• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.8 no.2
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• pp.232-241
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• 1997

The psychological problems following the experiences of school-violence could be more important than the physical problems. Victims could suffer from fear, depression, anger, lowered self-esteem, suicidal thought, and personality changes. To study the risk factors for school violence and the psychiatric problems after the experiences to school-violence provide us important informations to prevent and solve the problems of school violence. We examined clinical characteristics and psychosocial backgrounds of 13 adolescents who visited the psychiatric clinic after exposures to school violence from September, 1996 to May, 1997. The clinical data included intensity, motivations, durations, and methods of violence, psychiatric symptoms following exposure, findings of psychological test, and treatment course. The socioeconomic data included developmental characteristics of subjects, family characteristics, school life, and peer relationships. Of the 13 adolescents who experienced exposure to violence, 8 have experienced chronic psychiatric disturbances, 5 experienced transient psychiatric symptoms such as anxiety, depression, suicidal attempt who eventually returned to home and school life. Of the 8 adolescents who experienced chronic psychiatric disturbances, 4 experienced PTSD and depression lasting 3-6 months more, otherwise 4 showed converted features, such as aggressive behavioral disorder or perpetrator by strong compensatory effects after psychological shock. The subjects who have experienced chronic psychiatric disturbance have clinical characteristics such as physical or emotional abuse, physical illness or handicap, defects of ego functionings, and lack of family support. In summary, victims by school-violence manifested serious psychiatric disturbances, and they had clinically significant risk factors and some of them became perpetrators of school-violence.

• Korean Journal of Biological Psychiatry
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• v.11 no.2
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• pp.117-126
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• 2004

Objects:It has been reported that the incidence of tardive dyskinesia(TD), the remarkable abnormal involuntary movement, was higher in the schizophrenics with high blood sugar levels and that TD had been improved by small amount of insulin-injection for 90 days. And also it was generally known that the blood lipids were higher in the schizophrenics with tardive dyskinesia. Thus, we tried to replicate the correlations of abnormal involuntary movements with blood sugar levels and blood lipids in chronic schizophrenics treated with antipsychotics. Methods:Thirty-eight male schizophrenic inpatients who were stable in clinical state with medications, were included. The patients who had been already diagnosed as diabetes mellitus(DM), organic brain disorder, substance- related disorder, physical illness were excluded and also we excluded female patients to remove the hormonal effect on TD. Eleven patients who ranked higher(above five) in the Abnormal Involuntary Movement Scale(AIMS) were assigned into 2 groups, a dibenese group and a placebo group. Diabinese or placebos were administrated for 3 weeks with antipsychotics and AIMS was rechecked. Results:There were no correlations between the total AIMS scores and blood sugar and lipids levels in all subjects. The means of total and subscale scores(objective, face, and extremity) of AIMS did not reveal statistical significances between diabinese and placebo groups. However(total, jaw, face, upper arm, and objective feeling), were statistically higher in the diabinese group than those in the placebo group. And correlations of total cholesterol(TC) with fast blood sugar(FBS), weight with body mass index(BMI) and waist, total glycerol (TG) with BMI were statistically significant. Conclusion:In this study, there were statistical significances in the changes in ratings of AIMS scores between the diabinese group and the placebo group. Application of oral hypoglycemic agent might be a way of improving abnormal involuntary movements in schizophrenics with abnormal involuntary movements or TD. Althogugh it was not certain that there were correlations of abnormal involuntary movement with blood sugar and lipids, correlations of TC/TG with AIMS, of FBS with AIMS cautiously suggest that the regular check of $HbA_1C$, waist, and weight are recommended for schizophrenics.

