• 대한불안의학회지
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• 제12권1호
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• pp.21-27
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• 2016

Objective : The aim of this study was to investigate the relationship between subjective sleep problems and various types of traumatic events of patients with depressive disorder. Methods : A total of 411 patients diagnosed with depressive disorders were recruited in this study. The participants filled out Life Time Events Checklist (LEC), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI). We used the independent t-test and analysis of covariance to compare each component of PSQI between depressive patients with and without traumatic experiences. Results : The groups of patients who experienced a serious accident at work, home or during recreational activity, sexual assault, other unwanted or uncomfortable sexual experience, life-threatening illness or injury, and sudden, unexpected death of a near and dear one showed lower scores in a few components of PSQI. Sleep disturbance was a common problem in all five groups. Lower subjective sleep quality and longer sleep latency was observed in three groups. There were no differences in the other components of PSQI among groups. Conclusion : This study showed that various types of traumatic events may have different effects on subjective sleep quality as a consequence of the traumatic event which they had experienced.

• 한국보건간호학회지
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• 제33권2호
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• pp.214-227
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• 2019

Purpose: This study examined the socio-demographic factors, the disaster related factors, the physical health related factors and the psychological factors of older adults exposed to natural disaster and these factors may possibly cause the occurrence of PTSD. Methods: A cross-sectional study was designed using the secondary data from the 3rd Disaster Victims Panel Survey (2012-2017). The data from 1,397 disaster victims were analyzed using descriptive statistics and logistic regression analysis. Results: Compared with the younger adult disaster victims, the elderly were more likely to have symptoms of PTSD (15.0% vs. 12.1%). Factors such as the number of years since being exposed to the disaster, anxiety, depression and social adjustment were significantly associated with occurrence of PTSD for both older and younger adults. Female gender was the additional risk factors for the older adults, while marital status, income, having witnessed another person's injury or death, and having lost a home were associated with the occurrence of PTSD. Conclusion: The elderly were more likely to develop PTSD as compared with younger adults. More targeted post-disaster mental health services to the elderly with the symptoms of depressive, anxiety and impaired social adjustments, should be provided to improve their mental health.

• 호스피스학술지
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• 제2권1호
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• pp.21-40
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• 2002

Cancer is the second leading cause of the death in Korea. Family caregivers of dying patients manifest many psychological and physical symptoms of stress, and they often seek for informational support from health care providers. Unfortunately, however, few systematic studies identify the actual effect of such support on family caregivers. This study, thus, intends to evaluate the effect of informational support for hospice care. One group pretest-posttest design was used, employing the stress-coping model by Cohen and Wills as a conceptual framework. This research was conducted from July 1 to November 15, 1998, initially with 32 subjects sampled from hemato-oncology department of two general hospitals in Seoul, but reduced to 18 at the end due to the untimely death of patients or caregiver's refusal during the course of study. Informational supports were programmed to provide the family caregivers with 8 times of education and counseling as well as 24-hour hot-line for 4 weeks. A booklet that explains the various problems of hospice care was also prepared and distributed to all subjects. Data were collected by using self-report questionnaires and reviewing medical records. The tools used in this study were based on the Weinert's PRQ-II(scale of perceived social support), Spielberger's state anxiety inventory, and CES-D. Also included in the data collection were the general characteristics of family caregivers and patients, and the pain intensity and the performance status of patients. The data were analyzed with descriptive statistics, Wilcoxon sign rank test and paired t-test using SPSSWIN program. The results of the study were as follows: 1.The perceived social support of family caregivers was not significantly increased with informational support for hospice care(t=1.64, one tailed p=.060). 2.The anxiety of family caregivers was significantly reduced following informational support for hospice care(t=3.48, one tailed p=.002). 3.The depression of family caregivers was significantly reduced following informational support for hospice care(t=-2.18, one tailed=.022). 4.The pain intensity of patients with terminal cancer was significantly reduced following informational support for hospice care(t=-2.41, two tailed p=.027). The results suggest that the informational support provided to family caregivers of patients with terminal cancer reduced not only their anxiety and depression but also the pain intensity of patients. Further study is necessary to consolidate the conceptual framework of this study with expanded number of subjects. Nevertheless, it was certain that the informational support program for hospice care was very helpful to both caregivers and patients. Thus, the informational support program is strongly recommended for the hospitals which have no hospice unit yet.

