• 호스피스학술지
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• 제2권1호
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• pp.21-40
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• 2002

Cancer is the second leading cause of the death in Korea. Family caregivers of dying patients manifest many psychological and physical symptoms of stress, and they often seek for informational support from health care providers. Unfortunately, however, few systematic studies identify the actual effect of such support on family caregivers. This study, thus, intends to evaluate the effect of informational support for hospice care. One group pretest-posttest design was used, employing the stress-coping model by Cohen and Wills as a conceptual framework. This research was conducted from July 1 to November 15, 1998, initially with 32 subjects sampled from hemato-oncology department of two general hospitals in Seoul, but reduced to 18 at the end due to the untimely death of patients or caregiver's refusal during the course of study. Informational supports were programmed to provide the family caregivers with 8 times of education and counseling as well as 24-hour hot-line for 4 weeks. A booklet that explains the various problems of hospice care was also prepared and distributed to all subjects. Data were collected by using self-report questionnaires and reviewing medical records. The tools used in this study were based on the Weinert's PRQ-II(scale of perceived social support), Spielberger's state anxiety inventory, and CES-D. Also included in the data collection were the general characteristics of family caregivers and patients, and the pain intensity and the performance status of patients. The data were analyzed with descriptive statistics, Wilcoxon sign rank test and paired t-test using SPSSWIN program. The results of the study were as follows: 1.The perceived social support of family caregivers was not significantly increased with informational support for hospice care(t=1.64, one tailed p=.060). 2.The anxiety of family caregivers was significantly reduced following informational support for hospice care(t=3.48, one tailed p=.002). 3.The depression of family caregivers was significantly reduced following informational support for hospice care(t=-2.18, one tailed=.022). 4.The pain intensity of patients with terminal cancer was significantly reduced following informational support for hospice care(t=-2.41, two tailed p=.027). The results suggest that the informational support provided to family caregivers of patients with terminal cancer reduced not only their anxiety and depression but also the pain intensity of patients. Further study is necessary to consolidate the conceptual framework of this study with expanded number of subjects. Nevertheless, it was certain that the informational support program for hospice care was very helpful to both caregivers and patients. Thus, the informational support program is strongly recommended for the hospitals which have no hospice unit yet.

• Journal of Hospice and Palliative Care
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• 제11권2호
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• pp.91-98
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• 2008

목적: 본 연구는 암환자와 건강한 성인을 대상으로 각 군에서 스트레스 지각, 대응양상 및 우울을 조사하고 스트레스 지각과 대응양상이 우울에 미치는 영향을 비교하기 위함이다. 방법: 연구대상은 W시에 위치한 3차 병원에 내원하는 외래 암환자 139명과 지역사회에 거주하는 건강한 성인 139명의 종 278명을 편의표집 하였다. 자료수집은 스트레스 측정을 위한 스트레스 VAS (Visual Analog Scale), 대응양상 측정을 위한 W.C.C.L (Ways of Coping Check List), 우울 측정을 위한 Depression Index 및 일반적 특성과 질병특성을 포함하는 구조화된 질문지를 이용하여 설문조사를 실시한 후 자료를 분석하였다. 결과: 암환자와 건강한 성인간의 스트레스 지각, 대응 양상 및 우울에 대한 비교는 교육수준과 평균수입을 통제한 ANCOVA 분석을 실시한 결과, 암환자가 건강한 성인보다 스트레스 지각이 높았고 소망적 사고 대응이 낮았으며 우울이 더 높았다. 스트레스 지각과 우울과의 관계에 영향을 미치는 대응양상은 암환자에서는 조력추구 대응, 스트레스 지각, 그리고 교육정도의 순으로 우울을 유의하게 설명하였고 설명력은 20.2%였다. 건강한 성인에서는 스트레스 지각, 문제해결 대응, 그리고 조력추구 대응양상 순으로 우울을 유의하게 설명하였으며 설명력은 30.7%였다. 결론: 본 연구결과 암환자의 우울 감소를 위해서는 전체적으로 대응 전략 사용을 증진시키되 우울 감소에 효과적인 대응양상의 선택과 사용을 위한 훈련 프로그램 및 지원체계, 그리고 스트레스 감소를 위한 중재의 개발과 적용이 필요하다.

