• Title/Summary/Keyword: Behavioral disturbance

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Insomnia in Patients with Hematopoietic Stem Cell Transplantation(HSCT) (조혈모세포 이식 환자의 불면증)

  • Lee, Sang-Shin;Kim, Hyunseuk
    • Journal of the Korean society of biological therapies in psychiatry
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    • v.24 no.3
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    • pp.142-155
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    • 2018
  • Insomnia in patients with hematopoietic stem cell transplantation(HSCT) has been underdiagnosed and undertreated. This study reviewed the frequency, characteristics, physical and psychological effects, and treatments of insomnia in HSCT patients to highlight clinical importance in this specialized population. Furthermore, the authors intended to suggest a model that would conceptualize insomnia in the context of HSCT. In the pre-transplant period, about half of patients with HSCT suffered from sleep disturbance. A substantial number of patients experienced distressing insomnia during the HSCT procedure and recovered to the level of the pre-transplant period. However, sleep disruption could be a chronic symptom in HSCT survivors and could negatively impact quality of control, cancer-related fatigue(CRF), immune function, and psychological distress. The 3P's model(Predisposing, Precipitating, Perpetuating) explains insomnia in cancer population and could be also relevant to HSCT patients with specific consideration of CRF, graft-versus-host diseases, specific properties of hematological disease, and protective isolated milieu. Effective treatment of insomnia in HSCT includes non-pharmacological(e.g., cognitive behavioral therapy, environmental modification) and pharmacological interventions. The decision of pharmacological treatment should be based on the issue of safety due to high risk of potential drug-drug interactions. Screening, treatment, and further research of insomnia in HSCT patients using validated subjective and/or objective measures are warranted.

Characteristics of Premenstrual Changes in Patients with Affective Disorder (정서장애 환자의 월경전기변화 특성)

  • Ko, Young-Hoon;Joe, Sook-Haeng;Suh, Kwang-Yun
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.103-115
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    • 1999
  • Objectives : A large of studies have found an association between premenstrual syndrome and affective disorder, in particular, depression. Some studies have reported that women with depressive disorders may experience menstrual cycle-associated changes in the severity of their symptoms. This study was designed to compare the characteristics of premenstrual changes between control group and affective patient group, and to assess possible risk factors for premenstrual changes in patients. Methods : Eighty normal controls and eighty outpatients given maintenance therapy with fixed dose for at least more than four weeks were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and functional impairment. In addition, to compare the characteristics of premenstrual changes, 16 items based on DSM-IV criteria A for premenstrual dysphoric disorder were rated on the following scale : 0(no change), 1(mild), 2(moderate), 3(severe). Moderate or severe change in each item was considered as premenstrual change and the subjects who reported more than one premenstrual change were defined as premenstrual change group. Results : The results were as follows : 1) The percentage of premenstrual change group was 32.6% in patient group and 50% in control group. 2) Frequently reported premenstrual changes were as follows in control group : breast tenderness; anger ; affective liability ; lethargy, easy fatigability, or marked lack of energy ; abdominal pain or discomfort. In patients, the mood or behavioral changes were frequently reported. The changes were as follows : lethargy, easy fatigability, or marked lack of energy ; change in appetite; affective liability ; sense of difficulty in concentrating : hypersomnia or insomnia. 3) In the premenstrual change group, the patients with only mood or behavioral changes were significantly more than those with only physical changes or both changes. 4) The severity of functional impairment was significantly correlated with the frequency of mood or behavioral changes in patients. 5) There were no significant differences in menstrual characteristics between patients with premenstrual changes and patients without them except the severity of dysmenorrhea. And the severity of dysmenorrhea was correlated with the frequency of premenstrual change. Conclusion : The proportion of patients with affective disorder, who reported moderate-to-severe premenstrual changes, experiencing mood or behavioral changes larger than those experiencing physical changes during premenstrual period. It is possible that some patients with affective disorder, who reported premenstrual mood or behavioral changes, suffer from coexisting premenstrual syndrome with affective disorder or premenstrual exacerbation of affective disorder. Since the more premenstrual changes, the severer functional impairment, the patients reporting mood or behavioral disturbance in premenstrual period should be carefully evaluated, and appropriate therapeutic stategies might be considered.

