• The Korean Journal of Pain
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• 제35권4호
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• pp.361-382
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• 2022

The third opium war may have already started, not only due to illicit opioid trafficking from the Golden Crescent and Golden Triangle on the international front but also through indiscriminate opioid prescription and opioid diversion at home. Opioid use disorder (OUD), among unintentional injuries, has become one of the top 4 causes of death in the United States (U.S.). An OUD is defined as a problematic pattern of opioid use resulting in clinically significant impairment or distress, consisting of 2 or more of 11 problems within 1 year, as described by the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition. Observation of aberrant behaviors of OUD is also helpful for overworked clinicians. For the prevention of OUD, the Opioid Risk Tool and the Current Opioid Misuse Measure are appropriate screening tests before and during opioid administration, respectively. Treatment of OUD consists of 3 opioid-based U.S. Food and Drug Administration-approved medications, including methadone, buprenorphine, and naltrexone, and non-opioid-based symptomatic medications for reducing opioid withdrawal syndromes, such as α₂ agonists, β-blockers, antidiarrheals, antiemetics, non-steroidal anti-inflammatory drugs, and benzodiazepines. There are at least 6 recommendable guidelines and essential terms related to OUD. Opioid stewardship programs are now critical to promoting appropriate use of opioid medications, improving patient outcomes, and reducing misuse of opioids, influenced by the successful implementation of antimicrobial stewardship programs. Despite the lack of previous motivation, now is the critical time for trying to reduce the risk of OUD.

• 동의신경정신과학회지
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• 제34권1호
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• pp.33-42
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• 2023

Objectives: This study was conducted to observe the progression of symptoms according to the treatment period of patients with social anxiety disorder who received complex Korean medicine treatment. Methods: The medical records of 25 patients who were diagnosed with social anxiety disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and received complex Korean medicine treatment (herbal medicine, acupuncture, and Korean psychotherapy) for 12 weeks were analyzed. The State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI), the Korean-Social Avoidance and Distress scale (K-SAD), and the Korean-Fear of Negative Evaluation (K-FNE) were measured at the initial hospital visit and during the 4, 8, and 12 weeks of treatment to evaluate the effectiveness of treatment. Missing values were replaced with the average evaluation index value at that time. Results: 1) Statistically significant changes in STAI-X1, STAI-X2, BDI-II, BAI, K-SAD, and K-FNE scores were seen according to the time of treatment. 2) When scores were compared between each treatment time point, STAI-X2 and BDI-II showed statistically significant changes between the initial visit and four weeks of treatment, the initial visit and eight weeks of treatment, and the initial visit and 12 weeks of treatment. STAI-X1 and K-FNE showed statistically significant changes between the initial visit and eight weeks of treatment and the initial visit and 12 weeks of treatment. There was a statistically significant change in BAI scores between the initial visit and the 12th week of treatment. Conclusions: Complex Korean medicine treatment alleviated anxiety, depression, fear, and avoidance of social situation symptoms in patients with social anxiety disorder. The longer the treatment period, the more symptoms tended to be alleviated. However, the evidence should be supplemented with prospective, controlled research.

• Safety and Health at Work
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• 제14권4호
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• pp.467-475
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• 2023

Background: To mitigate the spread of Covid-19, nurses infected with the virus were required to isolate themselves from their families and community. Isolated patients were reported to have experienced mental distress, posttraumatic stress disorder symptoms, and suicide. Though studies have reported the psychological impact of the Covid-19 pandemic, less is known about the lived experiences of nurses who survived Covid-19 infection in sub-Saharan Africa. Methods: A descriptive phenomenological approach was used to study the lived experiences of registered nurses who survived Covid-19 disease. In-depth interviews were conducted among nurses diagnosed with Covid-19 from two hospitals in Kenya between March and May, 2021. Purposive and snowball sampling were used to recruit registered nurses. Data were analyzed using Giorgi's steps of analysis. Results: The study included ten nurses between 29 and 45 years of age. Nurses' experiences encompassed three themes: diagnosis reaction, consequences, and coping. Reactions to the diagnosis included fear, anxiety, and sadness. The consequence of the diagnosis and isolation was stigma, isolation, and loneliness. Nurses coping mechanisms included acceptance, creating routines, support, and spirituality. Conclusion: Our findings aid in understanding how nurses experienced Covid-19 infection as patients and will provide evidence-based content for supporting nurses in future pandemics. Moreover, as we acknowledge the heroic contribution of frontline healthcare workers during the Covid-19 pandemic, it is prudent to recognize the considerable occupational risk as they balance their duty to care, and the risk of infection to themselves and their families.

