• 제목/요약/키워드: Anxiety for Practice

검색결과 230건 처리시간 0.023초

통증 개념을 다룬 국내 간호 연구 분석 (An Analysis of Nursing Research on Pain Reported in Korea from 1970 to 1994)

  • 박정숙;박청자
    • 대한간호학회지
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    • 제25권1호
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    • pp.30-44
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    • 1995
  • This study aimed at analyzing the trend of re-search on pain in Korea, suggesting direction future pain research, and contributing to the use of pain interventions in nursing practice. Research studies on pain were selected from journals of medical and nursing schools, the Korean Nurse, the Korean Nurses' Academic Society Journal, the Central Journal of Medicine, the New Medical Journal, and from theses and dissertations, which were conducted between 1970 and 1994. The total number of the studies was 93. These studies were analyzed for 1) time of publication or presentation, 2) thesis for a degree or nondegree, 3) research design, 4) characteristics of subjects used in each study, 5) measurement tool, 6) types of correlated variables, 7) Korean terms for pain 8) types of nursing interventions, and 9) results of studies. The findings of the analysis can be summerized as follows : 1) The number of studies related to pain has increased rapidly since the early 1980's. The number of experimental research studies related to pain has increased chronologically, but the number of survey research studies related to pain was highest from 1981 to 1985, after that it decreased slowly. 2) The subjects in 19 studies were healthy people and, in 73 studies, patients with various illnesses. Thirty two studies were conducted with surgical patients. 3) Sixty one pain research studies were done for a thesis for a degree and 32 were nondegree research studies. 4) As measurement tools for pain, self- report pain scales were used in 54 studies and more than two tools were used in 28 studies. In the experimental studies, the trend was to use more than two tools. And in the nonexperirnental studies, the trend was to use self-report pain scales only. 5) There were 11 correlational studies. In these studies, the trend was to study anxiety, depression and variables such as intravenous infusion as related to pain.6) In the thirty six experimental studies, the effects of 16 types of nursing interventions weretested. Teaching and information, and relaxation technique were the most popular interventions for pain. 7) In eighteen methodological studies, the majority were studies testing the validity and re-liability of Dr. Lee's Korean Pain Rating Questionnaire. The following suggestions are made based on the above findings : 1) The patterns of these studies related to pain in Korea need to be compared with trends in other countries. 2) Meta - analysis should be done to analyze and integrate the results of various studies. 3) This analysis of pain research is needed to identify the present trend of pain research and to suggest the direction of future pain research, so these patterns of studies should be done in 5 to 10 year intervals. 4) More replicated pain research is needed to prove the effect of nursing interventions and more qualitative research on pain is needed to identify indepth the meaning of pain. 5) Pain researchers should make an effort to apply research result in various clinical settings and try to carry out team research with clinical nurses or with other multidiscipinary researchers.

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외과중환자를 위한 진통제와 진정제의 투여 양상 (The Administration Patterns of Analgesics and Sedatives for Patients in SICU)

