• Title/Summary/Keyword: Depression Care

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CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT PSYCHIATRIC INPATIENTS WITH MOOD DISORDER (입원한 기분장애 소아청소년의 임상특성 - 주요 우울증과 양극성장애의 우울삽화 비교를 중심으로 -)

  • Cho, Su-Chul;Paik, Ki-Chung;Lee, Kyung-Kyu;Kim, Hyun-Woo;Hong, Kang-E;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.2
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    • pp.209-220
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    • 2000
  • The purpose of this study is to find out the characteristics of depressive episode about major depression and bipolar disorder in child and adolescent. The subjects of this study were 34 major depression patients and 17 bipolar disorder patients hospitalized at child and adolescent psychiatry in OO university children's hospital from 1st March 1993 to 31st October 1999. The method of this study is to review socio-demographic characteristics, diagnostic classification, chief problems and symptoms at admission, frequency of symptoms, maternal pregnancy problem history, childhood developmental history, coexisting psychiatric disorders, family psychopathology and family history and therapeutic response through their chart. 1) The ratio of male was higher than that of female in major depressive disorder while they are similar in manic episode, bipolar disorder. 2) Average onset age of bipolar disorder was 14 years 1 month and it was 12 years 8 months in the case of major depression As a result, average onset age of major depression is lower than that of bipolar disorder. 3) The patients complained of vegetative symptoms than somatic symptoms in both bipolar disorder and depressive disorder. Also, the cases of major depression developed more suicide idea symptom while the case of bipolar disorder developed more aggressive symptoms. In the respect of psychotic symptoms, delusion was more frequently shown in major depression, but halucination was more often shown in bipolar disorder. 4) Anxiety disorder coexisted most frequently in two groups. And there coexisted symptoms such as somartoform disorder, mental retardation and personality disorder in both cases. 5) The influence of family loading was remarkable in both cases. Above all, the development of major depression had to do with child abuse history and inappropriate care of family. It is apparent that there are distinctive differences between major depression and bipolar disorder in child and adolescent through the study, just as in adult cases. Therefore the differences of clinical characteristics between two disorders is founded in coexisting disorders and clinical symptoms including onset age, somatic symptoms and vegetative symptoms.

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Management of Non-pain Symptoms in Terminally Ill Cancer Patients: Based on National Comprehensive Cancer Network Guidelines (말기암환자에서 통증 외 증상의 관리: 최신 NCCN(National Comprehensive Cancer Netweork) 권고안을 중심으로)

  • Lee, Hye Ran
    • Journal of Hospice and Palliative Care
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    • v.16 no.4
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    • pp.205-215
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    • 2013
  • Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.

The Analysis of Research Trend about Hospice in Korea ($1991{\sim}2004$) (국내 호스피스 논문 분석($1991{\sim}2004$))

  • Kim, Sang-Hee;Choi, Sung-Eun;Kang, Sung-Nyun;Park, Jung-Suk;Sohn, Sue-Kyung;Kang, Eun-Sil;Lee, Young-Eun
    • Journal of Hospice and Palliative Care
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    • v.10 no.3
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    • pp.145-153
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    • 2007
  • Purpose: This study was to analyze the research trend centering on the theses to hospice released in Korea. Methods: The researcher collected the academic degrees and theses published on the book of the academic society from 1991 to 2004, and examined 110 domestic papers of hospice. Results: 1) The number of articles increased 3 years after 1997, 52 (47%) theses were published in $2000{\sim}2002$. 97 (88%) articles were quantitative studies, and 13 (12%) were qualitative studies. 2) As for the subject, the results were: patients with end stage 44 (40%), nurse 18 (16%), hospice care system, facilities, and literature review 12 (10%). 3) As for main concepts of correlational studies 15 (13%), the results were: quality of life, activities of volunteers, suffering experience of nurse, and so on. 4) The subjects and contents of survey, the results were: pain control and need for nursing care in patients, need for spiritual and physical care in family, and so on. 5) The treatment of experimental research, the results were: hospice nursing, educational program, informational support, spiritual nursing, supportive nursing intervention, home hospice care, information services for control of cancer pain, and so on. 6) In the theme of the qualitative studies, the results were: experience of dying patients, perceive of hospice care and death, experience of family of terminal ill patients, meaning of dying in Korean. 7) In the instrument in studies, the results were: MQOL, EQOL, QOL, NIC, Need Scale, Spiritual Well-being Scale, Spiritual Perspective Scale, Coping for Grief Scale, K-CPAT, VAS, BPI, Depression Scale, Strait-anxiety Scale, Care-giver Burden Inventory, Burnout Inventory, Mental quality. Conclusion: More research needs to be encouraged in experimental and qualitative research fields. Researches should be conducted for the establishment of the basis of practical and theoretical framework and hospice polices.

