• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제16권1호
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• pp.72-78
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• 2005

목 적 : 종합병원에서의 소아청소년을 대상으로 한 정신과 자문의 임상적 특징을 알아보고자 하였다. 방 법 : 4년 동안 한 종합병원에서 소아정신과에 의뢰된 302명의 환자의 병원기록을 조사 분석하였다. 결 과 : 학령기 아동과 청소년의 소아정신과 자문비율은 $2.15\%$였다. 중, 고등학생에서는 여자에서 더 많이 자문이 의뢰되었으나 학령전기 아동에서는 남자에서 더 많이 의뢰되었다. 자문의 $50\%$가 내과와 소아과로부터 의뢰되었다. 자문의뢰의 주된 이유는 정신과적 평가$(31.1\%)$, 우울$(11.6\%)$, 그리고 불안$(11.3\%)$이었다. 가장 자주 행해진 치료 목적의 정신과적 처치는 정신과적 교육과 지지적 정신치료였다$(21.2\%)$. 결 론 : 정신과 자문 의뢰의 임상적 양상은 성인과 소아청소년 사이에 차이가 있다. 소아 및 청소년을 위한 자문서비스를 강화시키기 위하여 더 많은 연구가 필요하다.

• 한국사회복지학
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• 제62권1호
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• pp.237-261
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• 2010

본 연구는 정신장애인이 취업의 전 과정을 통해 어떤 경험을 하게 되며, 어떻게 자신의 역할을 가치화하고 궁극적으로 사회통합과정에 진입해 나가는지 심층적으로 이해하고자 하였다. 특정 현상의 본질적 모습을 참여자들의 삶과 연결하여 보다 생생하고 풍부하게 이해하기 위하여 현상학적 연구방법을 활용하였으며, Colaizzi의 분석방법을 통해 고유경험을 깊이 있게 기술하였다. 정신장애인의 취업경험에 관한 분석과 반성적 고찰을 통해 6가지의 주제묶음을 도출하였다. '좁은 문을 비집고 들어가기', '낯선 무대 위에 올려지기', '빠른 세상 속에 헛돌기', '버텨내기', '평범한 삶에 포개지기', '내 한계를 인정하며 한발 더 내딛기'이다. 참여자는 직업세계의 편견과 차별, 스스로의 기능적 제한을 경험하면서 사회적으로 성장하였고, 이를 통해 내재화된 환자역할에서 벗어나는 힘이 생기고, '장애'보다는 자신의 '능력과 노력'에 초점을 두어 자아를 통합하였다. 참여자들은 취업이 주는 정당한 고통이 자신이 지향하는 삶의 일부로 의미화하고, 한발 더 내딛어 세상에 합류하고자 하는 경험을 하였다. 본 연구는 이러한 연구결과를 통해 정신장애인의 취업지원을 위한 실천적 개입방향을 제시하였다.

• 한국보건간호학회지
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• 제16권1호
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• pp.95-104
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• 2002

Purpose : This study was conducted to investigate the extent to which the professional self concept between the psychiatric mental health nurse practitioner (PMHNP) and general nurse in psychiatric ward was comparable. The results were expected to provide basic data for developing the construct of professional self concept and making awareness of the importance of the program increasing professional self concept. Method : The subjects of this study were 227 PMHNP and 436 general nurse in psychiatric ward. The instruments used for this study were PSCNI by Arthur (1990), PSI by Heppner and Peterson(1982) and the index of work satisfaction by Slavitt et al.(1978). With the aid of the SAS, t-test. two-way ANOVA and stepwise multiple regression were conducted. Result : 1. The average item score of PSCNI of PMHNP was $2.82\pm0.27$. and that of general nurse was $2.66\pm0.27$. Statistically significant difference between two groups was found(p=0.0000) 2. There was statistically significant difference between two groups in the score of professional practice(p=0.0000), satisfaction(p=0.0024), leadersbip(p=0.0000) , flexibility(p=0.0000) and skill (p=0.0000). 3. Statistically significant differences between the two groups were observed in terms of age(p=0.0003), marital status(p=0.0001). education(p=0.0005), religion(p=-.0144), motive (P=-.0001), length of service as a nurse(p=0.0121), the length of service in psychiatric unit(p=0.0143). However there were no significant interaction effect with group and age, marital state. education, religion, motive, length of service as a nurse, length of service in psychiatric unit. 4. Job satisfaction (JS) and problem solving inventory score(PS) were found to be the highest factor predicting the professional self concept between the PMHNP and general nurse. JS and PS accounted for $43.4\%$ in the professional self concept of PMHNP, whereas PS, JS, age and religion accounted for $53\%$ in the professional self concept of general nurse in psychiatric ward. In conclusion, this study suggested that we need to develop programs and polices to increase the professional self concept of nurse, particularly of psychiatric mental health nurse practitioners.

