• 대한간호학회지
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• 제34권8호
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• pp.1451-1459
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• 2004

Purpose. With a sample of cognitively impaired nursing home residents and nursing staff, the following were examined 1) the proportion and nature of aggressive behavior, 2) the frequency and types of aggressive behavior, 3) the difference between the residents who demonstrate aggressive behavior and those who do not demonstrate aggressive behavior (age, mental status, functional status, and pain, length of nursing home stay), and 4) nursing staff responses to aggressive behavior by residents. Methods. A cross-sectional descriptive study design was used. Data were collected from cognitively impaired nursing home residents (N=205) and nursing staff (N=60) at two nursing homes using Ryden Aggression Scale I and II, Mini-Mental State Exam, Modified Barthel Index, Verbal Descriptor Scale, and aggressive behavior management questionnaire. Data were analyzed using descriptive statistics including t-test. Results. About $62.9\%$ residents were found to be aggressive and $38.5\%$ were both physically and verbally aggressive. Pushing, making threatening gestures, hitting, slapping, cursing/obscene/vulgar languages, making verbal threats were occurred frequently. Aggressive residents were significantly older, had more cognitive impairment, had more pain, and stayed longer in the nursing home when compared with non-aggressive residents. Considerable proportion of nursing staff responded to aggressive behaviors inadequately. Conclusion. Aggressive behavior among cognitively impaired nursing home residents is prevalent thus needs to be prevented and reduced. Along with environmental modification, educational programs for nursing staff and family caregivers need to be developed and implemented so that they can have extensive knowledge and skills to manage aggressive behaviors.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권4호
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• pp.271-280
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• 2017

Background: The number of patients with Alzheimer's disease is growing worldwide, and the proportion of patients requiring dental treatment under general anesthesia increases with increasing severity of the disease. However, outpatient anesthesia management for these patients involves great risks, as most patients with Alzheimer's disease are old and may show reduced cardiopulmonary functions and have cognitive disorders. Methods: This study retrospectively investigated 43 patients with Alzheimer's disease who received outpatient anesthesia for dental treatment between 2012-2017. Pre-anesthesia patient evaluation, dental treatment details, anesthetics dose, blood pressure, duration and procedure of anesthesia, and post-recovery management were analyzed and compared between patients who underwent general anesthesia or intravenous sedation. Results: Mean age of patients was about 70 years; mean duration of Alzheimer's disease since diagnosis was 6.3 years. Severity was assessed using the global deterioration scale; 62.8% of patients were in level ${\geq}6$. Mean duration of anesthesia was 178 minutes for general anesthesia and 85 minutes for intravenous sedation. Mean recovery time was 65 minutes. Eleven patients underwent intravenous sedation using propofol, and 22/32 cases involved total intravenous anesthesia using propofol and remifentanil. Anesthesia was maintained with desflurane for other patients. While maintaining anesthesia, inotropic and atropine were used for eight and four patients, respectively. No patient developed postoperative delirium. All patients were discharged without complications. Conclusion: With appropriate anesthetic management, outpatient anesthesia was successfully performed without complications for dental treatment for patients with severe Alzheimer's disease.

• 산업진흥연구
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• 제5권2호
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• pp.41-50
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• 2020

우리나라는 세계적으로 유례없이 빠른 노령화로 노년층의 인구와 치매유병률의 급격한 상승은 심각한 사회적 문제로 대두되고 있다. 치매노인의 부양은 보편적 삶과는 다른 방식이며 관계적 측면에서 새로운 문화적 실존 관계가 얽힌 세계이다. 이러한 측면에서 치매노인 부양가족의 심리적 문제는 단순한 기술적 문제를 떠나 심층적이고 본질적인 실존의 이해를 위해 연구할 필요성이 있다. 본 연구는 현상학적 연구방법 중 지오르기(Amedeo Giorgi)의 방법을 기반으로 치매노인 부양가족이 경험한 스트레스 현상을 실존주의 집단상담 기법을 활용하여 심층적으로 이해하고 기술하는 데 그 의의를 두었으며 집단상담은 총 8회기로 진행되었다. 실존주의 집단상담 과정을 통한 치매노인 부양가족의 스트레스에 대한 심층적 진술을 실존철학 기반의 지오르기 연구방법 4단계를 적용하여, 실존적 자기 인식 경험의 결과로서 정서적 스트레스, 심리 사회적 스트레스, 시간 의존적 스트레스 경험 현상을 도출하였다. 연구 결과를 통해 탐색된 자신의 아픔을 스스로 표현하지 못하는 치매노인 부양자 고통을 이해하고 치매노인 부양가족들은 자조적 집단상담 활동을 활성화하여 초고령화 사회 진입을 앞둔 우리 사회가 보다 건강해지는 데 기여할 수 있기를 기대한다.

