• Title/Summary/Keyword: Post-trauma

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A Qualitative Study on the Interpersonal Trauma Experience in Counseling Psychology Major University Students and their Growth Process as Counselors (상담심리전공 대학생의 대인 외상 경험과 상담자로서의 성장 과정에 대한 질적 연구)

  • Hong, Ye Young;Chang, Eun Jin
    • Journal of Convergence for Information Technology
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    • v.9 no.5
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    • pp.147-157
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    • 2019
  • In this study, we focused on the experience of interpersonal trauma among university students majoring in counseling psychology to understand the meaning of the trauma they experienced, and analyzed the process of their growth as counselors. To that end, we conducted a survey on interpersonal trauma and post-traumatic growth, and interviewed final six students in a face-to-face interview, and analyzed the collected data using the method of qualitative case study. As a result, the trauma and subsequent growth experience have been categorized into 38 semantic units, 15 subcategories and 5 categories, including 'Times of pain', 'A life of dealing with complex emotions alone', 'An experience of understanding and being understood', 'Attempts to change and new meanings' and 'Worries and expectations of growth as a counselor'. The results of this study are meaningful in providing basic information and educational materials needed for the intervention of students majoring in counseling psychology who have experienced trauma.

Validity of the scoring system for traumatic liver injury: a generalized estimating equation analysis

  • Lee, Kangho;Ryu, Dongyeon;Kim, Hohyun;Jeon, Chang Ho;Kim, Jae Hun;Park, Chan Yong;Yeom, Seok Ran
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.25-33
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    • 2022
  • Purpose: The scoring system for traumatic liver injury (SSTLI) was developed in 2015 to predict mortality in patients with polytraumatic liver injury. This study aimed to validate the SSTLI as a prognostic factor in patients with polytrauma and liver injury through a generalized estimating equation analysis. Methods: The medical records of 521 patients with traumatic liver injury from January 2015 to December 2019 were reviewed. The primary outcome variable was in-hospital mortality. All the risk factors were analyzed using multivariate logistic regression analysis. The SSTLI has five clinical measures (age, Injury Severity Score, serum total bilirubin level, prothrombin time, and creatinine level) chosen based on their predictive power. Each measure is scored as 0-1 (age and Injury Severity Score) or 0-3 (serum total bilirubin level, prothrombin time, and creatinine level). The SSTLI score corresponds to the total points for each item (0-11 points). Results: The areas under the curve of the SSTLI to predict mortality on post-traumatic days 0, 1, 3, and 5 were 0.736, 0.783, 0.830, and 0.824, respectively. A very good to excellent positive correlation was observed between the probability of mortality and the SSTLI score (γ=0.997, P<0.001). A value of 5 points was used as the threshold to distinguish low-risk (<5) from high-risk (≥5) patients. Multivariate analysis using the generalized estimating equation in the logistic regression model indicated that the SSTLI score was an independent predictor of mortality (odds ratio, 1.027; 95% confidence interval, 1.018-1.036; P<0.001). Conclusions: The SSTLI was verified to predict mortality in patients with polytrauma and liver injury. A score of ≥5 on the SSTLI indicated a high-risk of post-traumatic mortality.

Effects of a Cancer-Overcome BeHaS Exercise Program on Post-trauma Risk and Anxiety in Breast Cancer Patients (암 극복 베하스운동 프로그램이 유방암 환자의 위기와 불안에 미치는 효과)