• 한국환경보건학회지
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• 제38권6호
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• pp.510-519
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• 2012

Objectives: This study was conducted in order to evaluate the microbiological contamination of the indoor air of the lunchrooms at child care centers and investigate the toxin genes and toxin production ability of food-borne pathogens. Methods: A total of 64 child care centers were sampled to test total aerobic bacteria, coliform bacteria, fungi, Staphylococcus aureus, Bacillus cereus and Salmonella spp. according to the Korea Food Code. All toxin genes of pathogens were detected using the Polymerase Chain Reaction method. The Sthaph. aureus enterotoxin was detected by a Staphylococcus aureus enterotoxin-reversed passive latex agglutination kit. The heamolysin BL (HBL) and non-heamolytic enterotoxin (NHE) produced by B. cereus were detected using a B. cereus enterotoxin-reversed passive latex agglutination kit and Bacillus diarrheal enterotoxin visual immunoassay kit, respectively. Results: The means of total aerobic bacteria and coliform bacteria were $1.91{\pm}1.84$ log CFU/plate and $0.47{\pm}0.62$ log CFU/plate, respectively. The mean of fungi also showed $0.59{\pm}0.71$ log CFU/plate. Among the pathogenic bacteria tested in this study, Staphy. aureus and B. cereus were detected in four (6.3%) and 21 (32.8%) out of 64 indoor air samples from lunchrooms in child care centers, respectively. All Staphy. aureus tested in this study possessed no toxin genes and did not produce enterotoxin. The detection rate of nheABC, hblCDA, entFM and ces toxin gene in B. cereus was 100, 57.1, 76.2 and 0%, respectively. B. cereus isolates were classified into four groups according to the presence or absence of toxin genes. The nheABC gene was the major toxin gene among B. cereus tested in this study. The HBL was detected in 11 out of 21 B. cereus isolates (52.4%) and three B. cereus isolates produced NHE (14.3%). Conclusion: The results indicated that the contamination by microorganisms in the indoor air of lunchrooms was unqualified to supply safe catering in child care centers. The ongoing control of indoor air quality is required.

• 대한불안의학회지
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• 제4권2호
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• pp.142-147
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• 2008

Objective : Evidence from recent studies supports the role of genetic factors in the development of Posttraumatic Stress Disorder (PTSD). The primary aim of this study is to investigate the association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. The second aim is to examine the association between the DRD2 TaqI A polymorphism and clinical symptoms in patients with PTSD. Methods : We recruited 189 Vietnam veterans for participation in this study, among whom 99 were PTSD patients and 90 were control subjects. The presence of the DRD2 TaqI A polymorphism was determined by polymerase chain reaction (PCR). Several standardized research scales were used in the clinical assessment of PTSD, including the Combat Exposure Scale (CES), Clinician Administered PTSD Scale (CAPS), Beck Depression Inventory (BDI), and Clinical Global Impression (CGI). Results : There was no significant difference in the distribution of the DRD2 genotype, frequency and prevalence of the A1 allele, or the frequency of heterozygotes between the patients with PTSD and the controls. In the PTSD group, the patients with the A1 allele (A1A1, A1A2) scored higher on the CAPS-total (p=0.044), CAPS-avoidance symptoms (p=0.016) and BDI (p=0.024) than those without the A1 allele (A2A2). Conclusion : We could not find an association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. However, the A1 allele of DRD2 seemsto influence avoidance symptoms in patients with PTSD.

• 한국산학기술학회논문지
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• 제19권6호
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• pp.188-196
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• 2018

본 연구는 여대생이 지각한 부모-자녀 간 의사소통이 여대생의 스마트폰 중독과 우울에 미치는 영향을 규명하기 위한 서술적 조사연구이다. 본 연구를 위하여 S 도시에 소재한 3개의 대학교의 여대생 151명을 대상으로 부모-자녀 간 의사소통, 스마트폰 중독, 우울 검사를 실시하였다. 자료 수집기간은 2017년 11월 1일에서 12월 8일까지였다. 수집된 자료는 t-test, Pearson's correlation coefficients와 multiple regression으로 분석하였다. 연구 결과, 여대생의 스마트폰 중독은 35.08(SD=6.83)점으로, 어머니와의 의사소통이 폐쇄적이며 문제가 있다고 인식할수록 스마트폰 중독이 높은 것으로 나타났다(${\beta}=.27$, p=.028). 아버지와의 개방적 의사소통은 스마트폰 중독을 낮추는 것으로 나타났다(${\beta}=-.27$, p=.030). 여대생의 우울은 15.86(SD=10.45)점으로 45% 정도가 우울을 경험하고 있으며 어머니와의 의사소통이 문제가 있다고 인식할수록 우울이 높게 나타났다(${\beta}=.29$, p=.022). 연구 결과에 비추어 볼 때, 여대생의 부모-자녀 간 의사소통은 스마트폰 중독과 우울에 영향을 미친다고 할 수 있다. 그러므로 여대생의 스마트폰 중독과 우울의 정도를 줄이거나 예방하기 위한 전략으로, 권위적이고 폐쇄적인 의사소통보다는 자녀를 독립된 인격체로 존중하는 개방적인 의사소통에 중점을 둔 맞춤형 의사소통 프로그램이 도움이 될 것이다.

