• 한국융합학회논문지
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• 제9권8호
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• pp.77-85
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• 2018

본 연구는 일 지역 내 요양병원의 경도인지장애환자의 일반적 특성, 입원 및 진료특성을 분석하여 경도인지장애 환자에 대한 효율적 관리에 필요한 자료를 제공하고자 시행하였다. 연구대상은 2016년 일 지역에 소재하는 요양병원에서 경도인지장애(F067)를 주진단으로 하는 입원환자 303명의 명세서 건이다. 본 연구결과, 재원일수는 계절별로는 ADL 6~12점, ADL 13~20점 그룹 모두 겨울이 가장 긴 것으로 나타났다. 진료결과는 ADL 6~12점, ADL 13~20점 그룹 모두 퇴원일 때 재원일수가 긴 것으로 나타났다. 총 진료비는 계절별로는 ADL 6~12점, ADL 13~20점 그룹에서 겨울이 높았다. 환자 분류군는 ADL 4~5점 그룹에서는 인지장애군의 진료비가 가장 높았고, ADL 6~12점, ADL 13~20점 그룹 모두 문제행동군이 가장 높은 것으로 나타났다. 이와 같은 결과 경도인지장애에 대한 조기발견과 치료는 잠재적인 치매환자 발생과 그에 따른 사회적 비용 감소에 효과적인 방안이자 대단히 중요한 과제임을 알 수 있다.

• Annals of Geriatric Medicine and Research
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• 제22권4호
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• pp.176-183
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• 2018

Background: Although the frequency and intensity of headaches decrease in older adults, headaches in this population are still an important neurological disorder. The purpose of this study was to investigate the associations of headache characteristics in older adults with the development of cardiovascular disease and cognitive dysfunction. Methods: We prospectively enrolled 125 older (${\geq}65$ years old) patients with headache who were making their first visit to outpatient clinics and who had no prior history of cognitive dysfunction from 11 hospitals in Korea between August 2014 and February 2015. We investigated the occurrence of newly developed/or recurrent headache, cardiovascular disease, cognitive dysfunction, and poor functional outcomes. Results: The mean age of all included patients was 72.6 years, 68.8% were women, and 43 (34.4%) had newly developed/or recurrent headache during follow-up. During a median follow-up of 31 months (interquartile range, 28-34 months), 21 participants (16.8%) experienced cardiovascular disease, and 26 (20.8%) developed cognitive dysfunction. Upon multivariate analysis and after adjusting for sex, age, and other factors, presence of newly developed/or recurrent headache was found to be associated with cardiovascular disease (hazard ratio [HR], 4.03; 95% confidence interval [CI], 1.28-12.61; p=0.017) and frequency of headache for the recent 3 months was related with cognitive dysfunction (HR, 1.05; 95% CI, 1.00-1.09; p=0.017) and poor functional outcomes (HR, 1.06; 95% CI, 1.01-1.11; p=0.011). Conclusion: Our study demonstrated that there is an increased risk of cardiovascular disease, cognitive dysfunction, and poor functional outcomes in older patients with frequent, newly developed, or recurrent headache.

• 한국과학예술포럼
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• 제31권
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• pp.355-365
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• 2017

미래 한국의 인구 구성은 저 출산과 의료기술의 비약적 발전에 힘입어 고령자가 2060년에는 세계 2위 수준까지 예상되고 있다. 고령자를 위한 사회의 부담은 지속적으로 증가될 것으로 예상되고 있다. 고령자가 되면서 제일 먼저 나타나는 현상은 신체적인 변화이다. 기억력이 낮아지고 인지능력이 저하되는 현상이 생기면서 그들의 활동이 제한되고 경제적인 생산능력이 급격히 줄어들게 된다. 자급자족이 힘든 상황이 되면서 경제적이고 사회적인 측면의 도움을 필요하게 되었다. 그들에게 도움을 줄 수 있는 제품이 연구되고 개발되어 져야하는 시기가 도래되었다. 고령자들에게 흔히 나타나는 인지능력저하 단계인 경도인지장애(MIS)단계가 있다. 경도인지장애인들은 약물적 치료방법과 비약물적 치료 방법을 병행하는 것이 효과적이다. 비약물적 치료방법 중 음악에 대한효과가 입증되어 있다. 본 논문은 음악치료기법을 활용한 보조기구를 개발함에 있어 디자인적인 관점에서 디지털 융복합의 연구가 필요하다. 본 연구를 위해서 경도인지장애자를 대상으로 외형에 대한 선호를 알아보았다. 2번에 걸쳐 설문조사가 이루어졌다. 연구의 결과 경도인지장애자를 위한 홈케어 제품디자인은 기존의 게임기나 셋탑박스의 정형적이고 박스형태가 아닌 사용자의 상황과 특수성을 고려한 형태가 요구되고 있다. 기억력, 인지능력이 떨어지는 신체적인 변화와 주변 사람이나 환경이 변화되는 정신적인 변화에 맞는 제품이 개발되도록 디자인이 요구되고 있다는 결과이다.

