• 제목/요약/키워드: Psychiatric Approach

검색결과 101건 처리시간 0.035초

자폐증 청소년에서 체중감소와 연관된 반추적 구토의 정신과적 치료 (Psychiatric Treatment of Ruminative Vomiting and the Associated Weight Loss in an Adolescent Boy with Autism : A Case Report)

  • 신윤오;이문성
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • 제20권1호
    • /
    • pp.39-43
    • /
    • 2009
  • We treated the persistent ruminative vomiting of a 13-year-old autistic boy by using a behavioral and psychopharmacological approach in a closed ward. Before the interventions, the patient had lost about 10kg of body weight due to very high-frequency ruminative vomiting. Together with psychopharmacological trials, the psychiatric treatment included a combination of a behavioral approach and food regulation that emphasized food restrictions, and we provided regular light meals. There was a considerable reduction of the ruminative vomiting and 2kg weight gain was achieved during the admission. These therapeutic gains were maintained at the 4-month follow-up assessment and the vomiting symptom reached a near-zero level and the weight loss were recovered by about 8kg. The issues related to the treatment approaches for ruminative vomiting with autism are discussed.

  • PDF

미분화된 신체형장애를 향부자팔물탕(香附子八物湯)으로 치료한 소음인(少陰人) 환자(患者) 치험례 (A Clinical Study of the Undifferentiated Somatoform Disorder Improved with Hyangbujapalmul-tang)

  • 김나영;최인호;임창선;신미란
    • 사상체질의학회지
    • /
    • 제20권3호
    • /
    • pp.199-207
    • /
    • 2008
  • 1. Objectives Sasang Constitutional Medicine is Mind-Body medicine and it is based on difference of Nature & Emotion(性情) & real purpose(恒心). The purpose of this study is to evaluate the effect of Hyangbujapalmul-tang for somatoform disorders and is to drive the importance of psychiatric approach home. 2. Method The subject is about 49-year-old Soeumin patient presumed by Undifferentiated somatoform disorder based on his nature & emotion, physical characteristics, symptoms, and we have prescribed Soeumin Hyangsayangyui-tang, Ceongunggyegi-tang, Hyangbujapalmul-tang. Soeumin Hyangsayangyui-tang was prescribed based on oridinary symptoms(素症), Soeumin Ceongunggyegi-tang was prescribed based on real symptoms(病症), Soeumin Hyangsayangyui-tang was prescribed based on Nature & Emotion(性情) & real purpose(恒心). 3. Result and conclusions In result, Hyangbujapalmul-tang based on Nature & Emotion(性情) & real purpose(恒心) showed best positive response. It is necessary to approach to somatoform disorders not only in clinical view but also in psychiatric view based on Nature & Emotion(性情) & real purpose(恒心)

  • PDF

혼종모형을 이용한 정신 간호사의 공감적 의사소통역량 개념분석 (A Concet Analysis of Psychiatric Nurse's Compassionate Communication Competence: Hybrid Model)

  • 전원희;임혜숙
    • 문화기술의 융합
    • /
    • 제9권6호
    • /
    • pp.813-825
    • /
    • 2023
  • 본 연구는 혼종 모형 방식을 사용하여 정신 간호사의 공감적 의사소통역량에 대한 개념을 명확히 하기 위해 분석되었다. 이론적 단계에서 2000년부터 2022년까지 출판된 문헌을 수집하여 최종 38편의 논문을 분석하였다. 현장 작업단계를 위하여 2022년 12월 1일부터 12월 28일까지 8명의 정신 간호사를 대상으로 심층 면담을 진행하였다. 최종 분석 단계를 통해 정신 간호사의 공감적 의사소통역량의 차원과 속성을 도출하여 개념을 분석하였다. 이론적 단계와 현장 작업단계에서 파악된 속성을 바탕으로 정신 간호사의 공감적 의사소통역량을 정의하면 5개의 차원과 12개의 속성으로 종합되었다. 이에 따라서 정신 간호사의 공감적 의사소통역량은 정신 간호사가 대상자에 대한 공감과 이해를 바탕으로 효과적인 의사소통을 위해 적극적 경청과 공감적 스킬을 사용하고, 대상자의 생각과 감정에 민감하게 반응하여 대상자가 표현하고자 하는 바를 정확하게 전달하고 대상자를 존중하며 대상자에게 힘을 실어주는 기술과 능력을 의미한다.

