• 근관절건강학회지
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• 제5권1호
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• pp.26-38
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• 1998

The effects of coping on physical and psychosocial adaptation in the 297 patients with rheumatoid arthritis were investigated. The coping methods were divided into compliance of medical regimens, self-control activities, and cognitive control. The effects of these coping methods was analyzed with stepwise regression. The physical adaptation is found to be significantly affected by cognitive control, self-control activities, and compliance of medical regimens in order Compliance of the medical regimens affects negatively the physical adaptation. And psychosocial adaptation is significantly affected by the cognitive control. The analysis of these results by illness duration showed the distinct differences. That is in the patients who experienced the disease less than 48 months, the physical and the psychosocial adaptation were significantly affected only by the cognitive control. But in the patients who experienced the disease more than 96 months, the physical and the psychosocial adaptation were significantly affected by self-control activities. Based upon these results, it is recommended that the nurses who care the newly diagnosed patients emphasize on the positive side of the state. And the patients who are diagnosed long ago need the nursing programs which teach and promote self-control activities. Also it is suggested that the results of compliance must be considered rather than as the result variable.

• 보건교육건강증진학회지
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• 제30권5호
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• pp.139-151
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• 2013

Objectives: This study investigated how income, duration of illness, social stigma, quality of sleeping, ADL and social participation related to Parkinson's disease(PD) predict depression in a conceptual model based on the International Classification of Functioning(ICF) model. Methods: The sample included 206 adults with idiopathic Parkinson's disease(IPD) attending D university hospital in B Metro-politan City. A structured questionnaire was used and conducted face-to-face interviews. The collected data were analyzed for fitness, using the AMOS 18.0 program. Results: A path analysis showed that the overall model provided empirical evidence for linkages in the ICF model. Depression was manifested by significant direct effects of social stigma(${\beta}=.20$, p<.001), quality of sleeping(${\beta}=-.40$, p<.001), ADL(${\beta}=-.20$, p<.01), and social participation(${\beta}=-.12$, p<.05), indirect effects including income(p<.05), duration of illness(p<.05). These variables explained 45.9% of variance in the prediction model. Conclusions: This model may help nurses to collect and assess information to develop intervention program for depression.

• Child Health Nursing Research
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• 제2권2호
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• pp.5-18
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• 1996

The purposes of this study were to measure the degree of perceived uncertainty and to identify the rearing attitudes of mothers with chronically ill children, and to examine the relationship between the perceived uncertainty and the rearing attitude of these mothers. The subjects of this study consisted of 133 mothers with chronically ill children, registered at 2 university hospitals in Seoul. Data was collected from April 1 to May 31, 1996. The Parents' Perception of Uncertainty Scale(28-item 4 point scale) and the Maternal Behavior Research Instrument (49-item 5 point scale) were used. Data was analyzed by Cluster analysis, ANOVA MANOVA and t-test. Results of this study are summarized as follows : 1. Mothers perceived their uncertainty to be slightly high (Mn 2.48). The degree of perceived uncertainty by the four components slightly differed unpredictability(2.72), lack in clarity(2.58), vagueness (2.52) and lack of information(2.04) . The degree of perceived uncertainty of mothers with ill children revealed to be influenced significantly by the age of the ill children, duration of illness after the diagnosis, and the experience of hospitalization. 2. Among the rearing attitudes : moderatlely high affective(Mn 3.98) and resrictive(Mn 3.58) attitudes of mothers toward their ill children were identified. Mothers tend to give positive evaluations of their childrens' behaviors (Mn 3.38) and less rejection(Mn 2.81). 3. Mothers' rearing attitude were correlated with the degree of perceived uncertainty in illness ; mothers in the Low Perceived Uncertainty Group (Mn 1.99) revealed the highest affective (Mn 4.08), the lowest resrictive(Mn. 2.72) attitudes and tendency to give positive evaluations of their childrens' behaviors (Mn 3.54) compared to the High Perceived Uncertainty Group(Mn 3.26) and Moderate Perceived Uncertaity Group(Mn 2.57). 4. The degree of perceived uncertainty, the duration of illness after the diagnosis and the experience of hospitalization revealed to be significantly influential to the rearing attitude of mothers with chronically ill children. From the above results, it can be concluded that predicting and controlling mothers' uncertainty are necessary for improved, efficient nursing interventions and normal growth & development of the chronically ill children.