  • Kim, Sun Ae;Kim, Jong Im;Park, Sun Young
    • Journal of muscle and joint health
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    • v.21 no.1
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    • pp.27-35
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    • 2014
  • Purpose: The purpose of this study was to estimate the effects of a cancer-overcome BeHaS exercise program on post-trauma risk and anxiety in breast cancer patients. The cancer-overcome BeHaS exercise program consisted of exercise, education, and cognitive supports. Methods: A one group pretest-posttest experimental design was used for this study. Fourteen mastectomy patients, the subjects of the group participated in the BeHaS exercise program. The program was provided for 8 weeks, once a week in C hospital. Data were collected from October to November 2012 with self report structured questionnaires. Descriptive statistics, and Wilcoxon Signed Rank test were used to analyze data with the SPSS 19.0. Results: The mean age of participants was 53 and the mean postoperative period after the surgery was 18.64 months. After the BeHaS exercise program, while there was no significant decrease in post-trauma risk scores, there was a significant difference in anxiety (z=-2.20, p=.028). Conclusion: This program has effects on decreasing anxiety in patients with breast cancer. Therefore the BeHaS exercise program should be applied as a nursing intervention to reduce anxiety for the patients with breast cancer.

Cerebral Fat Embolism after Traumatic Multiple Fracture: A Case Report (외상성 다발성 골절 후 발생한 뇌 지방 색전증 1예)

  • Kim, Ho Hyun;Park, Yun Chul;Lee, Dong Kyu;Park, Chan Yong;Kim, Jae Hun;Kim, Yeong Dae;Kim, Jung Chul
    • Journal of Trauma and Injury
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    • v.26 no.2
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    • pp.58-62
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    • 2013
  • A cerebral fat embolism is an uncommon but serious complication of long bone fracture. It can be fatal, and early detection is not easy. Neurologic symptoms are variable, and the clinical diagnosis is difficult. The pathogenesis remains controversial, and several theories have been proposed. Magnetic resonance imaging can detect a cerebral fat embolism with a higher sensitivity than cerebral computed tomography. We report a case of a posttraumatic cerebral fat embolism without pulmonary involvement and review the existing literature.

Factors on the Pathway from Trauma to Suicidal Ideation in Adolescents

  • Kwon, Seo Young;Nam, Ji Ae;Ko, Boo Sung;Lee, Chang Wha;Choi, Kyeong-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.30 no.1
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    • pp.26-33
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    • 2019
  • Objectives: Suicide is the most frequent cause of death among Korean adolescents, and adolescents who have experienced trauma have an increased risk of post-traumatic stress disorder (PTSD) symptoms, depression, and suicide attempts. However, resilience and self-esteem are protective factors. We examined the effects of resilience and self-esteem on the relationship among traumatic experiences, PTSD symptoms, depression, and suicidal ideation. Methods: Middle-school students (n=403) completed questionnaires assessing traumatic experiences, PTSD symptoms, depression, suicidal ideation, resilience, and self-esteem. Path analysis was performed to investigate the mediating effects of PTSD symptoms, resilience, self-esteem, and depression on the relationship between trauma exposure and suicidal ideation. Results: Traumatic experience was positively correlated with PTSD symptoms, depression, and suicidal ideation. PTSD symptoms and depression were positively correlated with suicidal ideation. The relationship between traumatic experiences and suicidal ideation was mediated by PTSD symptoms, which had both direct and indirect effects on suicidal ideation; the indirect effect was mediated by resilience, self-esteem, and depression. Conclusion: Korean adolescents who had experienced trauma were more likely to develop PTSD symptoms, increasing their risk of depression and suicidal ideation. However, self-esteem and resilience may help protect against depression and suicidal ideation. Our findings could inform suicide prevention initiatives.

Analysis of Cultivator-related Trauma Cases in a Regional Trauma Center in the Rural Area of Gyeongbuk Province