신체화의 평가 및 치료 (Assessment and Treatment of Somatization)

  • 고경봉
    • 정신신체의학
    • /
    • 제8권2호
    • /
    • pp.149-164
    • /
    • 2000
  • 신체화는 진단보다는 오히려 일종의 과정으로 간주된다. 따라서 단순히 진단명을 선택하기보다는 정신병리를 알아 보려는 노력이 더 중요하다. 신체형장애의 진단 및 치료의 어려움은 환자의 질병행동 즉 정신사회적 문제를 부정하여 정신과적 접근을 기피하는 것과 밀접한 관계가 있다. 신체증상 이면에 있는 정신사회적 문제에 대한 단서를 포착하는 것은 정신과의사의 중요한 역할이다. 이런 점에서 신체화 환자들에 대한 치료적 접근은 정신과적 치료에 대한 수용을 촉진할 수 있는 특정 기술과 전략이 요구된다. 신체화 환자의 치료목표는 완치가 아니라 관리에 있다. 치료는 환자의 반응과 필요성에 따라 융통성을 두어야 한다. 평가 및 치료 초기부터 여러 과가 공동으로 접근하는 것이 효과적이다. 결론적으로 신체화의 평가 및 치료는 통합적인 접근 즉 생물정신사회적인 접근이 필요하다. 특히 다른 신경증 환자에서보다는 생물의학적 접근이 더 강조될 필요가 있다. 따라서 이런 환자들을 조기에 발견하고 환자의 정신과적 치료의 수용을 촉진시키기 위해서는 신체형환자에게 적절한 접근 즉 면담기술을 개발해야 함은 물론 다른과 의사들을 교육시키는 것도 정신과의사가 해야 할 중요한 역할에 속한다.

  • PDF

정신과에 의뢰된 내과계 환자들에 대한 치료적 접근 - 정신사회적 측면 - (Therapeutic Approaches to the Patients Who were Referred for Psychiatric Consultation from Medical Departments - Psychosocial Aspects in Consultation-liaison Psychiatry -)

  • 박종철
    • 정신신체의학
    • /
    • 제1권1호
    • /
    • pp.98-100
    • /
    • 1993
  • To become an effective and successful consultation-liasion psychiatrist the psychiatrist should consider two aspects of consultation before he/she meets his/her patients. First the psychiatrist should understand the internal need and psychological state of patients who visited their physician before being refered to a psychiatrist So psychiatrists should be careful in the evaluation of the patient's intention whether they are willing to accept the psychiatric treatment approach or not Second the psychiatrist should understand the situation and the physician's internal need in the consultation. Psychiatrists should recognize whether there are any factors which interfere with the mutual understanding and cooperation between physicians and psychiatrist.

  • PDF

지역기반 정신장애인 직업재활수행기관간 연계강화에 관한 연구 : 연계경험 및 예측요인 분석을 중심으로 (A Study on Promoting Inter-organizational Linkages for Vocational Rehabilitation of People with Psychiatric Disabilities : Focusing on Linkage Experiences and Predictors)

  • 이금진
    • 한국사회복지학
    • /
    • 제54권
    • /
    • pp.35-64
    • /
    • 2003
  • 본 연구에서는 우리나라에서 지역기반으로 정신장애인 직업재활서비스를 제공하는 기관을 조합하여 규정하고, 이들간의 연계경험과 연계실태 및 연계에 영향을 미치는 요인을 분석하였다. 연구방법은 질적조사와 양적조사를 병행하여 실시하는 삼각측정방식(triangulation)으로 진행되었다. 근거이론에 바탕을 둔 Strauss & Cobin의 절차에 따라 한 지역을 선정하여 담당자들의 연계경험을 분석하였으며, 설문조사를 통해 122개 기관의 연계실태와 연계시도요인, 연계강좌요인을 분석하였다. 조사결과, 연계경험은 '다른 기관에 관심돌리기', 즉 '협력추구'과정을 도출되었으며, 협력추구유형으로는 '주도형 협조형 권위형 반응형'으로 분류되었다. 연계실태는 전반적으로 Tobin(1986)의 연계긴밀도 5단계에 따라 정신장애인 직업재활수행기관들은 3단계 조정(Coordination)이 필요한 시기로 나타났으며, 정신보건기관과 전통적 재활기관사이에는 '협조(Cooperation)'가 정신보건기관간, 전통적 재활기관간에는'조정'이 더 필요한 것으로 나타났다. '연계시도'와 '연계강좌'에 영향을 미치는 요인에 대한 구성을 개인요인과 조직요인으로 구분하여 로지스틱 회귀분석과 중다귀회귀분석을 실시하였다. 그 결과, 개인의 '정신장애인 이해를 위한 교육연수경청'이 있을 경우, 조직의 '자원의존도'가 높을수록 연계시도를 할 확률이 증가하는 것으로 나타났다. 또한 개인의 '현 근무지 근무기간'이 길수록, '관련기관 사업인지도'가 높을수록, '정신장애인 이해를 위안 교육연수경험'이 있을 경우, 조직에 '직업재활전담인력'이 있을 경우 연계가 강화되는 것으로 분석되었다. 본 연구는 이러한 실증적 분석을 통하여 정신장애인 직업재활수행기관간 연계강화방안을 논의하였다.

