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The ages and stages questionnaire: screening for developmental delay in the setting of a pediatric outpatient clinic (ASQ :소아과외래에서의 발달지연 선별검사)

  • Kim, Eun Young;Sung, In Kyung
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1061-1066
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    • 2007
  • Purpose : Early identification of developmental disabilities allows intervention at the earliest possible point to improve the developmental potential. The Ages and Stages Questionnaire (ASQ), a parent- completed questionnaire, can be used as a substitute for formal screening tests. The purpose of this study was to evaluate the validity of the Korean version of the ASQ (K-ASQ) as a screening tool for detecting developmental delay of young Korean children in the setting of a busy pediatric outpatient clinic. Methods : Parents completed the K-ASQ in the waiting room of the pediatric outpatient clinic of St. Mary's Hospital, Catholic University Medical College. Out of 150 completed the ASQ, 67 who were born term and had no previous diagnosis of developmental delay, congenital anomalies, or neurological abnormalities were enrolled. The cut-off values of less than 2 standard deviations (SD) below the mean for the ASQ were used to define a "fail", and children who failed in one or more domains tested were classified as "screen-positive". Diagnosis of developmental delay was made when the developmental indices fell below -1 SD of the Bayley Scales of Infant Development-II. Results : (1) The mean age of children was $16.4{\pm}7.4$ months. Ten children (14.9%) were small-for- gestational age infants. The mean birth weight and gestational age were $3.1{\pm}0.6kg$ and $38.8{\pm}1.4$ weeks. Nine children (13.4%) were twins and 33 (49.0%) were male. The mean maternal education in years was $13.6{\pm}2.4$, and 31.3% had full-time jobs. The time for completing the ASQ was $10.2{\pm}3.0$ minutes. (2) Seventeen children (25.4%) were classified as screen-positive, four of them were delayed in development. Among eight children diagnosed with developmental delay, four were screen-positive and the other four were screen-negative by the ASQ. (3) The test characteristics of the ASQ were as follows: sensitivity (50.0%); specificity (78.0%); positive predictive value (23.5%); negative predictive value (92.0%). Conclusion : The high negative predictive value of the K-ASQ supports its use as a screening tool for developmental delay in the setting of a pediatric outpatient clinic.

From the Onset of Panic Symptoms to Getting to a Psychiatric Treatment : The Change by Improved Public Awareness of Panic Disorder in Korea (증상의 발현부터 치료의 시작까지 : 한국인의 공황장애 인식도 변화가 치료적 접근에 미친 영향)

  • Choi, Yong-Won;Seo, Ho-Jun;Han, Sang-Woo;Hong, Jin-Pyo;Lee, Kyoung-Uk;Kim, Se-Joo;Lim, Se-Won;Lee, Sang-Hyuk;Yang, Jong-Chul;Lee, Seung-Jae;Park, Seon-Cheol;Gim, Min-Sook;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.15 no.2
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    • pp.61-67
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    • 2019
  • Objective : This study aimed to investigate the general process from the symptom onset to the psychiatric treatment in Korean panic patients and the effect of improved public awareness on it. Methods : This study has a retrospective design. The subjects were the new patients with panic disorder who visited the psychiatric outpatient clinic in twelve university-affiliated hospitals all across Korea. The medical chart was reviewed retrospectively and the data were collected including chief complaints of symptoms, recent stressors, the time to visit the psychiatric outpatient clinic, and visit of other departments and diagnostic approaches for their symptoms. Results : A total of 814 participants were included in the study. The most common department other than psychiatry the panic patients visited were cardiology (28.3%), general internal medicine (16.0%) and neurology (11.4%). The most frequently used diagnostic tests were a echocardiography (17.9%), 24-hour Holter monitoring (11.2%), and brain MRI (8.2%). Only 37.3% of participants visited psychiatric clinic directly. About 80% of participants visited psychiatric department within 1 year after their first panic symptoms and it took $13.8{\pm}13.7weeks$ on average. Comparing before and after 2012, the number of participants increased who visit directly the psychiatric clinic without visiting other departments (p=0.002) and without visiting emergency room (p<0.001). Conclusions : Our results suggest that a substantial number of patients visit departments other than psychiatry when they experience first panic symptoms. However, most patients begin psychiatric treatment within 1 year after their first symptoms and the number of patient are increasing who visit psychiatric department directly without visiting other departments.