• 산업융합연구
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• 제18권4호
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• pp.33-40
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• 2020

본 연구는 정신약물을 복용하는 정신질환자의 진정, 섬망 및 낙상의 관계를 파악하기 위한 서술적 조사 연구이다. 2019년 3월10일부터 2019년 11월10까지 D시에 위치한 정신병원 2곳을 대상으로 정신과 간호사 4인이 정신질환자 총 149명에 대한 평가를 실시하였다. 수집된 자료는 SPSS 22.0를 이용하여 서술적 통계, t-test, ANOVA, Pearson's correlation coefficient로 분석하였다. 정신질환자의 진정과 섬망(r=.587 p=<.001), 진정과 낙상(r=.273 p=.001), 섬망과 낙상(r=.390 p=<.001)은 모두 유의한 양의 상관관계로 나타났다. 이에 본 연구는 정신약물을 복용하는 정신질환자의 진정, 낙상, 섬망의 정도를 파악하고 진정과 낙상 및 섬망간의 관계를 확인함으로써 정신약물 복용시 발생할 수 있는 낙상과 섬망을 예방하고 간호중재 전략을 마련하는 기초자료를 제공할 수 있을 것으로 생각된다.

• Journal of Preventive Medicine and Public Health
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• 제49권1호
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• pp.53-60
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• 2016

Objectives: The purpose of this study is to examine the magnitude of and the factors associated with the downward mobility of first-episode psychiatric patients. Methods: This study used the claims data from the Korean Health Insurance Review and Assessment Service. The study population included 19 293 first-episode psychiatric inpatients diagnosed with alcohol use disorder (International Classification of Diseases, 10th revision [ICD-10] code F10), schizophrenia and related disorders (ICD-10 codes F20-F29), and mood disorders (ICD-10 codes F30-F33) in the first half of 2005. This study included only National Health Insurance beneficiaries in 2005. The dependent variable was the occurrence of downward mobility, which was defined as a health insurance status change from National Health Insurance to Medical Aid. Logistic regression analysis was used to assess factors associated with downward drift of first-episode psychiatric patients. Results: About 10% of the study population who were National Health Insurance beneficiaries in 2005 became Medical Aid recipients in 2007. The logistic regression analysis showed that age, gender, primary diagnosis, type of hospital at first admission, regular use of outpatient clinic, and long-term hospitalization are significant predictors in determining downward drift in newly diagnosed psychiatric patients. Conclusions: This research showed that the downward mobility of psychiatric patients is affected by long-term hospitalization and medical care utilization. The findings suggest that early intensive intervention might reduce long-term hospitalization and the downward mobility of psychiatric patients.

• 한국콘텐츠학회논문지
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• 제14권2호
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• pp.396-408
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• 2014

본 연구는 치료적 관계형성 및 의사소통, 정신간호사정 교육을 위해 개발한 모의환자를 활용한 정신간호 시뮬레이션 교육프로그램이 자기주도적 학습, 학습 자기효능감 및 교육만족도에 미치는 효과를 검증하고자 시행하였다. 본 연구는 단일군 전후설계 실험연구로 119명의 간호학과 3학년을 대상으로 8시간의 시뮬레이션 교육 중재를 시행하였다. 그 결과 시행 전보다 시행 후에 자기주도적 학습, 학습 자기효능감이 유의하게 향상된 것으로 나타났으며, 이들 변수들은 교육만족도와 중간정도의 정적인 상관관계를 보였다. 이는 정신간호 실습교육에 있어서 모의환자를 이용한 시뮬레이션 교육이 효과적임을 보여주는 결과라 할 수 있다. 본 연구는 현장중심의 정신간호 실습교육 및 정신간호 임상실무의 질을 향상시키는데 기여할 수 있을 것이다.

• 정신신체의학
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• 제5권2호
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• pp.205-213
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• 1997

