• Title/Summary/Keyword: Anxiety Scale

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Associations between Vasomotor Symptoms and Depression, Stress and Quality of Life in Midlife Women (중년여성에서의 혈관운동증상과 우울, 스트레스, 삶의 질과의 상관성)

  • Nam, Yoon-Min;Joe, Sook-Haeng;Kwon, Eun-Joo;Ham, Byung-Joo;Han, Chang-Su;Ko, Young-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.2
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    • pp.146-156
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    • 2016
  • Objectives : The aim of this study was to evaluate the associations between vasomotor symptoms and factors such as sociodemographics, health behaviors, medical condition, depression, stress, anxiety, attitude toward menopause, and quality of life. Methods : We conducted a cross-sectional study in peri- and post-menopausal women enrolled by the Korean Association of Health Promotion. Subjects submitted self-report questionnaires about vasomotor symptoms and other clinical symptoms. Associations between vasomotor symptoms and clinical variables were analyzed using stepwise multiple regression analyses. Results : 1951 women completed self-report questionnaires and 1022 women were enrolled in the study. The prevalence of vasomotor symptoms in peri- and post-menopausal women was 63.9%. Variables showing significant differences between subjects with vasomotor symptoms and subjects without them were score of Beck Depression Inventory, Brief Encounter Psychosocial Instrument-Korean Version, proportions of clinically significant depression(Beck Depression Inventory ${\geq}16$), Menopausal rating scale, attitude towards menopause, the 4 subscales of World Health Organization Quality of Life-BREF(Physical health, psychological, social relationships, environment), and a History of Premenstrual syndrome/Premenstrual dysphoric disorder. Stepwise multiple regression analyses indicated that Beck Depression Inventory, Brief Encounter Psychosocial Instrument-Korean Version, Menopausal Rating Scale, and the Psychological subscale of World Health Organization Quality of Life -BREF show associations with vasomotor symptoms. Conclusions : Menopausal vasomotor symptoms are associated with various psychological factors, especially with depression. Midlife women suffering vasomotor symptoms should therefore be screened for depression. Future prospective studies where clinical subjects are diagnosed using structured interviews, focusing on the causal relationship between depression and vasomotor symptoms are necessary.

CLINICAL AND NEUROPSYCHOLOGICAL CHARACTERISTICS OF DSM-IV SUBTYPES OF ATTENTION DEFICIT HYPERACTIVITY DISORDER (주의력결핍 과잉행동장애의 아형별 신경심리학적 특성 비교)

  • Cheung, Seung-Deuk;Lee, Jong-Bum;Kim, Jin-Sung;Seo, Wan-Seok;Bai, Dai-Seg;Chun, Eun-Jin;Suh, Hae-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.139-152
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    • 2002
  • Objectives:This study was conducted to compare the clinical and neuropsychological characteristics by DSM-IV subtypes of attention deficit hyperactivity disorder(ADHD) patients who did not have comorbid psychiatric disorders. Methods:5-15 year old children with ADHD were recruited at psychiatric outpatient clinic of Yeungnam University hospital and the patients with comorbidity or neurological abnormalities were excluded. Finally, total 404 children with ADHD were selected for this study. There were 234 subjects of ADHD-C(57.9%), 156 subjects of ADHD-I(38.6%) and 14 subjects of ADHD-HI(3.5%), who fulfilled the DSM-IV diagnostic criteria. The mean age of the total subjects was 9.63±2.49 years old. The psychopathology, IQ, behavioral problems, neuropsychological executive function were evaluated before pharmacological treatment. The measures were Korean Personality Inventory of Child(K-PIC) for psychopathology, 4 behavioral check lists(ADDES-HV, ACTeRS, CAP, SNAP) for behavioral symptoms of ADHD, K-ABC and KEDI-WISC for IQ and Conner's CPT, WCST, SST for neuropsychological executive functions. Results:1) The prevalence of subtypes was ADHD-C, ADHD-I, ADHD-HI in decreasing order. There was no sex difference of prevalence among three subtypes. The mean age of ADHD-I was older than other subtypes. 2) There was significant differences of psychopathology among subtypes, the ADHD-C and ADHD-HI had higher than the ADHD-I in the scores of delinquent, hyperactivity and psychosis;the ADHD-C had higher than the ADHD-I in the scores of family relation and autism, the scores of ego resilience were lower than the ADHD-I. However, there was no difference in anxiety, depression and somatization scores among them. 3) The results of behavioral symptom check lists, the ADHD-C had higher the score of inattention, hyperactivity and impulsivity than the ADHD-I. Meanwhile the results of ACTeRs, which rated by the teachers, were different. 4) There were significant differences of sequential processing scale and arithmetics among subtypes in IQ using K-ABC, but there was no significant difference between the ADHD-C and the ADHD-I after excluding the ADHD-HI due to small numbers. 5) There was numerical difference among subtypes but did not reach statistical significance in three neuropsychological executive function tests. Conclusion:In conclusion, our results revealed that there was significant difference in clinical features among three subtypes but, no significant difference in executive functions.

