• 제목/요약/키워드: Insomnia severity index

검색결과 96건 처리시간 0.023초

정신과질환 4례를 통한 강평본(康平本) 『상한론(傷寒論)』의 태음병(太陰病) 진단 고찰 (A Study on Greater yin Disease in Gangpyeong-Shanghanlun by Analyzing Four Mental Illness Cases)

  • 하현이;윤효중;이성준
    • 대한상한금궤의학회지
    • /
    • 제12권1호
    • /
    • pp.23-48
    • /
    • 2020
  • Objectives : This study aimed to suggest distinct signs of Greater yin disease (tàiyīnbìng, 太陰病) by researching the etymology of three terms: zi-tong (自痛), jie-ying (結硬), and yin-er (因爾), which are exclusive found only in Greater yin disease (太陰病) in Gangpyeong-shanghanlun, but not in other categories. Methods : We studied the etymologies of the three terms that are unique in Greater yin disease, then found some pathological signs that are related with them through the four mental illness cases, which include somatization, obsessive-compulsive behavior, delusion, and panic disorder. Results : Based on the definitions of each term, we diagnosed the four patients who had mental illnesses as having Greater yin disease, and we observed meaningful improvements after administering herbal medication. After Gyejigajakyak-tang administration, the Insomnia Severity Index (ISI) score decreased from 18 to 7 and the Beck's Anxiety Index (BAI) score decreased from 36 to 18 in the first case, the ISI score decreased from 27 to 16 and the BAI score decreased from 50 to 33 in the second case, and the ISI score decreased from 23 to 4 and the BAI score decreased from 34 to 5 in the third case. In the last case, the ISI and BAI scores were 16 and 22, respectively, at the first visit, and it was found that the scores had changed to 6 and 22, respectively, at the last visit. Conclusions : We found that the unique terms in Greater yin disease, including zi-tong (自痛), jie-ying (結硬), and yin-er (因爾), can be interpreted as groundless arbitrary assumption, resting strong tension, and psychological projection based on the etymological hypothesis. Therefore, we suggest these as specific signs of Greater yin disease.

순환교대근무와 주간고정근무 여성 간호사의 회복탄력성에 대한 스트레스, 수면, 우울증의 영향 (Effects of Perceived Stress, Sleep, and Depression on Resilience of Female Nurses in Rotating Shift and Daytime Fixed Work Schedules)

  • 정주리;권혁민;김태형;최말례;은헌정
    • 수면정신생리
    • /
    • 제26권2호
    • /
    • pp.111-124
    • /
    • 2019
  • 목 적 : 건강한 수면은 중요하며 회복탄력성에 긍정적인 영향을 줄 수 있다. 본 연구에서는 교대근무 간호사와 주간 고정 근무 간호사 두 집단에서 회복탄력성의 차이를 비교하고 회복탄력성에 영향을 줄 수 있는 요인들을 조사해보고자 하였다. 방 법 : 두 개의 종합병원에 근무하는 만 20세 이상의 여성 교대근무 간호사와 주간고정근무 간호사 400명을 대상으로 하였으며 2017년 6월 12일부터 2018년 6월 12일까지 설문조사하였다. 한글판 스트레스 자각척도, 스트레스 대처전략 축약형, 사회심리적 건강측정도구, 한국판 역학연구센터 우울척도, 상태불안척도, 피츠버그 수면의 질 지수, 엡워스 주간졸음 척도, 불면증 심각도 척도, 코너 데이비슨 리질리언스 척도 질문지를 적용하였다. 결 과 : 교대근무간호사와 고정근무간호사 두 집단 간의 변수 통계량을 비교한 결과 스트레스 자각, 수면의 질, 주간 졸음증을 제외한 모든 변수에서 통계적으로 의미 있는 차이를 나타내었다. 회복탄력성과 유의한 상관을 보인 요소들은 근무자들의 스트레스 대처전략, 사회 심리적 건강수준, 우울증, 불면증 심각도 이었다(p < 0.05). 다중회귀분석에서는 긍정적 재구성1이 커질수록(β = 0.206, p < 0.001), 우울증이 줄어들수록(β = -3.45, p < 0.001), 사회심리적 건강수준이 높아질수록(β = 0.193, p < 0.001), 수용적 대처2가 증가할수록(β = 0.129, p < 0.05), 주간졸음이 줄어들수록(β = -1.17, p < 0.05), 적극적 대처2가 증가할수록(β = 0.118, p < 0.05), 긍정적 재구성2가 증가할수록(β = 0.110, p < 0.05) 회복탄력성이 커지는 것으로 나타났다. 결 론 : 본 연구에서는 교대근무자에 비해 주간고정 근무자의 회복탄력성이 높음을 밝힐 수 있었다. 또한 특정 스트레스 대처 전략과 사회심리적 건강수준, 수면, 우울증이 회복탄력성과 연관이 있는 것으로 확인되었다. 향후 더 많은 수면과 회복탄력성과의 관계를 밝히는 전향적 연구들이 필요할 것으로 생각된다.