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The Effects of Pet Dog-Assisted Activities on Self-Esteem, Depression and Cognitive Function among Elderly People (애완견 매개활동이 노인의 자기존중감, 우울 및 인지기능에 미치는 효과)

  • Shin, Esther;Lee, Sung-Kook
    • Journal of agricultural medicine and community health
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    • v.35 no.3
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    • pp.314-325
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    • 2010
  • Objectives: The purpose of this study was to investigate the effects of pet dog-assisted activities on self-esteem, depression and cognitive function of elderly people Method: The experimental group(pet dog-assisted group) consisted of 22 people over 65 years old out of about 90 elderly people registered with a home for the aged and the control group(non-pet dog assisted group) consisted of 22 people over 65 years old out of about 90 elderly people registered with another home for the aged in Daegu. Both groups had similar general characteristics, state of health, conduct on health and self-esteem, depression and cognitive abilities. Nineteen people who participated in the program at least 10 times out of 12, were chosen for the final analysis from the experimental group. For the control group, 20 people who responded to all three tests, which had been conducted before, 1 week after, and four week after the experiment, were analyzed. Result: Mean(${\pm}SD$) differences between before and 1 week after the experiment for self-esteem, depression, and cognitive function were 5.84(${\pm}3.06$), -3.26(${\pm}1.76$), 1.47(${\pm}1.26$), respectively. Those between before the experiment and 4 weeks after the experiment was 5.68(${\pm}3.64$), -3.94(${\pm}2.32$), 1.63(${\pm}0.96$), respectively. Those for control group between before and after the experiment were -0.40(${\pm}1.27$), 0.00(${\pm}0.92$), 0.15(${\pm}0.93$), respectively. Those for control group between before and 4 weeks after the experiment were -0.45(${\pm}2.24$), 0.25(${\pm}1.68$), 0.15(${\pm}0.93$), respectively. All the differences between experiment and control group in mean differences between before and 1 week after experiment, between before and 4 weeks after experiment were statistically significant(p<0.05). Conclusion: This study suggests that the pet-assisted activities can be useful solution for elderly people who have psychological and emotional problems caused by retrogression of physical, mental and social ability.

Effects of a Self-Help Program including Stretching Exercise on Reduction of Symptom in Patients with Fibromyalgia (신장운동을 포함한 자조관리프로그램이 섬유조직염환자의 증상완화에 미치는 효과)

  • Han, Sang-Sook
    • Journal of muscle and joint health
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    • v.5 no.1
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    • pp.39-56
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    • 1998
  • This study was an quasi-experimental study, done to identify factors Influencing the reduction of symptoms in patients with fibromyalgia. The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study Included out patient diagnosed with fibromyalgia based on the criteria developed by the American College of Rheumatology(1990) and H, University which is a tertiary patient care clinic for Rheumatism. The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy. The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals. Data were analyzed by SPSS windows and the results ire described below. 1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003). 2. The experimental group which participated in the Self-Help Program showed lower scores than the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided(F=9.483, p=.003 : F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 : p=.024, F=7.630 : P=.007, F=15.6512, p=.003 : F= 7.5412, p=.008). 3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043). 4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r= -.500, p=.001). 5. In the experimental group, the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r= -.253, p=.027, r=-.452, p=.001 : r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014). Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms (pain, number of tender points, level physical disability) and psychological symptoms (depression, fatigue, sleep disturbance, anxiety) were reduced. Moreover, It was found that the higher the self-efficacy, the the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise-performance influenced the level of physical disability, one of the symptoms of fibromyalgia. Accordingly, the conclusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotion of self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.