• 수면정신생리
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• 제18권1호
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• pp.23-28
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• 2011

목 적: 렘수면 행동장애는 기존 역학 연구에서 큰 관심을 받지 못했다. 본 연구는 유력 렘수면 행동장애의 유병률과 임상 양상에 대해 살펴보고자 하였다. 방 법: 오산시에 거주중인 60세 이상 노인 14,050명 중 1,588명이 임의추출을 통해 표본 집단으로 선정되었고 이들을 대상으로 렘수면 행동장애 선별 설문지로 선별검사를 시행했다. 선별 설문지 점수가 5 이상인 집단은 수면의학 전문가가 직접 개별 면담평가를 시행했다. 결 과: 14,050명의 모집단 중 886명이 1차 선별평가를 마쳤다. 선별검사 설문지 점수가 5 이상인 145명 중 123명이 2차 진단평가를 받았다. 이중 11명이 유력 렘수면 행동장애로 진단되었고 유병률은 1.5%(95% CI=0.70-2.30%)로 나왔다. 우울과 인지기능 저하의 빈도가 유력 렘수면 행동장애 진단군에서 그렇지 않은 군에 비해 유의미하게 증가되었다. 결 론: 유력 렘수면 행동장애는 노년층에서 드물지 않은 질환이지만 이에 대한 인식은 부족한 실정이다. 유력 렘수면 행동장애의 평가와 치료에 대한 관심이 더욱 요구된다.

• 대한불안의학회지
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• 제4권1호
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• pp.42-48
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• 2008

현재 PTSD와 관련한 여러 병태생리 기전들이 밝혀지고 있으며 이에 초점을 둔 다양한 약물치료가 행해지고 있다. 본 연구에서는 일 대학병원에서 PTSD로 진단된 환자들의 의무기록을 검토하여 약물치료의 경향에 대해 알아보았다.1998년 1월부터 2007년 12월까지 DSM-IV에 의해 PTSD로 진단된 입원 환자 75명이 대상군이 되었으며, 이들의 인구학적 요인들, 입원기간, 외상의 종류, 외상 후 경과시간 및 정신과적 공존병리 및 처방 받은 약물을 조사하였다. 조사 결과, 75명 중 남자는 33명, 여자는 42명이었다. 정신과적 공존병리는 총 50명(66.7%)에서 존재하였으며, 우울장애, 인지장애, 정신장애 및 불안장애 순이었다.73명(97%)의 대상군은 항우울제를 처방 받았으며, 그 중 paroxetine이 54.7%로 가장 많았고 두 가지 이상의 항우울제를 처방 받은 경우도 24%였다. 또 거의 대부분의 환자에서 비정형 항정신병약물(33.3%), 기분안정제(17.3%),항불안제(94.7%)가 항우울제와 병용 처방된 것으로 조사되었다. 여러 제한점에도 불구하고 본 연구에서 얻어진 약물 처방 경향은 향후 국내 실정에 맞는 치료 지침을 수립하는 데에 하나의 근거 자료가 될 수 있을 것이다.

• Journal of Korean Biological Nursing Science
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• 제22권2호
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• pp.111-118
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• 2020

Purpose: The purpose of this study was to understand the impact of long- and short-term energy drinks on anxiety-like, depressionlike, and cognitive behavior in adolescent rats. Methods: Adolescent rats (age six weeks) were randomly classified into a control group (CON), a long-term administration group (LT), and a short-term administration group (ST). The LT group was orally administered 1.5 mL/100 g (body weight) of energy drink twice daily for 14 days, the ST group was orally administered for one day, and the control group applied the same amount of normal saline. Later, an open-field test, a forced swim test, novel object recognition test, and an 8-arm radial maze test was conducted to assess the rats' anxiety, depression, and cognitive function. Results: There were different effects in the long- and short-term groups of energy drink administration. In the LT group, anxiety- and depressive-like behavior increased because of increased movement in the side corner and decrease of immobility time. Also, the time to explore novel objects decreased, and the number of correct responses was reduced, indicating a learning and memory function disorder. However, the ST group was not different from the control group. Conclusion: These results indicate that long-term consumption of energy drinks can increase anxiety-like, depression-like behavior, and this can lead to decrease in learning and memory functions. Thus, nurse and health care providers should understand the impact of energy drink consumption in adolescence to provide appropriate practices and education.