An investigational study on telephone calls to the pediatric nursing unit (외래 및 퇴원환아 부모의 전화상담요구와 간호중재에 대한 조사연구)

  • Kang Hwa Ja;Han Kyung Ja;Choe Myoung Ae;Park Seung Hyun;Kim Young Mi;Kwon Won Kyoung;Kim Sun Gu;Ahn Hye Young;Heo Mi Young
    • Child Health Nursing Research
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    • v.2 no.1
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    • pp.112-126
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    • 1996
  • The purpose of this study was to investigate the current status of the need of telephone call and to identify the status of nursing intervention through telephone. Head nurses of the pediatric nursing unit and a nurse of pediatric outpatient clinic wrote down the telephone record of calls by parents of children discharged from hospital from 7 am to 3 pm during the period of March to June, 1995. Content of 120 telephone calls but for 26 calls with incomplete record among 146 calls were analyzed into frequency of general characteristics, needs and nursing intervention. The needs of telephone call were identified and classified into 11 areas and analyzed into frequency of detailed content by 11 areas. Nursing intervention was identified and classified into 10 categories, and analyzed into frequency of detailed content by 10 categories. The findings of this study were as follows ; The need of telephone call was identified with nutritional state, medication, vital signs, language retardation, personal hygiene, vaccination, administration procedure, physical symptoms, follow up care management and others. The most frequent needs were physical symptoms and vaccination. A kind of food among nutrition dose of drugs among medication, fever among vital signs, cough among physical symptoms, and content of vaccination among vaccination was the most frequent needs. Nursing intervention through telephone was identified with instruction, knowledge offer, information offer, judgement, solicitation, referral and instruction, referral, connection, reassurance, reservation, and regulation. Instruction, knowledge offer and information offer was the most frequent nursing intervention by telephone call. Instruction was about a visit to hospital, a visit to nearby clinic, instruction about symptoms,, instruction about nursing care procedure, retelephoning and vaccination. Knowledge offer was about vaccination, knowledge related to medication, and dental care. Information offer and judgement was about vaccination and medication. Referral and instruction delivery was about instruction delivery following consultation to doctor, visit to emergency room and a visit to hospital following consultation to doctor. These results suggest that telephone call intervention program should be established as a field of extended pediatric nursing role in health care delivery system for the children.

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Sociomedical Study on the Person Recieved Permanent Sterilization Method in Busan Area (부산 일부 지역의 영구불임 피술자들에 대한 사회의학적 조사)

  • Song, Ill-Yong
    • Journal of Preventive Medicine and Public Health
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    • v.12 no.1
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    • pp.70-78
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    • 1979
  • This study was carried out for the evaluation on the sociomedical characteristics of 1,580 cases who had recieved vasectomy and laparoscopic sterilization at the Busan Family Planning Clinic from January 1975 to December 1973. The results obtained were as follows: 1. In age distribution, the most predominant age group consited of 30.34 years as 44.7%. In regional distribution, the most predominant region was Youngdo Ku in the vasectomy group and Dong Ku in the laparoscopic sterilization group. 2. The educational level showed that the high school graduates(49.2%) in the vasectomy group and the primary school graduates(47.0%) in the laparoscopic sterilization group were the highest each other. 3. The most predominant experienced contraceptive method before accepted permanant sterilization operation was oral pills and non-experienced contraceptive method group was 54.1% of the total. 4. By the span of marital life before accepted permanant sterilization operation, the 5-9 years group was the highest. 5. The average number of living children per family was 2.54 in the vasectomy group and 3.0 in the laparoscopic sterilization group. 6. The average frequency of pregnancy per case was 2 in the vasectomy group and 3 in the laparoscopic sterilization group and the most predominant frequency of induces abortion was 1 per case. 7. The most predominant motive of accepting the sterilization operation were family planning education at the reserve forces training in the vasectomy group and at the mother's club in the laparoscopic sterilization group. 8. By the residing status of the cases, rented room was the highest as 69.4%.