• 한국생활과학회지
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• 제18권6호
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• pp.1349-1361
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• 2009

The present study was designed to analyze the relationship of dietary behavior change and nutrient intake status owing to a depression degree for 143 people over 65 years old living in Echeong and Hansan islands area, South Korea. The depression degree was classified into non depression, minor depression and depressive disorder groups using. The Center for Epidemiological Studies-Depression (CES-D) scale for 143 subjects. The results are as follows; the depression degree significantly made differences according to sex (p<.001), marital status (p<.05), self-related economic status (p<.001) and living expenses (p<.05). The stage of dietary behavior according to the depression degree was as follows; the non depression group was 57.6%, the minor group was 46.8% and the depressive disorder group was 27.1% of the subjects. The intake frequency of the cereal group (p<.05) and fruit group (p<.01) was significantly different among food group intake status owing to the depression degree. Mean adequacy ratio(MAR)[13], MAR[10], and MAR[4] of the depressive disorder group were significantly lower than that of the non depression and minor depression groups. Each average of MAR[13], MAR[10], and MAR[4] for the subjects were $0.68{\pm}0.2$, $0.67{\pm}0.2$, and $0.55{\pm}0.2$. Concerned about the nutrients over 1.0 index of nutritional quality(INQ) 8 nutrients of protein, Phosphorous, iron, zinc, vitamin A, vitamin $B_6$, niacin and vitamin C belonged to the non depression group. Additionally, 6 nutrients of protein, Phosphorous, iron, zinc, vitamin $B_6$ and niacin were included for minor depression and depressive disorder groups.

• 대한간호학회지
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• 제29권6호
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• pp.1365-1378
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• 1999

This study is a methodological research study to develop an instrument to measure in patients with cancer and to test the validity and reliability of the instrument. The research procedure was as follows : 1) The first step was to develop conceptual framework based on a comprehensive review of the literature and in-depth interviews with patients with cancer. This conceptual framework was organized in to three dimensions (the intrapersonal dimension, the significant-other and context related dimension, the transcendental dimension). Initially 59 items were adopted. 2) These items were analyzed through the index of content validity(CVI) and 53 items were selected which met more than 80% on the CVI. 3) The pretest was carried out with 87 patients with cancer. After the pretest results were analyzed by item analysis, 44 items were selected. A second test of content validity was conducted and 6 items were eliminated considering the 80% CVI. 4) To test for reliability and validity, data collection was done during the period from January 25, 1999, to February 26, 1999. The subjects for the test were 160 patients with cancer and 185 healthy persons. analysis, item analysis and multitrait-multimethod method to analyze validity. The findings are as follows : 1) The Cronbach's alpha coefficient for internal consistency was .92 for the total 38 items and .79, .82, .85, for the three dimensions in that order. 2) The item analysis was based on the corrected item to total correlation coefficient( .30 or more) and information about the alpha estimate if this item was dropped from the scale. 3) As a result of the initial factor analysis using principal component analysis and varimax rotation, one item was deleted because of factor complexity (indiscriminate factor loadings). In the secondary factor analysis, 7 factors with eigenvalue of more than 1.0 were extracted and these factors explained 56 percents of the total variance. The seven factors were labeled as 'family relationship', 'emotional condition', 'physical discomfort', 'meaning and goal of life', 'contextual stimuli', 'change of body image', 'guilt feelings'. 4) The convergence effect between this instrument and the life satisfaction scale was identified and there was significant positive correlation(r= .52, p= .00). The discriminant validity between this instrument and the depression scale(CES-D) was tested and there was significant negative correlation(r= -.50, p= .00). The instrument for accessing the suffering of patients with cancer developed in this study was identified as a tool with a high degree of reliability and validity. In this sense, this tool can be effectively utilized for assessment in caring for patients with cancer.

