• 제목/요약/키워드: Community Mental Health

검색결과 740건 처리시간 0.028초

정신장애인의 치료동의능력 평가 도구 개발 : 신뢰도와 타당화 (Developing a Tool to Assess Competency to Consent to Treatment in the Mentally Ill Patient: Reliability and Validity)

  • 서미경;이민규;김승현;조성남;고영훈;이혁;이문수
    • 한국심리학회지ㆍ건강
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    • 제14권3호
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    • pp.579-596
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    • 2009
  • 본 연구는 한국형 치료동의 능력평가도구를 개발하여 이 도구의 신뢰도와 타당도를 검증하고 각 하위능력별 능력, 무능력을 구별할 수 있는 최적의 절단점을 알아보기 위해서 이루어졌다. 본 연구 참여자는 정신의료기관에 입원해 있는 정신질환자, 지역사회정신보건센터 및 사회복귀시설 프로그램에 참여하고 있는 정신질환자 중 본 연구의 참여에 동의한 사람으로, 정신분열증 160명, 기분장애 32명, 기타(강박장애, 알코올) 1명으로 총 193명이었다. 이해능력(understanding), 적용능력(appreciation), 표현능력(expression of a choice), 추론능력(reasoning) 등 총 14문항으로 구성되어 있는 본 치료 동의능력 평가도구와 타당도를 알아보기 위해서 K-MMSE, 지능, 통찰력검사, BPRS를 실시하였다. 그 결과 이 도구의 평정자간의 일치도가 .80~.98로 매우 높고 내적 일관성계수 역시 .56~.83으로 신뢰할만한 수준이었다. 본 도구의 구성개념 타당화를 확인적 요인분석으로 알아본 결과 타당한 것으로 나타났고, 준거관련 타당화를 위해 MMSE, BPRS, IQ, 병식을 검사한 결과 IQ, MMSE는 동의능력 중 이해, 적용, 선택의 표현, 추론 능력 모두와 의미 있는 상관관계를 가지는 것으로 나타났다. ROC 분석 결과 본 척도의 절단점으로 전체점수 18.5점, 하위 영역들의 절단점은 이해능력 4.5, 적용능력 8.5, 의사 표현 0.5, 추론 3.5점이 제안되었다. 이런 결과는 본 연구자들이 개발한 척도가 신뢰롭고 타당하며 진단성 효용성을 지님을 나타낸다. 마지막으로 본 연구의 시사점과 제한점에 대하여 논의하였다.

미국의 청소년 흡연예방을 위한 중재 프로그램의 현황 (An Exploratory Analysis School-based Intervention Studies to Prevent Smoking by American Adolescents)

  • 정혜선;하영미;장원기;이지원;이윤정;윤순녕
    • 한국학교보건학회지
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    • 제21권2호
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    • pp.119-134
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    • 2008
  • Purpose: The purpose of this study is to understand a variety of intervention studies to prevent smoking by adolescents in U.S. and find out implications for Korea. Methods: This study reviewed articles found in the internet and analysed the data of US DHHS and CDC. Results: The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs of U.S. The main components of SHPPS are health education and physical education, health services, mental health and social services, school policies, and school environments. The CDC guidelines for school health programs to prevent tobacco use and addiction are composed of policy, instruction, curriculum, training, family involvement, tobacco-use cessation efforts, and evaluation. School-based interventions to prevent smoking can be classified into the categories of information-giving curricula, social competence curricula, social influence approaches, combined methods draw on social competence and social influence approaches and multi-modal programmes and Youth Empowerment study. The key programs for adolescent smoking prevention are ALERT Project, HSPP, TNT Project, MPP, NC YES. Conclusions: As smoking is often the first step of unhealthy behaviour such as alcohol drinking, illegal drugs, and violence, smoking prevention programmes for adolescents in U.S. have been comprehensive school-based health programs. In smoking prevention programs for adolescents, CDC plays a critical role by supporting survey, research, policy, and funds. The effectiveness of the programs was high when it was based on school and involved parents, community, and mass media. As the effect of each programme is not expected to last for a long time, consistent repetition of these interventions is essential. Current smoking prevention programs for adolescents are exploring the empowerment approach focused on the active involvement of participants rather than traditional approaches using order and discipline.