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COMPARISON OF COMMUNICATION AND MOTHER-CHILD INTERACTION PATTERNS BETWEEN REACTIVE ATTACHMENT DISORDERED CHILDREN AND NORMAL CHILDREN (반응성 애착 장애아(反應性 愛着 障碍兒)와 정상아의 의사소통 및 모자 상호작용 유형 비교연구)

  • Lee, He-Len;Choi, Young-Rim
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.118-132
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    • 1994
  • The purpose of this study was to compare communication and mother-child interactions of reactive attachment disordered children with normal children. The subjects were 24 children and their mothers participated in this study'12 reactive attachment disordered children and mothers, 12 normal children and mothers. The mother and her child were brought into a p]lay room and the mother was instructed to play with her child as she normally would at home. The play situations were videotaped. Tapes were transcribed and transcribed data was analyzed with 13 mutually exclusive categories encompassing pragmatic functions represented in communication form the early stage of multiword speech in childhood. The tapes were analyzed with 10 behavioral mother-child interaction patterns. As the statistical method, t-test and correlation was calculated. The results of this study were as follows : 1) Reactive attachment disordered children used significantly fewer 'filler', 'information', 'requests', 'describes' and 'disscus self'. 2) Reactive attachment disordered children's mother used significantly fewer 'filler' and 'names'. 3) Reactive attachment disordered children used significantly more 'independent play', fewer 'intiates interaction', 'responsiveness' and 'answer' Reactive attachment disordered children's mother used more 'control play', 'observe' and fewer 'initiates interaction'. 4) Children's communication patterns were related lo mother·'s communication and mother-child interaction types. Children's 'filler', 'information requests', 'describes' and 'disscus self' were consistantly related to mother's 'filler' and 'names', (Children's 'filler', 'information requests', 'describes'. 'disscus self' and mother-child's intiates interaction 'responsivness' were significantly positively correlationed and 'independant play', 'control play', 'observation' were significantly negatively correlationed. The results of reveal that communication and mother-child interaction pattern of reactive attachment disordered group was different from normal group and children's communication pattern were influenced by mother's communication and interaction patterns.

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Effects of Dental Fear on Depression Symptom and Stress in Adults (일부 성인의 치과공포가 우울 증상과 스트레스에 미치는 영향)

  • Park, Eun-Seon
    • The Journal of the Korea Contents Association
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    • v.17 no.9
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    • pp.203-211
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    • 2017
  • The purpose of this study was to determine the association of some adult dental fear and depression, and stress. Among the patients who came to the dental clinic for periodontal treatment, 68 patients who agreed to participate in the study and who met the selection criteria were included. Dental fear, depression symptom questionnaire, salivary cortisol, which can objectively evaluate blood pressure, pulse, and stress. The results of the analysis showed that depressive symptom was related to 'delayed treatment promise', 'cancellation of treatment appointment', 'increased muscle tension', 'rapid breathing when entering dentistry', 'fear when waiting in the waiting room', 'fear when you smell the hospital', 'fear when looking at the dental clinic', 'fear when seeing the anesthetic needle', 'fear when tooth whistle was heard', 'fear when teeth were removed', and 'total fear of dentistry'(p<0.05). Stress symptoms were higher in 'having sweated in the dentist', 'faster pulse', 'fear of entering the dentist' and 'total fear of the dentist'(p<0.05). Based on these results, it is necessary to study the effective methods to control the depressive symptoms and stress of patients who visit dental clinics, and it seems that continuous management is needed to prepare methods such as relaxation therapy for dental fear patients.