• 인간식물환경학회지
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• 제23권2호
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• pp.245-254
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• 2020

Patients diagnosed with cancer face mental problems such as alienation, isolation, anxiety about death and fear, recovering from psychological difficulties. In this study, a forest healing program was provided for cancer patients to recover from psychological stress, depression, social isolation and self-esteem caused by cancer and changes in salivary cortisol through psychological and emotional recovery were measured. From September 19 to November 28, 2017, a forest healing program composed of a total of 10 sessions, two hours per session was provided for 12 cancer patients in the Forest of Taegyo located in Yongin. Psychological tests were performed with Social Adaptation Self-evaluation Scale (SASS), Korean-version Perceived Stress Scale (PSS) and Beck Depression Inventory (BDI) and the collected data were analyzed with the SPSS 18.0. The salivary cortisol level was measured along with the psychological tests and were analyzed by a specialized testing agency. The results of the analysis showed that the pre- and post-assessment score of SASS was 29.17 and 25.92, respectively, and that the pre- and post-assessment score of PSS was 30.50 and 23.92, respectively. The pre- and post-assessment score of BDI was 41.00 and 34.83, respectively, which showed significant differences. In addition, the pre- and post-assessment level of saliva cortisol was 3.13 and 1.68, respectively, showing a significant decrease. In short, the forest healing program was found to be effective in reducing physiological changes caused by social isolation and stress due to the emotional and psychological difficulties that the subjects who were diagnosed with cancer and were recovering from it have. In the future, it will be necessary to develop and implement a forest healing program by conducting a forest healing requirement survey on cancer patients.

• 대한한의학방제학회지
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• 제25권4호
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• pp.483-497
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• 2017

Background : Behavioral stress has been suggested as one of the significant factors that is able to disrupt physiological systems and cause depression as well as changes in various body systems. The stressful events can alter cognition, learning, memory and emotional responses, resulting in mental disorders such as depression and anxiety. Results : We used a restraint stress model to evaluate the alteration of behavior and stress-related blood parameter. The animals were randomly divided into two groups of five animals each group. Furthermore, we assessed the change of body weight to evaluate the locomotor activity as well as status of emotional and anxiety in mice. After 7 days of restraint stress, the body weight had significantly decreased in the restraint stress group compared with the control group. We also observed stress-associated behavioral alterations, as there was a significant decrease in open field and forced swim test, whereas the immobilization time was significantly increased in the stress group compared to the control group. We observed the morphological changes of neuronal death and microglia by immunohistochemistry and western blot. In our study restraint stress did not cause change in neuronal cell density in the frontal cortex and CA1 hippocampus region, but there was a trend for an increased COX-2 and iNOS protein expression and microglia (CD11b) in brain, which is restraint stress. Conclusion : Our study, there were significant alterations observed in the behavioral studies. We found that mice undergoing restraint stress changed behavior, confirming the increased expression of inflammatory factors in the brain.

• Journal of Hospice and Palliative Care
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• 제10권3호
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• pp.120-127
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• 2007

Bereavement is the state of loss resulting from death. Grief is the emotional response associated with loss, intense and acute sorrow resulting from loss. Complicated grief represent a pathological outcome involving social, physical, emotional, cognitive, spiritual morbidity. The common psychiatric disorders associated complicated grief or abnormal grief responses include clinical depression, anxiety disorders, alcohol abuse or other substance abuse, and dependence, psychotic disorders, and post-traumatic stress disorder (PTSD). Grief tasks involve a series of stage or phases following an important loss that gradually permit adjustment and recovery. Three phases of grief involve phase 1 (walking the edges), phase 2 (entering the depths), and phase 3 (reconnecting the world). For intervention to be effective they need to be individually tailored to abnormal grief reaction or unresolved grief reaction. Clear understandings of complicated grief, abnormal responses, factors increasing risk after bereavement will often enable us to prevent psychiatric disorders in bereaved patients.

• 수면정신생리
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• 제24권1호
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• pp.55-61
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• 2017

목 적 : 자살은 정신과 영역에서 큰 과제이며 특히 대한민국에서 자살은 젊은 성인들에서 주요한 사망원인이기도 하다. 따라서 지역 대학생들의 불안, 수면의 질이 자살사고와 어떠한 연관성이 있는지 알아보고자 하였다. 방 법 : 진주지역의 한 공과대학교 재학생 1094명을 대상으로 하였다. 자살생각척도, 병원 불안-우울 척도, 한국판 피츠버그 수면의 질 척도, 아침형-저녁형 설문지를 사용하였다. 자살사고척도가 높은 군과 낮은 군으로 나누어 두 군에서 유의미한 차이를 보이는 요인들에 대해 다중회귀분석을 수행 하였다. 결 과 : 자살사고 평가에 답한 292명의 학생들 중 자살사고가 높은 군은 31명 이었다. 두 군에서 유의미한 차이를 보이는 인구학적 변수는 성별, 운동여부, 일주기리듬, 수면의 질, 우울 그리고 불안 이었다. 이 변수들과 자살사고와의 관계성을 파악해 보기 위해 다중회귀분석을 시행한 결과 불안이 높을수록 수면의 질이 낮을수록 자살사고가 증가하는 것을 확인 하였다. 우울과 일주기리듬의 경우 유의한 관련성을 보이지 않았다. 수면의 질과 연관된 수면-관련 요인들의 특성을 파악하기 위해 다중회귀분석을 시행하였고 주말의 과수면 시간이 늘어날수록 수면의 질이 낮아지는 것을 확인하였다. 결 론 : 본 연구결과 지역 대학생들에서 불안이 심할수록, 그리고 수면의 질이 나쁠수록 자살사고가 증가하는 것을 확인하였다, 따라서 주말의 과수면을 줄여 수면의 질을 개선하고 불안을 줄이는 것이 자살사고를 줄이는 데 중요하다.

