• Title/Summary/Keyword: Post-Traumatic

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Analysis of Factors Influencing Secondary Traumatic Stress, Burnout, and Physical Symptoms in Firefighters (소방대원의 이차 외상성 스트레스, 소진 및 신체적 증상의 영향요인 분석)

  • Oh Jin-Hwan;Lim Nan-Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.1
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    • pp.96-106
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    • 2006
  • Purpose: This study was dont: to evaluate the factors that influence secondary traumatic stress, burnout, and physical symptoms experienced by firefighters. In addition, a hypothetical model was developed. Method: The data were collected using self-reported questionnaires from 410 field service firefighters. Data analysis was done with the SPSSWIN 10.0 program for descriptive statistics and Windows LISREL program to determine the causal relationship between the measurement variables. Results: The hypothetical model which was developed fits well with actual data(${\chi}^2$=3.16, p=0.99, GFI=1.00, AGFI=0.99, NFI=0.99, and NNFI=1.06). The variable, personality type, social support, and impact mobilization frequency had a significant effect and accounted for 7% of the secondary traumatic stress in firefighters. The variables, career, social support, and secondary traumatic stress had a significant effect and accounted for 24% of the burnout in firefighters. Social support, impact mobilization frequency, and secondary traumatic stress were important variables and accounted for 31% of the physical symptoms in firefighters. Conclusion: It is necessary for firefighters to manage themselves according to their personality types. Strategies that can increase the firefighters' social support and decrease their perceived secondary traumatic stress also need to be developed to minimize or prevent a negative effect on their health.

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Add-on Eye Movement Desensitization and Reprocessing (EMDR) Therapy for Adults with Post-traumatic Stress Disorder Who Failed to Respond to Initial Antidepressant Pharmacotherapy

  • Bae, Hwallip;Kim, Daeho;Cho, Yubin;Kim, Dongjoo;Kim, Seok Hyeon
    • Journal of Korean Medical Science
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    • v.33 no.48
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    • pp.306.1-306.6
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    • 2018
  • This study examined the add-on efficacy of eye movement desensitization and reprocessing (EMDR) therapy among adult civilians with post-traumatic stress disorder (PTSD) who continued to be symptomatic after more than 12 weeks of initial antidepressant treatment. Scores for the Clinician Administered PTSD Scale (CAPS) were rated pre- and post-EMDR and at a 6-month follow-up. After an average of six sessions of EMDR treatment, seven of 14 patients (50%) showed more than a 30% decrease in CAPS score and eight (57%) no longer met the criteria for PTSD. Our results indicate that EMDR could be successfully added after failure of initial pharmacotherapy for PTSD.

Prevalence and Risk Factors of Anxiety, Depression, and Post-Traumatic Stress Disorder in Critical Care Survivors (중환자실 퇴원 환자의 불안, 우울, 외상 후 스트레스 장애 유병률 및 위험요인)

  • Kang, Ji Yeon;An, Geum Ju
    • Journal of Korean Critical Care Nursing
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    • v.13 no.3
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    • pp.62-74
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    • 2020
  • Purpose : This study aimed to investigate the prevalence and risk factors of mental health problems in patients discharged from the intensive care unit (ICU). Methods : This was a secondary analysis study using data from a multicenter prospective cohort of post-ICU patients. We analyzed data of 311 patients enrolled in the primary cohort study who responded to the mental health questionnaire three months after the discharge. Anxiety and depression were measured on the Hospital Anxiety-Depression Scale, and post-traumatic stress disorder (PTSD) was measured on the Posttraumatic Diagnostic Scale. Results : The prevalence of anxiety, depression, and PTSD in patients at three months after ICU discharge were 25.7%, 17.4%, and 18.0%, respectively, and 7.7% of them experienced all three problems. Unemployment (OR=1.99, p=.033) and unplanned ICU admission (OR=2.28, p=.017) were risk factors for depression, while women gender (OR=2.34, p=.009), comorbid diseases (OR=2.88, p=.004), non-surgical ICUs (trauma ICU: OR=7.31, p=.002, medical ICU: OR=3.72, p=.007, neurological ICU: OR=2.95, p=.019) and delirium (OR=2.89, p=.009) were risk factors for PTSD. Conclusion : ICU nurses should proactively monitor risk factors for post-ICU mental health problems. In particular, guidelines on the detection and management of delirium in critically ill patients should be observed.