의대의학전문대학원 학생들의 삶의 질과 일주기 리듬 및 수면의 질과의 연관성 (Association between Quality of Life and Eveningness as well as Sleep Quality among Medical Students)

  • 장홍경;이소진;박철수;김봉조;이철순;차보석;이동윤;서지영
    • 수면정신생리
    • /
    • 제22권2호
    • /
    • pp.64-69
    • /
    • 2015
  • 목 적 : 의학전문대학원생들은 의학교육과정 동안 심한 스트레스와 수면 부족을 경험한다. 따라서 의전원생들의 수면 양상, 불면의 정도, 일주기 리듬이 삶의 질과 어떠한 연관성이 있는지 알아보고자 하였다. 방 법 : 경상대학교 의학전문대학원(의전원) 4학년 46명을 대상으로 하였다. 병원 불안-우울 척도, 불면증 심각성 척도, 아침형-저녁형 문항과 삶의 질을 측정하기 위한 세계보건기구 삶의 질 간편형 척도를 사용하였다. 삶의 질과 연관된 요인들을 밝히기 위하여 피어슨 상관분석을 시행하였고 상관성 있는 변수들을 선정하여 다중회귀분석을 시행하였다. 결 과 : 의전원 학생들 중 13명에서 약간의 불면증 경향이 있었다. 명백한 저녁형은 3명, 중등도 저녁형은 12명, 중간형은 28명, 중등도 아침형은 3명이었으며 명백한 아침형은 없었다. 피어슨 분석에서 신체적 영역의 삶의 질과 연관을 보인 요소들은 나이, 주중 및 주말 평균 수면시간, 주중과 주말의 수면 차, 우울, 불면증의 심각성 정도, 아침형-저녁형 점수였고 심리적 영역의 삶의 질과 연관을 보인 요소들은 주중 및 주말의 평균 수면, 불안, 불면증의 정도와 아침형-저녁형 점수였다. 사회적 영역의 삶의 질에서는 성별, 주중 평균 수면시간, 우울, 불면증 점수가 연관성이 있었고, 환경적 영역의 삶의 질에서는 주중 및 주말의 평균 수면시간과 불면증의 심각성 정도가 연관성이 있었다. 다중회귀분석을 통하여 불면증의 심각도가 낮을수록 신체적 건강영역, 심리적 영역과 환경적 영역의 삶의 질이 높고, 저녁형 일수록 신체적 건강 영역과 심리적 영역의 삶의 질이 높은 것으로 나타났다. 결 론 : 의전원 학생들에서 수면의 질이 좋을수록 신체적 및 심리적, 환경적 영역의 삶의 질이 높았고, 저녁형일수록 신체적 및 심리적 영역의 삶의 질이 높았다. 이를 통해 학생들의 수면 습관 개선이 정서적 문제에 대한 개입 못지 않게 중요하다는 것을 알 수 있다.