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A Study on the Degree of Physical, Psychological and Social Adaptation of CVA Patients (뇌졸중(腦卒中) 환자(患者)의 신체적(身體的).심리적(心理的).사회적(社會的) 적응도(適應度)에 관(關)한 연구(硏究))

  • Hwang Hyun-Sook;Park Kyung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.3 no.2
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    • pp.213-233
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    • 1996
  • This study was made on 274 apoplectics patients who received the rehabilitation therapy and tests on physical, psychological and social adaptations as outpatients in 23 general hospitals in the Seoul and Kyungi area. The basic data on degree of improvement of apoplectic patients studied from rehabilitation therapy. Data was collected over a period of 63 days, from February 21st till April, 23, 1996. The assigned physical therapist conducted direct interviews with patients after he answered the distributed questionnaires for each individual patient. The colleted data was processed by the $SPCC/C^+$ method. The results of the tests conducted to meascne the the degree of ADL dependency, depression and social activity corresponding to the physical, psychological, and social adaptation. The details are ; 1) The test to meascne the degree of ADL dependency, corresponding to the study of physical adaptation of CVA patients, indicated a mean score of 2.57(ideal score is 1.0) with a standard deviation of ${\pm}0.75$. The worst score was 3.95 while the best score was a perfect 1.0, representing a severe range of dependency. The distribution was centered with a median of 2.65 and a mode of 2.68. 2) The test to meascne the degree of depression which corresponds to the level of psychological adaptation yielded a mean of 2.99 which is higher than the normal limit of 2.45. The standard deviation was ${\pm}0.52$ and the worst score and the best score were 4.35 and Respectirdy. The distribution was centered with a median of 3.00 and a mode of 3.00. 3) The test to meascne the degree of social activities for the level of social adaptation indicated a very low mean score of 26.52 (perfect score is 144), with the standard deviation of ${\pm}16.23$. Some patients scored as high as 100, but others scored as low as 3. The distribution of social activities at a very low level was shifted to the left with a median of 24.00 and a mode of 20.00. 4) Factors influencing the level of physical, psychological and social adaptation are as follows : Factors significantly influencing the level of physical adaptation measured by ADL dependency are age, personal guardian, payer of medical expenses, and paralysis of the right arm, right leg and facial paralysis. Factors significantly influencing the level of psychological adaptation measured by the degree of depression, are age, marital status, education, medical history of individual and family, speech impediment, and facial paralysis. Factors significantly influencing the level of social adaptation measured by the degree of social activity are age, marital status, education, employment status, and the burden of medical expense. 5) The Corelationship is significant(9.00), between ADL dependeing as degree of physical adaptation and depreseion as degree of psychologial adaptation. ADL dependency is proportional to depression. But social activity is inversely protional to ADL dependeny and depression. In conclusion, the increased care for physical function of the patients is not the only necessary means to better facilitate the appropriate adaptation of CVA patients. The introduction of a solid rehabilitation program for psychological and social adaptation will also play the integral part of the treatment of CVA patients.

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The Effect of Marital Conflicts Perceived by Fathers on Preschoolers' Behavior Problems: Mediating Effect of Paternal Child Rearing Behavior (아버지가 지각한 부부갈등이 유아의 문제행동에 미치는 영향: 아버지 양육행동의 매개효과)

  • Kim, Lee Sook
    • Korean Journal of Childcare and Education
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    • v.12 no.2
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    • pp.127-142
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    • 2016
  • The purpose of this study is to analyze the effect of marital conflicts perceived by fathers on preschoolers' behavior problems, and to investigate the mediating effect of paternal child rearing behavior. This study used survey data on 4 year-old infants which was conducted in 2012(5th year) by KICCE. Correlation analysis and structural equation were conducted using SPSS 23 and AMOS 23 for the data analysis, and the results of this study are as follows. First, marital conflicts perceived by fathers and preschoolers behavior problems showed a positive correlation, and they especially showed a greater positive correlation with offensive behavior, anxiety/depression, and other problems. On the other hand, it was identified that paternal child rearing behavior has a negative correlation with marital conflict and preschoolers' behavior problems when paternal child rearing behavior is compassionate and dominant. Secondly, it was identified that warm parenting behavior of fathers mediates the effect of marital conflicts on preschoolers' behavior problems. However, it was verified that the mediating effect of controlling parenting behavior is not significant. On the other hand, it was identified that the mediating effect of warm parenting behavior of fathers has a greater effect on internalized problems than external problems.