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Development of validated Nursing Interventions for Home Health Care to Women who have had a Caesarian Delivery (조기퇴원 제왕절개 산욕부를 위한 가정간호 표준서 개발)

  • HwangBo, Su-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.1
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    • pp.135-146
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    • 2000
  • The purpose of this study was to develope, based on the Nursing Intervention Classification (NIC) system. a set of standardized nursing interventions which had been validated. and their associated activities. for use with nursing diagnoses related to home health care for women who have had a caesarian delivery and for their newborn babies. This descriptive study for instrument development had three phases: first. selection of nursing diagnoses. second, validation of the preliminary home health care interventions. and third, application of the home care interventions. In the first phases, diagnoses from 30 nursing records of clients of the home health care agency at P. medical center who were seen between April 21 and July 30. 1998. and from 5 textbooks were examined. Ten nursing diagnoses were selected through a comparison with the NANDA (North American Nursing Diagnosis Association) classification In the second phase. using the selected diagnoses. the nursing interventions were defined from the diagnoses-intervention linkage lists along with associated activities for each intervention list in NIC. To develope the preliminary interventions five-rounds of expertise tests were done. During the first four rounds. 5 experts in clinical nursing participated. and for the final content validity test of the preliminary interventions. 13 experts participated using the Fehring's Delphi technique. The expert group evaluated and defined the set of preliminary nursing interventions. In the third phases, clinical tests were held at in a home health care setting with two home health care nurses using the preliminary intervention list as a questionnaire. Thirty clients referred to the home health care agency at P. medical center between October 1998 and March 1999 were the subjects for this phase. Each of the activities were tested using dichotomous question method. The results of the study are as follows: 1. For the ten nursing diagnoses. 63 appropriate interventions were selected from 369 diagnoses interventions links in NlC., and from 1.465 associated nursing activities. From the 63 interventions. the nurses expert group developed 18 interventions and 258 activities as the preliminary intervention list through a five-round validity test 2. For the fifth content validity test using Fehring's model for determining lCV (Intervention Content Validity), a five point Likert scale was used with values converted to weights as follows: 1=0.0. 2=0.25. 3=0.50. 4=0.75. 5=1.0. Activities of less than O.50 were to be deleted. The range of ICV scores for the nursing diagnoses was 0.95-0.66. for the nursing interventions. 0.98-0.77 and for the nursing activities, 0.95-0.85. By Fehring's method. all of these were included in the preliminary intervention list. 3. Using a questionnaire format for the preliminary intervention list. clinical application tests were done. To define nursing diagnoses. home health care nurses applied each nursing diagnoses to every client. and it was found that 13 were most frequently used of 400 times diagnoses were used. Therefore. 13 nursing diagnoses were defined as validated nursing diagnoses. Ten were the same as from the nursing records and textbooks and three were new from the clinical application. The final list included 'Anxiety', 'Aspiration. risk for'. 'Infant behavior, potential for enhanced, organized'. 'Infant feeding pattern. ineffective'. 'Infection'. 'Knowledge deficit'. 'Nutrition, less than body requirements. altered', 'Pain'. 'Parenting'. 'Skin integrity. risk for. impared' and 'Risk for activity intolerance'. 'Self-esteem disturbance', 'Sleep pattern disturbance' 4. In all. there were 19 interventions. 18 preliminary nursing interventions and one more intervention added from the clinical setting. 'Body image enhancement'. For 265 associated nursing activities. clinical application tests were also done. The intervention rate of 19 interventions was from 81.6% to 100%, so all 19 interventions were in c1uded in the validated intervention set. From the 265 nursing activities. 261(98.5%) were accepted and four activities were deleted. those with an implimentation rate of less than 50%. 5. In conclusion. 13 diagnoses. 19 interventions and 261 activities were validated for the final validated nursing intervention set.

