• 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.

• 한국산학기술학회논문지
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• 제20권12호
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• pp.254-264
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• 2019

본 연구는 교통사고 환자의 외상후 스트레스 장애 위험정도, 회복탄력성 및 사회적 관계망이 외상후 성장에 미치는 영향을 알아보기 위해 시도된 서술적 상관관계 연구이다. 연구대상자는 K도 C시 소재 100병상 이상 5개 병원의 교통사고 환자 158명이었으며, 2018년 7월 1일부터 8월 31일까지 구조화된 설문지를 이용하여 자료를 수집하였다. 수집된 자료는 t-test, ANOVA, Pearson's correlation coefficients, Multiple Regression으로 분석하였다. 외상후 성장에 미치는 영향요인을 파악한 결과, 연구의 설명력은 36.9%로 나타났으며, 대상자의 외상후 성장에 미치는 영향요인은 사회적 관계망, 외상후 스트레스 장애 위험정도 순으로 나타났다. 또한 사회적 관계망은 회복탄력성과 외상후 성장의 관계를 완전매개하였다. 이를 토대로, 교통사고 환자의 사회적 관계망이 크고 외상후 스트레스 장애 위험정도가 클수록 외상 후 성장이 높아짐을 확인하였고, 사회적 관계망은 회복탄력성과 외상후 성장의 관계를 완전매개한다는 것을 확인하였다. 따라서 교통사고 환자의 외상후 성장을 돕기 위해 사회적 관계망과 회복탄력성 향상 방안에 대해 모색할 필요가 있고, 교통사고 환자에 대한 반복적이고 장기적인 관찰을 통해 외상후 성장에 대한 추가연구가 필요할 것으로 사료된다.

• 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.

• 한국산학기술학회논문지
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• 제19권4호
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• pp.167-177
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• 2018

본 연구의 목적은 산재환자에게 나타나는 외상후 스트레스가 삶의 질에 미치는 영향과 이들의 관계에 있어 회복탄력성의 효과를 확인하기 위한 서술적 조사연구이다. 본 연구는 2개 광역지역에 소재한 산재병원, 종합병원 및 준 종합병원에 입원중이거나 통원하고 있는 158명의 산재환자를 대상으로 이루어졌다. 자료수집은 2017년 7월 1일부터 9월30일까지 자기보고식 설문지로 이루어졌다. 자료는 SPSS 21.0을 이용하여, 기술통계, 상관분석, 위계적 회귀분석, Sobel test로 분석하였다. 연구결과, 연구대상자의 외상후 스트레스와 삶의 질, 회복탄력성은 음의 상관관계를, 삶의 질과 회복탄력성은 양의 상관관계를 보였다. 외상후 스트레스가 삶의 질에 대한 영향에서 회복탄력성의 효과를 규명하기위해 회귀분석을 실시한 결과, 외상후 스트레스와 삶의 질의 관계에서 회복탄력성은 부분 매개효과가 있었으나 조절효과는 없었다. 외상후 스트레스와 회복탄력성은 삶의 질에 45%의 설명력을 보여주었으며 이 중 외상후 스트레스는 삶의 질에 23%의 직접효과가 있었고 회복탄력성을 매개로 하여 22%의 간접효과가 있었다. 이상의 결과에 비추어 볼 때 외상후 스트레스와 회복탄력성은 삶의 질에 영향을 미치는 주요한 심리적 변수임을 알 수 있다. 따라서 산재환자의 삶의 질을 향상시키기 위해서는 이들의 외상후 스트레스를 줄여줄 뿐만 아니라 회복탄력성을 증가 시켜주는 중재가 필요할 것이다.

• 한국콘텐츠학회논문지
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• 제14권9호
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• pp.247-254
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• 2014

최근 발생하고 있는 범죄는 심각하고 흉포화 되었다. 이러한 특성은 그 범죄를 수사하는 경찰에게도 심각한 영향을 미치고 있다. 이러한 범죄를 접하는 경찰관도 인간이기 때문에 심리적인 미칠 수 있다. 실제로 많은 수사관련 경찰관이 큰 사건을 겪은 이후 수사 부서를 떠나거나, 경찰직을 그만두고 있다. 이러한 문제에 대하여 본 연구에서는 외상 후 스트레스 장애(Post Traumatic Stress Disorder; PTSD)가 실제 경찰관에게 미치는 영향을 살펴보고 이러한 영향이 조직몰입에 미치는 영향을 살펴보고자 하였다. 연구의 목적을 달성하기 위하여 본 연구에서는 과각성, 회피, 침습, 수면장애를 외상 후 스트레스 장애의 하위영역으로 설정하고, 조직몰입을 정서적 몰입, 지속적 몰입, 규범적 몰입으로 하위영역으로 나누었다. 측정을 위하여 만들어진 설문지는 대구지방경찰청 소속 경찰관 중 수사경과를 가지고 있는 형사부서 경찰관을 대상으로 설문을 실시하여 미치는 영향을 살펴보았다. 그 결과, 외상 후 스트레스 장애의 하위요인 중 침습이 정서적 몰입에 유의미한 영향을 미치는 것으로 나타났으며, 회피는 지속적 몰입에 유의미한 영향을 미친다고 나타났고, 침습과 회피는 규범적 몰입에 유의미한 영향을 미치는 것으로 나타났다.

