• 대한불안의학회지
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• 제12권2호
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• pp.69-78
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• 2016

Objective : Disaster causes psychological distress to a large number of people in a short period of time, by both direct and indirect exposure to traumatic events embedded in various realms of disaster experience. Optimal, well-planned treatment interventions should follow from the early acute period to recovery phase, extending up to several months later. In this context, there is an increasing need for systemic review to gain comprehensive insights for disaster interventions. These need to be added to public policy, and for the prevention and treatment of disaster-related psychopathology. Here, we review the published studies on psychological interventions for disaster-related posttraumatic stress disorder. Methods : Specific psychological interventions regarded as effective treatments for have been selected for this review, such as CBT (Cognitive-Behavior Therapy), Exposure Therapy, EMDR (Eye Movement Desensitization & Reprocessing), SIT (Stress Inoculation Therapy) and Psychoeducation. In addition, natural disasters, industrial disasters, and accidents involving aircraft and ships were also categorized as disasters, along with war and combat trauma. Results : Cognitive behavior therapy and exposure therapy had the strongest research support for effectiveness, and could be considered as the first-choice treatment for disaster-related PTSD. The second line of treatment is EMDR, although this treatment modality has the advantage of reaching certain treatment improvements in fewer sessions. However, the effects of SIT and psychoeducation to the survivors of disasters, remains unclear at this point. Additionally, we propose the possibilities of using virtual reality component and imagery rescripting as modified forms of traditional cognitive behavior therapy and exposure therapy. Conclusion : Cognitive behavior therapy and exposure therapy, deemed effective treatments for various trauma, are considered to be effective for survivors from disasters. However, the efficacy of other interventions has not yet been examined methodologically in well-designed studies, such as randomized controlled trials. In particular, future empirical studies are needed, since it is difficult to conclude that psychological interventions have similar effects on different types of disasters.

• 성인간호학회지
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• 제24권1호
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• pp.38-51
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• 2012

Purpose: In this study the literature of compassion fatigue in nurses was reviewed in order to analyze the trends of overall research for level of fatigue, symptoms, and factors. Methods: For this study, five databases were searched using the key words 'compassion fatigue', 'secondary traumatization', 'secondary traumatic stress', and 'vicarious traumatization'. Thirty-six papers were analyzed. Results: Most of the compassion fatigue research (86%) was conducted between 2006 and 2011 and the most frequent research approach was quantitative research with the ProQOL which was the most frequently used instrument in the studies. He research was conducted in pediatric, emergency & trauma, oncology, psychiatric, and hospice units with no consistent patterns of t compassion fatigue levels. Factors affecting compassion fatigue were personal factors such as age, education background, work-related factors such as caring for trauma patients, work hours, psychological factors such as work stress, burnout, and support/coping factors such as organizational support, and coping resources. Conclusion: Nurses' compassion fatigue varied from low to high by nursing specialties. Many factors affected the compassion fatigue of nurses. In the future there is a need for study on Korean nurses, and identification of groups at risk for compassion fatigue. Furthermore there is a need to develop management programs on compassion fatigue in nurses, stress reduction and wellbeing.

• 대한불안의학회지
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• 제5권2호
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• pp.80-88
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• 2009

Disorder of Extreme Stress, Not Otherwise Specified (DESNOS) is the proposed diagnosis that meets the severe, complex, and prolonged psychological sequela of victims with chronic traumatization (e.g., family violence, incest, and childhood sexual or physical abuse). The hallmarks of DESNOS are a multiplicity of symptoms (e.g., somatization, dissociation, and depression), pathological changes in relationships, identity disturbances, and a propensity to experience repeated harm and injury at the hands of oneself and others. DESNOS can be directly assessed by Structured Interview of Disorder of Extreme Stress (SIDES) and Self- Report Inventory of Disorder of Extreme Stress (SIDES-SR). The treatment of DESNOS should be phaseoriented and involve movement back and forth among three basic stages : 1) stabilization ; 2) trauma processing ; 3) reintegration.