  • 김화순
    • 대한간호학회지
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    • 제31권2호
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    • pp.304-314
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    • 2001
  • Major purposes of this study were to investigate the administration patterns of analgesics and sedatives in SICU and to identify the factors influencing the use of prn analgesics and sedatives by ICU nurses. The sample of this descriptive study was 50 adult patients in SICU and 53 ICU nurses. Patient's medical records were reviewed to investigate names, doses, the routes of administration, the interval of administration, and the type of prescription of sedatives and analgesics administered. Study medications were narcotics, hypnotics, and antipsychotics. To identify the factors influencing the use of prn analgesics and sedatives, 53 ICU nurses checked 9 items, and rank them from first to fifth. The selection of items was based on the previous studies and the experience of the investigator. The results of the study are as follows: 1. The mean age of the subjects was 53 years, 24 patients out of 50 subjects had received mechanical ventilation therapy. Most of the patients received neurosurgeries and abdominal surgeries. 2. For 4 days, 13 total study medications and combination of these were administered to the patients. Commonly prescribed drugs were Ketoprofen and Midazolam. Twenty six to fourty two percent of the patients did not receive any drugs for at least one day during the four days. 3. On the average, the study drugs were administerd 1.4 to 2.6 times per day during 4 days. 4. More than 50 percent of the prescription was as-needed (prn) except those of the POD 3. Fourteen percent of the patients did not have any prescription for sedation and pain control after surgery. 5. Examination of the frequency of sedatives and analgesics bolus administration revealed that a greater number of doses were given during daytime (from 7 am. to 7 pm.) than nighttime (from 7 pm. to 7 am.). The difference was significant at Alpha, .05. 6. First factor that most influenced nurses to administer sedatives and analgesics for intubated patients was the evaluation of patient's vital signs (51%). For non- intubated patients, the factors that nurses considered important were the patients' complaints of pain (64%) and evaluations of patients' vital signs (23%). In conclusion, the results of this study indicate that patients in SICU might not receive enough analgesics and sedatives to feel completely free from pain during the post operational period. Future study should be focused on the evaluation of the adequacy of current practice for pain and anxiety control in terms of the SICU patient's response.

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알코올중독 아버지와 사는 자녀의 경험에 관한 연구 (The Lived Experience of Children of Alcohol Dependent Fathers)

  • 김명아
    • 한국보건간호학회:학술대회논문집
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    • 한국보건간호학회 2002년도 제27회 보건종합학술대회
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    • pp.224-227
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    • 2002
  • Alcoholism affects not only the individuals who depend on it, but also their families. Children who have an alcohol dependent parent have various problems and need help, but little attention has been given to them. Many references report only negative characteristics of these children. In order to help the children of alcohol dependent parents, health professionals need more information. A wholistic understanding and analysis of these children is needed as a basis for the development of suitable programs of help them. A phenomenological methodology was used to identify the experience of children whose fathers were addicted to alcohol. The findings portray the essence of the lived experience of children of alcohol dependent fathers. Nine adolescents participated in in-depth inverviews and observation with the researcher, done between October and December 2001. The data were recorded on audio tape and transcribed. Sampling was continued until the data were theorectically saturated. The Colaizzi's method was used for data analysis. The results of this study are as follows. Three themes and twenty six meanings were identified. The first theme is Living Alone: living abusively as partner to an alcohol dependent father, living dangerously like an explosive fury, living as an object that ha no self, living with rejection of fatherly being, living with felt responsibility but having no power to help mother who suffers patiently with pain and abuse, living along with no shoulder to lean on, and living with the prejudice of sex discrimination. The second theme is Paradoxical Coping in Life. The meanings are obsessive behavior as a way to control father's behavior, always on the defensive due to anxiety and tension, being afraid of life alone due to paranoid thoughts, contradictory expectation about father's drinking behavior due to life with chronic tension, stress becoming familiar and life being boring and tendious without stimulation, life that is fake and filled with misinterpretations about reality, affection sought from others due to loneliness, compensatory life within peer group, negative expectation about the future due to negative experiences, controling others to protect ego, denial of real emotion to protect self from hurt, life of regretting self, and strong need for approval from others. The third theme is sustaining life. The meanings are ambivalence between revenge on father and pity, struggle for desirable self against fear of gather-like image, understanding father through self reflection, hope to find fatherly being through father's recovery, being able to stand through emotional control and cognitive restructuring, nurturing the seed of hope for the future while in a situation of desperation. The contribution of this study is to give a wholistic understanding of the empirical reality of children of alcohol dependent parents and to develop substantive theory in nursing knowledge. In nursing practice, the results of this study can provide a foundation for the development of programs for children of alcohol dependent parents.