• 생물정신의학
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• 제2권1호
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• pp.115-122
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• 1995

This study was performed to know the relationship between neurologic soft signs (NSS) and clinical variables such as psychopathology. history of illness, and premorbid social adjustment in patients with schizophrenia. The authors evaluated NSS in 31 patients with schizophrenia using the structured tool for measuring neurologic abnormalities, Neurological Evaluation Scale- Korean Version(NES-K). Relationships between NSS and clinical variables such as duration of illness, intensity of precipitating stressors, duration of outpatient treatment, schooling, peer relationship, total duration of unemployment, total days of psychiatric admission, age, total days of being medicated, age at the first psychiatric admission, frequency of admissions, content of treatment, social adjustment, and severity of symptoms were analyzed. Differences between paranoid and non-paranoid schizophrenics were examined. In addition, Differences between patients with schizophrenia who have predominant positive symptoms and who have predominant negative symptoms were examined too. Total scores of NES-K were correlated with lower schooling (${\gamma}$=0.44, p<0.01). Scores of motor coordination subcategory were correlated with poor peer relationship(${\gamma}$=0.67, p<0.001). Other clinical variables were not correlated with any scores of NES-K. Paranoid and non-paranoid schizophrenics were not different in scores of NES-K. Also positive and negative schizophrenics were not different in scores of NES-K. Most clinical variables except schooling and peer relationship were not related with NSS. This results indicated that the meaning of these signs was not fully be understood. Introduction of the new classification concepts such as deficit or non-deficit syndrome will be helpful to elucidate the meaning of NSS in patients with schizophrenia.

• 정신신체의학
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• 제9권1호
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• pp.58-65
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• 2001

연구목적 : 공황장애는 약물 치료와 인지 행동적 치료에 의해 두드러진 급성 치료 효과를 보이지만, 많은 환자에서 만성적으로 되고 자주 재발하는 경과를 보이는 것으로 알려져 있다. 본 연구에서는 공황장애에 대한 6 개월간의 전향적 추적 조사를 실시하여, 공황 장애의 치료 경과를 관찰하고, 좋은 치료 경과와 연관이 있는 인자에 대해 조사하고자 하였다. 방법 : 서울중앙병원 정신과 외래를 처음 방문해서 SCID(Structured Clinical Interview for DSM-III-R)에 의해 공황장애로 진단된 29명의 환자들을 대상으로 하였다. 최초 방문시의 인구통계학적 자료와 공황 증상의 임상적 특징 등을 측정하였고 6 개월이 경과한 후에 불안, 공포, 장애의 세 가지 척도를 이용해서 치료 경과를 측정하여 좋은 치료 경과를 보이는 환자의 비율을 조사하였고 공황장애의 좋은 치료 결과와 연관이 있는 인자를 분석하였다. 결과 : 19명에 대해 최종 분석이 가능하였다. 이들 중에 장해 척도와 공포 척도에서 각각 10명(52.6%)이 좋은 치료 경과를 보였고, 불안 척도에서는 8명(42.1 %)이 좋은 치료 경과를 보였다. 또한 8명(42.1 %)이 세 가지 척도 모두에서 좋은 치료 경과를 보였다. 공포 증상면에서는 최초 방문시 공포 척도 점수가 높을수록 좋은 치료 경과와 상관이 있었고(p=0.005) 유병기간이 짧은 것이 좋은 치료 결과와 통계적으로 유의하지는 않으나 상관성의 경향을 보였다(p=0.07). 결론 : 공황장애를 가진 환자 중에서 절반 정도(42.1%) 가 좋은 치료 경과를 보였고, 최초 방문시 공포 증상이 심한 환자와 유병 기간이 짧은 환자가 좋은 치료 경과를 보일 가능성이 있는 것으로 생각되었다.