• Journal of Preventive Medicine and Public Health
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• 제52권6호
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• pp.345-354
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• 2019

Objectives: It is well-known that post-traumatic stress disorder (PTSD) among firefighters contributes to their job-related stress. However, the relationship between burnout and PTSD in firefighters has rarely been studied. This study therefore explored the association between burnout and its related factors, such as trauma and violence, and PTSD symptoms among firefighters in Korea. Methods: A total of 535 firefighters participated in the Firefighter Research on Enhancement of Safety & Health study at 3 university hospitals from 2016 to 2017. The 535 participants received a baseline health examination, including questionnaires assessing their mental health. A Web-based survey was also conducted to collect data on job-related stress, history of exposure to violence, burnout, and trauma experience. The associations among burnout, its related factors, and PTSD symptoms were investigated using structural equation modeling. Results: Job demands (${\beta}=0.411$, p<0.001) and effort-reward balance (${\beta}=-0.290$, p<0.001) were significantly related to burnout. Burnout (${\beta}=0.237$, p<0.001) and violence (${\beta}=0.123$, p=0.014) were significantly related to PTSD risk. Trauma (${\beta}=0.131$, p=0.001) was significantly related to burnout; however, trauma was not directly associated with PTSD scores (${\beta}=0.085$, p=0.081). Conclusions: Our results show that burnout and psychological, sexual, and physical violence at the hands of clients directly affected participants' PTSD symptoms. Burnout mediated the relationship between trauma experience and PTSD.

• 대한약침학회지
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• 제20권1호
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• pp.5-9
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• 2017

Objectives: Gan Mai Da Zao (GMDZ) decoction is widely used for the treatment of various diseases of the internal organ and of the central nervous system. The aim of this study is to investigate the effects of GMDZ decoction on neuropsychiatric disorders in an animal model. Methods: We searched seven databases for randomized animal studies published until April 2015: Pubmed, four Korean databases (DBpia, Oriental Medicine Advanced Searching Integrated System, Korean Studies Information Service System, and Research Information Sharing Service), and one Chinese database (China National Knowledge Infrastructure). The randomized animal studies were included if the effects of GMDZ decoction were tested on neuropsychiatric disorders. All articles were read in full and extracted predefined criteria by two independent reviewers. Results: From a total of 258 hits, six randomized controlled animal studies were included. Five studies used a Sprague Dawley rat model for acute psychological stress, post-traumatic stress disorders, and unpredictable mild stress depression whereas one study used a Kunming mouse model for prenatal depression. The results of the studies showed that GMDZ decoction improved the related outcomes. Conclusion: Regardless of the dose and concentration used, GMDZ decoction significantly improved neuropsychiatric disease-related outcomes in animal models. However, additional systematic and extensive studies should be conducted to establish a strong conclusion.

• 동의신경정신과학회지
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• 제30권3호
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• pp.251-263
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• 2019

Objectives: The purpose of this study was to review the clinical research trends in the treatment of post traumatic stress disorder (PTSD) in Korean medicine (KM). Methods: We searched MEDLINE, CENTRAL, EMBASE, Google Scholar and five Korean databases through May 2019, for studies on KM to treat PTSD. Clinical research that conducted KM treatment of PTSD patients were included. Two researchers independently conducted study selection and data extraction process. Results: Totally, eight studies were included in this review. Types of traumatic events that patients experienced included physical violence/threatening, traffic accidents, sexual violence and personal tragic events. KM interventions performed included acupuncture, moxibustion, herbal medicine, physical therapy, and KM-based psychotherapy. Treatment duration varied from two days to more than five months. Follow-up began at least one week to three months after the end of treatments. It was reported that the major psychological and/or somatic symptoms of PTSD, such as anxiety, depression, insomnia, and musculoskeletal pain, subjectively improved, as well as other objective outcomes: Impact Event Scale-Revised Korean version (IES-R-K), Beck's Depression Inventory (BDI), State-Trait Anxiety Inventory, Hwabyung Symptoms/characters, Electroencephalography (EEG) change, etc. Statistical studies were conducted in three studies only. Outcomes such as Visual Analogue Scale (VAS), BDI, and IES-R-K showed statistically significant improvement after KM treatments. There was no study reporting adverse events during or after the interventions. Conclusions: According to this review, diverse types of KM treatments have been used among PTSD patients in eight studies. The KM treatments effectively improved psychological and somatic symptoms of PTSD patients. However, the lack of high quality research as well as the lack of standardization of KM treatments for PTSD are limitations. Further methodologically robust clinical trials should be performed, and the standardization of KM treatments for PTSD should be sought.

