• 재활간호학회지
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• 제15권2호
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• pp.91-99
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• 2012

Purpose: The purpose of this study was to identify the frequency and status of mentally ill patients who registered in a community health center (CHC) but they could not be accessed. Methods: A total of 233 mentally ill individuals who were registered to a CHC in B Metropolitan City participated in this survey. Data were collected from December 1 to 31, 2010 and analyzed. Results: There were 140 (60.1%) community dwelling mentally ill patients who had been registered to that CHC but were not accessible. The major reasons of this inaccessibility were patients' rejection to be accessed (27.1%) and the wrong or missing address in hospital's discharge note (22.9%). The nursing problems of the subjects were rejection of medication (93.4%); poor personal hygiene (85.8%); violence including harassment of family member(s), assault, property destruction, threat with weapon (38.7%); and so on. Among 159 cases of referrals and requests for help immediate action with patient's compliance were only 8.8%. Conclusion: The findings show that mentally ill patients who had registered to the CHC but were not able to be accessed failed to be managed properly. This would become risk factors of social problems which threat to the community as well as individuals. Thus, we need to prepare programs for this population to make them take medicine at a minimum.

• Journal of Preventive Medicine and Public Health
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• 제32권3호
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• pp.400-414
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• 1999

Objectives: This is a descriptive study which was carried out to identify characteristics of the chronic mentally ill and their families in a rural area and the influencing factors on family burden. Methods : Data was collected for seven months beginning April 1, 1998 by questionnaire from chronic mentally ill patients and their families in two towns and seven townships of the rural areas of Kyonggi Province. In additional to the mental diagnosis of the mentally ill patients, family burden was measured by interviewing the other family members using the questionnaire developed by Pai & Kapur (1981). Of those interviewed, 103 patients were selected for final analysis. Results : Of 103 mentally ill patients, 36.1% of the subjects were not under treatment. In particular, of 29 patients with schizophrenia, 48.3% of the subjects had stopped taking medication and 6.9% of the subjects had never been treated. According to the results of a specialized examination by a psychologist, 81% of patients were in need of Hospitalization. Most primary caregivers were parents. Of the 101 primary caregivers in the study, 39.6% were over 65 years old. In case of death of the primary caregiver, 50.5% of these 101 mentally ill patients would not have anyone to care for them. Of the various kinds of family burden, primary caregivers most often reported psychological stress. Overall, the families of dementia and schizophrenia patients complained of the most family burden. Through univariative analysis, the variables of sex, education and current treatment type of the patients, the relationship with the patient and marital status of the primary caregiver and the number of people living together in the household showed significant correlation with the family burden of schizophrenia patients. Univariative analysis also showed that there were a number of variables which were correlated to the family burden in mentally retarded patients. Concerning the need for mental health services, the most common requests were for entitlement to disability benefits and housing programs. Conclusions: Community mental health services in rural areas must be developed, planned and executed in consideration of the local situation. In particular, the development of various family support programs is needed in order to mitigate emotional, mental and economic burdens and carry out a positive role to care for and rehabilitate patients.

• 대한간호학회지
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• 제30권1호
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• pp.202-212
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• 2000

The purpose of this study was to identify the relationship between the burden of family with the mentally ill and professional needs. Data collection period was from June 29, 1998 to July 30, 1998. The subjects for the study was 134 family members of psychiatric in-patients and out-patients in Taejon and Chungnam. The questionnaire developed by OK-KYUNG YANG to measure the family burden and professional needs was used for this study. The tools used for this study were composed of General characteristics(30 items), family burden(43 items), professional needs(26 items). The data was analyzed by using on SPSSWIN program and included percentage, mean, S.D., t-test, ANOVA and Pearson correlation coefficient. The results of the analysis were as follows; The mean score of family burden was 134.26, which is higer than the mean score of the instrument. The mean score of professional need, the family caregiver who supporting of mentally ill patients, was .48 which is lower than the mean score of the instrument. Family burden was statistically correlated with professional needs(${\gamma}$=.6139, P<.001). There were statistically differences in family burden for respondent's relation, location of living, most care money giver, substant care money giver. There were statistically significant difference in professional need for family age, marriage status, substant care money giver, information status. The conclusion that can be drawn from this study is that addressing professional needs would contribute to reduce burden of the family caregivers with mentally ill. Therefore, Nursing interventions are needed to reduce family burden.