  • PDF

정신과 입원환자의 입원기간에 따른 불안정도에 관한 연구 (A Study of the Anxiety Levels of Hospitalized Psychiatric Patients in Terms of Length of Hospitalization)

  • 김윤희
    • 대한간호학회지
    • /
    • 제11권1호
    • /
    • pp.45-63
    • /
    • 1981
  • This study was done to determine the relationship between the anxiety levels of hospitalized psychiatric patients and various influencing variables. The purpose of this study was to determine factors that may help hospitalized psychiatric patients to experience lower levels of anxiety in relation to changing situations and provide the basic data for a dynamic approach which is important in the field of modern psychiatric nursing that understands and analyses the meaning of patients behavior. The anxiety may produce stress, which is a common experience among all human beings. Patients may merely feel uncomfortable in the state of mild anxiety, however, the severe state could be an obstacle to treatment and recovery from disease. The anxiety of the psychiatric patient is a factor which greatly influencing the patient's behavior, so his disorderd behavior is an expression of defence or pathologically fixed behavior. According the psychiatric patient's anxiety at the time of admission is the concern of the health team. The nurse's special concern has to do with understanding and supporting the patient and meeting his individual needs by frequent close contact during the entire hospitalization period, compared to other teamembers the nurse's responsibility in this regard is greated. So this study emphasizes the necessity of creating conditions these, but above all the psychiatric nurse should create a therapeutic environment by not only regarding the patient's behavior or symptoms but understanding the meaning of them. The subjects of this study were 57 psychiatric patients selected from the K neuropsychiatric hospital located in Kunsan city. Data were collected twice from the same patients within a 24 hour period after admission and 10 days after admission. (September 18th to November 8th, 1980). The data collected method was through direct interview, and the interview time was 20 minutes for each patient. Data analysis included Item Analysis & Internal Consistency Reliability Tests, Percentages, t-test, analysis of variance and stepwise multiple regression analysis. The findings of this study were as follows. A. Test of Hypothesis a. Hypothesis 1 :“The anxiety level of psychiatric patients within 24 hours after admission will be higher than those of the same patients 10 days after admission,”was accepted. (t = 3. 15 ; p < 0.005) b. Hypothesi 2:“The more the number of admissions the higher the level of anxiety related to two categories”, was accepted. (affective anxiety: F = 5.50, p < 0.005, Somatic anxiety: F = 9.12, p <.

  • PDF

정신장애인의 체험홈 이용경험에 관한 연구 (The Lived Experiences of Supported Housing among People with Psychiatric Disabilities)

