purpose of the current study was to examine factors related to childhood feeding problems for typically developing children via parental reports. Methods: The feeding questionnaire developed by the authors and the Childhood Eating Behavior Inventory (CEBI) were administered to 796 parents of children who recruited from 2 pediatric outpatient clinics (n=379) and community (n=417). Problem eaters (PE) were identified by parental report and frequency analysis was conducted for types of feeding problems and its severity, problem behaviors during mealtime, the feeding methods of the parents, and the need for treatment. Results: The CEBI scores were significantly different between the PE and non-problem eaters (NPE), which suggests that the parental reports were reliable. The younger children had more feeding problems than the older children. The most frequent and severe feeding problems were selective eating and longer mealtimes across all age groups. One-half of the children had more than one problem behaviors during mealtime. Most parents of PE used ineffective methods to deal with children's behaviors during meal time, such as cajoling, which was related to their increased level of stress. Many parents reported their children need professional help for the feeding problems. Conclusion: Feeding problems are prevalent among children, especially younger children. Children with feeding problems showed a number of problem behaviors during mealtime and parental coping methods appeared to be ineffective. The need for treatment was considerable, thus the characteristics of this population must be acknowledged for providing proper treatment and advice.

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A Study of Children's Dietary Habits, focusing on Parental Influences (자녀((子女)의 식습관(食習慣) 육성(育成)에 미치는 부모(父母)의 영향(影響)에 관(關)한 조사연구(調査硏究))

  • Kim, Ki-Nam;Mo, Su-Mi
    • Journal of Nutrition and Health
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    • v.9 no.1
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    • pp.25-42
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    • 1976
  • In order to determine nutrition education needs and related problems, a study was conducted of children's dietary habits, focusing on parental influence and degree of agreement between parent and child on foods liked, accepted, or disliked, in addition to a general survey of food atiitudes. This study was conducted throughout a two-month period, June to July of 1974. One thousand children of both sexes, from the fifth grade, junior and senior high schools of Seoul city, and their 2,000 matched parents, were surveyed, Teachers distributed questionnaires in the classroom and assisted the children in answering. Questionnaires also were distributed to the parents through their children, after the teachers explained the procedure of study. As to the influence of parents' food preferences, the following conclusiolns can be reached, in light of the results of chi-square tests conducted: 1. Agreement between mother and child on food preference was much higher than that between father and child, regardless of sex or birth order of the child. This observed difference in degree of agreement was greatest for children in the middle birth order, and greater for girls than for boys. 2. Various food attitudes: a. Food preferences: Beef, milk, and mandoo (boiled or steamed, filled dumplings) were extremely well liked by all subjects, regardless of age or sex. Cucumber, lettuce, and spinach also were lied. Most disliked foods were fatty layers of pork and liver. Cooked rice in the too wet or too dry state and pork were low preference items. b. Socioeconomic background and dietary practice: Higher educational background of the wife and higher income level of the family were associated with greater knowledge of nutrition, and interest in family nutrition and in introducing new foods to the family. But use of food as prize or punishment was found, regardless of the mother's educational and economic status. c. Change of food habit: Over 70 percent of subject had changed ad improved their dietary habits, mostly by reason of husbands' and wives' mutual influence after marriage. This study emphasized the great importance of nutrition eudation for mothers, and their prominent role and responsility in guiding the family to better nutrition, whatever the mother's educational background.

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