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중년층의 구강건강지식, 실천 및 보철치료 만족실태 조사 (A study for middle-aged on oral health knowledge, oral health care and satisfaction with prosthetic treatment)

  • 고은정;이용환;박광환
    • 한국치위생학회지
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    • 제11권5호
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    • pp.671-683
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    • 2011
  • Objectives : The purpose of this study was to examine the oral health knowledge and actual oral health care of the selected subjects, their decision making about prosthetic treatment, the state and characteristics of their prosthetic treatment and their satisfaction with prosthetic treatment in an attempt to provide some information on the improvement of the quality of life related to oral health and the promotion of oral health. Methods : The subjects in this study were 250 people who received education in two different lifelong education institutions in the city of Busan. After a survey was conducted from May 23 to June 15, 2011, the answer sheets from 217 respondents were analyzed. Results : 1. As for the general characteristics of the respondents, the men(52.1%) outnumbered the women. Those who were in their 60 and up(47.5%) made up the largest age group, and the married people(65.4%) outnumbered the unmarried ones. By occupation, the company employees(20.3%) made up the biggest group. By education, the greatest group was high-school graduates(36.1%). By monthly mean income, the biggest group gained an income of 2.01 million won or more(36.9%). As to medical security, community-based insurance was most prevailing (36.9%). In terms of health promotion, the largest group worked out to stay fit(52.4%). 2. Regarding oral health knowledge, they had a good knowledge about the cause of dental caries(56.7%), but they weren't well aware of the right time for regular dental checkup(47.9%). In relation to oral health care, regular scaling wasn't prevailing(16.9%). 3. Regarding connections between the general characteristics and satisfaction with prosthesis, the less-educated respondents expressed significantly more dissatisfaction(p=0.015). By monthly mean income, those who had a smaller income were dissatisfied in general(p=0.028). Conclusions : The findings of the study illustrated that it's required to spread awareness of the importance of oral health among people in general, and that differentiated incremental oral health care should be provided for different age groups. In order to raise the satisfaction of patients with prosthesis, how to relieve their pain and anxiety and how to adjust prosthetic treatment cost properly should carefully be considered. In addition, the government should take measures to offer assistance for the low-income classes in preparation for an increase in the elderly population.

소설과 말기 암환자를 통해 본 한국인의 죽음의 의미

  • 전혜원;김분한
    • 호스피스학술지
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    • 제3권2호
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    • pp.34-54
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    • 2003
  • Every one experiences death one day, however no one can knows exactly what it is because people can not experience death until it comes, it is therefore impossible to judge correctly on the phenomenon of the death. On the whole, man experiences indirect death through the mass communications such as TV drama, fiction, magazine etc because those methods can easily access by every one. In addition to this, people usually acquire the negative awareness of death through the dramatic change of story like dying of cancer for dramatic effect by giving scare and fear to the cancers. The purpose of this study is to provide basic information on the spiritual care that enables the facing death patients to accept death as a part of life and divert hope from scare about after death by comparing and analyzing of two aspects of death meaning I.e, Korean fiction and the end stage cancer patients. Additionally, for medical staff to understand the facing death cancer patients by making to aware patients correctly and provide the better quality of care. The study was performed from September 28, 2002 to February, 28 2003. The materials of this study were collected by direct data obtained from observation, interviews, note and diary of end stage of cancer patients and written materials acquired from Korean contemporary fiction. Participants of this study were 4 end stage cancer patients including 2 lung cancer patients, 1 liver cancer patient and 1 esophagus cancer patient. The methodology used in this study was divided into two types; Huberman & Miles methodology was used for fiction to find and categorize subject, and Colaizzi, one of phenomenological methodology was used for end stage cancer patients to find the major meaning, subject and categorization. 1.The death investigated in the fiction, was found as a progress of negative emotion, acceptance and sublimation, life related subjects in the negative emotion were tenacity for life, anxiety, lingering attachment, responsibility, abandonment and death related subjects were shock, isolation, fear, scare and rejection. Acceptance related subjects were acceptance, destiny, secularism, preparation and arrangement, and sublimation related subjects were sublimation through Christian and Buddhism. 2.The death showed in the participants was negative emotion, acceptance and sublimation, life related subjects were repentance, anxiety, responsibility and hopelessness, and death related subjects were dejection, solitude, anger, fear and scare. The acceptance was a type of religious acceptance that admitted instantly by reaching an understanding with the God, and death was accepted as a progress of preparation, arrangement, acceptance and hope. Sublimation related subjects were Christian sublimation and relief or destiny incurred from self-reflective sublimation through communications and thoughts. 3.The death in view of fiction and participants were positively accepted both death and negative emotion, and the study disclosed the fact that death was sublimated dependent on religion. 4.The progress of negative emotion, acceptance and sublimation was disclosed more complicated and various in the real end stage cancer patients and acceptance only found in the patients on the form of religious acceptance, according to the results compared with fiction and real end stage cancer patients. The death showed in the fiction was standardized, gradated and similar progress with psychological status of Kubler-Ross. However, death in the participants was showed complex and various feelings simultaneously, and sometimes they accepted death positively. The sublimation through religion was found in Buddhism and Christian in the fiction and mostly Christian in the participants due to a number of Hospice patients. It was found that negative emotion various types of death was more found in the participants than fiction. It is therefore necessary to study on the response of death in various types. In the participants death was incurred more systematic and variously, we knew that nursing practice focused on experience of participants is required and reality on death is much profound than we analyzed and presented, lots of situations and reactions should be premised because we can not completely rule out the negligence possibility of care mediation of participants. In caring for the facing death patients, we discovered and confirmed again through this study that the spiritual care should be needed as a mediation method.