• 대한장애인치과학회지
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• 제8권1호
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• pp.10-14
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• 2012

자폐증 및 정신 지체가 있는 환자의 입술 깨물기 증상을 mouthguard를 사용하여 성공적으로 조절하였다. 치과적으로 접근 가능한 구강 내 자해 증상의 치료는 가철성 혹은 고정성 장치를 이용하거나 관련 치아의 발치, 악교정 수술 등을 시도할 수 있으며 각 환자에 맞는 적절한 치료법을 선택하는 것이 중요하다. 자해 행동이 일시적으로 개선되었다 해도 재발의 가능성이 높으므로 장기적인 관리와 소아정신과와의 협진 하에 정신심리학적 환경 개선 및 약물 치료가 병행되어야 할 것이다.

• Environmental Analysis Health and Toxicology
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• 제31권
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• pp.19.1-19.7
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• 2016

A large portion of the Korean population has been exposed to toxic humidifier disinfectants (HDs), and considering that the majority of the victims are infants, the magnitude of the damage is expected to be considerably larger than what has currently been revealed. The current victims are voicing problems caused by various diseases, including but not limited to lung, upper respiratory tract, cardiovascular, kidney, musculoskeletal, eye, and skin diseases, etc. However, there has been difficulty in gaining validation for these health problems and identifying causal relationships due to lack of evidence proving that toxic HD is the specific causes of extrapulmonary diseases such as allergic rhinitis. Furthermore, the victims and bereaved families of the HD case have not received any support for psychological distress such as post-traumatic stress disorder, depression, feelings of injustice, and anger caused by the trauma. In addition, because the underlying mechanisms of the toxic materials within the HDs such as polyhexamethylene guanidine phosphate, poly(oxyalkylene guanidine) hydrochloride, chloromethylisothiazolinone /methylisothiazolinone have yet to be determined, the demand for information regarding the HD issue is growing. The victims of the HD cases require support that goes beyond financial aid for medical costs and living expenses. There is a desperate need for government-led integrated support centers that provide individualized support through health screenings; in other words, we need an integrated facility that provides the appropriate social support to allow the victims to recover their physical and mental health, so as to well prepare them to return to a normal life. The implementation of such a plan requires not only the close cooperation between those departments already directly involved such as the Ministry of Environment and the Ministry of Health and Welfare, but also active support on a national scale from pan-governmental consultative bodies.

• 한국산학기술학회논문지
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• 제17권3호
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• pp.93-102
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• 2016

본 연구는 MRI 검사 시 음악요법을 동반한 의사소통이 환자의 불안에 미치는 효과를 파악하기 위한 비동등성 대조군 전후 실험연구이다. 연구기간은 2014년 2월 1일부터 2014년 3월 31일이며, 대구광역시에 소재한 C병원에서 MRI 검사를 시행 받은 환자 중 연구에 동의한 60명을 대상으로 분석하였으며, 실험군이 30명, 대조군이 30명이었다. 실험군에게는 MRI 검사 도중 음악요법을 동반은 의사소통을 제공하였고, 대조군에게는 제공하지 않았다. 수집된 자료는 기술통계를 산술하고, 비교검증을 위해 t-test와 ANCOVA를 실시하였다. 연구결과, 음악요법을 동반한 의사소통을 제공받은 실험군과 제공받지 않은 대조군 간의 불안점수는 실험군에서 유의하게 낮았고(p=.001), 활력징후 중에서는 수축기혈압과 이완기혈압 모두 실험군과 대조군 간에 유의한 차이를 보이지 않았으나, 심박수가 실험군에서 유의하게 낮았다(p=.001). 신체적 불편감은 발한, 안면변화, 자세변화, 성음변화 등 4가지 항목 모두 실험군과 대조군 간에 유의한 차이가 없었으며, 정서적 불편감은 어지러움을 제외한 공포감(p=.001)과 긴장감(p=.001)에서 실험군이 유의하게 낮았다, 이상의 연구결과로 볼 때 음악요법을 동반한 의사소통은 MIR검사 시 환자의 불안 감소 및 활력징후 유지, 불편감 감소에 유용한 대체요법이 될 것으로 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.309-314
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• 2014