• Journal of Preventive Medicine and Public Health
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• v.11 no.1
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• pp.86-97
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• 1978

The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

• Tuberculosis and Respiratory Diseases
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• v.39 no.1
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• pp.28-34
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• 1992

Background: Diffuse panbronchiolitis (DPB) is a chronic obstructive pulmonary disease distinguished from bronchial asthma, chronic bronchitis, pulmonary emphysema, bronchiectasis, or alveolitis. It is prevalent in Japan, but is known to be rare outside of Japan. Only a few cases in Chinese, Italian, Noirth American and Korean have been reported. During recent two years we have found 16 cases of DPB in Seoul National University Hospital and analyzed the clinical characteristics. Method: We reviewed the patients' age, sex, duration of illness, smoking history, occupational history and past medical history. And we analyzed patients' symptoms, physical signs, laboratory findings and responses to treatment. Results: 1) Male: female ratio was 2.2:1, the ages ranged from 27 to 72 years old, and the duration of disease varied from 1 to 20 years. 2) Most of the patients were being treated as bronchiectasis, miliary tuberculosis, chronic bronchitis or bronchial asthma before they were diagnosed as DPB. 3) Only one patient was a smoker, and 25% of patients had the occupational history of exposure to particles or gas. And all patients had paranasal sinusitis. 4) High resolution computed tomography (HRCT) was very useful in diagnosing the disease in most of the patients. 5) PFT showed obstructive and restrictive abnormalities, and blood gas revealed hypoxemia in most of the patients. 6) Pseudomonas aeruginosa was isolated in the sputum of four patients (25%). 7) The titers of cold hemaglutinin, RA factor and CRP were elevated in most of the patients. 8) Most of the patients improved after treatment with erythromycin. Conclusion: DPB might not be a rare disease in Korea. So DPB should be suspected in a patient who has chronic cough, sputum, dyspnea and diffuse fine nodular chest X-ray abnormality. HRCT and open lung biopsy should be considered in a patient suspected of DPB.

• Sleep Medicine and Psychophysiology
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• v.14 no.2
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• pp.99-106
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• 2007

Objective: Restless legs syndrome (RLS) is known to be associated with chronic renal failure (CRF) patients on hemodialysis, however the prevalence of RLS in CRF patients on hemodialysis is variable due to different diagnostic criteria or dialysis technique. A few reports have indicated the association between RLS symptom and lower life quality in CRF patients on hemodialysis. This study aims to investigate the prevalence of RLS and its association with the quality of life in CRF patients of a single dialysis unit in Korea. Methods: A total of 83 Korean CRF patients on hemodialysis in the Korea University Hospital were examined. International Restless Legs Syndrome Study Group (IRLSSG) criteria and International Restless Legs Scale (IRLS) were used to determine the diagnosis and severity of RLS. Questionnaires including Athens Insomnia Scale (AIS), Epworth sleepiness scale (ESS), and Medical Outcome Study Form-36 (SF-36) were administered to all the patients for the assessment of sleep and quality of life. Hamilton Depression Rating Scale (HDRS) and Clinical Global Impression (CGI) were also measured for depression and status of mental illness by psychiatrist. Results: Of the 83 patients, 31 (37.3%) patients were found to have RLS and 43 (51.8%) patients met at least one of the RLS diagnostic criteria. The AIS (t=2.40, p=0.019), ESS (t=2.41, p=0.018), HDRS (t=3.85, p<0.001) and CGI (t=3.52, p=0.001) were higher in the subjects with RLS compared to other subjects. The SF-36 scores were significantly lower in the patients with RLS except physical functioning and bodily pain. Total (p=0.005), physical component (p=0.019), and mental component scores (p=0.019) of SF-36 were significantly lower in patients with more severe RLS symptoms. Conclusion: There was significant relationship between RLS and poor quality of sleep and life. More severe RLS symptom was proven to be an important factor to make a quality of life worsen.

• Journal of Korean Academy of Nursing
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• v.4 no.3
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• pp.105-116
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• 1974