한방 비만클리닉에 내원한 일부 비만 여성의 삶의 질 (Quality of Life of Some Obese Patients Wanted to Receive Korean Traditional Medicine)

  • 조현주;권영달
    • 동의생리병리학회지
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    • 제20권6호
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    • pp.1732-1741
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    • 2006
  • Obesity is chronic disease which influenced on health severly. The causes of obesity have been known as life change, lack of excercise, genetic factor, mental and social economic factors. Especially the obesity of women increased the risk of the diseases such as DM, osteoarthritis, cardiovascular disease, breast cancer and infertility. The limitations of the widely used negative definition of health as the absence of disease and WHO's 1946 definition of health as total social, psychological and physical well-being have long been recognized (WHO 1958). The Quality of Life (QoL) includes functional ability, the degree and quality of social and community interaction, psychological well-being as somatic sensation and life satisfaction. I investigated to compare the differences between obese women (n=63), non-obese women (n=37) in clinic and general women (n=43, control) on baseline characteristics and WHO QoL-BREF. The purpose of this study is to assist the diagnosis and treatment of obesity. WHO QoL-BREF is self administered type which consisted of 26 questions. The prospective question is calculated with 5 scores by Likert's method. The results are as follows : The means of physical, psychological, social, overall and total scores of QoL were significant among BMI group (P<0.05). The score of control group (BMI < 25) was higher than other groups significantly (P<0.05). In multiple regression analysis, the variable of high school/below middle school was significant in environmental and overall domain of QoL scores (P<0.05). The variable of college/below middle school was significant in environmental, overall domain and total score of QoL scores (P<0.05). The variable of above university/below middle school was significant in physical health, environmental, overall domain and total score in QoL scores (P<0.05). The variable of Health perception (moderate/bad) was positively significant in physical health, environmental, overall domain and total score of QoL scores (P<0.05). The variable of Health perception (good/bed) was positively significant in physical health, environmental, social, overall domain and total score of QoL scores (P<0.05). The variable as BMI non-=obese women/control was negatively significant in social domain of QoL scores (P<0.05). Above the results, It suggests that the variable as BMI did't affect on the QoL in patients and control, but the variables as education and health perception affected on the QoL scores. Further study is required to conduct QoL differences between before and after treatment of obese patients.

COVID-19로 인한 우울정도와 구강건강행위, 자가구강건강증상, 삶의 질의 융합적인 관련성 (Fusion correlation between the degree of depression and oral health behavior, autologous oral health symptoms, and quality of life due to COVID-19)

  • 허성은;김유린
    • 한국융합학회논문지
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    • 제12권3호
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    • pp.27-34
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    • 2021
  • 본 연구는 COVID-19 (coronavirus disease 19) 우울 정도가 삶의 질에 영향을 주는 요인에서 구강건강행위와 자가구강건강증상이 미치는 영향을 확인하기 위한 기초자료로 제공하고자 한다. 본 연구는 2020년 7월부터 2020년 9월까지 자료를 수집하였고, COVID-19로 인한 우울비증가 그룹 89명, 우울증가그룹 86명을 대상으로 최종 분석하였다. 분석방법으로 구강건강행위와 자가구강건강증상, 삶의 질을 비교하였고, 우울정도가 삶의 질에 미치는 영향에서 구강건강행위와 자가구강건강증상이 미치는 영향을 확인하기 위해 위계적 회귀분석(Hierarchical regression analysis)을 시행하였다. 그 결과 인구학적 특성을 통제하고, 삶의 질에 미치는 영향을 확인한 결과 구강건강행위를 제외한 우울정도(��=-0.155, p=0.012)와 자가구강건강증상(��=0.524, p<0.001)은 유의한 영향이 있었다. 따라서 COVID-19로 우울과 불안을 해소하기 위한 지역사회의 정신건강과 관련된 프로그램 개발이 시급하며, 치과치료를 적절한 시기에 받을 수 있도록 치과방문에 대한 불안감을 해소시키기 위한 홍보 활동이 필요할 것이다.

