• 한국사회복지학
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• 제42권
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• pp.340-371
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• 2000

The paradigm of care for persons with chronic mental illnesses has recently been shifted in Korea from institutionalization to community integration. Numerous changes in the service environment tend to target clients of mental health care organizations while a considerable proportion of people with similar clinical conditions have been institutionalized in various types of organizations whose auspices are other than mental health care. Under the current circumstances in which the subgroup of people, who tend to be socio-economically disadvantaged, has no viable alternative in the community to using such de facto mental health organizations, their chances of deinstitutionalization may decrease. This study thus aims at providing an increased understanding of the characteristics of the users and their service utilization, which in turn enables us to establish differentiated strategies within the current service context. In this study, a survey is conducted on the residential history of those with chronic mental illnesses both in the community and in institutions. Major characteristics of the users of de facto services are investigated along with the extent of their use of various existing mental and non-mental health services. Included is also an examination of the subjects' clinical and individual factors that may influence their use of de facto services. The study findings demonstrate relative disadvantages in deinstitutionalization in a subgroup of the population with chronic mental illnesses under the current mental health policies, and the author suggests intervening strategies specific to this population.

• Journal of Preventive Medicine and Public Health
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• 제48권1호
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• pp.62-71
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• 2015

Objectives: This study aimed to investigate North Korean refugees' knowledge of mental illnesses and treatments and analyze the factors affecting this knowledge. Methods: Subjects were selected via a snowball sampling method, and the survey outcomes of 152 North Korean refugee participants were analyzed. The factors affecting knowledge of mental illnesses were analyzed via a regression analysis by constructing a multivariate model with mental illness knowledge score as the dependent variable. Results: The North Korean refugees' mental illness scores ranged from 3 to 24 points, with an average score of 13.0. Regarding the factors that influence mental illness knowledge, the subjects with South Korean spouses and those who had spent more time in South Korea had higher knowledge scores. Furthermore, the subjects who considered the mental health of North Korean refugees to be a serious issue revealed lower knowledge scores than those who did not believe it was a serious issue. The subjects who visit psychiatric clinics showed higher knowledge scores than those who do not. The South Korean subjects who had at least a college education exhibited higher scores than did those without advanced education. The subjects who are satisfied with life in South Korea manifested a higher mental illness knowledge score than those who are not. Conclusions: This study is significant as being the first study to ever measure and evaluate the level of North Korean refugees' knowledge of mental illnesses. In addition, the evaluations of North Korean refugees' mental illness knowledge and influencing factors while residing in South Korea created basic data that formed the foundation of an effort to enhance mental health literacy and provide proper mental health services. The results of this study can be utilized to solve mental health problems that might frequently occur during the unification process of North and South Korea in the future.

• 대한간호학회지
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• 제22권3호
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• pp.352-361
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• 1992

This study was designed to identify the relation between the perceived family support and social adjustment of discharged patients with chronic mental illnesses. The subjects for this study were 50 patients with chronic mental illnesses receiving out-patient treatment at one general hospital and one private hospital in Seoul. The data were collected during the period from April 25, 1991 to May 27, 1991. The perceived family support was measured by the Family Support Scale developed by Hyun Sook Kang. A questionnaire which was developed by Weissman was modified by the author of this study to measure the Social Adjustment. The data were analyzed by descriptive statistics and Pearson Correlation Coefficients, using the SPSS program. The results of this study can be summarized as following ; 1) For the perceived family support, the mean was 2.63 points and the source of family support was almost always the mother. 2) For the social adjustment level, the mean was 2.62 points, and the results showed the best social adjustment was in the area of parental role and family adjustment, and the poorer adjustment was in the area of work and leisure. 3) The relationship between the perceived family support and social adjustment revealed a significant correlation.(r＝.38, p＜.05) Therefore the hypothesis “the higher the level of perceived family support, the higher the social adjustment level” was accepted. In conclusion, the study revealed that family support is an important factor related to the social adjustment level in patients with chronic mental illnesses.