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A Preliminary Epidemiologic Study on Korean Veterans Exposed to Herbicides in Vietnam War (파월국군장병의 고엽제 위해에 관한 예비적 역학조사)

  • Kim, Joung-Soon;Lee, Hyun-Sul;Lee, Hong-Bok;Lee, Won-Young;Park, Young-Joo;Kim, Sung-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.4 s.48
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    • pp.711-734
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    • 1994
  • Among chemical agents in herbicides, dioxin (2, 3, 7, 8-tetrachloro dibenzo-$\rho$-dioxin : TCDD), a chemical contaminant in herbicides sprayed during the Vietnam War has been known to be the major agent causing toxic effects. Approximately 320,000 korean soldiers participated the Vietnam War from 1964 to 1974. Although the potential hazards of the herbicides among Korean veterans exposed were implicated, the problem had not been a public issue until 1991 when Korean veterans were informed U.S. companies, the herbicides manufacturer payed fund, from which a trust fund for New Zealand and Australian Class members were established in 1985. After a series of appeals and demonstration by the Korean Veterans demanding medical care and compensation for their serious health damages, a bill of medical care and compensation for herbicides victims was promulgated in March 1993 and become effective from May 1993, This study was carried out with two major objectives : the first to understand the health problems caused from the herbicides by reviewing literatures published, and the second to examine the nature and extent of health impacts among Korean veterans exposed and to develop valid study methods for the major study by interviewing and reviewing records on a part of veterans (638 persons) registered and completed medical examination in Seoul Veterans Administration Hospital from June to October 1993. The results obtained are as followings: 1. The literature review of 107 papers revealed that 1) Dioxin is teratogenic, carcinogenic and affects almost all organs including nervous, endocrine, and reproductive systems in animal experiments. 2) The diseases showing evidence of causal association were Hodgkin's disease, non-Hodgkin's disease, lung cancer, lymphoma, soft tissue sarcoma, chloroacne and polyneuropathy when judged on the basis of consistency in study results and biological plausibility. 2. Interview and medical record review study on 638 veterans, though limited validity owing to lack of control group, crude estimates of dioxin exposure levels (no biomarkers measurable), and uncertainty of diagnosis, showed that: 1) Most of the study subject's were in their 40's of age and had been dispatched to Vietnam during the period from $1965{\sim}1970$ around one year. 2) Most frequently complained symptoms in medical examination were motor weakness (32%), sensory abnormalities in extremities (23%), skin diseases (22%), and pain in extremities (20%) whereas in Interview they were more frequent in order of skin problem (44%), motor weakness (38%), sensory abnormalities and pain in extremities(17% and 19% each). Kappa indices on the same category of complaints between two sources of information were variable and relatively low. 3) On medical examination, only a part of the 638 subjects had initial impression (442 pts) and final diagnosis (218 pts) suggesting decision making on diagnosis appeared to be difficult even with all available modern medical technologies: in initial impression disorders from peripheral and central neuropathy were predominant whereas in final diagnosis various types of skin disorder were most frequent 4) When dose-response relationship between several conditions (from questionnaire) and arbitrary exposure scores were examined by CMH linear trend test, spontaneous abortion, sexual problems and health problem of offsprings showed statistically significant linear trends. However, pregnancy, accident and suicidal attempts did not show any relationship in this study capacity. 5) Among complaints, psychosis and neurosis (anxiety, phobia) in interview study, and memory disorder and psychosis in medical record study revealed linear trend. 6) Skin disorder was the only condition showing linear trend in initial impression and none in final diagnosis on medical examination. Even though objective to select out dioxin-related disease or group of diseases from this study was not achieved the research experiences provided firm basis for developing various methodological approaches. 3. From this preliminary study we concluded that a larger scale major epidemiologic study on health impacts of herbicides among Korean veterans exposed is not only Indispensible but also well designed study with more valid exposure information and diagnosis may be able to establish causal relationship between certain groups of diseases and exposure to the herbicides among Korean veterans.

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Musical Instrumental Playing Activity using Blues Music Structure for the Improvement of Self-Efficacy in Female Middle School Students who have Depressive Tendencies (우울성향 여중생의 블루스 음악형식을 활용한 자기효능감 증진 연주활동)