아토피 피부염에 대한 화피(樺皮), 만형자(蔓荊子), 선학초(仙鶴草) 함유 외용제의 임상 효과 (Clinical Efficacy of External Application Containing Betula platyphyllae Cortex, Viticis Fructus, Agrimoniae herba in Atopic Dermatitis)

  • 홍지희;정현아
    • 한방안이비인후피부과학회지
    • /
    • 제27권1호
    • /
    • pp.1-16
    • /
    • 2014
  • Objectives : The aim of this study is to examine the effect of external application containing herbal extracts (Betula platyphyllae Cortex, Viticis Fructus, Agrimoniae herba) to patients with atopic dermatitis. Methods : Twenty patients (experiment group) were treated with the external application containing herbal extracts (Betula platyphyllae Cortex, Viticis Fructus, Agrimoniae herba) and other twenty patients (control group) were treated with normal external application that doesn't contain herbal extracts for 2weeks. We observed comparisons between experiment and control group after 1week, 2weeks. Degrees of severity of atopic dermatitis were measured by SCORAD index (Scoring of Atopic Dermatitis Index). Statistical significance was achieved if the probability was less than 5% (p<0.05). Results : 1. After 1week of external application treatment, SCORAD Index in experiment group was significantly decreased comparing with control group, which is a marginally significant result between two groups. But after 2weeks the experiment group showed no statistically significant result. 2. After 1week of external application treatment, Intensity Criteria (Erythema, Edema/papulation, Total) in experiment group was significantly decreased comparing with control group, which is a statistically significant result between two groups. But after 2weeks the experiment group showed no statistically significant result. 3. After 1week and 2weeks of external application treatment, comparison of changes in Subjective Symptoms (Pruritus, Insomnia) indicated that the experiment group showed no statistically significant result. 4. After 1week of external application treatment, Total Quality of life through Skindex-29 in experiment group was significantly decreased comparing with control group, which is a marginally significant result between two groups. But after 2weeks the experiment group showed no statistically significant result. Conclusions : As a result of applying the external application containing herbal extracts to patients with atopic dermatitis and watching the progress, we can speculate that the external application containing herbal extracts has especially short-term therapeutical effects in mitigating the symptoms of Atopic Dermatitis. Thus, it is concluded and considered that the external application containing herbal extracts can be used by atopic patients effectively with almost no side-effect.

유방암 환자에서의 디스트레스의 유병률 및 디스트레스가 삶의 질에 미치는 영향 (Prevalence of Distress and Its Influence on Quality of Life in Breast Cancer Patients)

  • 전수연;심은정;황준원;함봉진
    • 정신신체의학
    • /
    • 제18권2호
    • /
    • pp.72-81
    • /
    • 2010
  • 연구목적 디스트레스를 조기에 발견하여 치료하는 것이 효율적인 암 환자의 관리에 필수적이라는 인식이 확대되고 있다. 본 연구에서는 유방암 환자들의 디스트레스의 유병률을 조사하고, 그 디스트레스가 삶의 질에 미치는 영향을 알아보았다. 방 법 서울의 한 대학병원 유방암 환우회 환자 95명을 대상으로 병원우울불안척도, 불면증심각도척도, 사건충격척도 개정판, Functional assessment of cancer therapy-Breast(FACT-B)를 시행하였다. 결 과 디스트레스의 유병률은 우울 26.3%, 불안 26.3%, 불면 13.7%, 외상후스트레스장애 증상 24.3%였다. 한가지 이상의 디스트레스를 겪고 있는 환자는 전체의 47.4%였으며, 이들은 정상군에 비해 FACT-B 총점으로 측정한 삶의 질 평균점수가 유의하게 낮았다(82.91 vs. 107.20, p<0.001). 정상범위의 환자들에서도 디스트레스와 삶의 질은 유의한 관계를 보였다. 결 론 유방암 환자의 디스트레스를 조기에 발견하기 위한 주기적인 선별검사와 적절한 치료가 필요하다.