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The Effect of Structured Information on the Sleep Amount of Patients Undergoing Open Heart Surgery (계획된 간호 정보가 수면량에 미치는 영향에 관한 연구 -개심술 환자를 중심으로-)

  • 이소우
    • Journal of Korean Academy of Nursing
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    • v.12 no.2
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    • pp.1-26
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    • 1982
  • The main purpose of this study was to test the effect of the structured information on the sleep amount of the patients undergoing open heart surgery. This study has specifically addressed to the Following two basic research questions: (1) Would the structed in formation influence in the reduction of sleep disturbance related to anxiety and Physical stress before and after the operation? and (2) that would be the effects of the structured information on the level of preoperative state anxiety, the hormonal change, and the degree of behavioral change in the patients undergoing an open heart surgery? A Quasi-experimental research was designed to answer these questions with one experimental group and one control group. Subjects in both groups were matched as closely as possible to avoid the effect of the differences inherent to the group characteristics, Baseline data were also. collected on both groups for 7 days prior to the experiment and found that subjects in both groups had comparable sleep patterns, trait anxiety, hormonal levels and behavioral level. A structured information as an experimental input was given to the subjects in the experimental group only. Data were collected and compared between the experimental group and the control group on the sleep amount of the consecutive pre and post operative days, on preoperative state anxiety level, and on hormonal and behavioral changes. To test the effectiveness of the structured information, two main hypotheses and three sub-hypotheses were formulated as follows; Main hypothesis 1: Experimental group which received structured information will have more sleep amount than control group without structured information in the night before the open heart surgery. Main hypothesis 2: Experimental group with structured information will have more sleep, amount than control group without structured information during the week following the open heart surgery Sub-hypothesis 1: Experimental group with structured information will be lower in the level of State anxiety than control group without structured information in the night before the open heart surgery. Sub-hypothesis 2 : Experimental group with structured information will have lower hormonal level than control group without stuctured information on the 5th day after the open heart surgery Sub-hypothesis 3: Experimental group with structured information will be lower in the behavioral change level than control group without structured information during the week after the open heart surgery. The research was conducted in a national university hospital in Seoul, Korea. The 53 Subjects who participated in the study were systematically divided into experimental group and control group which was decided by random sampling method. Among 53 subjects, 26 were placed in the experimental group and 27 in the control group. Instruments; (1) Structed information: Structured information as an independent variable was constructed by the researcher on the basis of Roy's adaptation model consisting of physiologic needs, self-concept, role function and interdependence needs as related to the sleep and of operational procedures. (2) Sleep amount measure: Sleep amount as main dependent variable was measured by trained nurses through observation on the basis of the established criteria, such as closed or open eyes, regular or irregular respiration, body movement, posture, responses to the light and question, facial expressions and self report after sleep. (3) State anxiety measure: State Anxiety as a sub-dependent variable was measured by Spi-elberger's STAI Anxiety scale, (4) Hormornal change measure: Hormone as a sub-dependent variable was measured by the cortisol level in plasma. (5) Behavior change measure: Behavior as a sub-dependent variable was measured by the Behavior and Mood Rating Scale by Wyatt. The data were collected over a period of four months, from June to October 1981, after the pretest period of two months. For the analysis of the data and test for the hypotheses, the t-test with mean differences and analysis of covariance was used. The result of the test for instruments show as follows: (1) STAI measurement for trait and state anxiety as analyzed by Cronbachs alpha coefficient analysis for item analysis and reliability showed the reliability level at r= .90 r= .91 respectively. (2) Behavior and Mood Rating Scale measurement was analyzed by means of Principal Component Analysis technique. Seven factors retained were anger, anxiety, hyperactivity, depression, bizarre behavior, suspicious behavior and emotional withdrawal. Cumulative percentage of each factor was 71.3%. The result of the test for hypotheses show as follows; (1) Main hypothesis, was not supported. The experimental group has 282 minutes of sleep as compared to the 255 minutes of sleep by the control group. Thus the sleep amount was higher in experimental group than in control group, however, the difference was not statistically significant at .05 level. (2) Main hypothesis 2 was not supported. The mean sleep amount of the experimental group and control group were 297 minutes and 278 minutes respectively Therefore, the experimental group had more sleep amount as compared to the control group, however, the difference was not statistically significant at .05 level. Thus, the main hypothesis 2 was not supported. (3) Sub-hypothesis 1 was not supported. The mean state anxiety of the experimental group and control group were 42.3, 43.9 in scores. Thus, the experimental group had slightly lower state anxiety level than control group, howe-ver, the difference was not statistically significant at .05 level. (4) Sub-hypothesis 2 was not supported. . The mean hormonal level of the experimental group and control group were 338 ㎍ and 440 ㎍ respectively. Thus, the experimental group showed decreased hormonal level than the control group, however, the difference was not statistically significant at .05 level. (5) Sub-hypothesis 3 was supported. The mean behavioral level of the experimental group and control group were 29.60 and 32.00 respectively in score. Thus, the experimental group showed lower behavioral change level than the control group. The difference was statistically significant at .05 level. In summary, the structured information did not influence the sleep amount, state anxiety or hormonal level of the subjects undergoing an open heart surgery at a statistically significant level, however, it showed a definite trends in their relationships, not least to mention its significant effect shown on behavioral change level. It can further be speculated that a great degree of individual differences in the variables such as sleep amount, state anxiety and fluctuation in hormonal level may partly be responsible for the statistical insensitivity to the experimentation.