  • Koo, Sae Rom
    • Journal of Music and Human Behavior
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    • v.4 no.2
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    • pp.1-17
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    • 2007
  • Huge growth in developmental level, new accomplishment, and The period of adolescents is not only the transition stage but also improvement of academic level. In this level of stage, adolescents have difficulties in development, so they show psychological abnormality such as stress and depression. They could develop mental disorder such as depression or anxiety if they do not overcome the abnormality. According to the situation of the insufficiency of the decent program for adolescents' mental health in the current society, we are strongly requested to develop the psycho-therapeutic program for them. Therefore, in this study, we examined the effect of the musical activities as blues music structure on the improvement of the Self-Efficacy in the female middle school students who have depressive tendencies as well as what they experienced through the activities. The 3 participants were selected out of 70 students in the first year at the "D" middle school in Seoul by being tested with Child Depression Inventory(CDI) and Self-Efficacy Scale(SES). The musical activities were built with 3 steps. Of which, the first one was the introduction to each other, the formation of rapport, and induction of their interests to the musical activities through blues. The second one was letting participants learn the blues music structure by practice and play assigned music(including improvisation) during later 5 sessions with different difficulties at each session. The third one was giving them opportunities to play a music out of the acquired ones during the session or creative music by their own, which results in maximizing musical activities and an acquired experience. As a result, first of all, the scores of CDI test of 3 participants in 10 time sessions showed slight changes, suggesting the negative correlation between CDI and SES even though changes were not big differences. Secondly, the scores of SES test of 3 subjects in 10 time sessions were all changed and especially preference for tasking was significant. Thirdly, the scores of SES for musical playing test of 3 participants in 10 time sessions were all changed and especially preference for musical tasking was significant shown. Finally, according to answers of 3 participants in 10 time sessions for the after questionnaire on musical activities, participants experienced affirmative self-confidence and positive emotion. Taken together, it was suggested that musical activities using blues music structure could be promising therapeutic intervention method.

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The Relationship Between Social Security Network and Security Life Satisfaction in Community Residents: Scale Development and Application of Social Security Network (사회안전망과 지역사회주민의 안전생활만족의 관계: 사회안전망 척도개발과 적용)

  • Kim, Chan-Sun
    • The Journal of the Korea Contents Association
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    • v.14 no.6
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    • pp.108-118
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    • 2014
  • The purpose of this study is to develop a relationship of measuring method for the social security network and verify its validity and reliability and apply it to investigate the due to security life satisfaction. This study is based by setting general residents of Seoul in 2013 and using the stratified cluster random sampling method to analyze a total amount of 203 examples. The measuring methods for the social security network was developed through document research, conceptual definition and drafting the survey, experts' conference, preliminary inspection and original examination, verification of the validity and reliability of the survey. An experts' conference took pace to verify the validity of the survey, and 6 factors were extracted through exploratory factor analysis crime prevention design, street CCTV facilities, volunteer neighborhood patrol, local government security education, police public peace service, private security service. The conclusion are the following. Collected data was analyzed based on the aim of this study using SPSSWIN 18.0, and practice frequency analysis, F test, factor analysis, reliability analysis, correlation analysis, multiple regression analysis. First, the validity of the social security network measurement is very high. Thus, the factors constituting the social security network were found to be crime prevention design, street CCTV facilities, volunteer neighborhood patrol, local government security education, police public peace services, and private security services, and the crime prevention design factor was found to be most explanatory. Second, the reliability of the social security network measurement is very high. Thus, the correlation between the questions and the sector, the questions and the social security net was very high, and the internal consistency showed a Cronbach's${\alpha}$ value of over 0.865. Third, the establishment of a social security network had the biggest effect on people in their forties. Thus, when the crime prevention design, street CCTV facilities, local government security education, police public peace services are systematically established, the social anxiety of citizens was reduced.

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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Effect of Bright Light Exposure on Adaptation to Rapid Night Shift : A Field Study of Shift Work Nurses in Psychiatric Ward (순환제교대근무자에서 야간 근무 적응에 대한 광치료 효과)

  • Ko, Young-Hoon;Joe, Sook-Haeng
    • Sleep Medicine and Psychophysiology
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    • v.9 no.1
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    • pp.41-47
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    • 2002
  • Objectives: In a number of simulated night shift studies, timed exposure to bright light improves sleep quality and work performance. We evaluated the effect of bright light on adaptation to night shift work with a field study. Methods: Five female nurses working shifts at Korea University Hospital were recruited for participation in this study. We investigated two series of six consecutive shift rotations comprising three day and three night shifts, using wrist Actigraphy, the Stanford Sleepiness Scale, Visual-analogue scales, STIM and tympanic membrane temperature for daytime sleep quality, alertness, subjective feeling, attention performance, and temperature rhythm. The subjects were exposed to bright light (2,500 lux) from 24:00 to 04:00 a.m. on three consecutive night shifts during the second series, whereas they worked under normal lightening (650 lux) conditions during the first series. Results: Actigraphic assessment of daytime sleep showed no significant difference between the first and third night shift in both baseline and light exposure phase. The mean lowest temperature shifted earlier during baseline phase but not during the light exposure phase. Also, the score for subjective feelings of depression, anxiety, physical discomfort and sleepiness was significantly higher in the third night shift than the first during baseline phase but not during the light exposure phase. Attention and attention switching ability was significantly improved in the third night shift compared to the first night during the light exposure phase but there were no significant changes during the baseline phase. Conclusion: This result suggests that there were no significant differences between the two phases in measures of quality of daytime sleep, but subjective feelings, attention and alertness were enhanced during light exposure. Although some placebo effects and learning effects might influence this result, bright light exposure between midnight and 4:00 a.m. may improve adaptation to night shift. In future, further controlled studies with a larger sample size, including melatonin measurement, are needed for real shift workers.

