• Title/Summary/Keyword: Clinical Practice Anxiety

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The Korean Practice Parameter for the Treatment of Attention - Deficit Hyperactivity Disorder(II) - Diagnosis and Assessment - (주의력결핍 과잉행동장애 한국형 치료 권고안(II) - 진단 및 평가 -)

  • Cheon, Keun-Ah;Kim, Ji-Hoon;Kang, Hwa-Yeon;Kim, Bung-Nyun;Shin, Dong-Won;Ahn, Dong-Hyun;Yang, Su-Jin;Yoo, Han-Ik;Yoo, Hee-Jeong;Hong, Hyun-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.18 no.1
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    • pp.10-15
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    • 2007
  • Probably the three most important components to a comprehensive evaluation of patients with attention-deficit hyperactivity disorder (ADHD) are the clinical interview, the medical examination, and the completion and scoring or behavior rating scales. Teachers and other school personnel are often the first to recognize that a child or adolescent might have ADHD, and often play an important role in the help-seeking/referral process. A diagnostic evaluation for ADHD should include questions about ADHD symptoms, other problems including alcohol and drug use, family history of ADHD, prior evaluation and treatment for ADHD. Screening interview or rating scales as well as interviews should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with objective assessments of the ADHD symptoms, such as psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but they may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. Screening for intellectual ability and academic achievement skills is also important in determining the presence of comorbid developmental delay or loaming disabilities. The number and type of symptoms required for a diagnosis of ADHD vary depending on the specific subtype. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in daily functioning, and must not meet criteria for other mental disorders which might better account for the observed symptoms such as mental retardation, autism or other pervasive developmental disorders, mood disorders, anxiety disorders. This report aims to suggest a practice guideline of assessment and diagnosis for children and adolescents with ADHD in Korea.

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The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (II) - Diagnosis and Assessment - (주의력결핍 과잉행동장애 한국형 치료 권고안 개정안(II) - 진단 및 평가 -)

  • Lee, Moon-Soo;Park, Su-Bin;Kim, Gyung-Mee;Kim, Hyun-Jin;Park, Sangwon;Kim, Yunsin;Lee, Young Sik;Kweon, Yong-sil;Shin, Dongwon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.2
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    • pp.58-69
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    • 2017
  • Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood. ADHD should be diagnosed in the same manner as other common adult mental health disorders. The three most important components in the comprehensive evaluation of patients with ADHD are the clinical interview, medical examination, and completion and scoring of behavior rating scales. The diagnostic evaluation of ADHD should include questions about the symptoms, family history, prior evaluation and treatment of ADHD, as well as other problems including alcohol and drug use. Screening interviews or rating scales, as well as interviews, should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with the objective assessments of the ADHD symptoms, such as through psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. As comorbidity is the rule rather than the exception, clinicians should carefully screen for comorbid disorders as part of a comprehensive assessment of ADHD. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in his or her daily functioning, and must not meet the criteria for other mental disorders which might better account for the observed symptoms, such as mental retardation, autism or other pervasive developmental disorders, mood disorders and anxiety disorders. This report aims to suggest practice guidelines for the assessment and diagnosis of children, adolescents and adults with ADHD in Korea.

Prevalence of Depression in Breast Cancer Survivors: a Systematic Review of Observational Studies

  • Zainal, Nor Zuraida;Nik-Jaafar, Nik Ruzyanei;Baharudin, Azlin;Sabki, Zuraida Ahmad;Ng, Chong Guan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2649-2656
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    • 2013
  • Background: Depression is common in breast cancer patients. The aim of this paper was to make a systematic review of its prevalence and associated factors oin breast cancer survivors. Materials and Methods: An extensive systematic electronic review (PUBMED, CINAHL, PsyINFO and Ovid) and handsearch were carried out to retrieve published articles up to November 2012, using Depression OR Dysthymia AND (Cancer OR Tumor OR Neoplasms as the keywords. Information about the design of the studies, measuring scale, characteristics of the participants, prevalence of depression and its associated factors from the included studies were extracted and summarized. Results: We identified 32 eligible studies that recruited 10,826 breast cancer survivors. Most were cross-sectional or prospective designed. The most frequent instrument used to screen depression was the Center for Epidemiological Studies for Depression (CES-D, n=11 studies) followed by the Beck Depression Inventory (BDI, n=6 studies) and the Hospital Anxiety and Depression Scale (HADS, n=6 studies). CES-D returned about similar prevalence of depression (median=22%, range=13-56%) with BDI (median=22%, range=17-48%) but higher than HADS (median=10%, range=1-22%). Depression was associated with several socio-demographic variables, cancer-related factors, treatment-related factors, subject psychological factors, lifestyle factors, social support and quality of life. Conclusions: Breast cancer survivors are at risk for depression so that detection of associated factors is important in clinical practice.