  • PDF

화병 환자의 심박변이도 차이에 따른 황련해독탕의 효과: 화병에 대한 무작위 대조 비교임상시험 결과의 추가 분석 (Role of the Baseline Heart Rate Variability to the Effect of the Huanglian-Jie-Du Granule in Hwa-Byung Patients: Supplementary Analysis from the Randomized Trial Comparing Huanglian-Jie-Du Granule and Placebo for Hwa-Byung)

  • 최유진;조성훈
    • 스트레스연구
    • /
    • 제26권4호
    • /
    • pp.305-311
    • /
    • 2018
  • 화병은 뚜렷한 스트레스 사건과 관련되어 가슴의 답답함, 열감, 치밀어 오름, 억울하고 분한 감정 등이 나타나는 증후군이다. 본 논문에서는 화병에 대한 황련해독탕의 임상시험 결과를 교감신경의 활성도를 반영한다고 알려져 있는 심박변이도의 저주파(0.04~0.15 Hz) 영역 값을 중심으로 분석하여 다음과 같은 결과를 얻었다. 첫째, 황련해독탕 시험군에서 초기 심박변이도 저주파 값이 클수록 불면 증상의 개선 정도가 작게 나타났다. 둘째, 위약과 비교했을 때, 황련해독탕은 복용 7일 후 심박변이도 저주파 값을 유의하게 감소시켰다. 셋째, 화병 증상 중 가슴이 답답함, 치밀어 오름, 분노가 심박변이도 저주파 값과 유의미한 상관성이 있었다. 이를 바탕으로 심박변이도는 화병 환자를 평가할 때 유용할 것이라고 기대된다.

교통사고 후 발생한 급성 수면장애 환자에 대한 M&L 심리치료와 한방 복합치료 치험 3례 (Acute Insomnia in Post-Traffic Accident Patients Treated with M&L Psychotherapy Combined with Traditional Korean Medicine: Three Case Reports)

  • 구강모;박지원;지정효;김나영;이동환;김효림;임유라;손자연;양석규
    • 동의신경정신과학회지
    • /
    • 제35권2호
    • /
    • pp.205-216
    • /
    • 2024
  • Objectives: To evaluate the effectiveness of Mindfulness & Loving Beingness (M&L) psychotherapy combined with traditional Korean medicine in treating acute sleep disorders in patients hospitalized following traffic accidents. Methods: We applied traditional Korean medicine treatments in conjunction with various mindfulness meditation techniques from M&L therapy, including Resource Mindfulness and Nourishment Brief Therapy. This study was conducted on three patients who reported acute sleep disorder symptoms on the first day of hospitalization following a traffic accident. The effectiveness of these interventions was assessed using the PTSD Checklist for DSM-5 (PCL-5-K), Insomnia Severity Index (ISI), EuroQol 5-Dimension (EQ-5D), Numerical Rating Scale (NRS), and Patient Global Impression of Change (PGIC). Results: ISI and PCL-5-K scores showed significant improvements after treatment, indicating reduced sleep disturbances and stress symptoms. Additionally, EQ-5D and PGIC scores were enhanced, reflecting an overall improvement in quality of life. Conclusions: This study suggests that integrating M&L therapy with traditional Korean medicine could significantly improve symptoms in patients with acute sleep disorders following traffic accidents.

Reflection of Pain in Cancer Patients Using a New Screening Tool for Psychological Distress

  • Oh, Seung-Taek;Lee, San;Lee, Hyeok;Chang, Myung Hee;Hong, Soojung;Choi, Won-Jung
    • 정신신체의학
    • /
    • 제25권1호
    • /
    • pp.56-62
    • /
    • 2017
  • Objectives : The objective of this study was to investigate the relationship between psychological distress and pain in cancer patients. Methods : 249 patients with cancer who visited National Health Insurance Service Ilsan Hospital between April 2013 and March 2014 were evaluated with National Cancer Center Psychological Symptom Inventory(NCC-PSI) which consisted of Modified Distress Thermometer(MDT) and Modified Impact Thermometer(MIT). Each scale was divided into 3 subscales targeting separate symptoms: insomnia, anxiety, and depression. Psychological distress was defined as positive for those who scored above the cutoff values in at least one of all six subscales. The Numeric Rating Scale for Pain(NRS-Pain) was used to assess the subjective severity of pain. Logistic regression was performed to investigate the association between psychological distress and pain. Results : Univariate logistic regression analysis showed that pain, gender, compliance, and two subscale scores of Hospital Anxiety and Depression Scale(HADS) were significantly associated with psychological distress. Multivariate logistic regression analysis showed that pain and HADS anxiety subscale score maintained a statistically significant association with psychological distress adjusted for variables including age, gender, years of education, Eastern Cooperative Oncology Group performance status, cancer stage, Charlson Comorbidity Index, compliance, and HADS depression subscale score. One point increase in pain was 1.31 times more likely to cause psychological distress. In secondary analysis, pain was significantly associated with all subscales of NCC-PSI, except MIT-anxiety subscale. Conclusions : This study suggests that NCC-PSI, a screening tool for psychological distress, reflects pain. We recommend that physicians who treat cancer patients consider the examination of psychological distress which provides comprehensive evaluation of various factors regarding quality of life.