  • Hwang, Ui Kang;Youn, Seok Hwa;Park, Chan Yong
    • Journal of Trauma and Injury
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    • v.30 no.3
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    • pp.80-86
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    • 2017
  • Purpose: To analyze the data of patients who suffered trauma in a cultivator accident and visited the trauma center in rural Gyeongbuk Province. Methods: We retrospectively reviewed the medical records and Korean Trauma Data Bank data of 120 patients who suffered cultivator-related traumas and visited the rural regional trauma center in Gyeongbuk Province from January to December 2015. Results: The age of the patients ranged from 35 to 96 years (mean, 70 years). Ninety-one (75.8%) patients were men, and twenty-nine (24.2%) were women. Most of the patients were in their 70s (46 men [50.5%] and 13 women [44.8%]). In total, 113 patients (94.1%) arrived at the regional trauma center by ground transport and 7 (5.9%) arrived by air transport. Ninety-eight patients (81.7%) were transported to the regional trauma center directly from the scene of the accident, and twenty-two (18.3%) were transferred from another medical institute. The mean time from the accident to arrival at the emergency department was 139 minutes, and only 46 patients (38.3%) arrived within 1 hour. Twelve (10.0%) patients died, including two deaths on arrival and two post- cardiopulmonary resuscitation deaths in the emergency department. All deaths were of male cultivator operators. The causes of death were shock (hypovolemic, traumatic, or septic), subdural hematoma (open), hemothorax, rhabdomyolysis, and pneumonia. Conclusions: As the government - led regional trauma center project is on process, it would be clinically important to summarize the initial outcome of cultivator injuries, which are characteristically found more in regional trauma centers in the rural area, and have high mortality. Based on this study, in the future, it will be necessary to follow up and analyze more number of patients and to construct accurate database about trauma cases related to cultivator in Gyeongbuk region.

Effects of Trauma Center Establishment on the Clinical Characteristics and Outcomes of Patients with Traumatic Brain Injury : A Retrospective Analysis from a Single Trauma Center in Korea

  • Kim, Jang Soo;Jeong, Sung Woo;Ahn, Hyo Jin;Hwang, Hyun Ju;Kyoung, Kyu-Hyouck;Kwon, Soon Chan;Kim, Min Soo
    • Journal of Korean Neurosurgical Society
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    • v.62 no.2
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    • pp.232-242
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    • 2019
  • Objective : To investigate the effects of trauma center establishment on the clinical characteristics and outcomes of trauma patients with traumatic brain injury (TBI). Methods : We enrolled 322 patients with severe trauma and TBI from January 2015 to December 2016. Clinical factors, indexes, and outcomes were compared before and after trauma center establishment (September 2015). The outcome was the Glasgow outcome scale classification at 3 months post-trauma. Results : Of the 322 patients, 120 (37.3%) and 202 (62.7%) were admitted before and after trauma center establishment, respectively. The two groups were significantly different in age (p=0.038), the trauma location within the city (p=0.010), the proportion of intensive care unit (ICU) admissions (p=0.001), and the emergency room stay time (p<0.001). Mortality occurred in 37 patients (11.5%). Although the preventable death rate decreased from before to after center establishment (23.1% vs. 12.5%), the difference was not significant. None of the clinical factors, indexes, or outcomes were different from before to after center establishment for patients with severe TBI (Glasgow coma scale score ${\leq}8$). However, the proportion of inter-hospital transfers increased and the time to emergency room arrival was longer in both the entire cohort and patients with severe TBI after versus before trauma center establishment. Conclusion : We confirmed that for patients with severe trauma and TBI, establishing a trauma center increased the proportion of ICU admissions and decreased the emergency room stay time and preventable death rate. However, management strategies for handling the high proportion of inter-hospital transfers and long times to emergency room arrival will be necessary.

Missed Skeletal Trauma Detected by Whole Body Bone Scan in Patients with Traumatic Brain Injury

