• 대한간호학회지
• /
• 제5권2호
• /
• pp.11-22
• /
• 1975

Suicides have been considered to be one of the grave problems of modern societies. According to recent police statistics of Republic of Korea, 28.6 suicides in every 100, 000 were reported. Psychiatric Patients are believed to be predisposed to suicidal tendencies. This study was performed to investigate the characteristics of suicidal attempts and to analyse the environmental factors involved in the suicidal accidents of patients admitted to psychiatric hospitals. Records of 66 suicidal accidents from three psychiatric hospitals during the period of January 1971 through June 1971 were sampled. Data were analysed by percentile score. Results are as follows; 1. The age group of 21~30yrs. was revealed to be the highest in frequency of suicidal attempts (50.0%) Among the unsuccessful suicides; the age group of 31~40yrs. in men and the age group of 21~30 yrs. in women revealed to be the highest in frequency-Among the unsuccessful suicides; the age group of 21-30 yrs. in both sex revealed to be the highest in frequency. 2. Suicidal accidents occurred more frequently to the unmarried(63.6%)- Among the successful suicides; higher frequency was shown to unmarried in men and the frequency is contrasted in women. Among the unsuccessful; the unmarried in both sex were revealed to be highest in frequency. 3. Schizophrenia was revealed the highest of suicidal attempts in frequency (81.8%). 4, Suicides were most frequently attempted in the spring(46, 9%). Among the successful suicides; highest frequencies were shown in men in tile winter and in women in the summer season. Among the unsuccessful suicides :highest frequencies were shown in men in the winter and in women in the spring. 5. Suicidal attempts were most frequently occurred in hospital wards (40.9%), In women, unsuccessful attempts were found to be the highest on authorized leave at their homes. 6. The hanging was revealed to be the most frequently adopted methods for suicidal attempts (31.8%). Among the successful suicides; hanging was the most frequent method adopted in men white in women the drug over-dose, Among the unsuccessful suicides ; stabbing by sharp devices while in women drug-overdosage was adopted as well 7. The most frequently adopted instrument of different suicidal attempts were: house-hold wrapper (26.3%) in cases of hanging, knives (31.8%) in cases of stabbing, and drugs. 8. The suicidal attempts have occurred most frequently at dawn through early morning (2-6A. M.) (34.8%). Among the successful suicides i most frequent time of occurrence on week-days were revealed to be dawn, while on holidays the occurrence were in the evening as well Among the unsuccessful; the most frequent time of occurrence was the day hours while on holidays at dawn. 9. Suicidal attempts within the hospital ward were first noticed by nurses most frequently (42.2%). 10. Manifestations such as restlessness, depression, self-depreciation were revealed to be the most frequent pre-suicidal attempt behavior characteristics. 11. Among the successful suicides ; manifestations of physical damage were found on the neck while among unsuccessful attempts, the damages were found on exterminates.

• 한국간호교육학회지
• /
• 제13권1호
• /
• pp.114-122
• /
• 2007

Purpose: This study was aimed at evaluating the effects of Music Therapy for the autistic children. Method: The subjects of this study consisted of 3 autistic children who were trained in an Attachment Promotion Therapy Program for 6 months. The Children were all males and 4years 9months, 3years 1 month, and 3years 8month each, and diagnosed with Autism by Child and Adolescent Psychiatrists. Data was collected by using video-taping methods(ADOS, Fagot's Interactive Behavior Code), an interview and observational methods(SMS). Music Therapy intervention was done once a week for 6 months. Data was gathered by quantitative and qualitative analysis. Result: This study showed that the Autism Diagnostic Observation Scale and Social Maturity Quotient(SQ) much improved after the Music Therapy After the Music Therapy, the Interactive Behavior Code : Gaze, Gesture for the communication, Verbal language, Laughing/Smile, and Normal play behaviors increased more than before the intervention. As the results show, the child's behavior became more positively responsive, playful, and attentive to others. Conclusion: This study suggests that Music Therapy might be an effective intervention for autistic disorder children in order to decrease autistic symptoms and increase joint attention behavior.

