Purpose: The purpose of this study was to identify non-psychiatric nurses' difficulties in caring for patients with mental illness. Methods: Data were collected from eighteen general medical-surgical nurses working at a university hospital in Seoul, Korea. This study involved two focus group discussions and three in-depth individual interviews. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis. Results: General medical-surgical nurses experienced difficulties in 3 categories, 9 subcategories, 27 codes. The three categories were 'nurse' related factors, 'patient' related factors, 'resource' related factors. The nine categories were 'unpreparedness', 'nursing barriers due to stigma', 'undervaluing and avoidance of psychiatric nursing', 'eroding into the trap of a vicious cycle', 'facing unapproachable patients', 'dealing with unhelpful family members', 'burdening already overburdened staff', 'obstructive environment', and 'isolation of staff with heavy responsibilities'. Conclusion: The results of this study indicate the need to develop psychiatric mental health education programs for non-psychiatric nurses. Education about psychiatric mental health and support from institutions for non-psychiatric nurses can reduce their negative attitude toward psychiatric patients and difficulties in caring for psychiatric patients.
In the last few years, psychiatric nurse practitioners have shown a growing an interest in community psychosocial rehabilitation, caring for chronic psychiatric patients as case manager in South Korea. The purpose of this study was to evaluate the effectiveness of a community psychiatric rehabilitation nursing program on self-care activity and quality of life and to suggest this program as an effective nursing intervention in a group of chronic home-based psychiatric patients in a poor town. A nonequivalent control group, pretest-posttest design was used. Of the twenty women that started the program, sixteen finished it. The data were analyzed by the Wilcoxon Rank Sum Test. The program included the process of case management which consisted of four phases: the first was an active case finding and pre-test, the second was home visiting and contacted by phone. the third was group activity therapy of 12 sessions, and the fourth phase was terminal and post-test. The effects of the program were assessed by quality of life and self-care activity. The quality of life and the self-care activity, especially, area of nutrition. elimination, dressing. leisure activity, and follow-up clinic visiting showed greater improvement than those of the control group. The results of this study suggest that this program was effective in improving the quality of life of chronic home-based psychiatric patients.
Objectives : The purpose of the study is to investigate the relationship between variables associated with oral health status in psychiatric patients and to provide basic information on oral health education program development for the psychiatric patients. Methods : Subjects were 151 psychiatric patients who filled out the structured questionnaire. The data were analyzed for independent t-test, one-way ANOVA and hierarchical multiple regression by using SPSS Win Program 18.0 version. Results : Higher DMFT index was shown in the older age(p<0.001) and low perceived oral health group(p<0.001). Higher DMFT index included no tooth brushing after breakfast(p=0.045), wrong tooth brushing method(p<0.001). Chewing discomfort(p=0.027) and denture(p=0.027) were closely related to higher DMFT index. Bread(p=0.033) and snack(p<0.001) increased DMFT index. Factors affecting oral health status were age, denture, snack and bread. The explanation power of the final model was 29.4%. Conclusions : Dietary control for the psychiatric patients is very important to prevent dental caries. Tooth brushing and use of oral hygiene devices can improve good oral health care. Furthermore, this result can improve the oral health care for the disabled people.
Objectives : Posttraumatic stress disorder (PTSD) is classified as an anxiety disorder. PTSD occurrence is known to be increased in middle-aged and older people, female, and individuals with a previous history of psychiatric disorders, lower education levels, low socioeconomic status, and severely injured patients. Anxiety symptoms are also related to later development of PTSD. In this study, we investigate the influences of injury severity and sociodemographic factors on severe anxiety in PTSD patients with no previous history of psychiatric disorders. Methods : Forty-one PTSD patients without previous history of psychiatric disorders were recruited from the psychiatric clinic at Chosun University Hospital. Subjects underwent psychiatric and physical examinations including the Injury Severity Score (ISS), Beck Anxiety Inventory (BAI), and Korean-Wechsler Adult Intelligence Scale (K-WAIS). We defined severe anxiety as a BAI scores of 30 or more. Logistic regression analyses and multi-step model selection were applied to identify predictive factors for severe anxiety. Results : In univariate analysis, age, ISS, and socioeconomic status were found to be significant factors. Through multivariate logistic regression analyses and a stepwise model selection, we found the combination of age and ISS to be the best-fitted model for affecting severe anxiety in PTSD patients without a previous history of psychiatric disorders. Conclusion : Our findings suggest that the combination of age and ISS could develop severe anxiety in PTSD patients with no previous history of psychiatric disorders.