Purpose: Cigarette smoking causes many kinds of cancer, and it is more closely related with lung cancer, rather than other cancers. Smoking is the leading cause of lung cancer and ninety percent of the smokers are male in China, but there is little published data concerning the psychological responses in the male smokers with lung cancer and its influence on the symptom burden. The aim of the study was to verify the hypothesis that male smokers with lung cancer have more positive attitude and less symptom burden, comparing to male non-smokers. Methods: A total of 194 men with cancer in West China Hospital, Sichuan, China, were assessed by self-administered questionnaire. Psychological response was measured by the Chinese version of Mini-Mental Adjustment to Cancer scale (Mini-MAC), and symptom burden was measured by the physical symptom distress scale from the Rotterdam Symptom Checklist (RSCL). Results: We found that smokers with lung cancer got higher scores in positive attitude and a smaller symptom burden than non-smokers. Patients with education lower than high school got higher scores of positive attitude compared to college graduate patients (p=0.038). Smokers with lung cancer who knew the potential carcinogenicity of cigarette showed less negative emotions (p=0.011). The psychological response was not affected by age, clinical stage, cell type, smoking duration and amount. Conclusions: Male smokers with lung cancer have a more positive attitude and fewer symptoms, comparing to male non-smokers. Appropriate psychological intervention for non-smokers with lung cancer deserves more attention.

• 정신신체의학
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• 제22권2호
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• pp.71-78
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• 2014

연구목적 알츠하이머병 환자들의 행동심리증상(BPSD)은 임상적인 문제들을 일으켜 결국 기능의 감퇴, 간병인 스트레스, 입원, 사망률의 증가를 가져온다. 최근의 연구는 성별차이가 BPSD에서 중요한 역할을 한다고 보고하고 있으나, BPSD와 성별 사이 연관에 대한 국내 연구는 시행된 적이 없었다. 이에 본 연구는 알츠하이머병 환자들의 BPSD가 성별 차이에 의해 영향을 받는 것인지를 검증해 보고자 실시하였다. 방 법 면담과 인지기능평가를 통해 DSM-IV 진단기준에 의하여 알츠하이머병으로 진단받은 98명의 환자들이 본 연구에 참가하였다. 간이정신상태검사(MMSE), 임상치매평가척도(CDR), 전반적 퇴화척도(GDS), 한국형 신경정신행동검사(K-NPI)를 사용하여 인지기능 및 BPSD를 평가하였다. 성별 차이를 확인하기 위해서 독립 t 검증을 사용하여 분석하였으며, MMSE, CDR, GDS와 NPI 사이의 관련성을 살펴보기 위해 피어슨 상관분석을 사용하였다. 결 과 알츠하이머병 환자들의 BPSD에서 통계적으로 유의미한 성별 차이는 관찰되지 않았다. MMSE와 NPI 총점, 그리고 NPI 하위영역인 환각과 유의한 상관관계를 보였으며, CDR의 경우 NPI 총점, 무감동/무관심, 과민/불안정과, GDS의 경우 NPI 하위영역인 환각과 유의한 상관관계를 나타내었다. 결 론 본 연구결과 우리나라 알츠하이머병 환자들의 BPSD에서 성별의 차이는 나타나지 않았지만, 추후 알츠하이머형 치매의 BPSD가 성별 차이에 의한 것인지 혹은 개인 차에 의한 것인지를 더 명확하게 밝혀내기 위한 광범위하고 지속적인 연구가 필요할 것으로 생각된다.