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연극치료의 효과성에 관한 메타분석연구 (Meta-Analysis on the Effectiveness Research of Drama Therapy in Korea)

  • 신동인
    • 한국콘텐츠학회논문지
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    • 제21권11호
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    • pp.234-242
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    • 2021
  • 본 연구에서는 현재 국내에서 시행되고 있는 연극치료의 효과성을 메타분석을 통해 살펴보고 이를 통해 향후 보다 효과적이고 구체적인 연극치료의 실행방안을 제시하기 위하여, 국내에서 시행된 연극치료의 효과성에 대한 개별연구들을 메타분석하였다. 메타분석을 위한 자료 수집은 2021년 6월까지 국내에서 발표된 연극치료의 효과성과 관련된 학위논문 및 학술논문 등을 검색하여 이루어졌고, 구체적 선정기준에 따라서 최종 18편의 논문을 선정하여 메타분석을 실시하였다. 분석을 위해서 메타분석 통계프로그램인 CMA(Comprehensive Meta-Analysis) software 2.0을 사용하였으며, 주요 결과는 다음과 같다. 첫째, 연극치료의 평균효과크기를 살펴보면, 자아존중감은 평균효과크기가 1.325, 우울·불안은 -1.230, 스트레스는 1.025, 사회성은 1.018, 정서지능은 0.907, 심리적 안녕감은 0.897로 모두 큰 효과크기를 나타내었다. 둘째, 연극치료의 효과성이 조절 변수에 따라 차이가 나는지 살펴본 결과, '자아존중감'의 효과크기에 있어서 '대상자의 특성(아동·청소년 or 성인)', '총회기수(10회 미만 or 10회 이상)', '연극치료유형(복합연극치료유형 or 공연중심 연극치료유형)' 이 통계적으로 유의미한 차이를 나타내었다. 이러한 측면을 고려할 때, 향후 연극치료를 실행하는데 있어서 효과성의 종속변수로 '자아존중감'을 향상시키기 위해서는 성인대상, 총회기수는 10회 이상, 공연중심의 연극치료유형 등을 보다 확대해서 실시할 필요가 있음을 제시하였다. 이와 같은 본 연구결과를 바탕으로 향후 국내 연극 치료의 실행방안과 함의를 제안하였다.