• 재활간호학회지
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• 제1권1호
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• pp.111-123
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• 1998

The related factors of the quality of life (QOL) in stroke patients was identified empirically. The subjects were 254 stroke patients who were discharged and taken follow-up care at the outpatient department. In this model, the physical, psychological, and social status were assumed to affect the QOL. And the social support was assumed to moderate these effects. NIH stroke state, ADL, and IADL were used to measure the physical status. Using CES-D, the psychological status was measured. The social status was defined as the job change after stroke attack. The satisfaction with the care by primary caregivers, significant others, and health professionals was measured as the social support. To identify the effect of the physical, psychological, and social status on the QOL, multiple regression analysis was carried out. The psychological and social status were found to be the significant predictors of the QOL(R2=0.27, p=0.00). Next, to identify the moderating effect of the social support, the subjects were divided into two groups, that is, the low social support group and the high social support group. It is found that the predicting variance is different between these two groups. In the low social support group, the psychological, social, and physical status predicted as much as 42% of the QOL. On the contrary, the psychological status predicted only 8% of the QOL in the high social support group. So it is concluded that the social support moderates the effects of the physical, psychological, and social status on QOL. Finally, to identify the social support which moderates those effects, the social support was divided into three classes. Each social support class was divided into the low and high social support group again. In the every class of social support, the difference between two groups was also identified. So the model of the QOL is recommended for the framework of the care for the stroke patients. Also these results support the claim that the long-term facilities for stroke patients are necessary.

• 재활간호학회지
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• 제6권1호
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• pp.79-89
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• 2003

Purpose: This research with one group pre-post design was carried out to test the practical feasibility to administrate the Music Movement program developed for the stroke patients. Subjects: 12 stroke survivors at "J" Public Health Center in Seoul. were participated in. The average age was 68 years old, the ratio of sex was almost 5.8:4.2, the duration of was almost over 1 year. Method: Music Movement program was conducted for 2 hours ${\times}$ 1day ${\times}$ 6 weeks. The contents of Music Movement program were consisted of the preparatory activities, main activities and the wrap up activities. The preparatory activities are ice braking, greeting, explanation of the aims of music movement program, and introduction of stroke disease and ROM exercise. The main activities are the body motions with singing and playing musical instruments. The wrap up activities are stretching and joints and discussion of home activities. Data Collection: The outcome variables are muscle strength, finger pinch power, ROMs, flexibility, depression, and life satisfaction. Depression was measured by CES-D(Kim, I. J., 1999), life satisfaction by ladder scale(McDowell & Newell, 1996), and ADL state(Holbrook & Skilbeck, 1983). Data Analysis: SPSS/PC 10.0 for Window was used. Wilcoxon Signed Ranks Test was used to analyze outcome measures. The level of statistical significance was set at p<.05. Results: This program was effective to decrease the depression level of subjects(p<.05). The muscle strength, hand grip power, ROMs, life satisfaction, and rehabilitation state of the subjects were slightly increased but no significant differences were found between the pre and post test. Additionally every patient replied that they were very satisfied and expressed their appreciation for this program very much. Of course they strongly want to continue to participate in and meet the peer group again. Conclusion: Considering these results, the practical feasibility of Music Movement program can be supported. Therefore, this Music Movement program can be examined with the quasi-experimental design with control group and ongoing reviews. After that, this program would be applied in public health centers, medical institutes, and welfare centers for the rehabilitation of stroke patients.

• 국제물리치료학회지
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• 제5권1호
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• pp.661-667
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• 2014

This study is a cross-sectional study for conscripts with chronic low back pain, where it is designed to investigate general characteristics that conscripts with chronic low back pain carry, and it is also aimed to analyze the correlation as well as discrepancy within pain, depression and body mass index depending on their ranks. In this study, 90 Korean conscripts with chronic low back pain participated. And in order to analyze general characteristics as well as pain, depression and body mass index of the subjects, this study adopted a survey questionnaire upon general characteristics, and it also employed Visual Analogue Scacle(VAS) and Center for Epidemiological Studies Depression(CES-D) Scale which have proven their credibility, where BMI values for the subjects were calculated based on 'Asian Pacific standard' Body Mass Index(BMI). From the general characteristics exhibited by the subjects through this study, average age and average height of the subjects were $20.78{\pm}1.41$ and $175.97{\pm}5.34$ respectively; and corporals displayed the highest ratio of 42% with the chronic low back pain while 40% of the total subjects experienced the duration of the illness less than 6 to 9 months. Moreover, 57.8% of all subjects were reportedly suffering moderate pain, and 48% exhibited depression while 49% carried BMI value between 18.5 and $22.9kg/m^2$(normal range). Based on the analysis of correlation among pain, depression, discrepancy of BMI depending on the ranks and each independent variable, it appears that there is no significant difference amongst the ranks, and there is no correlation between independent variables; however, it was obvious that all groups divided by the ranks had a moderate pain(45-74mm), depression(${\geq}16$) and BMI value in normal range(18.5-22.9).