• Journal of Preventive Medicine and Public Health
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• 제46권3호
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• pp.147-154
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• 2013

Objectives: Many epidemiological studies have suggested that a variety of medical illnesses are associated with suicide. Investigating the time-varying pattern of medical care utilization prior to death in suicides motivated by physical illnesses would be helpful for developing suicide prevention programs for patients with physical illnesses. Methods: Suicides motivated by physical illnesses were identified by the investigator's note from the National Police Agency, which was linked to the data from the Health Insurance Review and Assessment. We investigated the time-varying patterns of medical care utilization during 1 year prior to suicide using repeated-measures data analysis after adjustment for age, gender, area of residence, and socioeconomic status. Results: Among 1994 suicides for physical illness, 1893 (94.9%) suicides contacted any medical care services and 445 (22.3%) suicides contacted mental health care during 1 year prior to suicide. The number of medical care visits and individual medical expenditures increased as the date of suicide approached (p<0.001). The number of medical care visits for psychiatric disorders prior to suicide significantly increased only in 40- to 64-year-old men (p=0.002), women <40 years old (p=0.011) and women 40 to 64 years old (p= 0.021) after adjustment for residence, socioeconomic status, and morbidity. Conclusions: Most of the suicides motivated by physical illnesses contacted medical care during 1 year prior to suicide, but many of them did not undergo psychiatric evaluation. This underscores the need for programs to provide psychosocial support to patients with physical illnesses.

• 보건행정학회지
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• 제33권3호
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• pp.264-272
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• 2023

Background: Private health insurance supplements the coverage of national health insurance in Korea. In this situation, the subject of the study is to identify the healthcare utilization of people with physical and mental illnesses according to private health insurance. Methods: This study used data from the Korea Health Panel Survey 2018. The study population consisted of 813 individuals with physical and mental illnesses (PMI). Multiple logistic regression analysis and binominal logistic regression analysis were conducted about the utilization of emergency, inpatient, and outpatient medical services of people with PMI depending on enrollment in private health insurance (PHI). Results: The results of this study indicated that individuals with PHI utilized emergency and outpatient medical services less frequently compared to those without PHI. Conversely, having PHI was associated with a higher utilization of inpatient medical services compared to not having PHI. Binomial logistic regression analysis revealed that individuals with PMI who had PHI exhibited a higher frequency of visits to emergency and outpatient medical services compared to those without PHI. However, the significance of this trend was not observed in the case of emergency medical services. On the other hand, individuals with PMI who had PHI showed a lower frequency of visits to inpatient medical services compared to those without PHI. Conclusion: In conclusion, there was a significant relationship between having PHI and the utilization of medical services in people with PMI. There is a need for a follow-up study considering the type of mental illnesses, length of stay, and health outcome of people with PMI depending on having PHI.

• 한국사회복지학
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• 제67권3호
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• pp.57-82
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• 2015

본 연구의 목적은 동네환경과 정신장애인의 지역사회통합과의 관계에서 지역사회응집력의 조절효과를 검증하는 데 있다. 스트레스과정 모델, 사회해체이론, 그리고 동네무질서모델을 이론적 근거로 연구모형을 설정하였다. 서울과 경기도에 거주하는 정신장애인 총 692명에게 설문조사를 실시하여 자료를 수집한 뒤, 조절회귀분석을 수행하였다. 주요한 연구결과는 첫째, 동네무질서가 사회적 통합에 직접적 영향을 미치는 것으로 나타났다. 둘째, 지역사회응집력의 조절 효과는 물리적, 사회적, 심리적 통합 모두에서 유의미하게 나타났다. 연구결과를 바탕으로 정신장애인의 지역사회통합을 달성하기 위해서는 개인차원이나 서비스 차원의 개입전략에서 더 나아가 지역사회차원의 개입이 필요함을 제안하였다.