최근 5년간 연세대학교 치과대학병원 소아치과의 환자 분포 및 치료 경향 (The Distribution of Patients and Treatment Trends in the Department of Pediatric Dentistry, Yonsei University Dental Hospital for Last 5 Years)

  • 강정민;이효설;최형준;최병재;손흥규;이제호
    • 대한소아치과학회지
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    • 제41권2호
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    • pp.134-144
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    • 2014
  • 본 연구는 환자분포 및 치료경향을 조사하여 소아치과의 변화하는 진료 양상을 알기 위해 시행하였다. 2008년 1월부터 2012년 12월까지 연세대학교 치과대학병원 소아치과에 내원한 환자를 대상으로 전자의무기록을 수집하고 분석하였다. 조사 결과 초진환자와 비선택 진료의사 1인당 환자 수는 감소하였고 외국인 환자수가 급증하였다. 신환은 만 0~2세의 연령층이 가장 많았고, 내원 주소는 치아우식증, 외상, 부정교합 순으로 높게 나타났다. 수복치료의 분포 결과 복합레진 수복, 아말감 수복, 치면열구전색술은 감소하였고, 자가중합형 글라스아이오노머, 예방적 레진수복이 증가하는 추세였다. 다내원근관치료가 감소하고 당일발수 근관 충전이 증가했으며, 치수복조술과 치수절단술과 같은 보존적 치수치료의 비율이 증가하였다. 환자의 불안을 감소시키기 위해 진정법을 선택하는 경우가 증가하였으며 아산화질소의 이용이 주를 이루었다. 내원 환자의 분포 및 특성을 파악하고, 최신 치료 경향을 제공함으로써 환자의 요구에 부합하는 적절한 치료계획을 수립하는데 도움이 될 것으로 생각된다.

기후변화에 대한 '집합적 책임'과 기독교교육 (Christian Education and Collective Responsibility for Climate Change)

  • 이인미
    • 기독교교육논총
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    • 제71권
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    • pp.155-179
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    • 2022
  • 본 연구의 목표는, 여성 정치사상가 한나 아렌트(Hannah Arendt)가 『책임과 판단』에서 소개한 개념 '집합적 책임'을 들여와 기후변화를 주제로 하는 기독교교육 분야에 응용하는 것이다. 먼저 본 연구는 '집합적 책임' 개념을 집합적 유죄 개념에 대비하면서 작금의 기후변화 문제가 개인윤리의 과제라기보다는 정치적 과제로 인식되어야 한다는 사실을 강조한다. 그리고 기후변화에 대한 '집합적 책임'의 교육활동이 그 자체로 교육자와 학습자가 공히 참여하는 공공의 정치행위로 전개되어야 마땅하다고 주장한다. 본 연구는 정치행위로서 기독교교육 활동의 전개방안에 관하여 다음의 네 가지를 제안한다. 첫째, 기후변화로 인한 인류존망 위기에 대한 불안 및 분노의 감정을 공적 수준에서 발표하며 공유하기. 둘째, 칸트가 말한 "확장된 심성(공통감각)"을 통하여 이기주의(이권 편향)를 초월하기. 셋째는 "시민참여로서 아렌트적 토론학습"으로 호명되는 대화와 토론의 학습공동체를 결성하는 일이다. 마지막으로 넷째는, 그 같은 학습공동체 안에서 "사랑으로 행동하는 믿음"을 이웃사랑의 지평에서 실천할 수 있도록 격려하는 기독교교육이 일어나야 한다는 점이다. 본 연구의 학술적 의의는 아렌트의 정치이론을 기후변화 및 기후활동, 그리고 기독교교육에 관계지어 구체적으로 다룬 국내 최초의 학제간 연구논문이라는 사실이다. 비록 정치이론을 기독교교육에 응용하는 이론적 조직신학적 연구를 표방하나, 실제 교육장면에서 활용가능한 실천적 제안을 동반하고 있음을 자부한다.