지역사회 노인의 우울에 영향을 미치는 행동계획과 신체활동의 경로분석 (The Path Analysis of Action Planning and Physical Activity that affect the Depression in the Aged in Community)

  • 황환
    • 한국노년학
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    • 제37권3호
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    • pp.567-582
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    • 2017
  • 본 연구의 목적은 지역사회 노인의 행동계획, 신체활동, 우울로 구성된 경로모형을 분석하여 그 관계에 대한 이해를 증진시키고, 지역사회 노인의 우울관리를 위한 행동계획과 신체활동의 활용에 대해 제안하는 것이다. 이를 위해 선행연구를 고찰하고 신체활동 프로그램을 실시하여 참여노인의 행동계획, 신체활동, 우울 간 관계를 경로모형으로 설정하였다. 수도권 지역의 5개 복지관을 이용하면서 우울증상을 호소하는 노인 116명을 대상으로 행동계획이 포함된 신체활동 프로그램을 실시하고 설정된 경로모형을 검증하였다. 연구결과, 첫째, 설정된 경로모형은 실제 자료에 부합한 것으로 나타났다. 둘째, 행동계획이 증가할수록 신체활동도 증가하였다. 셋째, 행동계획이 사후우울에 부적 영향을 미쳤다. 넷째, 신체활동이 사후우울에 부적인 영향을 미쳤다. 다섯째, 행동계획이 사후우울에 대해 신체활동보다 상대적으로 더 큰 영향을 미쳤고, 우울과 행동계획과의 관계에서 신체활동이 매개효과를 나타냄을 확인하였다. 이러한 결과를 바탕으로 국가적 차원의 신체활동증진전략에 행동계획 지침의 포함, 지역사회 정신보건 관련 기관에 행동계획을 포함한 신체활동 프로그램의 보급과 전달체계 구축, 행동계획 수행의 질적 향상을 위한 내러티브 접근의 활용 등을 제언하였다.