Anxiety Hastened Depressive Recurrence in Bipolar Disorder : An Interim Analysis of Prospective Follow-Up Study (양극성 장애 환자에서 불안이 질병 경과에 미치는 영향 : 전향적 추적관찰에 대한 중간분석)

  • Kim, Soojeong;Kim, So Jeong;Song, Hye Hyun;Lee, Wonhye;Chon, Myong-Wuk;Nam, Yoon Young;Park, Dong Yeon
    • Korean Journal of Biological Psychiatry
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    • v.28 no.1
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    • pp.13-22
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    • 2021
  • Objectives Despite growing attention to anxiety in bipolar disorder (BD), little research has assessed anxiety symptoms in the course of BD. The current prospective follow-up study examines the influence of subjectively and objectively measured anxiety symptoms on the course of BD. Methods A total of 49 patients with BD were followed-up prospectively for average of one year at an average of four months interval. The Korean version of the Beck Anxiety Inventory (K-BAI), the Hamilton Anxiety Rating Scale, heart rate variability (HRV) were used to measure anxiety subjectively, objectively and physiologically. Participants were divided into high and low anxiety groups based on their K-BAI scores. Kaplan-Meier survival analysis was performed to compare the recurrence of mood episode, suicide attempt, emergency room visit, and psychiatric hospitalization between two groups. Mediators were investigated with Cox proportional hazards models. Results Compared to the low anxiety group, the high anxiety group reported significantly higher impulsiveness (p = 0.016) and lower high frequency component on HRV (p = 0.007) after controlling for severity of BD. Regarding survival analysis, the high anxiety group showed hastened depressive episode recurrence (p = 0.048) and suicidal ideation was the mediator of the hazard ratio (HR) 1.089 (p = 0.029) in the Cox model. Moreover, the high anxiety group showed a tendency of accelerated suicide attempt (p = 0.12) and impulsivity was the risk factor of suicide attempt (HR = 1.089, p = 0.036). Conclusions This interim analysis of prospective study suggests that high anxiety level in BD may anticipate unfavorable course. Further studies are needed to understand the multifactorial mechanism of anxious bipolar patients.

A study on patients' choices over dental clinics and factors of complaint against medical service -focused on Seoul, Kyoungi, and Incheon areas (치과내원환자들의 의료기관 선택 및 의료서비스 불만요인에 관한 연구 - 서울, 경기, 인천지역을 중심으로 -)

  • Yoo, Eun-Mii;Kim, Sun-Kyoung;Hwang, Yoon-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.8 no.1
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    • pp.93-105
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    • 2008
  • In order to provide basic information to help dental medical service with supplying gratifying service for patients. the survey is conducted on the patients who frequently visited dental clinics located in the areas such as Seoul, Kyoungi, and Incheon from May of 2006 to June. The survey results are as following : 1. Judged from the factors to make patients choose one dental clinic over another. the low cost of treatment accounts for 32.8%. and followed by physician's academic background / career experiences with 20.5%. In case of recommending to their acquaintances, physician's proficiency in treatment is ranked high as 56.7%. 2. For most desirable facilities for dental hospitals. the results indicate that cutting-edge medical equipment holds 46.7% and followed by a comfortable waiting room with 32.8%. 3. Examined the questions of what patients are most satisfied with dental clinics. 43.1% of respondents point out kind and detailed explanation. 14.1% also responds to constant care after the treatment. This result suggests that after-care and detailed explanation also play an important role in dental care as well as the treatment itself. 4. For desirable services in the waiting room. 28.5% of the respondents choose a selection of magazines and newspaper and 18.7% say that they want to converse with the staff. As to how long can wait with patience. 38.2% of the participants agree on as long as 20 minutes. 5. Among unsatisfactory sources against dental clinics while visiting, the high cost of the treatment is scored high as 34.1% and followed by a long waiting time with 22.1%. The figure points to the fact that dental medical clinics should consider these two factors to solve in the future. In case where patients find the treatment discontent and they are asked what to do, 36.4% of the respondents respond that they go to a different hospital without saying anything. As to the enquiry about how the complains should be dealt, 46.% wishes that the matter should be taken care immediately upon complaining, 21.8% suggests that they like to feel understood and acceptable when presenting complaints.