The aim of this study is to find the relationship between interictal psychiatric symptoms and seizure-related variables such as structural changes, regional interictal perfusion changes, the number of interictal epileptic discharges and the presence of accompanying generalized tonic clonic seizure(GTC). The subjects were 75 patients (47 males : mean age $28.3{\pm}7.7$) with intractable epilepsy, Interictal psychiatric symptoms were rated by Symptom Checklist-90-R(SCL-90-R). Each of 4 seizure variables was measured by MRI, $^{99m}TC-HMPAO$ SPECT and the prolonged EEG monitoring. The mean SCL-90-R subscale T-scores and the ratio of the patients with definite psychiatric symptoms(T-score > 65 at any one subscale of SCL-90-R) were compared among the groups with different seizure variables. Demographic variables and clinical variables were not statistically different among the groups with different seizure variables. The patients with right mesial temporal sclerosis had higher mean SCL-90-R scores for obsessive compulsive symptom, interpersonal sensitivity, depression, hostility and psychotic symptoms than the patients with left mesial temporal sclerosis, and they also showed higher ratio of definite psychiatric symptoms. The presence of interictal epileptic discharges was related with higher T-scores of paranoid subscale. The areas of hypoperfusion, the presence of the GTC, and other clinical seizure variables showed no significant influences on the mean SCL-90-R subscale T-scores. from these results, the authors speculated that interictal subictal epileptic dischrages may be related with psychiatric symptoms of the intractable epileptic patients, especially with right mesial temporal sclerosis.

• 정신신체의학
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• 제4권1호
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• pp.64-70
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• 1996

The prevalence rate of psychiatric symptoms of the refractory epileptic patients was evaluated according to the location of the epileptic focus. The subjects were 91 patients admitted to Epilepsy Monitoring Unit of Seoul National University Hospital. The psychiatric symptoms were assessed by Korean version of Symptom Checklist-90-R(SCL-90-R). The locus of epileptic focus was assessed by clinical features, 2-hour interictal EEG, long-term video-EEG monitoring, brain MRI, interictal and ictal brain SPECT, and interictal brain PET The subjects were divided into three groups according to the epileptic focus, non-temporal(N=29), left temporal (N=26), and right temporal(N=32). There were no statistical differences in demographic and seizure-related variables among groups. The number of patients with $T-score {\geq} 65$ at any subscale of the SCL-90-R were compared by $X^2-test$ among groups. The mean T-scores of each subscale of the SCL-90-R were compared by oneway-ANOVA among groups. The prevalence rate of psychiatric symptoms of the refractory epileptic patients was 38.5%. There was no statistical difference in the prevalence rate of psychiatric symptoms among groups. However, the patients with non-temporal or right temporal epileptic foci showed statistically significant higher mean T-scores of interpersonal sensitivity, depression, hostility, and phobic subscales than the patients with left temporal epileptic foci. These results suggest that the epileptic focus plays an important role in the production of interictal psychiatric symptoms of the refractory epileptics.

• 생물정신의학
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• 제11권2호
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• pp.88-93
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• 2004

Background:Serotonin transporter gene-linked polymorphism region(5-HTTLPR) and catechol-O-methyltransferase( COMT) genes are thought to be important factors in some personality traits and the etiology of anxiety disorder. The goal of this study was to determine the role of these genes in personality traits. Method:The participants included 116 healthy adults with no history of psychiatric disorders and other physical illness for the last 6 months. All participants were tested by Temperament and Character Inventory(TCI). The 5-HTTLPR, COMT val158met gene polymorphisms were analyzed with PCR(Polymerase Chain Reaction). Differences on TCI dimensions and sub-scales among groups were examined with t-test and ANOVA. Result:There were possible relationships of the 5-HTTLPR with self-transcendence(P=0.050) and COMT val158met polymorphism with cooperativeness(P=0.053). Conclusion:We found associations between 5-HTTLPR, COMT polymorphisms and the some TCI character dimensions. Further studies of polymorphisms of other genes and their interactions may clarify the complex relationship between personality and genes.

• 대한불안의학회지
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• 제11권2호
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• pp.136-142
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• 2015

Objective : Subjective tinnitus is defined as an acoustic sensation perceived without any external source. Patients with tinnitus have often experienced psychological distress and low quality of life. However, the connection between psychiatric characteristics and tinnitus has not yet been established. The purpose of this study was to investigate the relationship of psychiatric characteristics with tinnitus severity. Method : A total of 124 patients with tinnitus were included in the study. Demographic and clinical characteristics were retrospectively collected in the otolaryngology clinic. The self-reported scales including the Tinnitus Handicap Inventory, the Hospital Anxiety and Depression Scale and the Anxiety Sensitivity Index were used in this study. Results : The Pearson product moment correlation revealed significant correlations between tinnitus severity and psychiatric characteristics including depression (r=0.26, p<0.01), anxiety (r=0.38, p<0.01), anxiety sensitivity (r=0.27, p<0.01). After controlling for age, sex and awareness of tinnitus, tinnitus severity was positively correlated with anxiety (partial r=0.39, p<0.01) and anxiety sensitivity (partial r=0.28, p<0.01). These correlations remained significant in male but not in female patients. Conclusion : Results of the present study indicated that not only anxiety symptoms but also anxiety sensitivity could relate to tinnitus severity. Our findings have implications for the understanding of the psychiatric characteristics in patients with tinnitus.