• 중환자간호학회지
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• 제12권1호
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• pp.22-35
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• 2019

Purpose : This study was to determine the levels of environmental stressor, posttraumatic stress disorder, and quality of life in intensive care units (ICU) survivors after intensive care, and to explore the factors affecting posttraumatic stress disorder and quality of life. Methods: With a longitudinal survey design, data were collected from 116 patients who were discharged from the ICU of a university hospital. The environmental stressor, posttraumatic stress disorder, and quality of life were measured immediately following and 1 month after the ICU discharge. Results: Of all the subjects, 16.4% experienced posttraumatic stress disorder after discharge. Multiple regression analysis revealed that ICU environmental stressors, experience of ICU readmission, using psychotropic drugs and narcotic analgesics, and ICU admission after surgery or cardiac intervention accounted for 22.2% of posttraumatic stress disorder. Posttraumatic stress disorder and sedation status when entering ICU accounted for 28.3% of the quality of life 1 month after ICU discharge. Conclusion: Nursing interventions focused on ICU environmental stressors would not only reduce environmental stress but also contribute to the reduction of posttraumatic stress disorder and later improvement of quality of life.

• 통합자연과학논문집
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• 제11권2호
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• pp.101-106
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• 2018

Corticotropin - releasing hormone receptor 1 (CRHR1) forms an integral part of the pathophysiology of disorders like post-traumatic stress disorder, stress, anxiety, addiction, and depression. Hence it is essential to look for new, potent and structure-specific inhibitors of CRHR1. We have analysed the protein-protein interaction complexes of the CRHR1 receptor with its native ligand CRF and full agonist Sauvagine. The structure of Sauvagine was predicted using homology modelling. We have identified that the residues TYR253, ASP254, GLU256, GLY265, ARG1014 and LY1060 are important in the formation of protein-protein complex formation. Future studies on these residues could throw light on the crucial structural features required for the formation of CRHR1-inhibitor complex and in studies that try to solve the structural complexities of CRHR1.

• 통합자연과학논문집
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• 제11권1호
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• pp.19-24
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• 2018

CRFR is involved in the pathophysiology of various disorders including depression, stress, anxiety, post-traumatic stress disorder, and addiction. The discovery of novel and structurally diverse CRF1 receptor inhibitors becomes essential. In this study, we have performed molecular docking of CRF1R with the derivatives of 8-substituted-2-aryl-5-alkylaminoquinolines as CRF1R inhibitors. The antagonist molecules were optimized and docked into the binding site of the receptor. On analysing the docked complexes we have identified that the residues HIS214, THR215, ARG227, ARG1008, LYS1060 and ASP1061 are important in forming hydrogen bond with the inhibitors. Further studies on these residues could reveal important structural features required for the formation of CRF1R-inhibitor complex and thus in the discovery of novel and potent inhibitors.

• Journal of Hospice and Palliative Care
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• 제18권1호
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• pp.35-41
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• 2015

목적: 본 연구는 항암치료 단계 유방암 환자의 PTSD, 대처방식, 사회적 지지의 관계를 파악하여 암환자의 PTSD에 관한 효과적인 간호중재의 기초자료를 제시하기 위함이다. 방법: J시 소재 G지역암센터 외과 외래를 방문한 만 30세 이상이며, 항암치료단계인 유방암 환자134명을 대상으로 조사하였다. 수집된 자료는 SPSS WIN 18.0프로그램을 이용하여 서술통계, ANOVA, Pearson correlation coefficients 등을 실시하였다. 결과: 항암치료 단계 유방암 환자의 외상 후 스트레스 장애는 26.9%가 PTSD 고위험군, 17.9%가 PTSD 위험군에 속하는 것으로 나타났다. 대상자의 PTSD 그룹(고위험군, 위험군, 정상)의 대처방식(적극적 대처, 소극적 대처), 사회적 지지의 상관관계는 PTSD 고위험군인 경우 적극적 대처와 소극적 대처가 유의미한 정적 상관관계를 가지는 것으로 나타났으며, PTSD 고위험군에서 사회적 지지와 적극적 대처는 유의미한 정적 상관관계를 가지고 있는 것으로 나타났다. 결론: 항암치료 단계 유방암 환자 중 26.9%가 PTSD 증상을 보이는 것으로 나타났으며, PTSD 고위험군에서 사회적 지지가 증가할수록 적극적 대처가 증가하는 것으로 나타났다. 암은 평생 자기관리가 필요한 질병임을 고려할 때 높은 사회적 지지는 자신의 건강관리 능력을 증진시킬 수 있는 계기가 될 수 있을 것이며, 더 나아가 PTSD 고위험군에게 있어 높은 사회적 지지는 환자의 스트레스를 줄이고 삶의 질을 높이는데 효과적인 역할을 할 것이라 여겨진다.