• 대한불안의학회지
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• 제11권1호
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• pp.61-68
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• 2015

Objective : Police officers are exposed to job-related traumatic events and have a high prevalence of post-traumatic stress disorder (PTSD). This study examined the relationship between PTSD symptoms and dimensions of temperament and character in police officers. Method : Thirty-six police officers participating in a psychological support program were enrolled. All subjects were asked to complete a demographic questionnaire, the Impact of Event Scale-Revised (IES-R), the Temperament and Character Inventory (TCI) and other self-reported symptoms scales. Results : Among all participants (age $40.8{\pm}10.2$, men 94.4%), the rate of 'post-traumatic stress symptoms group' was 47.2%. After controlling for confounding factors, lower self-directedness scores were significantly associated with higher PTSD symptoms (${\beta}=0.6$, p=0.03) in multiple regression analysis. Conclusion : Character traits, especially self-directedness, were associated with the severity of PTSD symptoms severity. These findings may provide useful information regarding personality factors related to PTSD in police officers.

• 대한불안의학회지
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• 제15권1호
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• pp.45-52
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• 2019

Objective : The objective of this study is to determine the effects of fear of Middle East respiratory syndrome (MERS) on socio-psychological health during an outbreak of MERS and the post-traumatic stress as a mediator on the relationship between stress and socio-psychological health. Methods : Visual Analog Scale, Impact of Event Scale -Revised, Psychosocial well-being index short form was implemented for 150 medical persons who worked at the hospital in which exposure to MERS cases had been confirmed and 96 ordinary people. A Pearson correlation coefficient and a hierarchical multiple regression was carried out to confirm the effect of fear of MERS and the mediating effect of post-traumatic stress between fear and socio-psychological health. Results : The higher the fear, the lower the socio-psychological health in both healthcare workers and the public (r=0.32, p<0.01) and the higher post-traumatic stress (r=0.32, p<0.01). But, the research results showed that only healthcare workers had a partially mediating effect of post-traumatic stress in the relationship between fear and socio-psychological health (${\beta}=0.45$, t=6.33 p<0.001), (${\beta}$ value : 0.39>0.26). Conclusion : This study demonstrated that the post-traumatic stress can indirectly lead to a negative effect on the socio-psychological health of healthcare workers when under the fear of MERS and shows adverse effects on psycho-social wellbeing. This suggests that clinical intervention and psycho-social approach aiming at reducing post-traumatic stress is important to maintain mental health during crisis development.

• 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.

• 대한간호학회지
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• 제47권1호
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• pp.39-48
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• 2017

Purpose: The purpose of this study was to verify the relationships among social support, resilience and post traumatic stress disorder (PTSD), and especially to identify factors influencing PTSD in police crime scene investigators. Methods: A cross-sectional design was used, with a convenience sample of 226 police crime scene investigators from 7 Metropolitan Police Agencies. Data were collected through self-report questionnaires during July and August, 2015. Data were analyzed using t-test, ${\chi}^2$-test, Fisher's exact test, and binary logistic regression analysis with SPSS/WIN 21.0 program. Results: The mean score for PTSD in police crime scene investigators was 13.69 .11 points. Of the crime scene investigators 181 (80.1%) were in the low-risk group and 45 (19.9%) in high-risk group. Social support (t=5.68, p<.001) and resilience (t=5.47, p<.001) were higher in the low-risk group compared to the high-risk group. Logistic regression analysis showed that resilience (OR=4.74, 95% CI: 1.57~14.35), and social support (OR=2.13, 95% CI: 1.23~3.69) are effect factors for PTSD low group. Conclusion: For effective improvement of PTSD in police crime scene investigators, intervention programs including social support and strategies to increase should be established.

• 지역사회간호학회지
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• 제28권4호
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• pp.524-536
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• 2017

Purpose: This study aims to examine the relationships among experiences of traumatic events, post-traumatic stress (PTS), and the needs for health promotion programs of 119 paramedics. Methods: Experiences of traumatic events, PTS, and needs for health promotion programs were measured using a structured questionnaire. The subjects were 193 paramedics in Jeju Island. Data were analyzed using descriptive statistics, t-test and $x^2$ test. Results: The most experienced event out of the 16 different traumatic events was 'retrieve a suicide's body.' A high-risk classification of PTS was observed in 36.2% of the subjects. The rates of experiences were higher than those of the actual needs for all 26 health promotion programs. The programs reported as highly needed by respondents were stress management (75.5%) followed by exercise (74.6%) and PTS management (72.5%). Subjects with longer career periods, a fire sergeant, perceived obesity, numerous experiences of traumatic events, and in the PTS risk group had a higher need for a stress management program. Conclusion: These findings indicate that a significant number of 119 paramedics experienced PTS. They also show that onsite strategic management is strongly required. In addition, implementation of health promotion programs based on the needs of 119 paramedics is highly needed.