• 부모자녀건강학회지
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• 제7권2호
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• pp.168-181
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• 2004

Purpose: The purpose of this study was to identified patterns of studies and to analyze the nursing research related to the massage intervention in Korea and to improve direction of nursing research in massage intervention in Korea. Methods: The research studies related to the massage were selected from the Korean Nurses Academic Society Journal and dissertation which were conducted experimental research design the last 7 years in Korea. The total numbers of the studies were 58. Result: The study subjects were post operational state in 34.5%, healthy adult in 17.2% studies. The others dealt with infant, cancer, dementia, hypertension, preterm neonates, elderly. Types of massage were whole body in 31.1%, foot in 22.6%, hand in 17.2%, back in 13.8% studies. And Meridian massage in 17.2%. Length of massage was below 5 minutes in 17.2%, 6~10 minutes in 29.4% and 11~20 minutes in 32.8% studies. Frequency of massage was only 1 time in 25.9%, 2~5 times in 31.1% studies. Massage produced psychological and physiological effects. Positive psychologic effects were anxiety relief, pain relief, mood enhancement and fatigue relief. Positive physiologic effects on body systems were blood pressure, heart rate, edema, skin temperature, immune system, blood glucose, excretion, PMS syndrome and growth and development. Conclusion: As a result, effects of massage were almost positive. Therefore massage is useful alternative nursing intervention. But more attention research is needed to identify the objectivity instrument to measure and repeat research.

• 기본간호학회지
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• 제10권3호
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• pp.392-398
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• 2003

Purpose: The purpose of this study was to analyze trends in complementary and alternative therapy in nursing research in Korea. Method: The researchers examined academic theses and dissertations published from 1990 to 2002, and 151 articles were used for the analysis. Result: Nursing research on CAT increased rapidly from 1995 Articles with quantitative research designs made up 93.9% of the total and there were more experimental studies than non-experimental studies. Patients who had surgery, mental disorders, renal failure, hypertension, arthritis, dementia & cancer were the most frequently participants in studies on CAT. The type of CAT used in nursing research were mind-body therapy (65.8%), manual healing therapy (28.7%), phamacologic & biological therapy (3.7%), bioelectromagnetics (0.9%) and herbal therapy (0.9%). In 44 articles both psychological and physiological parameters were used as dependent variables. In 34 articles only physiological parameters were used and in 13 only psychological parameters. The most frequently used physiological parameters in CAT were pain, physiological function and vital signs, while the most used psychological parameters were anxiety, depression and stress. Conclusion: More studies about CAT are needed to extend the role and fields for professional nursing. There is a need to conduct qualitative studies in nursing about the experiences of patients who receive CAT and nurses who use CAT.

• Journal of the Korean Data and Information Science Society
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• 제27권3호
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• pp.773-789
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• 2016

본 연구는 노인요양병원 입원노인의 수면양상 및 영향요인을 파악하여 이들의 수면의 질 향상을 위한 중재프로그램 개발 시 기초자료로 활용하고자 시도된 서술적 조사연구이다. G시 노인요양병원에 입원한 65세 이상의 노인환자 142명을 대상으로 구조화된 설문지와 24시간 수면기록지를 사용하여 자료 수집하였다. 요양병원 입원노인의 일일 평균 수면시간은 10.7시간이었으며 낮 수면시간은 평균 3.9시간, 밤 수면시간은 평균 6.8시간 이었다. 총 수면규칙성은 71.7%였고, 낮 수면규칙성은 평균 58.1%, 밤 수면규칙성은 평균 80.5%였다. 요양병원 입원노인의 수면시간에 영향을 주는 예측요인은 병실 내 치매환자 유무로 10.3%의 설명력을 나타냈고, 수면 규칙성에 영향을 미치는 예측요인은 통증, 병실 내 치매환자 유무, 신체기능으로 16.1%의 설명력을 나타냈다. 따라서 요양병원 입원노인의 수면양상에 영향을 미치는 추가요인 규명을 위한 후속 연구의 필요성과, 본 연구에서 확인된 요양병원 입원노인의 수면에 영향을 미치는 요인을 고려한 중재프로그램 개발 및 적용이 필요하다.