Preoperative Nutritional Status in Elderly Orthopedic Surgery Patients: Evaluation and Related Factors (정형외과 수술 노인의 수술 전 영양상태 평가 및 관련 요인)

  • Jang, In Sil;Kim, Min Young
    • Journal of muscle and joint health
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    • v.24 no.2
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    • pp.67-76
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    • 2017
  • Purpose: The purpose of this study was to evaluate preoperative nutritional status in elderly patients with orthopedic surgery and identify related factors for malnutrition risk. Methods: This study enrolled 337 patient's medical record who underwent orthopedic surgery in hospital between January and December 2015. Data was collected retrospectively. Nutritional status was evaluated by using the Nutritional Risk Screening 2002. Multivariable logistic regression analysis was used to identify independent related factors for malnutrition risk. Results: Malnutrition risk developed in 58 patients (17.2%). Logistic regression analysis identified low physical activity, visual impairment, depression, sleep disorder, low serum calcium level, and low serum albumin level as related factors. Conclusion: Orthopedic surgery in elderly patients was associated with high risk of preoperative malnutrition. The results of this study suggest that evaluating the nutritional status and related factors should be done with preoperative status of elderly patients. At the same time, interventions for nutritional care should be adjusted to meet the nutritional needs of individuals and decrease the risk of malnutrition.

The Roles of Study Habits and Emotional-behavioral Problems in Predicting School Adjustment Classification Among 3rdGraders (초등학교 3학년 아동의 학교적응 유형을 예측하는 학습습관과 정서행동문제의 역할)

  • Sung, Miyoung;Chang, Young Eun;Seo, Byungtae
    • Korean Journal of Childcare and Education
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    • v.12 no.6
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    • pp.79-102
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    • 2016
  • The purpose of this study was to identify school adjustment groups by applying a Latent Profile Analysis(LPA) and to investigate the effects of children's emotional problems and study habits on determining the membership of these groups. LPA and multiple logistic regression were conducted using the data of 2,200 third-graders from the Korean Children and Youth Panel Study. The results are listed as follows. First, four school adjustment groups were identified: adjustment, approach to adjustment, maladjustment risk, and maladjustment group. Second, accomplishment value and mastery goal orientation were relatively strong predictors of membership of the school adjustment groups. Time management was also a significant variable that predicted the membership of maladjustment or the maladjustment-risk group. Third, attention problems and depression were the most consistent predictors of membership of maladjustment or the maladjustment-risk group. Physical symptoms and social withdrawal were also significant. Based on the results, implications for intervention to promote early school adjustment were discussed.

Effects of a Fall Prevention Program on Falls in Frail Elders Living at Home in Rural Communities (농촌 지역의 재가 취약계층 허약노인을 위한 낙상예방 프로그램의 효과)

  • Yoo, Jae-Soon;Jeon, Mi Yang;Kim, Chul-Gyu
    • Journal of Korean Academy of Nursing
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    • v.43 no.5
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    • pp.613-625
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    • 2013
  • Purpose: This study was conducted to determine the effects of a fall prevention program on falls, physical function, psychological function, and home environmental safety in frail elders living at home in rural communities. Methods: The design of this study was a nonequivalent control group pre posttest design. The study was conducted from July to November, 2012 with 30 participants in the experimental group and 30 in the control group. Participants were registered at the public health center of E County. The prevention program on falls consisted of laughter therapy, exercise, foot care and education. The program was provided once a week for 8 weeks and each session lasted 80 minutes. Results: The risk score for falls and depression in the experimental group decreased significantly compared with scores for the control group. Compliance with prevention behavior related to falls, knowledge score on falls, safety scores of home environment, physical balance, muscle strength of lower extremities, and self-efficacy for fall prevention significantly increased in the experimental group compared with the control group. Conclusion: These results suggest that the prevention program on falls is effective for the prevention of falls in frail elders living at home.