• Journal of Hospice and Palliative Care
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• 제3권1호
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• pp.60-73
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• 2000

목적 : 연구의 목적은 말기 암환자의 총체적 고통의 내용과 총체적 고통의 관련요인을 파악하는 것이다. 방법 : 본 연구는 후향적 서술적 연구로 연구의 표본은 1단계에서는 1997년에 일개 대학에서 운영하는 호스피스 사업소에 등록된 환자전수를 대상으로 하였고 2단계에서는 4명의 호스피스 간호사에 의해 선정된 가장 고통이 심한 5명의 환자를 대상으로 하였다. 자료 수집 방법은 Twycross model의 분류 틀을 사용하여 호스피스 환자의 의무기록지를 분석하고 5명의 환자들을 담당하였던 호스피스 간호사와의 심층면담을 통해 의무기록지의 내용을 보충하였다. 또한 호스피스 정규 Team meeting시 사례연구를 통하여 고통의 내용과 관련요인을 확인하였다. 자료의 분석은 SPSS를 이용하여 서술적 통계를 사용하였고 간호사와의 심층 면담은 내용을 분석하였다. 결과 : 말기 암환자들이 주로 경험하는 주요문제들은 통증과 변비, 가족대응, 영적 고뇌(우울, 불안 등) 등으로 통증조절뿐만 아니라 가족의 대응 및 지지, 심리적 영적 지지와 함께 다른 증상조절에 필요한 적절한 간호중재가 요구됨을 나타내고 있다. Twycross model이 문화적인 차이가 있는 한국에도 정도의 차이는 있지만 죽음이라는 사실을 당면한 환자에게 유용한 총체적 고통 model로 사료된다. 결론 : 본 연구의 결과 Twycross model이 한국적 상황에서의 총체적 고통을 설명하는데 유용하였으나 새로운 요인들이 첨가되었으므로 한국의 말기 암환자에 대한 평가가 필요하다.

• 기본간호학회지
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• 제3권2호
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• pp.235-246
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• 1996

The purpose of this study was to discover the experience of hemodialysis which clients confronted hemodialysis at the same time as CRF diagnosis and to understand the nature and meaning of their crisis experience. The research subjects were 6 clients receiving hemodialysis in Seoul from Jan. 1996 to Jul. 1996. Data were collected by informal indepth interview and participant observation. Content Analysis(by Seaman & Verhonick, 1982; Woods & Catanzaro, 1988) was applied to collect similar contents and common experience in order to derivate concepts and categories for better understanding of their hemodialysis experience. As a result, 6 categories derivated to indentify their hemodialysis experience of the CRF clients-confronted hemodialysis at the same time as CRF diagnosis-were as follows: 1) The category of shocking crisis composed the concepts of shock, amagement and suffocation. 2) The category of denial composed the concepts of disease refusal and hemodialysis refusal. They repeatedly visited hospitals or didn't visit hospital in order to refuse disease, then depended on folk remedy or shamanistic method. 3) The category of severe anxiety composed the concepts of abandoned feeling, shame, resentment, neurosis and anger. 4) The category of depression composed the concepts of grief, suffering of unfairness, tearing, desire to death. 5) The category of powerlessness composed the concept of hopelessness. 6) The category of resigned acceptance composed the concepts of resignation and acceptance. In this study, the CRF clients who confronted hemodialysis at the same time as CRF diagnosis experienced six stages in accepting hemodialysis but these stages were mingled simultaneously and went on.

• 건축역사연구
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• 제25권2호
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• pp.21-30
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• 2016

Autonomia movement that emerged in Italy in the 1960s from workerist (operaismo) communism gives historical and discursive context to Manfredo Tafuri's famous criticism of ideology. His thesis on the death of architecture was a radical criticism of Keynesian intervention which was a strategy to cope with the Great Depression. For him, this capitalist development had taken away ideological prefiguration from architecture. At least Tafuri's this early intellectual phase was formed in the wake of magazine Contrapiano and Antonio Negri's influence. Tafuri almost entirely adapted Negri's thought on the importance of capitalist innovation that was uncovered by Keynes, Schumpeter, and Manheim and the periodization in modern history. When we read Tafuri's text with this concrete context, we can avoid being plunged into his abstruseness. On the other hand, 1980's Korea cannot understand Tafuri comprehensibly. 1980's situation to struggle to acquire democracy prescribed only one mode of reception of Tafuri's historiography in Korea. Tafuri's so-called pessimist view point could not satisfy student activists. They want to take intellectual means to sustain student movement and to secure political dynamics of protest. But at the same time they have anxiety to understand tafuri's thesis that they consider ad a critical theory for Korean Architecture. Double contexts of Tafuri's criticism of ideology bring to light to historicize both Tafuri's historiography itself and reception of his text in Korea.