Imaging Neuroreceptors in the Living Human Brain

  • Wagner Jr Henry N.;Dannals Robert F.;Frost J. James;Wong Dean F.;Ravert Hayden T.;Wilson Alan A.;Links Jonathan M.;Burns H. Donald;Kuhar Michael J.;Snyder Solomon H.
    • 대한핵의학회지
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    • 제18권2호
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    • pp.17-23
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    • 1984
  • For nearly a century it has been known that chemical activity accompanies mental activity, but only recently has it been possible to begin to examine its exact nature. Positron-emitting radioactive tracers have made it possible to study the chemistry of the human mind in health and disease, using chiefly cyclotron-produced radionuclides, carbon-11, fluorine-18 and oxygen-15. It is now well established that measurable increases in regional cerebral blood flow, glucose and oxygen metabolism accompany the mental functions of perception, cognition, emotion and motion. On May 25, 1983 the first imaging of a neuroreceptor in the human brain was accomplished with carbon-11 methyl spiperone, a ligand that binds preferentially to dopamine-2 receptors, 80% of which are located in the caudate nucleus and putamen. Quantitative imaging of serotonin-2, opiate, benzodiazapine and muscarinic cholinergic receptors has subsequently been accomplished. In studies of normal men and women, it has been found that dopamine and serotonin receptor activity decreases dramatically with age, such a decrease being more pronounced in men than in women and greater in the case of dopamine receptors than serotonin-2 receptors. Preliminary studies in patients with neuropsychiatric disorders suggests that dopamine-2 receptor activity is diminished in the caudate nucleus of patients with Huntington's disease. Positron tomography permits quantitative assay of picomolar quantities of neuro-receptors within the living human brain. Studies of patients with Parkinson's disease, Alzheimer's disease, depression, anxiety, schizophrenia, acute and chronic pain states and drug addiction are now in progress. The growth of any scientific field is based on a paradigm or set of ideas that the community of scientists accepts. The unifying principle of nuclear medicine is the tracer principle applied to the study of human disease. Nineteen hundred and sixty-three was a landmark year in which technetium-99m and the Anger camera combined to move the field from its latent stage into a second stage characterized by exponential growth within the framework of the paradigm. The third stage, characterized by gradually declining growth, began in 1973. Faced with competing advances, such as computed tomography and ultrasonography, proponents and participants in the field of nuclear medicine began to search for greener pastures or to pursue narrow sub-specialties. Research became characterized by refinements of existing techniques. In 1983 nuclear medicine experienced what could be a profound change. A new paradigm was born when it was demonstrated that, despite their extremely low chemical concentrations, in the picomolar range, it was possible to image and quantify the distribution of receptors in the human body. Thus, nuclear medicine was able to move beyond physiology into biochemistry and pharmacology. Fundamental to the science of pharmacology is the concept that many drugs and endogenous substances, such as neurotransmitters, react with specific macromolecules that mediate their pharmacologic actions. Such receptors are usually identified in the study of excised tissues, cells or cell membranes, or in autoradiographic studies in animals. The first imaging and quantification of a neuroreceptor in a living human being was performed on May 25, 1983 and reported in the September 23, 1983 issue of SCIENCE. The study involved the development and use of carbon-11 N-methyl spiperone (NMSP), a drug with a high affinity for dopamine receptors. Since then, studies of dopamine and serotonin receptors have been carried out in over 100 normal persons or patients with various neuropsychiatric disorders. Exactly one year later, the first imaging of opitate receptors in a living human being was performed [1].

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Effects of the Weight Management Program Based Self-Efficacy for Body Composition, Blood Lipid Profile, Weight Self-Efficacy Lifestyles, Depression in Middle-Aged Obese Women

  • Park, Nam-Hee;An, Hye-Gyung
    • 대한간호학회지
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    • 제36권8호
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    • pp.1359-1366
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    • 2006
  • Purpose. This study was done to determine the effects of weight management program using self-efficacy in middle-aged obese women. The study also attempted to measure the effects of the program on the weight efficacy lifestyle, body composition, and depression. Method. The research design of this study was a nonequivalent control group pretest-posttest design. The experimental group consisted of 21 middle-aged obese women and another 21 middle-aged obese women in the control group. The women in the experimental group participated in the weight management program for 12 weeks using self-efficacy. The weight management program using self-efficacy included education on effects of exercise for weight control, aerobic exercise program, muscle training and counseling through the telephone. Results. After 12 weeks of participation in the program, BMI (p <.0001), body fat % (p <.0001), abdominal fat (p <.0001), in the experimental group were significantly decreased compared to the control group. Weight self-efficacy lifestyle (p <.0001) and depression (p =.006) in the experimental group were significantly improved after the program compared to the control group. According to these findings, weight management program self-efficacy for middle-aged obese women could increase weight efficacy lifestyle, and decrease depression, BMI, body fat, and abdominal fat. Conclusion. The result also suggested that the increasing weight efficacy and lifestyle help the obese women to perform and continue exercise. This program could be used in the community such as public health center for weight care and mental health promotion of middle-aged obese women.

