• 산업진흥연구
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• 제7권3호
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• pp.77-83
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• 2022

본 연구는 개인의 성장과정에서 불안정 애착을 경험한 중년여성이 자신의 성장 과정을 재조명함으로써 긍정적인 변화를 경험하도록 돕는 목적으로 수행되었다. 본 연구 기간은 2020년 8월부터 2021년 9월까지 총 14회기에 걸쳐 심층 면담을 진행하였고, 면담 내용은 내러티브 연구방법론에 따라 참여자의 불안정 애착과 외상 후 성장에 관한 경험의 의미를 존재적 맥락, 관계적 맥락, 생애적 맥락 등으로 텍스트를 기술하였다. 연구결과는 불안정 애착과 외상 후 성장을 경험한 참여자 3명을 선정하여 다음과 같은 결론이 도출되었다. 첫째, 존재적 맥락에서의 의미는 인정 받기 위한 욕구, 완벽주의, 불안한 가정환경, 스트레스 대처방법, 상처를 마주할 용기, 자기수용 및 긍정, 주변 사람들에게 감사, 삶의 희망은 참여자 경험 속에서 의미로 해석하였다. 둘째, 관계적 맥락에서의 의미는 부모, 남편, 자녀, 대인관계, 종교와의 경험으로 해석하였다. 셋째, 생애적 맥락에서의 의미는 돌봄의 결핍, 통제의 재현, 장녀로의 책임감, 소중한 가정, 삶의 의미와 가치는 과거 부모와의 다양한 경험이 현재 참여자들의 삶에 영향을 미치는 현재의 경험 속에서 해석하였다. 이상의 연구 결과를 통해 본 연구는 내러티브 기법으로 참여자들의 어린 시절 불안정 애착 경험과 외상 후 성장 과정을 기술하고 그들의 삶에 긍정적인 대안을 제시하고자 한다.

• 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.

• 대한간호학회지
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• 제53권5호
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• pp.500-513
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• 2023

Purpose: Women are more vulnerable to post-traumatic stress (PTS) than men, causing several health problems. Nurses should understand and work with women who have experienced trauma and provide interventions to promote their physical, social, and mental health. Methods: This quasi-experimental pilot study used a one-group pre-test/post-test design. Data were collected from 14 women recruited between December 2019 and May 2020 from a self-sufficiency support center in South Korea for sexually-exploited women who had experienced trauma. The program consisted of six one-on-one intervention sessions per week for six weeks. Each session averaged 60~120 minutes. Participants were assessed at pre-test, post-test, and one-month follow-up. Changes in outcome variables over time were analyzed using the Wilcoxon signed-rank and Friedman tests. Results: The caring program for health promotion was divided into six sessions: understanding the self, sharing traumatic events and negative emotions, reframing the meaning of traumatic events, identifying thoughts and physical and emotional responses, developing health promotion activities, and maintaining a positive attitude during the process of change. As a result of the caring program, PTS (F = 36.33, p < .001), depression (F = 24.45, p < .001), health-promoting behaviors (F = 7.06, p = .004), and self-esteem (F = 19.74, p < .001) among the participants differed significantly at pre-test, post-test, and follow-up. Conclusion: This study provides foundational information for the implementation of a theory-driven program by nurses in clinical and community settings to provide comprehensive care for women who have experienced trauma.

• Journal of Audiology & Otology
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• 제23권4호
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• pp.204-209
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• 2019

For a minimally invasive approach to access the facial nerve, we designed an extended epitympanotomy via a transmastoid approach that has proven useful in cases of traumatic facial nerve palsy and pre-cholesteatoma. To evaluate the surgical exposure through an extended epitympanotomy, six patients with traumatic facial nerve palsy were enrolled in this study. The same surgical technique was used in all patients. Patients were assessed and the degree of facial nerve paralysis was determined prior to surgery, 1-week post-operatively, and 6-months post-operatively using the House-Brackmann grading system. In all cases, surgical exposure was adequate. All patients with traumatic facial nerve palsy were male and the age range was 13 to 83 years. In all cases, the location of the facial nerve damage was limited to the area between the first and second genu. Symptoms of all the patients improved by 6 months post-operation (p=0.024). There were no complications in any of the patients. Extended epitympanotomy is useful for safe, rapid surgical exposure of the attic area, sparing the patient post-operative dimpling, skin incision complications, and lengthy exposure to anesthesia. We suggest that surgery for patients with facial nerve palsy secondary to trauma be performed using this described technique.

• 대한청각학회지
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• 제23권4호
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• pp.204-209
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• 2019

For a minimally invasive approach to access the facial nerve, we designed an extended epitympanotomy via a transmastoid approach that has proven useful in cases of traumatic facial nerve palsy and pre-cholesteatoma. To evaluate the surgical exposure through an extended epitympanotomy, six patients with traumatic facial nerve palsy were enrolled in this study. The same surgical technique was used in all patients. Patients were assessed and the degree of facial nerve paralysis was determined prior to surgery, 1-week post-operatively, and 6-months post-operatively using the House-Brackmann grading system. In all cases, surgical exposure was adequate. All patients with traumatic facial nerve palsy were male and the age range was 13 to 83 years. In all cases, the location of the facial nerve damage was limited to the area between the first and second genu. Symptoms of all the patients improved by 6 months post-operation (p=0.024). There were no complications in any of the patients. Extended epitympanotomy is useful for safe, rapid surgical exposure of the attic area, sparing the patient post-operative dimpling, skin incision complications, and lengthy exposure to anesthesia. We suggest that surgery for patients with facial nerve palsy secondary to trauma be performed using this described technique.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.151-154
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• 2011

In trauma patients, cognitive impairment may develop due to several causes: traumatic brain injury such as intracranial hemorrhage, diffuse axonal injury, hypoxic brain injury or reperfusion injury, the psychologic disorder, such as acute stress disorder, post-traumatic disorder or delirium. We describe a 62-year-old male with post-trauma cognitive impairment due to a primary central nervous system lymphoma.