• 기본간호학회지
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• 제5권2호
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• pp.237-256
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• 1998

Death and dying of human being is a comprehensive system, and death orientation, the subjective meaning related to every component of the death system is developed throughout life. This study was designed and carried out to identify, describe and classify the orientations of Korean adult towards the death system. In an attempt to measure the subjective meaning of death and dying, unstructured Q-methodology was used. The 65 Q-statements developed by Kim(1994), used by Kim(1994) and Park(1996) were adopted as Q-population and 39 Q-statements were selected by the three researchers for Q-items for this study. Thirty-three P-samples were sampled from P-population of literate Korean men and women, 35 and 55 years of age, lived in urban Korea for the last 10 years. Sortings of the 39 Q-items according to the level of personal agreement, and a forced normal distribution into the 9 levels were carried out by the P-samples. The Z-scores of the Q-sort data were computed, and the principal components factor analysis by PC-QUANL Program were carried out. The demographic, socio-cultural and health-related attributes of the P-samples were descriptively analysed. Eight types of death orientation were identified ; Type I ; 'naturalist'. Six P-samples. Death is a natural phenomena, to be accepted as it is and to follow its natural course. Prefer to be informed of all facts and possibilities concernig the course of dying and death to occur to self. Type II ; 'life-after-life negator'. Three P-samples. Time and process of death is the destiny of each person. Death means 'darkness' and 'end to every thing, the absolute end'. Yet, wish physical integrity at the dying and after death. Type III ; 'life-after-life believer'. Six P-samples. Men are travellers passing by this life bound to the life-after-life. Priority concerns are on the activities to prepare self for the eternal life ahead. Disregard premature and sudden death. Type IV ; 'here-now believer' Five P-samples. Positive regard to the cremation of the body and donation of the organs on death. Regard religious and customary post-motem rituals meaningless. Negate life-after life. Type V; 'believer of rituals'. Five P-samples. Death being accepted as a part of, a natural end to, and destiny of human life. Concerned to ensure a dignified end to personal life and dignified post-mortem rituals. Type VI ; 'Realist'(derived from Type I). Two P-samples. Life and death as universal reality. The abrupt death at golden age at the peak of happiness is favored to avoid inevitable physical and mental distress of self and the family. Agreed to the cremation of the body. Disregard rituals. Type VII : 'Fatalist' (derived from Type II). Five P-samples. Not favored, yet, all man are destined to death, the inevitable end of all living beings. To ensure dignified end by personal consummation, information on one's dying and imminent death are to be shared. Type VIII ; 'reality avoider'(derived from Type III). One P-sample. Negative to longevity, artificial prolongation of, meaningless and distressful life. Highly positive to postmortem organ donation.

• 한국사회복지학회:학술대회논문집
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• 한국사회복지학회 2000년도 춘계학술대회 자료집
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• pp.615-628
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• 2000

스트레스란, 개인과 환경간의 특별한 관계가 개인의 안녕을 위협하고 개인이 가진 자원을 초과하는 것을 말한다. 븐 연구는 청소년 임신과 스트레스에 관한 문헌연구를 통하여 청소년 임신과스트레스와의 관계에 대해서 살펴봄으로써 임신력 있는 청소년들을 위한 스트레스 관련 임상사회 사업 서비스 개입 방안을 제시하고자 하는데 목적이 있다. 임신으로 인한 부모됨의 변화가 청소년기 자체의 인생 주기 상에서의 스트레스와 중복될 때, 누적된 스트레스는 보다 커진다. 변화의 중첩은 개인 역할의 애매함을 초래하여 스트레스를 가중시키고 발달 과업의 우선순위에 혼란을 가져온다. 청소년기의 임신은 성인기로 이동하는 청소년 당사자, 그 자녀, 사회이 부정적인 영향을 미친다. 이러한 부정적인 영향은 단기간에 끝나지 않으므로 임신한 청소년들의 대처 기술과 적응력을 향상시키기 위한 개입의 노력이 필요하다. 임신한 청소년들의 경우에는 개인 상담 접근만으로는 불충분하며 효과적인 예방 프로그램은 보다 나은 대안이자 동시에 목적이 될 수 있다. 이러한 개입은 임신한 청소년들을 출산 이후에 노출되기 쉬운 디스트레스로부터 보호해주고 성인으로 성장하게 될 청소년들의 건강한 정신건강 도모이 기여하는 것으로 나파났다. 이는 결국, 임신한 청소년들을 대상으로 한 스트레스 대처 능력을 향상시키고 긍정적인 인지를 발달시킬 수 있는 스트레스 관리 프로그램의 필요성을 암시하고 있다. 이러한 연구 결과가 갖는 결론과 함께 앞으로 실천적 개입방안에 대한 더욱 정교한 연구가 요구된다.