  • Seo, Yongsik;Whang, Kum;Pyen, Jinsu;Choi, Jongwook;Kim, Joneyeon;Oh, Jiwoong
    • Journal of Korean Neurosurgical Society
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    • v.63 no.5
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    • pp.649-656
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    • 2020
  • Objective : Unclear mental state is one of the major factors contributing to diagnostic failure of occult skeletal trauma in patients with traumatic brain injury (TBI). The aim of this study was to evaluate the overlooked co-occurring skeletal trauma through whole body bone scan (WBBS) in TBI. Methods : A retrospective study of 547 TBI patients admitted between 2015 and 2017 was performed to investigate their cooccurring skeletal injuries detected by WBBS. The patients were divided into three groups based on the timing of suspecting skeletal trauma confirmed : 1) before WBBS (pre-WBBS); 2) after the routine WBBS (post-WBBS) with good mental state and no initial musculoskeletal complaints; and 3) after the routine WBBS with poor mental state (poor MS). The skeletal trauma detected by WBBS was classified into six skeletal categories : spine, upper and lower extremities, pelvis, chest wall, and clavicles. The skeletal injuries identified by WBBS were confirmed to be simple contusion or fractures by other imaging modalities such as X-ray or computed tomography (CT) scans. Of the six categorizations of skeletal trauma detected as hot uptake lesions in WBBS, the lesions of spine, upper and lower extremities were further statistically analyzed to calculate the incidence rates of actual fractures (AF) and actual surgery (AS) cases over the total number of hot uptake lesions in WBBS. Results : Of 547 patients with TBI, 112 patients (20.4 %) were presented with TBI alone. Four hundred and thirty-five patients with TBI had co-occurring skeletal injuries confirmed by WBBS. The incidences were as follows : chest wall (27.4%), spine (22.9%), lower extremities (20.2%), upper extremities (13.5%), pelvis (9.4%), and clavicles (6.3%). It is notable that relatively larger number of positive hot uptakes were observed in the groups of post-WBBS and poor MS. The percentage of post-WBBS group over the total hot uptake lesions in upper and lower extremities, and spines were 51.0%, 43.8%, and 41.7%, respectively, while their percentages of AS were 2.73%, 1.1%, and 0%, respectively. The percentages of poor MS group in the upper and lower extremities, and spines were 10.4%, 17.4%, and 7.8%, respectively, while their percentages of AS were 26.7%, 14.2%, and 11.1%, respectively. There was a statistical difference in the percentage of AS between the groups of post-WBBS and poor MS (p=0.000). Conclusion : WBBS is a potential diagnostic tool in understanding the skeletal conditions of patients with head injuries which may be undetected during the initial assessment.

Post traumatic malocclusion and its prosthetic treatment

  • Park, In-Phill;Heo, Seong-Joo;Koak, Jai-Young;Kim, Seong-Kyun
    • The Journal of Advanced Prosthodontics
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    • v.2 no.3
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    • pp.88-91
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    • 2010
  • Mandible fractures belong to the most common fractures encountered in maxillofacial trauma. Because mandible is such a unique structure with hinge joint and masticatory muscles attached to the body of mandible, attention must be paid to avoid displacement during treatment. Displacement during fracture reduction leads to malocclusion. Many TMJs function with complete comfort and apparent normalcy in adapted centric posture, even though they have undergone deformation caused by trauma. This clinical report describes the patient with post traumatic malocclusion and its prosthetic treatment. His fractured mandible was openly reduced in changed position, as a result his occlusion has been changed. He was treated by prosthetic method in so-called adapted centric posture.

Delayed Post-Traumatic Spinal Cord Infarction with Quadriplegia: A Case Report

  • Kim, Tae Hoon
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.279-283
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    • 2021
  • Traumatic spinal cord infarction is a rare condition that causes serious paralysis. The regulation of spinal cord blood flow in injured spinal cords remains unknown. Spinal cord infarction or ischemia has been reported after cardiovascular interventions, scoliosis correction, or profound hypotension. In this case, a 52-year-old man revisited the emergency center with motor and sensory abnormalities in all four extremities 56 hours after a motor vehicle collision. Despite the clinical presentation and imaging examination, there were no specific findings on the patient's first visit to the trauma center. Cervical spine computed tomography angiography showed a narrow vertebral artery, and diffusion-weighted imaging revealed spinal cord infarction from C3 to C5 with high signal intensity. It should be kept in mind that delayed-onset spinal cord infarction may occur in minor or major trauma patients as a result of head and neck injuries.