• 제목/요약/키워드: PTSD(Post-Traumatic Stress Disorder)

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외상 후 스트레스 장애에 대한 한방정신요법 기반 심리치료 개발 및 예비적 임상시험 (Development of Korean Medical Psychotherapy and Preliminary Clinical Trial for Post Traumatic Stress Disorder)

  • 김진형;서주희;이고은;김남권;최성열;유영수;강형원
    • 동의신경정신과학회지
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    • 제26권1호
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    • pp.49-61
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    • 2015
  • Post traumatic stress disorder (PTSD) is an anxiety disorder that usually occurs after suffering from a psychological trauma that can not threatening events, which is one of the individual's subjective pain and their families and the larger society due to the chronic disease burden results. Treatment with a medication, as well as cognitive behavioral therapy (CBT), exposure therapy, prolonged exposure therapy (PE), eye-movement desensitizing, and reprocessing (EMDR) are preferentially performed, including psychotherapy. Korean medical psychotherapy consists of a wide range of manual therapy, but it does not have systematically screening limits. This study was developed by Korean medical psychotherapy program for PTSD, and it was carried out as a preliminary clinical trial for validity. The Korean medical psychotherapy program for PTSD consists of four stages as follows: building chapter of safety, flow and send, accept, and integration. Based on this preliminary clinical study of PTSD, seven patients were treated for 2 hours per week for 5 weeks. We report the meaningful results gained by observing the changes in IES-RK points, questionnaire on five-faceted mindfulness, quality of life, anxiety, depression, insomnia, hwabyung scale, HRV, and EEG, before and after the Korean medical psychotherapy program.

의료사고 환자들의 외상후 스트레스 장애(PTSD) 실태: 의료진의 설명 및 태도와 사회적 지지의 상호작용 (Post Traumatic Stress Disorder (PTSD) in Medical Accident Patients: The Interaction Effect of Clinicians' Explanation and Attitude and Social Support)

  • 김나연 ;이수란 ;최예은 ;손영우
    • 한국심리학회지 : 문화 및 사회문제
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    • 제23권2호
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    • pp.215-237
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    • 2017
  • 의료사고 관련 연구들은 의료분쟁 및 피해구제와 관련한 법이론적 연구가 대부분이며 의료사고 환자들의 심리적 경험을 심층적으로 탐구한 연구는 부족한 실정이다. 이에 본 연구는 의료사고를 겪은 환자들의 외상후 스트레스 장애(Post Traumatic Stress Disorder: PTSD) 현황을 알아보고, 의료진의 설명 및 태도와 PTSD 증상의 관계에서 사회적 지지의 조절효과를 검증하였다. 의료사고 단체와 의료사고 관련 온라인 커뮤니티에서 모집된 총 180명의 의료사고 환자의 자료가 분석에 사용되었다. 분석 결과, 연구대상자 중 171명(95%)이 완전 PTSD 증상 수준으로 선별되었으며 다른 외상 경험자들과 비교해도 PTSD 증상의 심각도가 높은 것을 확인하였다. 또한 의료진의 설명 및 태도가 PTSD 증상에 미치는 주효과는 유의미하지 않았지만 의료진의 설명 및 태도와 PTSD 증상의 관계에서 사회적 지지 수준의 조절효과가 유의한 것으로 나타났다. 즉, 사회적 지지 수준이 높을 때는 의료진의 설명 및 태도에 따른 PTSD 증상의 유의미한 변화가 없었으나, 사회적 지지 수준이 낮을 때는 의료진의 설명 및 태도가 미흡할수록 PTSD 증상이 악화되었다. 이러한 연구 결과를 바탕으로 의료사고 환자들의 PTSD 증상을 완화하고 예방하는데 있어 심리적, 사회적, 제도적 방안들을 제언하였다. 마지막으로 본 연구의 제한점과 향후 연구 방향에 대해 논의하였다.