• 생물정신의학
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• 제24권2호
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• pp.75-81
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• 2017

Objectives Obsessive-compulsive disorder (OCD) is a chronic and disabling psychiatric disorder. The duration of untreated illness (DUI) has been suggested as one of the predictors of clinical course and outcome in various psychiatric disorders. There is increasing evidence that cognitive dysfunction is associated with the prognosis of OCD. The aim of this study was to investigate the influence of DUI on the neurocognitive functions in patients with OCD. Methods Sixty-two patients with a DSM-IV diagnosis of OCD from the outpatient clinic were included in this study. We defined the short DUI if the DUI was 2-year or less and the long DUI if it was longer than 2-year. Neurocognitive functions were assessed by visuospatial memory function test and 4 subsets of K-WAIS such as vocabulary, arithmetic, block design and picture arrangement. Differences in neurocognitive functions as well as clinical variables between OCD patients with short DUI and those with long DUI were investigated. Correlation analyses were also performed to determine the correlation between DUI and neurocognitive functions. Results Compared with the short DUI group, the long DUI group performed worse in the block design test, which measures executive function. The long DUI group also had a higher level of compulsive symptom severity than the short DUI group. However, the DUI was not correlated with neurocognitive functions. Conclusions Findings in this preliminary study suggest that the long DUI in patients with OCD is associated with more severe executive dysfunction. Studies with larger samples and longitudinal design are needed to further confirm the prognostic role of the DUI in OCD.

• Tuberculosis and Respiratory Diseases
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• 제39권4호
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• pp.343-347
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• 1992

연구배경 : 한쪽폐의 전체가 파괴되는 경우는 여러 원인이 있을 수 있다. 이중에서 폐결핵으로 인하여 만성적 염증과 섬유화등을 통하여 파괴된 경우 그 좌우 발생빈도에 차이가 있음을 보고 최근 4년간 국립 공주 결핵뱅원 흉부내과에 입원하였던 224명의 환자를 대상으로 하여 조사하였다. 방법 : 입원 당시의 흉부 방사선 소견을 4가지로 분류하고 성별, 연령, 질병기간, 세균학적 검사를 조사하였다. 결과 : 1) 남녀비는 2 : 1이고 연령은 31~40세가 67명 (30%)으로 가장 많았다. 2) 질병기간은 대부분(88%)이 3년 이상 장기간의 병력을 가지고 있었으며, 6~10년 사이가 87명(39%)로 가장 많았다. 3) 객담 검사상 대부분(80%)이 양성이었다. 4) 흉부 방사선 소견상 좌측폐 전체가 파괴되고 우측에 부분적 병변을 가진 경우가 181명(81%)으로 가장 많았으며 우측폐 전체가 파괴되고 좌측에 부분적인 병변을 가진 경우 31명(14%), 좌측 전폐 파괴만 있는 경우 11명(5%) 그리고 우측 전폐 파괴만 있는 경우 1명 이었다. 5) 성별, 연령, 질병기간 그리고 객담 검사와 흉부 방사선 소견 사이에는 뚜렷한 차이점을 발견할 수 없었다. 결론 : 본 조사결과 폐결핵 환자에서 한쪽폐의 전체가 파괴되는 경우 주로 좌측임을 알게 되었다. 이는 폐결핵 자체의 직접전파, 폐결핵 합병증과 그에 따른 2차적 변화, 기관지 결핵 등에 있어서 좌측폐의 파괴가 더 용이하기 때문으로 생각된다. 질병 기간에 따른 소견 및 질병 초기부터의 변화과정에 대하여 더 많은 연구가 필요 하라라 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제83권4호
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• pp.303-311
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• 2020