영동군 고령자들의 우울, 불안, 스트레스 정도가 자살생각에 미치는 영향 (The Effect of Depression, Anxiety, Stress on Suicidal Ideation of the Elderly in Youngdong County)

  • 장우심
    • 한국콘텐츠학회논문지
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    • 제16권7호
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    • pp.720-729
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    • 2016
  • 본 연구는 영동군 일부 고령자들의 우울, 불안, 스트레스 정도가 자살생각에 미치는 영향을 알아보고 고령자들의 자살 예방대책을 마련하여 삶의 질 향상에 도움이 되고자 하였다. 본 연구의 조사기간은 2015년 5월 6일부터 5월 23일까지였으며 영동군 11개 읍면에 거주하는 60세 이상의 고령자 367명을 임의표집하여 설문조사를 실시하였고 수집된 자료는 SPSS 19.0을 이용하여 분석하였다. 연구 결과, 우울, 불안, 스트레스가 정의 방향으로 자살생각에 영향을 미치는 것으로 나타났다. 우울, 불안, 스트레스, 자살생각 간의 상관관계는 유의하였으며, 우울과 불안간의 상관관계는 .796으로 가장 높았고 유의확률은 0.05 미만이었다. 본 연구의 결과를 토대로 고령자 자살 예방을 위해서는 첫째, 노인 정신건강 전수조사 및 관리, 둘째, 고령자를 위한 일자리 제공, 셋째, 보건안전요원의 증원과 함께 촘촘한 안전망 구축, 넷째, 생명존중에 대한 인식강화가 필요하다.

인플루엔자 관련 뇌증 1례 (A Case of Influenza-associated Encephalopathy)

  • 송연이;최창환;최종운;김세영;김현수;김열;임동진
    • Clinical and Experimental Pediatrics
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    • 제46권10호
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    • pp.1024-1028
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    • 2003
  • 저자들은 인플루엔자 유행시기에, 생후 3년 1개월 환아에서 갑작스런 고열을 동반한 경련 발작과 의식소실을 주소로, 6일간 입원 치료에도 불구하고 급격한 급성 뇌증의 악화와 간기능수치 증가 및 신장기능 부전, 범발성 혈관내 응고증으로 사망한 남아에서 인플루엔자 바이러스 항체 검사상 A/H1N1에 대한 HI titer가 초 회 항체 역가의 4배 이상 증가됨을 관찰하여 국내에는 보고된 예가 없는 급성 인플루엔자 뇌증으로 진단한 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

농민의 작업환경별 노동부담 경감방안에 관한 연구(I) -겨울철 비닐하우스에서 상추재배 작업을 중심으로- (A Study for Farmers to Reduce Work Load on the Different Working Conditions (part I) - Cultivating Lettuce in the Winter Greenhouse -)

  • 김명주;최정화
    • 한국농촌생활과학회지
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    • 제8권2호
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    • pp.111-117
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    • 1997
  • In this study we tried to give a decision on propriety of working conditions, to present ideas on reducing work loads. and to grope for efficiency of agricultural works. For this we examined the actual conditions of working environment, farmer's clothes, working posture, working methods, working time, resting state, fatigue recovery methods during cultivating lettuce in the winter greenhouse. And Ive improved harmful factors that affect farmer's health by considering results of previous study and farmer's subjective sensation. And we measured, compared, and analyzed the farmer's work loads before and after improvement. The results of this study are as follows ; 1. According to examine the actual conditions of cultivating lettuce in the winter greenhouse, farmers have experienced physical and mental chronic fatigue on the basis of the hot and humid crops-centered working environment, the rough ground condition, inconsistent arrangement of working stand and sorter, heavy-weared habits. and unsuitable working posture. 2. When we improved harmful factors that affect farmer's health, conformed the positive effects on important work efficiency index such as heart rate, electromyovolume, body temperature, and microclimate inside clothing and work loads were decreased by improving the hot and humid working environment, eliminating the hillock and obstacles of working path. deliver way, arranging the working stand and sorter consistantly, decreasing the clothing weight, improving the working postures and methods as using assistant appliances, alloting the working time and sequence effectively and presenting the light gymnastic exercises and rest for fatigue restoration.

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