코로나바이러스감염증 환자를 돌본 일개 상급종합병원 의료인의 외상 후 스트레스 장애와 소진 (Post-traumatic Stress Disorder and Burnout of Healthcare Providers who cared for Patients with Coronavirus Disease-19 (COVID-19) in a Tertiary General Hospital)

  • 김경덕;이영희
    • 중환자간호학회지
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    • 제15권3호
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    • pp.101-114
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    • 2022
  • Purpose : This study aimed to identify post-traumatic stress disorder (PTSD) and burnout experienced by healthcare providers who cared for patients with Coronavirus Disease 2019 (COVID-19) and their influencing factors. Methods : Data were collected from 135 healthcare providers who cared for patients with COVID-19 in a tertiary general hospital from June 8 to September 2, 2021, using a questionnaire. Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, t-test, ANOVA and Scheffe's test, Pearson's correlation coefficients, and multiple regression were used for analysis using SPSS/WIN 27.0. Results : Participants' average PTSD score was 9.31 ± 11.80, and 8.9% were in the high-risk group. Participants' average burnout score was 51.77±21.28, and 62.2% were at high risk. PTSD scores differed significantly according to participants' age, education, job, position, and current workplace. Burnout scores differed significantly according to their age, gender, marital status, parental status, and education. There was positive correlation between participants' PTSD and burnout. The factors influencing participants' PTSD were term of self-isolation and age (R2=.09). There were no significant influencing factors on participants' burnout. Conclusion : This study reconfirmed that healthcare providers who cared for patients with COVID-19 experienced both PTSD and burnout, suggesting that interventions are needed such as regular pre-training or simulation training and establishing a support system.

난임 여성의 비합리적 부모신념, 외상 후 스트레스 장애, 배우자 지지가 삶의 질에 미치는 영향 (Effects of Irrational Parenthood Cognition, Post Traumatic Stress Disorder and Spousal Support on Quality of Life of Infertile Women)

  • 양소라;여정희
    • 여성건강간호학회지
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    • 제23권2호
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    • pp.145-153
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    • 2017
  • Purpose: This study examined degrees of irrational parenthood cognition, post traumatic stress disorder (PTSD), spousal support, and quality of life and investigated factors that influence the quality of life of infertile women. Methods: Research design was a cross sectional correlational survey with a total of 113 female patients receiving treatment for infertility. Data were collected from August 1 to November 30, 2015. The collected data were analyzed using t-test, ANOVA, Pearson's correlation, and multiple regression analysis. Results: The mean score of the quality of life was $59.0{\pm}14.8$. The quality of life was significantly associated with irrational parenthood cognition (r=-.70), post traumatic stress disorder (r=-.65), and spousal support (r=.56). The factors significantly affecting the quality of life in infertile women were irrational parenthood cognition (${\beta}=-.45$), post traumatic stress disorder (${\beta}=-.34$), and spousal support (${\beta}=-.32$). The explained variance by these factors was 70.4%, and the regression model was valid (F=89.81, p<.001). Conclusion: This study may contribute to the development of nursing intervention program to improve the quality of life of infertile women.

중환자실 생존자의 외상 후 스트레스장애 발생정도와 영향요인 (Influential Factors of Post-Traumatic Stress Disorder in Survivors of Intensive Care Units)