• 정신신체의학
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• 제9권1호
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• pp.37-48
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• 2001

연구목적 : 외상후 정신장애 환자들을 두부손상의 부위에 따라 국소화시켜 구분하여 감정장애와 인지기능 장애가 어떻게 관련되는지 심리검사를 분석하여 차이를 알아보고자 하였다. 방법 : 두부외상 후 기질성 정신장애 환자를 MRI 판독에 따른 부위에 따라 4 개의 군으로 분류하여 다면적 인성검사와 한국판 펙슬러 지능검사 척도에 따라 차이를 평가하였다. 결과 : 다면적 인성검사의 우울증 척도는 좌반구 손상환자에서 높은 결과를 보였고 한국판 웩슬러 지능검사의 토막짜기 척도는 우반구 손상환자 군에서 낮은 결과를 보였다. 결론 : 두부외상후 발생하는 정서장애와 인지장애는 병변의 위치에 따라 특정반구의 특정 부위가 상대 우위적인 역할을 하고 병변의 위치에 따른 심리검사 결과 분석이 임상경과와 치료 예후를 예측하는데 도움이 될 것이다.

• Journal of Korean Neurosurgical Society
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• 제55권4호
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• pp.190-194
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• 2014

Objective : Post-traumatic stress disorder (PTSD) is a group of diseases that are observed in patients who had experienced a serious trauma or accident. However, some experienced it even after only a mild traumatic brain injury (TBI), and they are easily ignored due to the relatively favorable course of mild TBI. Herein, the authors investigated the incidence of PTSD in mild TBI using brief neuropsychological screening test (PTSD checklist, PCL). Methods : This study was conducted on patients with mild TBI (Glasgow coma scale ${\geq}13$) who were admitted from January 2012 to December 2012. As for PCL, it was done on patients who showed no difficulties in communication upon admission and agreed to participate in this study. By using sum of PCL, the patients were divided into high-risk group and low-risk group. PTSD was diagnosed as the three major symptoms of PTSD according to the Diagnostic and Statistical Manual of Mental Disorders, fourth-edifion. Results : A total of 314 TBI patients were admitted and 71 of them met the criteria and were included in this study. The mean age was 52.9 years-old (range : 15--94). The mean PCL score was 28.8 (range : 17--68), and 10 patients were classified as high-risk group. During follow-up, 2 patients (2.7%) of high risk group, were confirmed as PTSD and there was no patient who was suspected of PTSD in the low-risk group (p=0.017). Conclusion : PTSD is observed 2.8% in mild TBI. Although PTSD after mild TBI is rare, PCL could be considered as a useful tool for screening of PTSD after mild TBI.

• Journal of Trauma and Injury
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• 제31권3호
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• pp.166-173
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• 2018

Purpose: Many traumatic patients die from sepsis and multiple organ failure. Early recognition of post-traumatic sepsis in traumatic patients will help improve the prognosis. Recently, procalcitonin (PCT), macrophage migration inhibitory factor (MIF), and lactic acid have emerged as predictive factors. Our study aims to explore the significance of PCT, MIF and lactic acid as a predictor of posttraumatic-sepsis in trauma patients. Methods: This study was conducted on prospective observational study patients who visited an emergency medical center in a university hospital from March 2014 to February 2016. We measured the white blood cells, c-reactive protein (CRP), lactic acid, PCT, and MIF with serum taken from the patient's blood within 1 hour of the occurrence of the trauma. The definition of post-traumatic sepsis was defined as being part of systemic inflammation response syndrome criteria with infections within a week. Results: A total of 132 patients were analyzed, wherein 74 patients were included in the low injury severity score (ISS) group (ISS <15) and 58 patients were included in the high ISS group (ISS ${\geq}15$). The mean PCT, MIF, and lactic acid levels were higher in the high ISS group (p<0.05). Meanwhile, 38 patients were included in the early sepsis group and 94 patients were included in the non-sepsis group. The mean MIF levels were higher in the sepsis group than the non-sepsis group (p<0.05) and there were no significant differences in the initial CRP, lactic acid, and PCT levels in these two groups. Conclusions: MIF may be considered as a predictive factor for sepsis in trauma patients.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제32권2호
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• pp.63-70
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• 2021

Objectives: Adverse childhood experiences (ACEs) of mothers may negatively affect the mental health of their offspring. Little is known about the intergenerational effect of maternal ACE on post-traumatic stress disorder (PTSD) in the offspring. This study investigated the impact of maternal ACEs on PTSD in the offspring. Methods: A total of 156 mothers with children aged 13-18 years completed the Diagnostic Interview Schedule for Children (DISC) Predictive Scales to determine the presence of psychiatric disorders in their offspring. The subjects completed the ACE questionnaire and the Early Trauma Inventory Self-Report-Short Form. Multivariable logistic regression was used to analyze the relationship between maternal ACEs and PTSD in the offspring. Results: Of the mothers, 23.7% had at least one ACE, and PTSD was reported in 21.8% of the offspring. The offspring of the mothers in the ACE group had a significantly higher rates of traumatic experiences and PTSD than the offspring of the mothers in the no ACE group. Maternal household dysfunction independently predicted offspring PTSD [odds ratio (OR)=3.008, p=0.05), and three or more maternal ACEs were significantly related to PTSD in the offspring (OR=10.613, p=0.025). Conclusion: Maternal ACEs have a significant impact on the risk of traumatic experiences and PTSD in the offspring. These findings suggest the presence of intergenerational transmissions by which maternal ACEs affect the mental health of the offspring.