Background: If the duration of mechanical ventilation (MV) is related with the intensive care unit (ICU) readmission must be clarified. The purpose of this study was to elucidate if prolonged MV duration increases ICU readmission rate. Methods: The present observational cohort study analyzed national healthcare claims data from 2006 to 2015. Critically ill patients who received MV in the ICU were classified into five groups according to the MV duration: MV for <7 days, 7-13 days, 14-20 days, 21-27 days, and ≥28 days. The rate and risk of the ICU readmission were estimated according to the MV duration using the unadjusted and adjusted analyses. Results: We found that 12,929 patients had at least one episode of MV in the ICU. There was a significant linear relationship between the MV duration and the ICU readmission (R²=0.85, p=0.025). The total readmission rate was significantly higher as the MV duration is prolonged (MV for <7 days, 13.9%; for 7-13 days, 16.7%; for 14-20 days, 19.4%; for 21-27 days, 20.4%; for ≥28 days, 35.7%; p<0.001). The analyses adjusted by covariables and weighted with the multinomial propensity scores showed similar results. In the adjusted regression analysis with a Cox proportional hazards model, the MV duration was significantly related to the ICU readmission (hazard ratio, 1.058 [95% confidence interval, 1.047-1.069], p<0.001). Conclusion: The rate of readmission to the ICU was significantly higher in patients who received longer durations of the MV in the ICU. In the clinical setting, closer observation of patients discharged from the ICU after prolonged periods of MV is required.

• 정신신체의학
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• 제8권2호
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• pp.172-180
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• 2000

연구목적 : 상부 위장관의 소화 장애를 가진 환자들이 스트레스를 지각하였을 때 나타내는 반응 및 소화장애 증상의 여러 변인들과의 관계를 알아봄으로써 특정 정신신체질환군에서의 스트레스에 대한 반응특성과 해당 질환과의 연관성을 알아보고자 한다. 방법 : 소화장애 증상으로 인천기독병원 소화기내과를 방문하여 위내시경 소견 상 병변이 확인된 84명의 환자와 94명의 정상 대조군을 대상으로 국내에서 개발된 스트레스반응 지각척도를 사용하여 스트레스를 인지하였을 때 나타내는 반응을 비교분석하였다. 또한 환자군에서 현재 호소하는 소화장애 증상의 기간, 소화장애의 과거력, 증상의 심각도, 심리적 고통의 존재 여부에 따라 스트레스에 대한 지각반응이 어떻게 나타나는지 평가하였다. 결과 : 스트레스반응 지각척도는 8개의 하위척도로 구성되어 있으며 연구 대상자 178명에서 8개 하위척도와 척도전체의 내적 일치도는 .65~.95로써 통계적으로 유의하게 높았다. 환자군이 대조군에 비해서 척도의 전체총점과 일반적 신체증상척도, 특정신체증상척도의 접수가 통계적으로 유의하게 더 높았다. 소화장애 증상과 스트레스반응 지각척도와의 관련성은 소화장애의 기간, 소화장애의 과거력, 증상의 심각도는 특정신체증상을, 심리적 고통의 존재는 인지기능의 저하와 일반적 부정적 사고를 잘 예측해 주는 것으로 나타났다. 결론 : 실제 상부위장관에 병변을 가진 소화장애 환자들은 정상인에 비해서 강한 스트레스 반응 지각을 나타내었으며 특히 스트레스를 경험하고 인지하였을 때 감정, 인지, 행동 영역의 반응보다는 자율신경계 및 특정신체부위와 연관된 신체증상을 주로 경험하고 있음을 알 수 있다. 또한 이들은 소화장애의 기간이 길고, 과거력이 있을수록, 그리고 증상이 심할수록 스트레스에 대해 소화기 증상을 주로 한 특정신체증상으로 반응하며 심리적 고통을 주는 스트레스의 존재는 인지기능을 저하시키고 부정적인 사고반응을 일으킴을 알 수 있다.

• 수면정신생리
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• 제16권2호
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• pp.56-60
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• 2009

Excessive daytime sleepiness in childhood might be abnormal phenomenon and often related to the sleep disorders or insufficient sleep duration. The most common cause of excessive daytime sleepiness would be insufficient sleep. However, narcolepsy, idiopathic hypersomnia, circadian rhythm sleep disorders, medication, medical illness and other sleep disorders that could cause insomnia and poor quality of sleep also result in excessive daytime sleepiness. The misdiagnosed and untreated excessive daytime sleepiness in childhood can lead to serious developmental and educational problem.