  • 김소혜;주현옥
    • 임상간호연구
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    • 제26권1호
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    • pp.97-106
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    • 2020
  • Purpose: This study was conducted to investigate the incidence and associated factors with post-traumatic stress disorders (PTSD) in patients with intensive care units (ICU) admission experience. Methods: This study is a retrospective observational study using self-reporting questionnaire. Patients who were admitted to ICU more than 72 hours and agreed to participate were enrolled in this study. PTSD were assessed by Korean version of post-traumatic diagnosis scale, and PTSD was defined as 20 points or more. Medical records of participants were reviewed to identify influencing factors of PTSD. To analyzed the data, descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test and gamma regression were utilized using SPSS/WIN 23.0 program. Results: A total of 128 patients participated in the study. Mean age of participants was 58.3±11.7 years and 50 patients (39.1%) were female. Mean duration of ICU stay was 8.43±8.09 days and PTSD was diagnosed in 12 patients (9.4%). In the results of a Gamma regression analysis, Psychiatric history (B=1.09, p=.002), APACHEII score (B=.04, p=.005), CPR experience (B=1.65, p=.017) and physical restraint (B=.68, p=.049) were independently associated with PTSD occurrence. Conclusion: The results of this study suggest that a various factors influencing PTSD should be identified to prevent PTSD in patients who requires ICU care. In addition, post-ICU care programs are required to assess and reduce PTSD.

외상후 스트레스 장애와 감별이 필요한 외상관련 자기애적 증상(TANS) - 증 례 보 고 - (Trauma-Associated Narcissistic Symptoms as a Differential Diagnosis from Post-Traumatic Stress Disorder - A Case Report -)

  • 전상원;박효인;김대호
    • 대한불안의학회지
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    • 제5권2호
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    • pp.133-138
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    • 2009
  • Diagnosing post-traumatic stress disorder (PTSD) is challenging for several reasons: a lack of training in trauma assessment for most clinicians, underreporting and avoidance by patients, the overlapping of symptoms, and a high comorbidity with other mental disorders. Thus, a careful evaluation and differential diagnosis are essential for the treatment and management of this population. A concept of posttraumatic reaction in people with narcissistic vulnerability, called Trauma-Associated Narcissistic Symptoms (TANS) had appeared in the literature; this has not been, however, systemically investigated. This study examines three cases of TANS that developed after traumatic events such as traffic accidents and physical assault. TANS may mimic PTSD and can show similar features; however, a careful attention to the context and meaning of symptoms can help the clinicians in differentiating TANS from PTSD. Clinicians working with trauma and compensation evaluators should be on alert for this easily overlooked condition.

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노인에서의 외상 후 스트레스 장애 (Post-Traumatic Stress Disorder in Elderly)

  • 류성곤
    • 대한불안의학회지
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    • 제2권1호
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    • pp.9-16
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    • 2006
  • As an aging population is increasing, more elderly people are exposed to traumatic stress. Although this issue has received more attention in some literature, it is clear that numerous questions exist in aftermath of trauma exposure in elderly people. In case of Korean elderly suffers, traumatic experience includes the Korean war, military dictatorship and violent demonstration. Studies regarding elderly PTSD is not active and a lot of patients are not still engaged in treatment. We suggest that concerns that are unique to this population are necessary.

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응급실 간호사와 응급구조사의 외상성 사건의 경험, 외상후 스트레스장애에 대한 지식, 태도 및 회복탄력성 (Experiences of traumatic events, knowledge and attitudes concerning post-traumatic stress disorder, and resilience among nurses and paramedics working in emergency department)

  • 홍선우;방경숙;방활란;현혜진;이미영;정유나
    • 한국간호교육학회지
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    • 제29권1호
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    • pp.86-97
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    • 2023
  • Purpose: This study aimed to assess exposure to traumatic events, knowledge and attitudes concerning post-traumatic stress disorder (PTSD) and the level of resilience among nurses and paramedics working in emergency departments. Methods: Data were collected from May 22 to June 12, 2022, using a self-administered survey questionnaire. The participants comprised 135 nurses and 80 paramedics working in emergency departments. The collected data were analyzed with descriptive statistics, a t-test, and an analysis of variance with Scheffé's test. Results: Compared with emergency room nurses, paramedics were more positive about the government's spending on job opportunities for people with PTSD. There were no significant differences in attitude regarding government strategies and people with PTSD between nurses and paramedics. Paramedics had higher scores on the effective treatment for PTSD, while emergency room nurses showed higher scores on effective psychotherapy. General knowledge of PTSD differed according to sex (t=-2.33, p=.021) and education level (F=3.21, p=.042). Resilience scores differed significantly according to sex (t=2.02, p=.045), education level (F=4.10, p=.018), self-reported economic state (F=10.34, p<.001), and self-reported health (F=11.57, p<.001). Conclusion: The findings support that emergency department nurses and paramedics are in need of self-care programs to support their mental health and indicate that intervention programs should be developed to enhance resilience in emergency department professionals.