• Perspectives in Nursing Science
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• 제15권1호
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• pp.29-40
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• 2018

Purpose: The present study aimed to review the characteristics of cognitive behavioral therapy (CBT) programs for alcohol use disorders and to examine the outcomes of such programs. Methods: We searched for domestic and foreign studies that implemented a CBT program for alcohol use disorders, published from 2006 to 2017. Studies that met inclusion/exclusion criteria were selected and a quality assessment was performed using the Risk of Bias (RoB) and Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) instruments. We utilized a five-stage analysis process, through which nine experimental studies were selected. Results: Of these nine studies, four were randomized controlled trials, four used a quasi-experimental design, and one used a qualitative design. The CBT involved the three domains of cognitive reconstruction, problem solving, and coping. Coping with drinking situations and communication constituted most of the sessions. The outcomes of such interventions showed that CBT had a positive effect on alcohol use and self-evaluation. Conclusion: CBT is an effective way to change alcohol use behaviors, motivation, interpersonal relationships, emotional control, and self-efficacy among patients with alcohol use disorders. This study provides evidence for the effectiveness of CBT-based programs for the treatment of alcohol use disorders.

• 대한간호학회지
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• 제43권5호
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• pp.579-586
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• 2013

Purpose: This article provides an update and overview of a nursing research program focused on understanding the pathophysiology and management of irritable bowel syndrome (IBS). Methods: This review includes English language papers from the United States, Europe, and Asia (e.g., South Korea) from 1999 to 2013. We addressed IBS as a health problem, emerging etiologies, diagnostic and treatment approaches and the importance of a biopsychosocial model. Results: IBS is a chronic, functional gastrointestinal disorder characterized by recurrent episodes of abdominal pain and alterations in bowel habit (diarrhea, constipation, mixed). It is a condition for which adults, particularly women ages 20-45, seek health care services in both the United States and South Korea. Clinically, nurses play key roles in symptom prevention and management including designing and implementing approaches to enhance the patients' self-management strategies. Multiple mechanisms are believed to participate in the development and maintenance of IBS symptoms including autonomic nervous system dysregulation, intestinal inflammation, intestinal dysbiosis, dietary intolerances, alterations in emotion regulation, heightened visceral pain sensitivity, hypothalamic-pituitary-adrenal dysregulation, and dysmotility. Because IBS tends to occur in families, genetic factors may also contribute to the pathophysiology. Patients with IBS often report a number of co-morbid disorders and/or symptoms including poor sleep. Conclusion: The key to planning effective management strategies is to understand the heterogeneity of this disorder. Interventions for IBS include non-pharmacological strategies such as cognitive behavior therapy, relaxation strategies, and exclusion diets.

• 생물정신의학
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• 제8권1호
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• pp.47-52
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• 2001

It is known that the personality is the crucial factor in the treatment outcome of depression. The authors tried to identify the results of such studies and various components which determine the treatment outcome of depression. Nearly 60 papers published between the year 1990 and 2000 about the treatment of depression and personality were reviewed. Among them about 30 papers were selected to compare the research methods, results and discussions. The arguments and critics of the papers were discussed. In the many debates, the authors admitted the fact that premorbid personality trait influences the treatment outcome of depression negatively regardless of treatment method. Subtyping of depression is feasible along the presence of good or bad predictors of treatment outcome for depression. Differentiation of depression and personality seems to have no problem, however test of personality state before the development of psychiatric disorder such as depression is not amenable. For example, cluster A personality trait is often misunderstood as depression in clinical setting. In some cases cognitive behavioral therapy is effective in the treatment of depression accompanying personality disorder. The authors insist that the analysis of personality in the dimensional aspect rather than in the categorical aspect gives more information in the research of personality influencing the treatment outcome of depression. In addition, the reason why we understand the relationship between depression and personality were discussed.

• 대한한의학회지
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• 제40권4호
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• pp.84-90
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• 2019

Objectives: Chronic fatigue syndrome (CFS) is a debilitating illness impairing seriously quality of life, while CFS would be an optimized target disorder of Korean medicine. This study aims to present the recent information especially in aspect of medical policy and new diagnosis criteria for CFS. Methods: The literature survey was conducted using the terms of "chronic fatigue syndrome", "myalgic encephalomyelitis" and "fibromyalgia" in PubMed database and Google database in its entirety from January 2011 to February 2019. The in-depth review was made focusing on the changes in policy and medical perspective for CFS. Results: Recently large medical attentions and researches for CFS have been existed worldwide. By supporting of USA government, IOM made a report which leaded to a turning point in clinical practices and research in 2015. This report recommended a new name of CFS to systemic exertion intolerance disease (SEID), and new diagnostic criteria focusing on post-exertional malaise, unrefreshing sleep, cognitive impairment and orthostatic intolerance. The medical perspective also was changed into "a serious, chronic, complex, systemic disease" from a psychological-like disorder, and then UAS and EU governments sharply increased the research grants. Conclusions: This study provided practitioners in Korean medicine (KM) a core information about the recent changes in CFS-related perspectives. This review would be helpful for KM-derived researches or therapeutics development for CFS.