• 동의신경정신과학회지
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• 제12궈1호
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• pp.137-149
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• 2001

Cytokines are polypeptides which possess various biological properties affecting. host defense function and response to disease. Inflammatory cytokines, tumor necrosis $factor-{\alpha}$(TNF-${\alpha}$), interleukin(IL)-1 and IL-6 induce inflammation, fever, hypotension and pain when injected into animals or human subject. When glial cell cultures were prepared from neonatal mice or rats, astrocytes were reported to produce these inflammatory cytokines to viral infection, lipopolysaccharide(LPS), or cytokines. The purpose of this study was to investigate the regulatory effect of these cytokines secretion from primary cultures of rat astrocytes. Substance P(SP) can stimulate secretion of TNF-${\alpha}$ from astrocytes stimulated with LPS. Sesim-Tang significantly inhibited the TNF-${\alpha}$ secretion by astrocytes stimulated with SP and LPS. IL-1 has been shown to elevate TNF-${\alpha}$ secretion from LPS-stimulated astrocytes while having no effect on astrocytes in the absence of LPS. We therefore also investigated whether IL-1 mediated inhibition of TNF-${\alpha}$ secretion from primary astrocytes by Sesim-Tang. Treatment of Sesim-Tang to astrocytes stimulated with both LPS and SP decreased IL-1 secretion significantly. The secretion of TNF-${\alpha}$ by LPS and SP in astrocytes was progressively inhibited with increasing amount of IL-1 neutralizing antibody. Furthermore Sesim-Tang inhibited the IL-6 secretion by astrocytes stimulated with SP and LPS. The inhibitory effect of inflammatory cytokines by Sesim-Tang, observed in this study, might reflect an antiinflammatory activity and a reduction of various-type pains, fever etc. in the central nervous system.

• 대한예방한의학회지
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• 제22권1호
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• pp.61-67
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• 2018

Objectives : The purpose of this study was to examine the effectiveness and satisfaction of visiting Korean Medicine doctor program. Method : The senior center visiting Korean Medicine doctor program was conducted in ten senior centers in Seongnam city from April 2016 to December 2016. Korean Medicine doctors were assigned senior center one by one. The program consisted of health lectures and health counseling. The health lectures embraces stroke, musculoskeletal disease, dementia, depression and self care for the elderly Results : A total of 194 elderly persons participated the program. The self-health awareness level were changed from $50.86{\pm}25.31$ to $57.17{\pm}24.62$ (p-value=0.003). The physical pain level was decreased from $5.33{\pm}2.99$ to $5.04{\pm}2.86$. The quality of life were changed from $0.791{\pm}0.155$ to $0.792{\pm}0.144$ (p-value=0.923). Overall satisfaction of visiting Korean Medicine doctor program was $9.36{\pm}2.11$. The need for sustainability for visiting Korean Medicine doctor program was $9.76{\pm}0.60$. Conclusions : The study demonstrated that visiting Korean Medicine doctor program had a positive effect on the health awareness level. The overall satisfaction and further need were high. Further program for senior center will be needed.