Effects of phylloquinone supplementation on lipid profile in women with rheumatoid arthritis: a double blind placebo controlled study

  • Kolahi, Sousan;Gargari, Bahram Pourghassem;Abbasi, Mehran Mesgari;Jafarabadi, Mohammad Asghari;Shishavan, Neda Ghamarzad
    • Nutrition Research and Practice
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    • v.9 no.2
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    • pp.186-191
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    • 2015
  • BACKGROUND/OBJECTIVES: Rheumatoid arthritis (RA) is associated with an excess mortality from cardiovascular disease which is likely attributed to an atherogenic lipid profile. Among nutritional factors vitamin K has been recently focused as a pivotal nutrient in improvement of lipid related markers. Thus, this study was designed to determine the effects of vitamin K on lipid profile in this disease. SUBJECTS/METHODS: Fifty eight patients with definitive RA were participated in the present double blind placebo controlled study. They were randomly allocated into two groups to receive vitamin $K_1$ as phylloquinone [10 mg/day] (n = 30) or placebo pills (n = 28), for eight weeks. In order to control the effects of probable confounders dietary intakes, anthropometric measurements including weight and height, clinical status using disease activity score-28 (DAS-28), physical activity and anxiety status were evaluated at baseline. Moreover, serum levels of lipid related markers including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were measured at baseline and at the end of intervention. RESULTS: There were no significant differences between the two groups regarding any of the baseline characteristics. After adjusting for some relevant confounders, in comparison between two groups, we observed no significant changes in lipid related markers at the end of intervention. Also, there was no significant difference between before and after intervention values within groups (P > 0.05). CONCLUSIONS: Function of vitamin $K_1$ in lipid profile modification remains still controversial. This study showed that vitamin $K_1$ has no effect on lipid profile in women with rheumatoid arthritis. Further studies with a longer follow-up are required to determine the effects of vitamin K on atherogenic lipid profile.

Usefulness of Application of Tube Voltage Changes to Reduce Patient Dose during Abdominal CT Follow up (반복적인 복부 컴퓨터단층촬영 시행 시 환자선량 감소를 위한 관전압 변화 적용의 유용성)

  • Yoon, Joon;Kim, HyeonJu
    • Journal of the Korean Society of Radiology
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    • v.15 no.3
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    • pp.293-299
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    • 2021
  • In order to reduce the irresistible radiation exposure of patients who perform periodic examinations using a CT among various scan parameters a method to reduce patient dose was investigated through changes in the tube voltage close to X-ray penetrating power. As a result of the experiment 100 kVp was applied instead of 120 kVp which is commonly used in clinical practice and CTDI decreased by about 41% during scan. In addition the degree of change in image quality was measured as 1046.1±3.7 HU for CT value and 71.4±7.9 for Pixel value and statistical analysis showed no significant difference (0.05

Effects of Family Violence during Childhood on Early Adulthood Adaptation. - Focusing on 'experienced violence' and 'observed violence' - (성장기 가정 내 폭력 경험이 성인 초기 적응에 미치는 영향 - 부모간의 폭력 관찰 경험과 자신에 대한 폭력 행동 경험을 중심으로 -)

  • Gwi-Yeo-Roo Ahn;Kyung-Hyun Suh
    • Korean Journal of Culture and Social Issue
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    • v.13 no.4
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    • pp.83-100
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    • 2007
  • It is the aim of present paper to examine the effects of experienced violence and observed violence in original family on adaptation in college students. In addition, the degree of contribution of two types of aggression in family were examined. Participants were 220 college students. Among them, those who have experienced violence from mother are 60.3%. And 52.3% reported violence from father. Those who have observed their parents violent behavior are 28.8%. These childhood 'experienced violence' and 'observed violence' was significantly associated early adulthood adaptation. But its effect is dependent on participant's sex. Experienced violence from mother is positively related to confidence in scholastic achievement in female. Experienced violence from father is positively related to trumatic symptoms and trait anxiety in male. On the other hand, observed violence showed significant relationship with traumatic symptoms, impulsivity, depression, self-esteem and trait anxiety. Most importantly, multiple regression analysis showed observed violence explains early adulthood adaptation more significantly than experienced violence. The discussion addressed implications of the findings for future research and for clinical practice.