• 한국사회복지학
• /
• 제66권3호
• /
• pp.253-276
• /
• 2014

본 연구의 목적은 국내에서 단축형 간이정신진단검사(Brief Symptom Inventory-18, BSI-18)가 정신장애인의 정신과적 증상을 평가하고 치료 개입의 성과를 측정하는 도구로 활용될 수 있도록 타당도와 신뢰도를 검정하는 것이었다. BSI-18은 BSI-53의 축소버전으로 임상 현장에서 효과적인 개입을 위해 정신과적 증상을 확인하고 진단하며, 치료프로그램의 성과로서 증상변화를 측정하기 위해 개발된 도구이다. 본 연구에서는 정신장애인 180명을 대상으로 하여 첫째, BSI-18 전체 문항과 하위요인에 대한 내적일치도 및 검사-재검사 반복측정을 통해 신뢰도를 파악하였으며, 둘째, 확인적 요인분석을 실시하여 해당구성개념의 요인구조를 확인하였으며, 셋째, BSI-18의 우울 점수와 대표적인 우울척도인 BDI, CES-D 20의 우울 점수 간에 상관관계를 검토하여 준거 타당도를 살펴보았다. 연구의 주된 결과는 다음과 같다. 첫째, BSI-18 전체 문항과 하위요인 등의 검사-재검사 반복측정 결과 선행연구들과 유사한 높은 수준의 반복측정 신뢰도 및 내적일관성을 보여주었다. 둘째, 확인적 요인분석 결과 정신장애인을 대상으로 BSI-18은 3요인 모형이 가장 자료에 부합하는 것으로 나타났다. 셋째, BSI-18의 우울증상은 BDI, CES-D 20과 유의한 정적상관관계가 나타나 준거 타당도가 확보되었다. 이러한 결과들에 대한 연구함의를 논의하여 제시하였다.

• 대한간호학회지
• /
• 제20권1호
• /
• pp.16-37
• /
• 1990

A cost analysis for hospitalized patients was carried out based upon Patient Classification System(PCS) in order to determine an appropriate nursing fee. The data were collected from 21 nursing units of three teaching hospitals from April 1 to June 30, 1989. first, all of the 22,056 inpatients were classified into mildly ill(Class Ⅰ), moderately ill(Class Ⅱ), acutely ill(Class Ⅲ), and critically ill(Class Ⅳ) by the PCS which had been carefully developed to be suitable for the Korean nursing units. Second. PCS cost accounting was applied to the above data. The distribution of inpatients, nursing costs, and nursing productivity were as follows : 1) Patient distribution ranged from 45% to class Ⅰ, 36% to class Ⅱ, 15% to class Ⅲ, and 4% to class Ⅳ, the proportion of class Ⅳ in ‘H’ Hospital was greater than that of the other two hospitals. 2) The proportion of Class Ⅲ and Ⅳ in the medical nursing units was greater than that of surgical nursing units. 3) The number of inpatients was greatest on Tuesdays, and least on Sundays. 4) The average nursing cost per hour was W 3,164 for ‘S’ hospital, W 3,511 for ‘H’ hospital and W 4,824 for ‘K’ hospital. The average nursing cost per patient per day was W 14,126 for ‘S’ Hospital, W 15,842 for ‘H’ hospital and W 21,525 for ‘K’ hospital. 5) The average nursing cost calculated by the PCS was W 13,232 for class Ⅰ, W 18,478 for class Ⅱ, W 23,000 for class Ⅲ, and W 25,469 for class Ⅳ. 6) The average nursing cost for the medical and surgical nursing units was W 13,180 and W 13,303 respetively for class Ⅰ, W 18,248 and W 18,707 for class Ⅱ, W 22,303 and W 23,696 for class Ⅲ, and W 24,331 and W 26,606 for class Ⅳ. 7) The nursing costs were composed of 85% for wages and fringe benefits, 3% for material supplies and 12% for overhead. The proportion of wages and fringe benefits among the three Hospitals ranged from 75%, 92% and 98% for the ‘S’, ‘H’, ‘K’ hospitals respectively These findings explain why the average nursing cost of ‘K’ hospital was higher than the others. 8) According to a multi- regression analysis, wages and fringe benefits, material supplies, and overhead had an equal influence on determining the nursing cost while the nursing hours had less influence. 9) The productivity of the medical nursing units were higher than the surgical nursing units, productivity of the D(TS) - nursing units was the lowest while the K(Med) - nursing unit was the highest in 'S' hospital. In ‘H’ hospital, productivity was related to the number of inpatients rather than to the characteristics of the nursing units. The ‘K’ hospital showed the same trend as ‘S’ hospital, that the productivity of the medical nursing unit was higher than the surgical nursing unit. The productivity of ‘S’ hospital was evaluated the highest followed by ‘H’ hospital and ‘K’ hospital. Future research on nursing costs should be extended to the other special nursing areas such as pediatric and psychiatric nursing units, and to ICU or operating rooms. Further, the PCS tool should be carefully evaluated for its appropriateness to all levels of institutions(primary, secondary, tertiary). This study took account only of the quantity of nursing services when developing the PCS tool for evaluating the productivity of nursing units. Future research should also consider the quality of nursing services including the appropriateness of nursing activities.