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A Study on the Safety of a Screening X-ray Laboratory Using Containers in accordance with the COVID 19 Outbreak (COVID 19 유행에 따른 컨테이너를 이용한 선별 X-선 검사실의 안전성에 대한 고찰)

  • Kim, Jae-Seok
    • Journal of the Korean Society of Radiology
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    • v.14 no.4
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    • pp.425-431
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    • 2020
  • When a radiation generating device is installed in an export container due to COVID-19, the purpose of this study was to measure the space dose in the radiation room and to study the effectiveness of the shielding wall in the laboratory. Air dose measurement method was set behind the X-ray tube, 50 cm, 100 cm, 200 cm, and measured 12 locations. The dose values before and after the use of the movable radiation shielding wall were compared by measuring 3 locations behind the X-ray tube using the movable radiation shielding wall. The measured values were 50 cm on the left behind the X-ray tube: 1.446 μSv, behind the X-ray tube: 0.545 μSv, and 50 cm on the right behind the X-ray tube: 1.466 μSv. Measurements behind the radiation barrier were 0.190 μSv, 0.204 μSv, and 0.191 μSv. As a result of performing the corresponding sample t test of the average value according to the use of movable barrier walls, p <0.001 was found. As a result of the actual measurement, the medical exposure of the examiner due to the shielding wall in the laboratory decreased to 82.3%. In order to reduce occupational exposure in screening radiological laboratories, it is recommended that sufficient separation from radiation sources and the use of shielding walls are recommended.

The Clinical Characteristics and Mortality Factors of Patients with Hemorrhagic Complications after Anticoagulation Therapy with Warfarin (와파린 항응고 유지요법 중 발생한 급성출혈의 임상소견과 사망관련 인자)

  • Lee, Se-Ho;Kim, Nam-Kyu;Sohn, Chang-Hwan;Kim, Jung-Hun;Kim, Won;Lim, Kyung-Soo;Oh, Bum-Jin
    • Journal of The Korean Society of Clinical Toxicology
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    • v.7 no.2
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    • pp.164-171
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    • 2009
  • Purpose: The number of patients who take warfarin is growing and so is the number of complications. Hemorrhage is the major complication, but the clinical characteristics and outcomes have not been determined for Korean patients. Therefore, we tried to evaluate the characteristics of the patients with hemorrhagic complications after taking warfarin as anticoagulation therapy. Methods: We retrospectively reviewed the medical records of the patients who visited the emergency room with bleeding complications after taking warfarin anticoagulation at the out-patient clinic for 1 year from 1 st January 2008. We compared between two groups (the major hemorrhage group vs. the minor hemorrhage group) according to the clinical criteria, the unstable vital signs that required blood transfusion, transfusion more than 2 units of blood, the need for further laboratory follow-up, the need for interventional treatment and the development of critical complications or death due to bleeding. Results: There were 150 patients who met the criteria and had acute hemorrhagic complications (the major group: 90 patients and the minor group: 60 patients). In the major hemorrhage group, the frequent sites of bleeding were the gastro-intestinal system (40 patients), lung (14 patients) and intracranium (7 patients). At the emergency room, the major group showed a higher initial INR of the activated prothrombin time than did the minor group (p=0.02). The bleeding sites of the fatal cases were the gastro-intestinal system (3 patients), lung (3 patients) and intracranium (3 patients), but the percentage of fatality was the highest for intracranium bleeding. Conclusion: In the major hemorrhage group, gastrointestinal bleeding was the most frequent complication and fatality was the highest for intracranium bleeding. An initially higher INR showed a greater risk of major bleeding, but not more fatalities.

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