• 대한임상검사과학회지
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• 제49권3호
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• pp.271-278
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• 2017

치매유발제인 염화알루미늄(aluminum chloride, $AlCl_3$)의 세포독성을 대뇌교종세포인 C6 glioma 세포를 대상으로 산화적 손상측면에서 조사하였으며, 또한 $AlCl_3$의 세포독성에 대한 금은화(Lonicerae flos, LF) 추출물의 영향을 세포생존율을 비롯한 DPPH-라디칼 소거능, superoxide anion-radical (SAR) 제거능 및 지질과산화(lipid peroxidation, LP) 억제능과 같은 항산화 측면에서 분석하였다. 본 실험에서 배양 C6 glioma 세포에 $120{\sim}160{\mu}M$의 $AlCl_3$가 각각 포함된 배양액에서 처리한 결과 처리 농도에 비례하여 세포생존율이 대조군에 비하여 유의한 감소를 보였으며, 이 때 $XTT_{50}$값은 $128.8{\mu}M$에서 나타나 중간독성(mid-toxic)인 것으로 나타났다. 또한, 항산화제인 BHT는 $AlCl_3$의 세포독성을 유효하게 방어하였다. 한편, $AlCl_3$의 세포독성에 대한 금은화(LF) 추출물의 영향에 대한 조사에 있어서, LF 추출물은 $AlCl_3$에 의하여 감소된 세포생존율을 유의하게 증가시킴으로써 세포독성을 방어하였다. 이와 동시에, LF 추출물은 DPPH-라디칼 소거능을 비롯하여 SAR 제거능 및 LP 억제능을 보임으로서 항산화 효과를 나타냈다. 위의 결과로부터 $AlCl_3$의 세포독성에 산화적 손상이 관여하고 있으며, 또한 LF 추출물은 $AlCl_3$의 독성을 항산화능에 의하여 효과적으로 방어하였다. 따라서, LF 추출물과 같은 천연성분은 알루미늄과 같이 산화적 손상과 관련된 치매유발제의 독성을 방어함으로써 차후 치매와 같은 산화적 손상 관련의 질환 치료를 위한 항산화 물질로서의 개발적 가치가 있다고 사료된다.

• 치위생과학회지
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• 제9권4호
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• pp.475-483
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• 2009

한국 노인을 대상으로 외국에서 비교적 높은 신뢰도와 타당도가 입증된 Oral Health Impact Profile 14(OHIP 14)를 한국의 문화적 특성이나 사고방식에 맞게 번역하여 강릉시에 거주하는 노인 만 65세 이상 668명을 대상으로 2005년 1월부터 2월까지 2개월간 OHIP 14 지표의 신뢰도와 타당도를 검증(Kappa index, Cronbach's alpha Correlation & Spearman ranked correlation coefficient)하고, OHIP 14와(구강)건강인식도, 구강건강상태, 전신건강 상태와의 차이를 검증(Kruskal Wallis test, Mann-Whitney U-test)함으로써, 향후 우리나라 노인 구강건강문제를 포괄적으로 파악하기 위한 지표로 활용할 수 있는 지를 검토하고자 하였다. 1. (구강)건강인식도와 OHIP 14는 전신건강인식도, 구강건강인식도, 치과치료필요도, 구강건강만족도, 통증에 대한 시각적 정도, 틀니만족도, 구강건강상태와 OHIP 14는 무치악 여부, 현존 자연치아의 개수, 치아치료필요, 전신건강상태와 OHIP 14는 질병의 개수, 치매, 눈, 귀, 호흡기, 심혈관, 소화기, 비뇨생식기, 근골격계, 신경계, 심리상태가 상관관계가 있는 것으로 나타났다. 2. (구강)건강인식도에 따른 OHIP 14는 전신건강인식도, 구강건강인식도, 치과치료필요도, 구강건강만족도, 통증에 대한 시각적 정도, 틀니만족도, 구강건강상태에 따른 OHIP 14는 무치악 여부, 치아치료필요, 현존 자연치아의 개수, 전신건강상태에 따른 OHIP 14는 치매, 귀, 호흡기, 심혈관, 소화기, 근골격계, 신경계, 심리상태에서 현저한 차이를 보였다. 본 연구는 일부 노인에서 임상지표를 이용한 OHIP 14에서 (구강)건강인식도, 구강건강상태, 전신건강상태가 OHIP 14와의 타당도와 연관성이 있다는 사실을 일부에서 확인할 수 있었다. 이상의 결과로 향후 한국노인의 구강건강문제를 포괄적으로 파악하는데 전통적인 구강건강 상태검사, 전신건강상태검사와 더불어 '구강건강 관련 삶의 질' 지표인 OHIP 14를 활용할 수 있을 것으로 사료된다.