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Effect of Aromatherapy on Behavioral and Psychological Symptoms of Dementia (아로마요법이 치매행동심리증상에 미치는 효과)

  • Choi, Seung Wan
    • 한국노년학
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    • v.28 no.4
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    • pp.1069-1087
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    • 2008
  • The purpose of this study was to closely examine the effects of aromatherapy on Behavioral and Psychological Symptoms of Dementia(BPSD) to the elderly in a nursing home, and to help the application of aromatherapy is expected to be conducive to managing the quality life in the dementia and the care-giver, and to provide a base of the aromatherapy application as an elderly program in geriatric institutions. This is an one group pre-post test design and the research subjects were the dementia in a nursing home those were totally 15 available for communication or intention observation. Aromatherapy was offered for 3 weeks totally 15 times by once a day in each with aroma hand massage and inhalation, by blending essential oils, Lavender, Chamomile Roman and Grapefruit. The results are as follows. Given examining a change in the whole about whether there are effects of aromatherapy on BPSD, there was significant difference in a change depending on the experimental period with 1.47 for the pre-measurement value, 1.09 for the post 1-measurement value, 1.01 for the post 2-measurement value and 0.71 for the post 3-measurement value. And, even the difference in experimental period was indicated to have significant difference(F=11.501, p<0.001). As an itemized results, the effect of aromatherapy were indicated to have significant difference on easing the anxiety, anguish, fear, dreadful feeling, depressed feeling, and outstandingly bustling movement, and outstandingly inactive behavior, and sleep disturbance and behavior of wandering about at night. On the basis of the result in this study, the application of aromatherapy is expected to lead the quality life in the dementia, and to contribute to health of mind and body in the dementia as an program in geriatric institutions.

The Rate of Diagnostic Agreement and Concordance Ratings on Psychiatric Recommendation in Consulted Delirious Cases (자문의뢰된 섬망환자에 대한 진단 일치율과 정신과 의견의 반영도)

  • Oh, Eung-Seok;Nam, Jung-Hyun;Kim, Seok-Hyeon;Park, Yong-Chon;Kim, Sung-Mok
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.2
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    • pp.174-181
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    • 2001
  • Objectives : The author investigated the rate of diagnostic agreement between consultants and consultees and concordance ratings on the consultees' recommendation to examine the interactive collaborativeness and find the factors that influence the reflectiveness on treatment. Methods : The subjects were 54 patients with delirium selected from 583 cases referred from other departments who were admitted to Hanyang University Kuri Hospital from July 1, 1995 to Dec. 31, 1997. The information on demographic data, diagnostic impression, symptoms, management before consultation, psychiatric recommendation, management after consultation, diagnoses at the referring departments and the psychiatric department on delirium was obtained by medical records and consultation papers retrospectively. The reflectiveness of the psychiatric recommendation was divided into complete concordance, partial concordance, and nonconcordance and among them the complete and partial concordance were considered for concordance. The reflectiveness was compared among all the departments and between medical unit and surgery unit. Results: The rate of diagnostic agreement on the cause of delirium was highest(85.7%) in organic brain syndrome and lowest in general medical condition(0%). There was no statistically significant differences between medical unit and surgery unit. Neither differences were there among all the departments. In comparing symptoms affecting the reflectiveness, it was 73.5% in impulsive and aggressive behavioral changes, whereas 40.0% in behavioral changes. Reflectiveness of psychiatric recommendation showed higher scores in the case of behavioral changes. The cases of sleep problem showed higher scores of reflectiveness. When these two symptoms of behavioral change and sleep problem were compared as one factor, the results suggested that there were significant differences. The cases with both two symptoms showed 80% in reflectiveness, and the cases with only one symptom or no symptoms showed 44.8% in reflectiveness. There were no statistical significances between concordance ratings and symptoms such as disturbance of consciousness, disorientation, and hallucination that cannot be easily evaluated at the referring departments. Conclusions : The rate of diagnostic agreement on the cause of delirium was highest in the case of organic brain syndrome in which lesions can be easily recognized. The factors that influence the reflectiveness of psychiatric recommendation were behavior changes and sleep disorders in the symptoms of evaluated cases.