Safety and efficacy of target controlled infusion administration of propofol and remifentanil for moderate sedation in non-hospital dental practice

  • Douglas Lobb;Masoud MiriMoghaddam;Don Macalister;David Chrisp;Graham Shaw;Hollis Lai
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제23권1호
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    • pp.19-28
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    • 2023
  • Background: Fearful and anxious patients who find dental treatment intolerable without sedative and analgesic support may benefit from moderate sedation. Target controlled infusion (TCI) pumps are superior to bolus injection in maintaining low plasma and effect-site concentration variability, resulting in stable, steady-state drug concentrations. We evaluated the safety and efficacy of moderate sedation with remifentanil and propofol using TCI pumps in non-hospital dental settings. Methods: A prospective chart review was conducted on 101 patients sedated with propofol and remifentanil using TCI pumps. The charts were completed at two oral surgeons and one general dentist's office over 6 months. Hypoxia, hypotension, bradycardia, and over-sedation were considered adverse events and were collected using Tracking and Reporting Outcomes of Procedural Sedation (TROOPS). Furthermore, patient recovery time, sedation length, drug dose, and patient satisfaction questionnaires were used to measure sedation effectiveness. Results: Of the 101 reviewed sedation charts, 54 were of men, and 47 were of women. The mean age of the patients was 40.5 ±18.7 years, and their mean BMI was 25.6 ± 4.4. The patients did not experience hypoxia, bradycardia, and hypotension during the 4694 min of sedation. The average minimum Mean Arterial Pressure (MAP) and heartbeats were 75.1 mmHg and 60.4 bpm, respectively. 98% of patients agreed that the sedation technique met their needs in reducing their anxiety, and 99% agreed that they were satisfied with the sedation 24 hours later. The average sedation time was 46.9 ± 55.6 min, and the average recovery time was 12.4 ± 4.4 min. Remifentanil and propofol had mean initial effect-site concentration doses of 0.96 µ/.ml and 1.0 ng/ml respectively. The overall total amount of drug administered was significantly higher in longer sedation procedures compared to shorter ones, while the infusion rate decreased as the procedural stimulus decreased. Conclusion: According to the results of this study, no patients experienced adverse events during sedation, and all patients were kept at a moderate sedation level for a wide range of sedation times and differing procedures. The results showed that TCI pumps are safe and effective for administering propofol and remifentanil for moderate sedation in dentistry.

스마트폰 중독의 중재 프로그램에 관한 체계적 고찰 (A Systematic Review on the Intervention Program of Smartphone Addiction)

  • 김덕주
    • 한국산학기술학회논문지
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    • 제21권3호
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    • pp.276-288
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    • 2020
  • 본 연구의 목적은 스마트폰 중독의 중재 프로그램에 대해 체계적으로 분석함으로써, 스마트폰 중독 치료에 대한 근거를 제시하고자 하는 것이다. 연구 분석을 위해 2010년 1월부터 2019년 7월까지 출판된 문헌들을 대상으로 하였으며, 국외 문헌은 'Pubmed, Science Direct'에서 검색하였고, 국내 문헌은 'RISS, Keris, KISS'를 통하여 검색하였다. 총 310편의 논문이 검색되었고, 포함기준과 배제기준을 바탕으로 분석하여 최종 16편의 논문이 분석에 사용되었으며, 근거수준 I이 13편(81%), III이 3편(19%)이었다. 분석결과 스마트폰 중독을 위한 중재 방법에는 미술치료가 6편(37.5%)으로 가장 많았으며, 운동치료가 4편(25.0%), 인지행동치료가 3편(18.6%)을 차지하였다. 분석에 포함된 대상자는 초등학생이 가장 많았으며, 중재기간은 6~8주 사이, 치료 회기는 6회기 혹은 12회기가 가장 많았다. 대부분의 프로그램 중재 후 스마트폰 중독의 금단증상 감소, 우울, 불안 및 충동성과 같은 부정적인 감정 감소, 자아존중감과 같은 긍정적인 감정의 증가 등 좋은 결과를 나타내었다. 평가항목을 보면, 스마트폰 중독 진단척도가 가장 많이 사용되었으며, 인터넷 중독진단, 불안평가, 우울평가, 충동평가, 애착평가 등과 같이 심리적인 부분을 측정하는 평가가 대다수를 차지하였다. 향후 이러한 연구들이 스마트폰 중독의 치료를 위한 중재도구로 효과적으로 활용될 수 있을 것으로 기대한다.