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.
This study investigated the anxiety of families of psychiatric patients at discharge. The purpose was to contribute to the improvement of psychiatric nursing care, rehabilitation and social adjustment of psychiatric patients and community mental health. The objectives of this study were to identify the acceptance of the psychiatric nurse by the families, their anxiety at the time of discharge, whether any help was wanted to reduce anxiety, the attitude toward the patient after discharge and feelings about the patients. The population studied consisted of 180 family members of patients from 10 mental hospitals (including local clinic) in Seoul and Kyung- Ki province, from March I to April 30, 1977. The date were collected by an interview schedule, and compared and analysed by Computer usings х$^2$- test. Results were as follows : 1. Many of the families(83.6%) expressed a acceptance of psychiatric nurse. 2. A little more than half of the families(51.1%) expressed happiness but a largo portion (38.9%) had "anxious" feelings at discharge. 3. Almost all families(92.6%) wanted a physician′s help to reduce discharge anxiety. Younger families tended to want the physician′s help more. 4. Many of the families(83.1%) wanted a nurse′s help. Families of parents patients admitted for the 1 st time wanted the nurse′s help more. 5. Comparing the feelings at a previous discharge with the present discharge, 49.1% of the family expressed greater happiness at tile latter than the former. 6. More than half the families responded positively toward the patient. Unmarried family members responded more positively than married Families of 1 st admission patients responded more positively than families of readmission patients. 7. Many families(78.8%)had positively feelings toward the patients. More negative responses came from women than from men, from lower education levels, lower incomes and readmission patients.
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.
Objectives: Psychiatric symptoms in epilepsy are very common, and the most common symptoms are depression, insomnia, and anxiety. These symptoms not only lower the quality of life of epilepsy patients, but also elevate the risk of epileptic seizures. There are no specific criteria for the available antiepileptic drugs to ameliorate these symptoms in patients with epilepsy, and there is a lack of evidence to support the efficacy and safety of existing drugs. The Shugan Jieyu capsule (SJC) is a traditional herbal medicine composed of Acanthopanax senticosus and Hypericum perforatum and is reported to be effective in relieving psychiatric symptoms. The purpose of this study was to assess the efficacy of SJC as a treatment for psychiatric symptoms in epilepsy patients. Methods: Electronic databases will be investigated for publications in English, Korean, Japanese, and Chinese. The participants of the study are epilepsy patients with psychiatric symptoms diagnosed using any validated criteria. All types of controls will be compared-placebo, conventional treatments, and no treatment-to groups treated with SJC or modified SJC. We will measure the degree of improvement in psychiatric symptoms and check epileptic symptoms, such as the frequency of seizures. The study selection and data extraction will be performed by two independent reviewers, who will also assess methodological quality using the risk-of-bias tool by Cochrane. We will use Review Manager software (RevMan) to carry out all statistical analyses. Results: This systematic review and meta-analysis will be performed in accordance with the PRISMA-P statement. Conclusion: This systematic review is the first study to assess the efficacy and safety of SJC for the treatment of psychiatric symptoms in epilepsy. We expect that this study will provide clinically applicable evidence for patients with epilepsy when selecting drug treatments.
Purpose: This study analyzed the general features, psychiatric histories, past suicidal attempts and psychiatric diagnoses of suicide victims admitted via the emergency department (ED). Methods: Reviewing the charts of 138 inpatients of suicide attempts admitted via the ED from January 2002 to December 2003, we analyzed various data, including sex, age, season, stressful events, psychiatric histories, previous suicidal attempts, and psychiatric diagnoses during admission, and we used a chi-square test to chart the statistical data. Results: A significant difference was found between 1 st attempts and repeated attempts as to the mechanical methods used for the suicide attempts, There was a significant difference in the kinds of drugs between patients with and without psychiatric histories. In the psychiatric diagnosis, there was a significant difference in AXIS I between patients with and without psychiatric histories. In AXIS II, there was a significant difference between patients with and without psychiatric histories, 1st attempts and repeated attempts. Conclusion: We emphasize the importance of psychiatric consults, treatments, and follow-ups for suicide victims and the emergency physicians' function in helping them to contact psychiatric doctors.
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.
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