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Predicting User Acceptance of Strong AI using Extension of Theory of Planned Behavior: Focused on the Age Group of 20s (확장된 계획적 행동이론을 통해 본 강한 인공지능 제품에 대한 이용자의 수용의도: 20대 연령층을 중심으로)

  • Rhee, Chang Seop;Rhee, Hyunjung
    • The Journal of the Korea Contents Association
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    • v.20 no.10
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    • pp.284-293
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    • 2020
  • The rapid progress of AI technology gives us the expectation to solutions to various problems in our society, and at the same time, it gives us anxiety about the side effects that can occur if AI develops beyond human control. This study was conducted in the early 20s with less objection to advanced devices. We attempted to provide clues to understand thoughts and attitudes of the targets about the future environment that will be brought by AI through the process of finding intent the acceptance of strong AI technology. For this, we applied the Theory of Planned Behavior, and further expanded this research model to identify factors affecting the attitude toward AI. As a result, the attitude toward AI and perceived behavioral control had a significant effect on the intention to use to strong AI. In addition, we found that the expectation of the benefit of improving task performance and the anxiety on the threat of relationship disturbance had a significant effect on the attitude toward AI. This study suggests implications for AI-related companies establishing the direction of technology development and for government setting a policy direction for AI adoption.

Bisphenol A Disturbs Intracellular Calcium Homeostasis and its Relationship with Cytotoxicity (Bisphenol A에 의한 신경계 세포의 칼슘 항상성 교란 및 세포독성에 미치는 영향)

  • Lee Yoot Mo;Lee Sang Min;Son Dong Ju;Lee Sun Young;;Nam Sang Yun;Kim Dae Joong;Yun Young Won;Yoo Hwan Soo;Oh Ki Wan;Kim Tae Seong;Han Soon Young;Hong Jin Tae
    • Toxicological Research
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    • v.20 no.3
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    • pp.241-250
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    • 2004
  • We previously found that bisphenol A (BPA) caused neurotoxic behavioral alteration. Since disturbance of calcium homeostasis is an implicated contributor in the neurotoxic mechanism of environmental toxicants, we investigated whether BPA alters calcium homeostasis. Unlike other neurotoxic agents which cause increase of intracellular calcium level, BPA decreased $[Ca^{2+}]_i$ dose-dependently in PC12 cells and cortical neuronal cells regardless of the calcium existence in buffer. BPA at greater concentrations than 100 $\mu\textrm{M}$ reduced cell viability significantly in both types of cells. BPA also suppressed L-glutamate (L-type channel activator, 30 mM) and trifluoperazine (calmodulin antagonist, 30 $\mu\textrm{M}$)-induced increase of $[Ca^{2+}]_i$. BPA further lowered caffeine (RYR activator, 100 $\mu\textrm{M}$)-decreased $[Ca^{2+}]_i$, but did not alter dantrolene (RYR inhibitor, 100 $\mu\textrm{M}$), heparin (IP3 inhibitor, 200 units/ml) and xestospongin C (IP3 inhibitor, 5 $\mu\textrm{M}$)-decreased $[Ca^{2+}]_i$. Cell viability was not directly related to intracellular calcium change by bisphenol A that alternation of intracellular calcium may not be a direct causal factor of BPA-induced neuronal cell death.