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Validity and Reliability of the Korean Version of the Global Assessment of Recent Stress Scale (전반적인 스트레스평가 척도 한국판의 타당도 및 신뢰도)

  • Koh, Kyung-Bong;Park, Joong-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.2
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    • pp.201-211
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    • 2000
  • Objectives : The purpose of this study was to determine the validity and reliablity of the Korean version of the Global Assessment of Recent Stress(GARS) Scale developed for assessing the severity of current perceived stressors, and then to use the scale in clinical practice. Methods : The questionnaire was completed by 215 healthy subjects. A comparison was made regarding the perception of stressors among 242 patients(71 with anxiety disorder, 73 with depressive disorder, 47 with somatoform disorder, and 51 with psychosomatic disorder) and 215 healthy subjects. Factor analysis was done using oblique rotation after maximum-likelihood factor analysis. Results : Factor analysis yielded 1 subscale. Reliability was computed by administering the GARS Scale to 69 healthy subjects during a 2-week interval. Test-retest reliability for 8 items and the total score was significantly high, ranging between 0.85-.95. Internal consistency was significant(Cronbach's a for 7 items : .86). Convergent validity was computed by correlating the 8 items and the total score with the total score of the stress response inventory(SRI), the perceived stress questionnaire(PSQ), and the somatization, anxiety, depression, hostility subscales and general indices of the symptom checklist-90-revised(SCL-90-R). The correlations were all at significant levels. Discriminant validity was computed by comparing the 8 item scores of the patient and control groups. Significant differences were found in area relevant to sickness or illness and the overill global area. The patients with anxiety disorder were significantly higher in area relevant to sickness or illness than the healthy group, whereas the patients with depressive disorder was significantly higher in the overall global score than healthy group. The depressive disorder group was the highest in overall global score of the GARS scale among 4 patient groups, and showed a significant higher scores in interpersonal relationship and overall global area than the psychosomatic disorder group. Conclusions : These results indicate that the Korean version of the GARS scale is highly reliable and valid, and that it can be utilized as an effective measure of perceived stressors for research in stress-related fields. It is suggested that depressive disorder patients are more likely to perceive recent stressors than psychosomatic disorder patients.

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The Death Orientation of nursing students in Korea and China (한국과 중국 간호대학생의 죽음에 대한 의식)

  • Li, Zhen-Shu;Choe, Wha-Sook
    • Korean Journal of Hospice Care
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    • v.8 no.1
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    • pp.1-12
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    • 2008
  • Perpose: The purpose of this study was to investigate the perception of death between Korean and Chinese nursing students. And it will help develop curriculum for preparing death, the quality of hospice care, as well as nursing education and practice. Methods: Data was collected from 492 nursing students participated(248 Korean and 244 Chinese) by questionnaire designed for examining Death Orientation (Thorson & Powell, 1988). They were analyzed using Cronbach's Alpha coefficients, factor analysis, t-test, ANOVA and regression analysis (SPSS; win 12.0 version) Results: More than half of the Korean nursing students followed a religion (58.5%) while the majority of Chinese nursing students did not follow a religion (93.9%). In the view of the afterlife, nursing students in China had two views. 'I really don't know what happens after a person dies (30.3%)' and ‘There is no afterlife and death is the end (29.5%)’. On the other hand the Korean nursing students’ answer were, 'After dying, a person goes to heaven or hell (27.3%)' and 'I really don't know what happens after a person dies. (22.9%)' The study also found that the average of 25 items in Death Orientation is 2.36points of nursing students in Korea and 2.50points of nursing students in China. This means that the concern, anxiety and fear were of the middle level for the Chinese Students and were higher than Korean students (t=3.51, p=.000). In the low factor of death orientation, those in Korea had higher 'anxiety of burden to family' than those in China (t=-3.50, p=.001). The nursing students in China had higher 'anxiety of the unknown (t=4.96, p=.000)', 'fear of suffering (t=6.88, p=.000), 'fear of extinction body and life (t=5.20, p=.000), 'fear of lost self-control(t=2.12, p=.034)', and 'anxiety of future existence and nonexistence (t=2.33, p=.020)' than those in Korea. There was no statistically significant difference for the 'concern of body and fear of identity lost' category. The death orientation of Korean nursing students had statistically significant differences according to age (t=3.20, p=.002), religion (t=2.56, p=.011), and afterlife (F=4.64, p=.000). The contribution of Death Orientation had a statistically significant difference, the afterlife variable (0.735, p=0.001). The death orientation of Chinese nursing students did not have any statistically significant differences. Conclusion: In conclusion, there were differences in death orientation between Korean and Chinese nursing students. In particular, those who believed in afterlife showed acceptance of death. The results of this study suggest that nursing curricula should include education program on death and spiritual nursing. Additional studies are needed to establish death education in China with careful considerations on Chinese policies, cultures and social systems.