외상 후 스트레스 장애에 대한 옥시토신의 역할: 체계적 문헌 고찰 (Role of Oxytocin in Post-traumatic Stress Disorder: A Systematic Review)

  • 오재욱;김민수;추상희
    • Journal of Korean Biological Nursing Science
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    • 제24권1호
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    • pp.1-16
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    • 2022
  • Purpose: Recently, oxytocin has been introduced experimentally as a pharmacological treatment for post-traumatic stress disorder (PTSD). This study attempted to investigate the possibility of oxytocin as a treatment option for patients with PTSD by examining its dose, interval, and effectiveness in patients with PTSD. Methods: A systematic review was done on articles published from 1967 to 2020 using the PubMed, PsycINFO, and Cochrane databases. Our inclusion criteria were 1) subjects 18 years of age or older diagnosed with PTSD or exposed to a traumatic event that met criterion A of the Diagnostic and Statistical Manual of Mental Disorders (DSM) for PTSD, 2) oxytocin was administered at least once, 3) clinical trials, and 4) studies published in Korean or English. Two independent researchers reviewed 22 articles and recorded the contents. The risk of bias was evaluated to determine the quality of the reviewed article. Results: The parameters for evaluating the effectiveness of oxytocin were identified as socio-behavioral measures in 11 articles, neuronal imaging in 9, and biomarkers in 4. In 5 papers, oxytocin was administered multiple times. Socio-behavioral measures were improved in 3 out of 5 studies in which oxytocin was administered multiple times. In 2 studies in which prolonged exposure treatment and nasal oxytocin administration were combined for 10 weeks, patient symptoms were decreased compared to the control group. Conclusion: The possibility of oxytocin as an adjuvant treatment for PTSD psychotherapy was confirmed. Further studies are necessary to evaluate the long term effectiveness of administering oxytocin multiple times combined with psychotherapy.

외상 후 스트레스 장애 난민에 관한 뇌 영상 연구 동향: 주제범위 문헌고찰 (Trends in Brain Imaging Research on Refugees with Post-Traumatic Stress Disorder: A Scoping Review)

  • 윤진수;김민수;추상희
    • Journal of Korean Biological Nursing Science
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    • 제23권3호
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    • pp.159-169
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    • 2021
  • Purpose: The purpose of this study was to analyze research trends and find whether Post-Traumatic Stress Disorder (PTSD) of refugees could affect structural or functional changes of brains of those under MRI, focusing on volumes, functional connectivities, and metabolites. Methods: A literature search was done using PubMed, Embase, RISS, and KMBase to identify studies that matched our research purpose. A total of eight studies were identified using Prisma flow diagram by two reviewers independently. Results: Eight studies were identified. Three studies were on North Korean defectors as subjects. The number of studies that observed structural changes, functional changes, and metabolite changes in brains was 2, 5, and 2, respectively. Although each study observed various parts of the brain, anterior cingulate cortex (ACC) was observed commonly in three studies. The PTSD group showed reduction of ACC volume and N-acetyl-aspartate (NAA) metabolite in ACC compared to the non- PTSD group. When exposed to negative stimuli, the PTSD group showed higher neural activity than the non-PTSD group, but not vice versa. Conclusion: ACC showed significant difference in volume, neural activity, and NAA metabolite between the PTSD and the non-PTSD group, resulting in significant differences in structural changes, functional changes, metabolite changes, respectively. This study showed the need for conducting more research using various biomarkers to clarify the relationship between PTSD of refugees and their brain changes.