Effects of Non-pharmacological Interventions on Primary Insomnia in Adults Aged 55 and Above: A Meta-analysis (수면장애가 있는 중장년 환자에게 적용한 비약물적 중재의 효과: 메타분석)

  • Kim, Ji Hyun;Oh, Pok Ja
    • Korean Journal of Adult Nursing
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    • v.28 no.1
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    • pp.13-29
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    • 2016
  • Purpose: This study was performed to evaluate the effects of non-pharmacological interventions on sleep disturbance amongst adults aged 55 and above. Methods: PubMed, Cochrane Library, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms including non-pharmacological interventions and presence of insomnia. Non-pharmacological interventions included cognitive behavioral therapy, auricular acupuncture, aromatherapy, and emotional freedom techniques. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.3 program of Cochrane Library. Results: Sixteen clinical trials met the inclusion criteria with a total of 962 participants. Non-pharmacological interventions was conducted for a mean of 5.5 weeks, 7.7 sessions, and an average of 70 minutes per session. The effects of non-pharmacological interventions on sleep quality (ES=-1.18), sleep efficiency (ES=-1.14), sleep onset latency (ES=-0.88), awakening time after sleep onset (ES=-0.87), and sleep belief (ES=-0.71) were significant, and their effect sizes were ranged from moderate to large. However, the effects on total sleep time and insomnia severity were not significant. Conclusion: The findings of the current study suggest that non-pharmacological interventions have a positive impact on attitudes and beliefs about sleep, sleep quality, sleep duration, and sleep efficiency. Therefore, the findings of the study provide an evidence to incorporate various non-pharmacological interventions into nursing practice to improve both sleep quality and quantity in patients with insomnia.

Development of robust flocking control law for multiple UAVs using behavioral decentralized method (다수 무인기의 행위 기반 강인 군집비행 제어법칙 설계)

  • Shin, Jongho;Kim, Seungkeun;Suk, Jinyoung
    • Journal of the Korean Society for Aeronautical & Space Sciences
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    • v.43 no.10
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    • pp.859-867
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    • 2015
  • This study proposes a robust formation flight control technique of multiple unmanned aerial vehicles(UAVs) using behavior-based decentralized approach. The behavior-based decentralized method has various advantages because it utilizes information of neighboring UAVs only instead of information of whole UAVs in the formation maneuvering. The controllers in this paper are divided into two methods: first one is based on position and velocity of neighboring UAVs, and the other one is based on position of neighboring UAVs and passivity technique. The proposed controllers assure uniformly ultimate boundedness of closed-loops system under time varying bounded disturbances. Numerical simulations are performed to validate the effectiveness of the proposed method.

The Effect of Cyber Group Counseling on the Depression of Internet Addiction Children (사이버 집단상담이 인터넷 중독 아동의 우울증에 미치는 효과)

  • Han, Eun-Su
    • The Korean Journal of Elementary Counseling
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    • v.4 no.1
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    • pp.191-214
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    • 2005
  • This study aimed to examine the effect of Cyber Group Counseling on the depression of internet addiction children in elementary school. In this study, the following questions were posed: How effective is the Cyber Group Counseling on the depression of internet addiction children? In this study, subjects were 24 students who got 14 points over in KAIS and got 11 points over in CDI among 245 of 5th, 6th grade students in Daegu and Chongdo Kyungbuk who did Internet addiction scale for Korean Adolescent(KAIS) and Children's Depression Inventory(CDI). They were divided into experimental group and comparative group. Subjects in experimental group practiced Cyber Group Counseling for 12 sessions(60 minutes per session) for 6 weeks. But the control group had no treatment during the period. During the experiment, 2 of each groups were left out. The counseling schedule and hor· to join the Cyber Group Counseling clinic were notified by e-mail. The Cyber Group Counseling was on every Monday and Thursday. The Cyber Group Counseling progressed by internet chatting, bulletin board, e-mail and a slip paper counsel. The collected data were analyzed with SPSS/PC+ (statistical package for the social science/personal computer) program and t -test. The findings of this study were as follows: First, the depression of internet addiction children who joined in Cyber Group Counseling was significantly reduced than the others. So, Cyber Group Counseling was proved one of the useful psychotherapy approach. Second, the subordinate of depression including behavioral disturbance and anhedonia was significantly reduced. Third, the subordinate of depression including the dysphoric mood, the self-deprecation and physiological symptoms was reduced. But it was not statistically significant.

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