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A Systematic Study of the Intervention Effect of Social Stories in Children with Sleep Disorders (수면장애 아동을 위한 사회적 이야기 중재 효과: 체계적 고찰)

  • Kim, Ji-Ho;Yoo, Eun-Young
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.2
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    • pp.69-83
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    • 2023
  • Objective : This study sought to systematically examine the intervention effect of social stories when applied in relation to children with sleep disorders. Methods : Studies available in the SCOPUS, ScienceDirect, PsycArticles, and PubMed databases that were published from 2001 to 2022 were searched. The keywords used for the search were as follows: ("social story" OR "social stories") AND ("sleep" OR "sleep disorders" OR "sleep wake disorder bedtimes" OR "sleep initiation and maintenance disorders" OR "sleep wake disorder" OR "sleep arousal disorders"). Based on the selection criteria, six experimental studies were selected and analyzed. Results : The selected studies were two randomized controlled trials, three individual trials, and one case study. The subjects were mostly children diagnosed with autism spectrum disorder who were school-aged or adolescent. The intervention types were often complex interventions, including social stories and other interventions, while the durations of the interventions varied from one day to more than 40 days. The interventions had a positive effect on the subjects' sleep quality, with night wakings, sleep onset delay, and sleep anxiety all being improved. As standardized assessment tools to evaluate the effectiveness of social stories, the Child Sleep Habits Questionnaire and the Child Behavior Checklist were used in two papers each, and were the most commonly used. As non-standardized assessment tools, each of the four papers used turbulence and sleep diaries as assessment tools. Conclusion : The effect of social story mediation can be divided into sleep quality and sleep-related behavior. In terms of sleep quality, studies showing improvements in night wakings, sleep onset delay, and sleep anxiety accounted for a large proportion of the sample. The detailed effect area of sleep quality showed a significant improvement after the interventions in most studies, and in all six studies analyzed in the present study, the continuation of the effect after the intervention was confirmed via follow-up tests. Thus, the findings of this study are expected to be helpful when applying social stories in children with sleep disorders in clinical practice due to presenting the intervention effects, outcome evaluation tools, and intervention periods in children with sleep disorders in prior investigations involving social stories.

Perception of the Nurse on the Nursing Malpractice and Its Case (간호사고와 관련판례에 대한 임상간호사의 지각)

  • Jeong, Ji-Yun;Lee, Myung-Ha
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.3
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    • pp.445-462
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    • 1999
  • The purpose of this study is to provide some basic data for the direction of nursing education and practice to prevent nursing malpractice as investgating perception of the nurse on the nursing malpractice and its case. Data were collected from 450 nurse working in four general hospitals which were located in Chonbuk province from November 9 to 21, 1998 through questionnare. The structured instruments developed by the reseacher were used for collecting data. The Results were as follows: 1) As for the cognition of the nursing malpractice case, the transfusion accident was 37.3%, the side-effects of KCL injection(19.3%), hymen rupture by uterus cancer test, the side-effects of aminophyllin injections on dyspnea patient and the others were 10% below. 2) With regard to the channel of the perception of the nursing malpractice case, mass-communication was taken first and followed through by neighbors, In-service education, school education, continuing education 3) As for the direct${\cdot}$indirect experience of the nursing malpractice case, transfusion accident was 51.3%, the fall of NPO patient after an operation 40.1%, the side-effect of KCL injection 32.5%, suicide of the psychiatric patient 32.5%, and the others were 30% below. 4) The possibility of nursing malpractice case was an average 2.57(${\pm}$0.91) and the highest was the fall of the NPO patient after an operation. 5) The perception on the responsibility of the nursing malpractice in its case was indicated as a joint-fault in ten nursing malpractice instances. As compared to the real decision, nurse's perception of the responsibility in the fall of the NPO patient after an operation, the side-effect of KCL injection, the tracheal edema of the patient who had a thyroid operation, the suicide of psychiatric patient, the hymen rupture by uterus cancer test accorded real decisions. But the other cases were different from the real decisions. These cases were perceived as ones of joint fault even in cases determined as Dr's single fault cases or those in which both doctor and nurse were declared free of fault. 6) Knowledge levels of the nursing malpractice, school education and In-service education were perceived as low but anxiety levels of the malpractice were high. 7) With regard to the countmeasure of the hospital after nursing malpractice, the rate answered as "the practice settled the accident temporarily and forced the person in charge to be punished" was highest. In conclusion, the level of the cognition of the clinical nurse on nursing malpractice cases was low. As nurses' perception on the responsibility of the nursing malpractice case was compared to the real decision, there was a difference in five cases out of the ten cases.

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