• 한국융합학회논문지
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• 제11권4호
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• pp.265-275
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• 2020

본 연구는 내러티브 탐구를 활용하여 정신과 낮병원 이용 환자들의 경험을 연구하였다. 연구자들은 낮병원 이용경험이 있는 정신과 환자 4명을 대상으로 3회 이상 심층면담을 실시하였으며 낮병원 퇴원 후 외래 진료 과정에서 추가 면담을 실시하여 자료를 수집했다. 연구 참여자들의 낮병원 이용 경험의 의미는 '세상과 끊어진 줄을 다시 묶다.', '힘이 되는 마음의 안식처.', '삶에 대한 방향성을 찾다.' 세 가지 주제로 나타났다. 본 연구는 정신과 낮병원 이용 당사자들의 이야기를 깊이 있게 다루었다는 점에서 의의가 있다. 연구 결과를 바탕으로 정신과 환자의 고립 해소를 위한 제도적 지원, 다양한 지지체계 활성화 노력, 프로그램 개발 활성화의 정책적 제안을 한다.

• 한국보건간호학회지
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• 제15권1호
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• pp.56-72
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• 2001

Community mental health management system emphasizing on the rehabilitation and the return to the community has been established and carried out for many years. The study has been demanded to prove that the decreasing rate of the recurrence of the mentally ill resulted to lower their medical costs, to enrich the quality of life, and to reduce the psychological burden of their family. This study tried to prove that the mental health services to the mentally ill which were registered in community mental health center of A city have an influence on the medical cost, the quality of their lives. the family burden. The subject group of this study were 39 home-based mentally ill patients and their 37 family members, totally 76 people registered in mental health center of A city and participated in its program. This research had been measured twice, the first before the intervention and the second after at least a year. The measuring tools in the research were the medical cost measurment tools developed by the researcher, the quality of life index by Yoo ja, Noh(1988) and the family burden by Montgonery(1985). The methods were modified and supplemented in this study. This research made use of SPSS Win 10.0. The results of this study are the same as followings. 1) There were the significant difference in the medical cost before and after the mental health service delivery. 2) The quality of lives of the mentally ill, after the mental health services delivered were significantly higher than before. 3) The family burden were significantly reduced after the delivery of community mental health services. Community mental health services brought out efficient results to the social return and rehabilitation. And these results means that the mentally ill changed highly the quality of life and their burden of family and medical cost were reduced. So the public organization and the private society should help positively the mentally ill and their family through mental health policy and social service agency to live healthy lives and to be valuable member of society.

• 대한간호학회지
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• 제3권3호
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• pp.62-72
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• 1973

THE author conducted a field survey form Feb.1, 1973 to March 31, 1973 in the Busan area, standing six "institutions" where mentally ill patients are kept. These six institutions are registered at Busan Government, but are not regular hospitals. There suits of these investigation are as follows: \circled1 There are six institutions. which are registered at Busan City Government. All six are operated by layman who have little psychiatric knowledge and little human is tic motivation. \circled2 These institutions are allegedly to promote the welfare of the mentally sick. However they give little help for the patients. And they do not even have a resident medical person. The staff of those places will not accept professional medical help, and try to keep all information secret. \circled3 The finances are largely composed of patients′fees and partially from city′s help. The buildings are of high quality compared with the poor therapeutic situation. There also exist factors which make the patients worse, i,e. very small room space, compelling the patients to sit in a uteral position. This situation makes them worse and more autistic. \circled4 At the time of this survey, those lucrative overcrowded six institutions had 1.000 patients. At the same time the legitimate hospitals in Busan area had about 200 patients, \circled5 In my opinion, the City Government must take a more positive policy for the mentally ill patients, instead of the passive attitude which has held till now. And most of all, these patients must be medically and humanistically helped, instead of being left in a forgotten, depressed snake pit.