  • 구춘영;김미영;구진희
    • 문화기술의 융합
    • /
    • 제5권2호
    • /
    • pp.1-11
    • /
    • 2019
  • 이 연구의 목적은 정신장애인들의 체험홈 이용 경험을 깊이 있게 연구하고자 현상학적 접근을 활용하였다. 총 9명의 정신장애인들이 연구참여자로 모집되었으며, 2016년 9월부터 2018년 3월에 걸쳐 심층인터뷰를 통해 자료를 수집하였다. 모든 자료는 녹음하였으며, 자료는 Colaizzi방법으로 분석하었다. 분석결과 6개의 주제모음, 17개의 하위주제가 도출되었으며, 다음과 같다: 1) 생활터전의 혼란스러움, 2) 체험홈에서 느끼는 여유로움, 3) 나에 대한 인식이 변화함, 4) 주도적인 행동을 선택함, 5) 스스로 살아가는 힘을 키움, 그리고 6) 진정한 삶에 통합함으로 나타났다. 연구결과는 정신장애인을 위한 체험홈 프로그램 확대 및 프로그램 질 향상의 필요성을 제기한다. 이와 더불어, 정신장애인에 대한 정신건강서비스 개입과 회복을 위하여 전문지식을 갖춘 사례관리자 확대가 정신보건영역에서 필요할 것으로 사료된다.

비정신과 간호원의 정신질환 및 정신질환자에 대한 태도 조사 연구 (A Study of the Attitudes of Nonpsychiatric Registered Nurses towards Mental illness and Mental Patients)

  • 박예숙
    • 대한간호학회지
    • /
    • 제3권2호
    • /
    • pp.31-43
    • /
    • 1973
  • The trend in modern nursing is toward the performance of comprehensive nursing care. Psychiatric nursing emphasizes education which enables the nurse to understand the underlying difficulties being expressed through a wide range of emotions and through practice to be more adept in her selection of a manner of approach which best meets the needs of a given situation. Presently, in Korea, there is nothing in the literature regarding evaluation of the effect of psychiatric nursing education on the attitudes of nurses towards mental illness and mentally ill patients. This stud!1 was attempted in order to understand 1) some of the problems in psychiatric nursing education 2) some of tile factors which affect the attitudes of nurses towards mental illness and mental patients. A questionnaire, a Korean translation of the "Opinions about Mental illness Scale" by Cohen and Stranding, 1962, was administered to 188 nonpsychiatric registered nurses employed in Yonsei University Hospital (Y. Hospital) and Seoul National University Hospital (S. Hospital) located in the city of Seoul. All of the nurses were directly involved with adult patient care. They graduated from various nursing schools. The data was collected during the period of October 2 to October 16,1972. The age, educational background , marital status, type of previous psychiatric experience, experience as a graduate nurse and close personal relationship with someone who was a psychiatric patient were compared with the O.M.I. scores. The mean and standard errors for each of the comparison groups were computed and tile relationships calculated by a t-test. The results of the study are summarized as follow: 1. There is no significant difference between the age of the nurses and their attitudes toward mental illness and mental patients. 2. There is no significant difference between the. educational backgrounds of the nurses and their attitudes toward mental illness and mental patients. 3. There is a significant difference in the nurses ′student psychiatric nursing experience and their attitudes towards mental illness and mental patients for the nurses in 5. Hospital only. The nurses who had 3-4 week of student psychiatric nursing experience had a significantly higher mean score for Benevolence (factor B) than nurses whose student psychiatric experience had been less than 1 Ivcek (P<0.05). The nurses who had 1-2 weeks, 3-4 weeks and more than 4 weeks of student psychiatric nursing experience had significantly higher mean scores for Interpersonal Ethology (factor E) than nurses whose student psychiatric had been less than 1 week (p<0.05), 4. There is a significant difference in the nurses′student psychiatric nursing experience by types of institution and their attitudes towards mental illness and mental patients for S. Hospital nurses only. The nurses who had their student psychiatric nursing experience in the government psychiatric hospitals recorded significantly higher mean score for Authoritarianism (factor A) than nurses who had their. experience in private psychiatric hospitals (p<0.05). 5. There is no significant difference in the nurses′psychiatric nursing experience as a graduate nurse and their attitudes toward mental illness and mental patients. 6. There is no significant difference in the nature and variety of the nurses′experience as a graduate nurse and their attitude toward mental illness and mental patients. 7. There is no significant difference in the presence or absence of a close personal relationship with a mentally ill person and the nurses′attitude toward mental illness and mental patients. 8. There is no significant difference in the nurses′ marital status and their attitude toward mental illness and mental patients. 9. There is no significant difference between the nurses who were employed ill S. and Y. hospitals and their attitudes towards mental illness and mental patients. Major suggestion for further study was to have more larger and wider scale research for establishing of the reliability and validity of the Korean translation of the O.H.I. Scale.

  • PDF