• 대한간호학회지
• /
• 제28권4호
• /
• pp.881-892
• /
• 1998

This study attempts to identify attitudes of community leaders toward mental illness in order to obtain useful information concerning the planning of community mental health services. The community sample consists of 50 community leaders including, civil servants, doctors, herb doctors, school nurses, counselors, village leaders, pharmacists, and pastors. Individuals were asked to give demographic data, their personal attitudes toward mental illness' etiology & prognosis, and toward neighbors who are psychiatric patients. The interview with open questions was used to collect data. According to the study community leaders 82% believed that mental illness could be treated, 66% believed that mental illness was caused by genetic factors and environmental stress, and 76% had negative impressions about mentally ill people such as fear, seclusion, asylum, also crime. Only 28% of mentally ill people were accepted as neighbors in community. 52% of community leaders rejected opening of mental hospital, and thought that the Chunchon community needed facilities such as group homes, or day care centers (30%), however, 34% of the leaders they didn't recognize community mental health. These findings suggest that mental health professionals need to pay special attention to change the attitude of Chunchon community leaders and mental health institutions need to a develop mental health education program for community leaders.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제18권2호
• /
• pp.121-127
• /
• 2015

Purpose: To evaluate clinical and laboratory profile of Wilson's disease (WD) in children. Methods: This cross sectional study was conducted at Bangabandhu Sheikh Mujib Medical University Hospital. Bangladesh, over a period of 3 years. One hundred consecutive children of WD between 3 to 18 years of age were evaluated. Results: Mean age was $8.5{\pm}1.5years$. Male female ratio was 2:1. Ninety-one percent of patients were Muslim and 9% Hindu. A total of 53% cases of hepatic WD presented between 5 to 10 years of age and most of the neurologic WD manifested in 10-15 years age group. Sixty-nine children presented only with hepatic manifestations, 6 only with neurological manifestations, 14 with both hepatic and neurological manifestation, 10 children was asymptomatic and 1 patient presented with psychiatric features. WD presented as chronic liver disease (CLD) in 42%, CLD with portal hypertension in 34%, acute hepatitis in 20% and fulminant hepatic failure in 4% cases. Stigmata of CLD were found in 18% patients. Keiser-Fleischser ring was found in 76% total patients. Elevated serum transaminase was found in 85% cases, prolonged prothrombin time in 59% cases and hypoalbuminaemia in 53% cases. A total of 73% patients had low serum ceruloplasmin, basal urinary copper of >$100{\mu}g/day$ was found in 81% cases and urinary copper following penicillamine challenge of >$1,200{\mu}g/day$ was found in 92% cases. Conclusion: Majority of studied WD children presented with hepatic manifestation of which 76% presented with CLD. Any child presented with jaundice after the age of 3 years should be investigated for WD.

• 생물정신의학
• /
• 제13권2호
• /
• pp.82-94
• /
• 2006

Objectives : In order to explore effects of board-game therapy for cognitive rehabilitation in patients with schizophrenia, we investigated the change of executive cognitive function over a 2-month period of board-game therapy in patients with schizophrenia. Methods : Two groups of chronic schizophrenic inpatients were participated in this study. One group(n=21) were treated with board-game therapy for 2 months and the other control group(n=19) were not treated. For the evaluation of the executive cognitive function, a Wisconsin Card Sorting Test(WCST) was administered before and after the introduction of the board-game therapy. PANSS score change was also evaluated. Result : At the beginning of this study, there was no significant difference in performance of cognitive function tests, demographical data or clinical severity between both patient groups. After 2 months of treatment with the board-game therapy, the board-game therapy group showed significant improvements of executive cognitive function without any significant change of their schizophrenic symptoms. On the contrary, there was no change in control group. Conclusion : This study showed that a board-game therapy is effective for the enhancement of executive cognitive function in patients with chronic schizophrenia. A board-game therapy could be introduced with ease into psychiatric fields, such as inpatients' or outpatients' clinic wards and day hospital. Our result indicates that the board-game therapy is a promising tool for the enhancement of cognitive function, especially executive cognitive function and helpful for cognitive rehabilitation for schizophrenic patients.