This study was made on patients who were Hospitalized due to sickness caused by the abuse of marihuana at the Psychiatric Section of a hospital during the period from Feb. to Oct., 1974. The following conclusion was obtained by reviewing the literature with respect to the nursing, and problem solving of those patients. 1. It appears that marihuana is a comparatively mild intoxicant in ordinary preparation without causing physical dependence or tolerance. 2. According to the status of men who are marihuana smokers, approximately 20% of them were college students, those preparing to retake college entrance examinations, non-employed and pharmacists. The men belong mostly to the middle foreigner′s mistress of higher, income bracket, and in the case of women, most of the smokers were US. servicemen entertainers. 3. Dynamic developmental factors: Case 1. : The patient had a characteristic, hysterical and emotionally unitable character, and was of low intelligence, In addition, to this already existing problem, the added uses of marihuana caused a mental illness to develope. Case 2 : The character, was reserved and introspective, her creative power and sentiment was fading and his ability of self-control was weakened. She used the smoking of marihuana to get rid of her own feeling of inferiority complex and tensions coming from interpersonal relationships. Case 3 : The patient was unconditionally resistive to the authoritativeness of superiors and irresponsible in his relationship with women, in his attitude concerning sex in general. He smoked marihuana because he felt become peace-loving and get enchanted experience through smoking it. 4. The points of issue appearing from the above case; (1) Movement of anti-social feelings against the "established system" by the youngsters. (2) Family problem. (3) Shamelessness, loss of motivation, disorderly attitude toward the sex, (4) Worries concerning the future. (5) Lack of knowledge concerning smoking of cigarette and marihuana. Chronic use of marihuana made, those youngman who had originally been ambitions to achieve something in life, lazy, inefficient, unable to make long-term plans, are such weak mined persons that they did not try to overcome problems when encountered. This will pose a great and important question in the mental health of the society, 5. Treatment and Problem sieving According to the literature, we will have to place importance upon hospitalized treatment The phases of treatment were divided into five parts. (1) Prehospital phase (2) Withdrawal Phase (3) Rehabilitation phase (4) Transitional phase (5) After-care phase The experiments have proved that there was much progress in the recovery of patients through environment therapy, supportive therapy and group psychotherapy. This was the above mentioned 5 phases of treating process in accordance with the weekly schedule of the hospital. It was thought that the patients would require prolonged after care management even after they were released from the hospital and that they will also require periodic visit, to the hospital and doctor′s interview with their family. In conclusion, the question of the young generation and marihuana smoking is becoming a great social problem in which their resistances to the "established system" and society is growing in the from of antiestablishment movements. In our country, the smoking of marihuana is gradually developing, therefore, I think, that it would be a very fortunate thing for us, if this report could be helpful for the motivation of further study on the questions of the young generation and its problems.

• The Journal of Korean Academic Society of Nursing Education
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• v.3 no.2
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• pp.163-192
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• 1997

As the population over the age of 65 increases, the demand for nurses who care for this group also continues to grow. Well-prepared nurses who are knowledgeable and skilled for the elderly can be prepared through systematic gerontological nursing curricula. This study was carried out to identify the needs for gerontological nursing curricular contents. The subjects for this study were two participant groups the educators who teach gerontological nursing in three-year and four-year baccalaureate nursing programs, and the nurses who are working with the elderly in hospitals, community health centers, social welfare agencies, and community health practioner's posts. The major findings of the study are as follows : 1. The differences between actual contents and essential contents of the educators : Concerning the actual contents that is actually taught, the educators showed the highest scores on the demographics of older adults and the lowest scores on the cultural variations affecting health care. Regarding the essential contents, the educators showed the highest scores on the demographics and the lowest scores on the economics of aging. Aside from the demographics, all of the items were found to have significant differences between essential and actual contents. This implies that all the content areas except demographics should be emphasized. 2. The differences between actual knowledge and essential knowledge of the nurses : Concerning the nurses' actual knowledge, the nurses showed the highest scores on the common health problems and their treatment and the lowest scores on the politics of aging. Regarding the essential knowledge, nurses showed the highest scores on the chronic illness and common health problems and the lowest scores on their roles and functions. However, they thought all the items to be essential. All of the items were found to have significant differences between actual and essential knowledge. The nurses who studied gerontological nursing in their school years and after graduating had more knowledge. However, they felt more knowledge was needed. This implies that the nurses need more education in all content areas of gerontological nursing. 3. The differences between educators and nurses : Concerning the essential contents, the educators showed higher scores on the demographics and growth and development than the nurses. Whereas, the nurses showed higher scores on the cultural variations, long-term care, economics of aging, politics of aging, legal and ethical issues, and common health problems than the educators. 4. Activities of nursing care for the elderly : Most common activities were related to direct nursing care such as giving physical care, counseling/teaching clients, and assessing and planning care for the clients. Nurses thought that all the items were critical, but they showed relatively low scores on the following :'serve on multidisciplinary committee', 'preparing reports', 'evaluation of outcomes of care', 'determine policy for nursing service', 'set patient care standards', and 'participate in nursing research' The constraints in providing better nursing service were time constraints, administrative restraints, social restraints, and inadequate knowledge.