• 의료법학
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• 제25권1호
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• pp.87-115
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• 2024

우리나라는 급격한 발전과 더불어 많은 성장을 이루는 과정에서 스트레스에 노출이 정신적 고통을 수반하게 되었고 다양한 사회문제로 나타나며, 응급입원의 빈도가 높아지고 있다. 정신질환자의 경우 '비자의 입원'이 문제가 되며, 경찰, 119구급대원이 정신질환자의 신체억제를 시도하며, 많은 문제점이 노출되고 있다. 이는 정신건강복지법 상 응급입원의 조항의 구성요건이 현실을 반영하지 못해 하나의 정신질환자를 두고 각 기관이 다른 입장을 내며, 응급입원이 원활하게 진행되지 않거나, 관계기관의 마찰로 이어지며 정신질환자의 안전이나, 타인의 안전이 확보되지 못하는 경우가 발생하고 있다. 응급입원은 주체가 '정신질환자로 추정되는 사람으로 자신의 건강 또는 안전이나 다른 사람에게 해를 끼칠 위험이 큰 사람을 발견한 사람'으로 정하고 있으며, 그 상황이 매우 급박하여 스스로 입원을 결정하는 입원절차를 거칠 시간적 여유가 없는 경우 의사와 경찰관의 동의를 얻어 응급입원을 의뢰할 수 있다고 규정하고, 이 경우 119구급대원이 정신의료기관까지의 호송하도록 하고 있다. 이러한 응급입원의 조항은 정신의료기관까지 이송하는 과정에 많은 문제를 내포하고 있다. 실무를 담당하는 경찰관이나 119구급대원이 응급입원과정 중 '물리력'을 사용하게 되면, 필연적으로 부작용이 발생하게 되는데, 업무상과실이 문제가 될 수 있으며, 구체적으로는 물리력을 행사할 때 법령에 근거하고 비례원칙에 따른 필요최소한도의 신체억제가 필요하게 되는데, 법령상 119구급대원이나 경찰관의 주의의무의 부재가 결국 다른 법령을 적용하여 해결하게 된다는 것이다. 이에 정신건강복지법 상 응급입원 조항의 주체를 경찰, 소방기관의 장점을 살려 주체를 변경하고, 정신보건법의 시행규칙으로 신체보호대 사용을 정의하고, 규정함으로써 119구급대원과 경찰관의 주의의무를 설정하고 정신질환자가 안전하게 치료받을 수 있도록 이송에 대한 환경을 조성함으로써 자기 또는 타인의 위험을 내포하고 있는 정신질환자 또한 안전한 환경에서 정신의료기관으로 이송될 수 있는 계기가 될 것이다.

• 한국사회복지학
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• 제46권
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• pp.210-235
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• 2001

This study purposed to standardize the Korean versions of the General Health Questionnaire, especially KGHQ-20 and KGHQ-30, through the evaluation of their reliability and validity. The two KGHQs, along with several other scales that measure psychological symptoms, were administered to 916 students and 102 chronically mentally ill patients at mental health hospitals in Korea. Both of the KGHQs were found to have high reliability based on test-retest correlation coefficients, internal consistency (Chronbach's ${\alpha}$) as scales, and item-total correlations for most of the items. The two KGHQ scores were shown to have high validity based on three methods of analysis; first, both KGHQ scores had highly significant correlations with most of other measures for psychopathology, such as SCL-90, CES-D, SDS, BAI, STAI; second, there were significant differences of the two KGHQ scores between the group of mentally healthy students and the group of chronically mentally ill patients; the validity of the KGHQ-30 was also derived from high sensitivity and specificity, which helped identify the best cut-off points: 15/16 for the KGHQ-30. The cut-off point for the KGHQ-20 was determined at 12/13 based on the mean scores and standard deviations of other scales as well as of the KGHQ-20.