Efficacy of arthrocentesis and lavage for treatment of post-traumatic arthritis in temporomandibular joints

  • Park, Joo-Young;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.3
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    • pp.174-182
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    • 2020
  • Objectives: Joint injuries frequently lead to progressive joint degeneration that causes articular disc derangement, joint inflammation, and osteoarthritis. Such arthropathies that arise after trauma are defined as post-traumatic arthritis (PTA). Although PTA is well recognized in knee and elbow joints, PTA in the temporomandibular joint (TMJ) has not been clearly defined. Interestingly, patients experiencing head and neck trauma without direct jaw fracture have displayed TMJ disease symptoms; however, definitive diagnosis and treatment options are not available. This study will analyze clinical aspects of PTA in TMJ and their treatment outcomes after joint arthrocentesis and lavage. Materials and Methods: Twenty patients with history of trauma to the head and neck especially without jaw fracture were retrospectively studied. Those patients developed TMJ disease symptoms and were diagnosed by computed tomography or magnetic resonance imaging. To decrease TMJ discomfort, arthrocentesis and lavage with or without conservative therapy were applied, and efficacy was evaluated by amount of mouth opening and pain scale. Statistical differences between pre- and post-treatment values were evaluated by Wilcoxon signed-rank test. Results: Patient age varied widely between 20 and 80 years, and causes of trauma were diverse. Duration of disease onset was measured as 508 post-trauma days, and 85% of the patients sought clinic visit within 2 years after trauma. In addition, 85% of the patients showed TMJ disc derangement without reduction, and osteoarthritis was accompanied at the traumatized side or at both sides in 40% of the patients. After arthrocentesis or lavage, maximal mouth opening was significantly increased (28-44 mm on average, P<0.001) and pain scale was dramatically decreased (7.8-3.5 of 10, P<0.001); however, concomitant conservative therapy showed no difference in treatment outcome. Conclusion: The results of this study clarify the disease identity of PTA in TMJ and suggest early diagnosis and treatment options to manage PTA in TMJ.

Acupuncture for Subacute and Chronic Post-thoracotomy Pain in Patients with Traumatic Multiple Rib Fractures: A Study Protocol for a Randomised-controlled, Two-arm, Parallel Design, Pilot Trial

  • Kim, Kun Hyung;Cho, Hyun Min;Lee, Chan Kyu;Seok, JunePill;Kim, Seon Hee;Kim, Jung-Eun;Shin, Yu Kyung;Kim, Min Kyung
    • Journal of Acupuncture Research
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    • v.35 no.2
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    • pp.95-100
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    • 2018
  • Background: The aim of this study is to assess the feasibility of acupuncture treatment for the management of subacute and chronic post-thoracotomy pain in patients with traumatic multiple rib fractures. Methods: A total of 30 participants who have undergone thoracotomy after traumatic multiple rib fractures will be recruited. Participants will be invited and equally randomised into acupuncture plus usual care and usual care alone groups. A computer-generated random number sequence will be used and concealed using opaque, sealed, sequentially numbered envelopes. Twelve sessions of manual and electrical acupuncture performed by Korean medicine doctors will be provided over a span of 3 months to participants allocated to the acupuncture group. Participants in the usual care group will continue pain medication, exercise and physical therapy as required. Study feasibility will be measured based on the proportion of patients who complete the measurement of pain at 12 or 24 weeks after baseline. The clinical outcomes will include; the average pain intensity over the recent week at rest, movement and cough, quality of life, patient's global assessment of recovery, respiratory function measured by the pulmonary function test and use of pain medication at 4, 8, 12 and 24 weeks after enrolment. Adverse events will be recorded for all participants. Written informed consent will be obtained from all participants. The local ethics committee has approved the study. This pilot trial will inform further studies investigating the potential role of acupuncture for subacute and chronic post-thoracotomy pain in patients with traumatic multiple rib fractures.

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

  • Oh, Jaeuk;Kim, Minsu;Chu, Sang Hui
    • Journal of Korean Biological Nursing Science
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    • v.24 no.1
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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.

A Study on the Necessity of Psychological First Aid for Firefighters (소방공무원의 심리적 응급처치 필요성에 관한 연구)

  • Ju-Hyun Kim;Sang-Hyuk Park
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.5
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    • pp.385-390
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    • 2023
  • The purpose of this study is to study the need for psychological first aid for stress of fire officials. a 1:1 in-depth interview with 10 paramedics to solve the research problem. Through interviews, the policy on the need for psychological first aid to improve the mental health of firefighters was proposed as follows by analyzing the working environment of paramedics, post-traumatic stress experience, and psychological first aid experience. First, fire officials need to be assigned to the site to educate in advance about post-traumatic stress and the resulting physical symptoms before being exposed to traumatic events. Second, fire officials should provide psychological first aid at an appropriate time after exposure to trauma cases. Third, it is necessary to supplement the manpower and institutional devices that will specialize in mental health work. Fourth, for customized professional medical services and psychological support suitable for fire officials, it is necessary to link fire-fighting complex healing centers and national firefighting hospitals.