• Korean Journal of Psychosomatic Medicine
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• v.2 no.1
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• pp.69-79
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• 1994

The authors investigated the relationship between the response to the external stimulation and ability of verbal behavior in the patients with somatoform disorder who have pain. The subjects consisted of 34 patients(male 10, female 24) and 37 normal controls(male 19, female 18). Pressure pain thesholds were measured by algometer and alexithymia was assessed by Toronto Alexithymia Scale(TAS). Somatization Scale of SCL-90R and Parental Bonding Instrument were also used. It was shown that 82.4% of the patients had chronic somatic complaints. The mean values of TAS, degree of somatic symptoms and pressure pain thresholds were significantly higher in the patient group than in the normal controls. 44.1% of the patients was considered alexithymia group and there was no correlation between scores of alexithymia and value of pressure pain thresholds. In conclusion, the patients with somatoform disorder who had pain were dull in pain perception to external physical stimulation. This result suggested that their low perception of pain could be closely related with chronicity of illness. And the Poverty of verbal expression of inner emotion was suggested to be one of the factors affecting somatization and difficulty in psychotherapy.

• Women's Health Nursing
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• v.5 no.1
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.3
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• pp.477-492
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• 1999

The disease patterns among the Korean was shifted from acute and infectious diseases to chronic diseases. According to the these disease patterns trends, people have concerned about the health promotion and health behaviors. Pender's(1996) revised health promotion model(HPM) is consist of three categories; Individual characteristics and experiences, Behavior-specific cognitions and affect, behavioral outcome. Of these categories, individual characteristics and experiences, this category of variables is considered to be of biological, psychological and socio-cultural personal factors, especially, individual fatigue. Futhermore. these variables constitute a critical core for nursing intervention, as they are subject to modification through nursing actions. But there is no few the research of the relationship between the fatigue and health promotion. Therefore, the purpose of this study is to investigate the correlation between the fatigue and health promoting life style among a rural college students. Additionally, this descriptive correlational study identified the relation of demographic factors and fatigue, health promoting life style. From June 20 to 26, 1998, a convenience sample of 270 college students completed the questionnaire of the fatigue and health promoting life style profile which were developed by the Yoshitake(1978) and Walker, et al.(1987), respectively. The descriptive correlational statistics, mean, t-test, ANONA, Pearson correlation coefficient were used to analyze the data gathered with SAS pc+ program. The results were as it follows: 1. The average fatigue score of the subjects was $64.93{\pm}12.89$. Fatigue scores by subcategory were physical symptoms($23.5{\pm}4.87$). psychological symptoms($22.11{\pm}4.66$) and neuro-sensory symptoms($19.32{\pm}5.14$). With the respect to the demographic characteristics of the subjects, there were statistically significant differences between the demographic factors and fatigue, especially, sex(t==3.69 p<0.01), major(t=-2.89 p<0.01). the experience of family illness(t=2.76 p<0.01). 2. The average health promoting life style item score of the subjects was $2.33{\pm}0.33$. In the subcategories, the highest degree of performance was self-actualization(2.94), following interpersonal support(2.81). stress management(2.33), exercise(2.20), nutrition(2.10), and the lowest degree was health responsibility(1.73). There were the significant differences on the learning of health education(t=2.00 p<0.01). religion(F=3.01, p<0.05), circle activity(t=2.07, p<0.05), nutrition control(t=5.25, p<0.01) of demographical factors with the health promoting life style. 3. The correlation between the fatigue and health promoting life style made statistically no significance(r=-0.09731, p>0.05). But there was negative significant relationship between health promoting life style and psychological symptom as a fatigue subcategory(r=-0.15721, p<0.05). The self-actualization showed negative significant correlation with all fatigue subcategory. The health responsibility showed significant relationship with total fatigue(r=0.13050. p<0.05). For further research, it suggests to replicate the correlational and causal study between the fatigue and the health promoting life style using the another fatigue scale which is able to measure the subjective and objective fatigue degree. And it needs to develop the nursing intervention program for maintaining and promoting the health behavior as well as for decreasing the college students's fatigue.