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COMPARISON BETWEEN ATTENTION DEFICIT HYPERACTIVITY DISORDER AND MANIA IN CHILDREN AND ADOLESCENTS (주의력결핍과잉행동장애와 소아, 청소년기 조증의 비교 연구)

  • Sung, Yang-Sook;Hong, Kang-E;Cho, Soo-Churl;Nam, Min
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.91-99
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    • 1999
  • Objects:It is difficult to differentiate between attention deficit hyperactivity disorder(ADHD) and mania because of similar symptoms and atypical symptoms of mania in children and adolescents. The purpose of this study is to identify the characteristics and to clarify the relationship by comparing the clinical features and comorbidities of ADHD and manic patients. Methods:The subjects consisted of 35 patients with ADHD and 19 manic patients. To Compare the characteristic symptoms between the two disorders, we selected 29 patients with ADHD and 14 patients with manic disorders. 6 ADHD patients who had manic disorders as comorbid disorder, and 5 manic patients who had ADHD as comorbid disorders were manic disorders were excluded. Results:1) There were significant differences in ages of onset and state anxiety scale scores, birth weights, numbers of perinatal problem, gestational ages, school behavioral problems between ADHD patients and manic patients(p<0.01). 2) There were significant differences in loses things(p<0.05) of ADHD-symptoms and grandiosity(p<0.01), decrease in sleep(p<0.05), delusions(p<0.01), hallucinations(p<0.05) of mania-symptoms between ADHD patients and manic patients. 3) The comorbid disorders of ADHD patients are significantly high(p<.05) than that of manic patients in major depression. 4) The familial loading of manic patients are significantly high(p<.05) than that of ADHD patients in mood disorder. Conclusions:The above results suggest that ADHD and mania are different disorders, considering the significant differences of clinical features and characteristics, familial loadings of the two disorders.

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Present Conditions of Mental Health Care in Rural Areas: Community Mental Health Program of Public Health Center (농촌지역 정신보건관리실태: 보건소 지역사회정신보건사업)

  • Lee, Weon-Young;Kim, Dong-Moon
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.1-14
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    • 2003
  • Objectives: This paper introduces need and supply level of rural mental health care service and especially focuses on the evaluation for the community mental health programs of Public Health Centers(PHCs) in rural areas as the facilities for primary mental health care. Methods: We defined the need as prevalance rate and service utilization rate, for which reviewed the results of the epidemiological study of mental disorders using Korean Composite International Diagnostic Interview surveyed on a nationwide scale in 2001. Supply was appraised in terms of psychiatric beds and primary mental heath care facilities such as private psychiatric clinics, facilities for social rehabilitation, PHCs running community mental health programs. For this, we reveiwed a variety of annual reports related mental health published by Ministry of Health and Welfare. To evaluate the community mental health programs of PHCs in rural areas, we selected. randomly samples out of the 3rd community health plans including the contents of community mental health programs, which submitted by 89 rural counties and 44 cities mixed with rural areas, and used the program's guideline established by central government as a standard. Results: Prevalence rates of major psychiatric diseases such as schizophrenia, alcoholism, major depression, anxiety disorder were higher in rural area than in urban area and 8.9% of psychiatric patients in both areas stayed at homes contacted with mental health manpower more than one time during the last year. Psychiatric beds were sufficiently supplied, but urban area had less beds than rural area contrary to general health care service. Psychiatric clinics were supplied very insufficiently in rural areas and PHCs bridged the gap instead. However rural PHCs got less financial support for community mental health programs from higher positioned agencies than urban PHCs. Rural community health programs not supported hardly worked out. Conclusions: Central government should consider a special policy for rural primary mental health care, because private psychiatric clinics can't be introduced in rural areas due to demand-deficiency and the financial independence of rural counties was very vulnerable.

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