• 생물정신의학
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• 제3권2호
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• pp.211-215
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• 1996

The present study investigated the associations between CT measures and obstetric complications and family history of major mental illnesses. We had the hypothesis of diosthesis-stress model in the etiology of schizophrenia. We had the following findings. 1) Family history of major mental illnesses is inversely related to obstetric complications. 2) Prefrontal sulcal widening and family history of schizophrenia. are inversely related. 3) In female but not in male patients those with family history of schizophrenia tended to have less prefrontal sulcal widening and ventricular brain ratio. These results suggest that more genetic factors contribute to structural brain abnormalities in female than in male patients.

• 생물정신의학
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• 제18권1호
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• pp.5-14
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• 2011

Neuroimaging in psychiatry encompasses the powerful tools available for the in vivo study of brain structure and function. MRI including the volumetry, voxel-base morphometry(VBM) and diffusion tensor imaging (DTI) are useful for assessing brain structure, whereas function MRI, positron emission tomography(PET) and magnetoencephalography(MEG) are well established for probing brain function. These tools are well tolerated by the vast majority of psychiatric patients because they provide a powerful but noninvasive means to directly evaluate the brain. Although neuroimaging technology is currently used only to rule in or rule out general medical conditions as opposed to diagnosing primary mental disorders, it may be used to confirm or make psychiatric diagnoses in the future. In addition, neuroimaging may be valuable for predicting the natural course of psychiatric illness as well as treatment response.

• International Journal of Advanced Culture Technology
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• 제10권3호
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• pp.210-219
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• 2022

Psychiatric nursing is a specialty where nursing students experience many difficulties in applying what they have learned in theory to clinical practice. Therefore, a situation-oriented case-based strategy is required to help them overcome the limitations of psychiatric nursing clinical practice and reduce their burden. This study aimed to measure the effectiveness of a psychiatric nursing clinical practice program using situation-oriented case-based learning. Participants comprised 63 nursing students in psychiatric nursing classes. The students were asked to create a scenario of interaction between a nurse and patient based on a case study. Empathy, therapeutic communication ability, and attitudes toward mental illnesses were measured. We analyzed the effectiveness of the program by comparing changes in the nursing students' empathy, therapeutic communication ability, and attitude toward mental illness after the program. The participants showed significant increases in empathy and therapeutic communication abilities. However, there were no significant changes in attitudes toward mental illnesses. Based on the results of this study, it is expected that situation-based learning will be effective for students who have difficulties in certain aspects, such as COVID-19, or where there are limited clinical practice opportunities, such as psychiatric nursing.

• 한국콘텐츠학회논문지
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• 제13권11호
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• pp.213-220
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• 2013

본 연구의 목적은 정신질환자를 돌보는 가족의 오명 체험을 파악하고 기술하여 간호중재 방안을 모색하고자 한다. 연구 참여자는 정신질환자 가족으로 부모3명, 자녀1명, 형제1명이다. 자료수집기간은 2010년 6월부터 2010년 10월 까지였고, 참여자와의 심층 면담과 참여 관찰을 통해 자료를 수집하였다. 자료는 Giorgi가 제안한 현상학적 분석방법을 이용하여 분석하였다. 결과: 원 자료에서 발췌된 의미기술은 217개였고, 이를 바탕으로 더욱 추상적이고 통합적인 언어로 묶어 26개의 주제를 도출하였으며 여기서 다시 7개의 중심의미를 도출하였다. 7개의 중심의미는 정신질환자 가족의 오명은 "적절하지 못한 대처, 주변인과의 관계상실, 드러낼 수 없는 자신, 주변간의 갈등, 감당할 수 없는 연민, 자신의 무능력, 자신의 책임전가"이다. 이러한 결과는 정신질환자를 돌보는 가족에 대한 오명을 파악함으로써 사회에서 분리되어야 하는 이들의 아픔을 이해하고 효율적 간호중재 개발에 과학적 근거 자료를 제공한다.