우울장애 한약치료에 대한 전향적 관찰연구 (A Prospective Observational Study of Herbal Medicines on Depressive Disorder)

  • 김주연;김환;이지윤;정진형;양창섭;이미영;정인철
    • 동의신경정신과학회지
    • /
    • 제31권2호
    • /
    • pp.63-76
    • /
    • 2020
  • Objectives: The purpose of this study was to verify the clinical effects of herbal medicines on patients with depressive disorder. Methods: A prospective observational study on patients with depressive disorder was conducted. The patients were treated with herbal medicines for eight weeks. The Korean Hamilton Depression Rating Scale (K-HDRS) was evaluated as the primary outcome and the Korean Beck's Depression Inventory (K-BDI), Instrument on Pattern Identification for Depression, Korean Symptom Checklist-95 (KSCL-95), Insomnia Severity Index (ISI), Korean State-Trait Anxiety Inventory (STAI-K), Korean State-Trait Anger Expression Inventory (STAXI-K), EuroQol five-dimensional Questionnaire (EQ-5D), Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Heart Rate Variability (HRV) were measured as the secondary outcome. Adverse events were assessed for safety. Results: A total of 35 participants were observed for 12 weeks. The K-HDRS improved significantly in four, eight, and 12 weeks and the K-BDI showed significant differences in four, and eight weeks. There were no significant improvements in other evaluation scales. Gyejibongnyeong-hwan was the most frequently and continuously prescribed, showing significant improvements of K-HDRS after eight weeks of treatment. Conclusions: In our observational study, herbal medicine was effective for relieving the depression of patients with depressive disorder and Gyejibongnyeong-hwan showed the most significant effectiveness.

교대근무 간호사의 월경 전 증상 영향 요인 2차자료 분석: 수면, 직무 스트레스를 중심으로 (Secondary Data Analysis on the Factors Influencing Premenstrual Symptoms of Shift Work Nurses: Focused on the Sleep and Occupational Stress)

  • 백지현;최스미
    • 대한간호학회지
    • /
    • 제50권4호
    • /
    • pp.631-640
    • /
    • 2020
  • Purpose: This study aimed to examine premenstrual symptoms (PMS) of shift nurses and identify the association between PMS, sleep, and occupational stress. Methods: This study was conducted with a secondary data analysis that used data from the Shift Work Nurse's Health and Turnover study. The participants were 258 nurses who were working in shifts including night shifts. PMS, sleep patterns (sleep time and sleep time variability), sleep quality, and the occupational stress of each participant were measured using the Moos Menstrual Distress Questionnaire, a sleep diary, an actigraph, the Insomnia Severity Index, and the Korean Occupational Stress Scale, respectively. Data were analyzed using SPSS 23 and STATA 15.1 to obtain descriptive statistics, Pearson's correlation coefficients, multiple linear regression with generalized estimating equations (GEE) and Baron and Kenny's mediating analysis. Results: The average PMS score, average sleep time, average sleep time variability, average sleep quality score, and average occupational stress score of the participants was 53.95 ± 40.45, 7.52 ± 0.89 hours, 32.84 ± 8.43%, 12.34 ± 5.95, and 49.89 ± 8.98, respectively. A multiple linear regression analysis with GEE indicated that sleep time variability (B = 0.86, p = .001), and sleep quality (B = 2.36, p < .001) had negative effects on nurses' PMS. We also found that sleep quality had a complete mediating effect in the relationship between occupational stress and PMS. Conclusion: These findings indicate that both sleep time variability and sleep quality are important factors associated with PMS among shift work nurses. To improve shift nurses' PMS status, strategies are urgently needed to decrease sleep time variability and increase sleep quality.