• 한국사회복지학
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• 제37권
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• pp.217-239
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• 1999

본 연구는 일차적 보호제공자인 가족들이 만성 정신장애인으로 인한 스트레스에 적극적 대처를 하는 것이 그들의 치료와 재활에 중요한 요소라는 전제하에 정신장애인 가족의 적극적 대처에 어떠한 요인들이 관련되는지 알아보고자 하는 것이다. 따라서 총 191명의 만성정신장애인 가족들을 대상으로 그들의 인구사회학적 요인과 정신장애인에 대한 보호부담, 사회적 지지가 적극적 대처와 어떤 관련을 갖는지 그리고 그러한 요인들의 적극적 대처에 대한 영향력은 어느 정도인지 알아보았다. 그 결과, 인구학적 배경에서는 대상 가족의 성별과 교육정도가 적극적 대처와 유의한 상관관계를 보였고 가족이 느끼는 여러 가지 보호부담과의 관계에서는 사회적, 제도적 지원부족에 대한 부담만이 통계적으로 의미 있는 정적인 상관관계를 보였다. 사회적 지지와의 관계에서는 사회적 지지의 하위 척도인 판단적 지지, 정서적 지지, 물질적 지지 모두가 적극적 대처와 높은 정적 상관 관계를 보였다. 적극적 대처에 영향을 주는 요인들을 알아보기 위해 회귀분석을 실시한 결과 인구학적 배경, 보호부담, 사회적 지지는 적극적 대처에 통계적으로 유의한 영향력을 가지는 것으로 나타났고 그 설명력은 26.2%이다. 또한 단계적 회귀분석을 실시한 결과 정서적지지, 사회적, 제도적 지원부족에 대한 부담, 대상자의 교육정도가 적극적 대처에 영향력 있는 예측요인이었고 이 3가지 요인만으로도 21.9%의 설명력을 가지는 것으로 나타났다. 이러한 결과를 통해 본 연구에서는 정신장애인 가족들의 대처를 강화하기 위해 지지집단의 활성화와 정서적 지지, 교육, 가족치료를 포괄적으로 제공하는 교육 및 지지모델의 임상적 활용을 제안하였다.

• 대한간호학회지
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• 제12권1호
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• pp.13-24
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• 1982

The main purpose of this study was to investigate attitudes toward mental illness and the mentally ill of psychiatric nurses in Korea and to identify the relationships between the nurses' attitudes and demographic variables. Subjects in this study were 122 psychiatricnurses and 111non-psychiatric nurses in active service at 12 hospitals in Seoul. The insrtument used for measuring attitudes was a questionaire developed by Cohen and Struening (1962) referred to as the“Opinions about Mental illness(OMI) Scale”made up to 51 Likert-type items. The findings of this study indicated hatnurses showed negative attitudetoward mental illness and the mentally ill: Very high on social restrictiveness (factor D), low on Mental Health Ideology (factor C), and Interpersonal Etiology (factor E). Since the high score on Factor A, B and the low score on Factor B, C, E reflect a negative altitudes toward mental illness, this study population related extremely negative attitudes compared to any other surveys. And of the demographic variables that related to their attitudes the education degree and the kind of the hospital in active service showed very significant differences. On the basis of the investigation the findings indicated the followings; 1) Althohg attitudes toward mental illness and the mentally ill of psychiatric nurses were not significant differences from non-psychatric nurses, there was a trend that attitudes of psychaitric nurses did show more negative responses rather than those of non-psychiatric nurses. 2) Demographic variables that relate to their attitudes on the OMI scale were the education degree of the respondent and the kind of their hospital in active service. 3) About attitudes toward mental illness and the mentally ill baccalaureate nursesshowed more positive attitudes in Factor A (Authoritarianism), Factor C (Mental Health Ideology) and Factor D (Social Restrictiveness) than diploma program murses. 4) Nurses in active Service in the private hospital revealed more positive attitudes(A,B,C,D) except Factor (E) than those in the national or public hospital. 5) The ages, duration of work, wanted or unwantedG roup of psychiatric ward and satisfactory level of psychiatric nursing service were non-significant.