• 한국보건간호학회지
• /
• 제16권2호
• /
• pp.400-411
• /
• 2002

This study was performed to identify the drug use and reuse relating characteristics and reuse relating factors in illegal drug users. Subjects consisted of 88 illegal drug users. Some of them were confined in a mental hospital or National Forensic Psychiatric Hospital located in Chung-nam province, others on attending a drug abuse prevention program in Seoul Probational Institute. Data were collected during the period from February 1, 2002 to February 25, 2002, and analyzed by SAS program. version 6.12. for Wilcoxon rank sum test, Pearson Correlation, Multiple regression. Results were as follows; 1. Drug use characteristics were as follows. $19.3\%$ was has drug family history and $20.7\%$ was has alcohol family history. Main drug was Phillopon$44.3\%$, inhalants $35.2\%$, LSD et al $22.7\%$. Drug use rate of months was everyday $31.2\%$, every other day $24.4\%$. 2. $100\%$ has experienced abstinence and reuse. Abstinence period was less than 12 months in $49.4\%$ and reuse period was less than 6 months in $58.6\%$. 3. Drug use and reuse characteristics related to general characteristics was identified as below. Abstinence period of male was longer than that of female. Person who have drug family history experienced more drugs and person who have family alcohol history started earlier. 4. Reuse periods was correlated with abstinence periods, age. And abstinence period was correlated with age and outcome that following reuse. 5. The multiple regression was used to identify the relating factors that influence reuse period and abstinence period. At the state of controlling abstinence period. inhalants users have 10.07 days shorter reuse period than others. And abstinence period had lengthened age, bad health status, early initiate age, and long reuse period.

• Journal of Pharmaceutical Investigation
• /
• 제23권3호
• /
• pp.165-177
• /
• 1993

The relationship between the plasma haloperidol (HP) concentration and clinical response, and the effects of its active metabolite, reduced haloperidol (RH) on clinical response of HP were investigated in schizophrenic patients. In clinical study I, with 17 schizophrenic patients (male 8, fermale 9) who were administered with three different fixed doses of HP (15, 30 and 50 mg/day) for 3 weeks, the concentrations of HP and RH in plasma and blood and clinical response had been checked before and every week during the study. The clinical response was evaluated by the method of brief psychiatric rating scale (BPRS), and relative improvement of clinical response based on baseline BPRS (before drug treatment) was calculated. The concentrations of HP and RH in plasma and blood were assayed by HPLC. In clinical study II, the plasma RH/HP concentration ratios were checked in 11 patients who were administered with high doses of HP, over 60 mg a day, because of the poor clinical response at usual doses of HP. Plasma HP concentration and relative improvement of BPRS at 3 week in schizophrenic patients showed a 'curvilinear' relationship, and the clinical response was improved relatively over 50% based on the baseline BPRS in the range of $5{\sim}57\;ng/ml $ of HP in plasma. Also, the plasma RH concentrations were increased nonlinearly as the plasma HP concentration increased, and in high plasma HP concentration, over 30 ng/mI, clinical response gradually decreased, while the plasma RH/HP concentration ratio increased nonlinearly. Blood partition coefficients of HP and RH were not changed according to daily HP dose and duration of drug therapy. From these results, it is noted that the higher plasma RH/HP concentration ratio, resulted from the accumulation of RH as HP concentration increased, might explain the 'curvilinear' decrease of HP clinical response.

• 정신신체의학
• /
• 제19권1호
• /
• pp.41-47
• /
• 2011

연구목적: 고프로락틴혈증은 항정신병약물로 인한 흔한 부작용이다. 그럼에도 불구하고 이러한 고프로락틴혈증에 대한 임상가들의 관심은 적은 편이다. 왜냐하면 고프로락틴혈증으로 인한 부작용의 심각성이 널리 알려지지 않았기 때문이다. 특히 아미설프라이드로 인한 고프로락틴혈증에 대한 국내 연구는 전무한 실정이다. 본 연구에서는 한국인에서의 아미설프라이드로 인한 프로락틴 수치의 변화를 알아보고자 한다. 방 법: 2008년 1월부터 2010년 12월까지 일산백병원 신경정신과의 외래와 입원 환자 24명을 대상으로 의무기록을 검토하여 자료를 분석하였다. 이를 통해 아미설프라이드 사용 전후의 프로락틴 수치의 변화를 비교하였다. 또한 아미설프라이드 용량, 투약 기간과 프로락틴 수치 변화율과의 상관관계를 통계적으로 분석하였다. 결 과: 아미설프라이드를 투여한 모든 환자에서 고프로락틴혈증이 발생하였다. 아미설프라이드 투여 후의 프로락틴 수치는 투여 전 보다 유의하게 상승하였다(z=-3.702, p=0.000). 아미설프라이드 용량과 프로락틴 상승의 정도는 유의한 상관관계를 보였으나(r=0.61, p=0.002), 아미설프라이드 투여 기간과 프로락틴 상승의 정도는 유의한 상관관계를 보이지 않았다. 또한 아미설프라이드 용량과 프로락틴 수치 변화율은 유의한 상관관계를 보이지 않았다. 결 론: 아미설프라이드를 포함한 항정신병약물은 프로락틴 수치를 증가시켜 장 단기간의 부작용을 발생시킬 수 있다. 따라서 아미설프라이드를 사용하는 임상의는 프로락틴 수치를 정기적으로 측정하여야 하며 고프로락틴혈증과 관련된 부작용을 평가하여야 한다.