• Title/Summary/Keyword: Psychiatric patients

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A Literary Review of Day- Hospital for Psychiatric Patients (낮병원에 관한 문헌적 고찰 - 정신질환 환자를 위한 -)

  • 유숙자
    • Journal of Korean Academy of Nursing
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    • v.7 no.1
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    • pp.55-62
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    • 1977
  • Varieties of literatures were reviewed in regard to the fundamental concept of day hospital, historical trends, the recipient of its care, facilities and personnel, therapeutic programmes and the follow-up care plans. Through the research the advantages of day hospital were highlighted in order to provide the reference for those who consider planning such health care institution. Since the introduction of the concept of day hospital and its implementation in 1930, many psychiatric patients world over are treated and cared. Patients with specific health problems ; alcoholism, acute or serious psychiatric disease, tendencies of humidor suicidal attempts, and with serious physical problems were excluded from the general recipient. Day hospital were annexed to the psychiatric hospitals in most in instances ; facilities, personnel, except nursing personnel, were shared. All therapeutic care were planned in daley, weekly programmes, and were focussed on socialization. The follow-up care were provided for those participating post- therapy club activities which were planned and introduced ahead. Many advantages of day-hospital care in contrast to the traditional hospitalization care were found: 1. The abrupt discontinuity of his family and other social role is prevented. 2. Therapeutic progress is faster. 3. Lessened economic burden to the family. 4. Behavioral regression is lessened and the lessened fear of hospitalization. 5. Less injury to the patients, self- respect, through lessened anxiety of hospitalization. 6. Incidents of secondary crisis believed to be existing in long term cases are decreased. 7. Therapeutic care implemented in freer atmosphere, better Patient-personnel relationships are created. 8. Varieties of group activities are Induced which enable faster recovery. 9. Patients could engage himself with social activities including getting job on part-time basis. 10. Rehabilitation of patient could be implemented.

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Association between Thyroid Dysfunction and Severity, Treatment Response in Schizophrenic Inpatients (조현병 입원 환자에서의 갑상샘 기능이상과 증상 심각도, 치료 반응과의 관계)

  • Jung, Mee-Jool;Hwang, Hyun-Kuk;Seo, Yung-Eun;Choi, Jong-Hyuk
    • Korean Journal of Biological Psychiatry
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    • v.26 no.1
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    • pp.14-21
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    • 2019
  • Objectives Thyroid hormone deficiency during the neurodevelopmental period can impair brain development and induce psychiatric symptoms. This study examined the association between thyroid dysfunction and the severity of symptoms in schizophrenia patients, and the treatment response of patients with schizophrenia. Methods Three hundred thirty-eight schizophrenia patients, with no prior history of thyroid disease or taking medication associated with it, were studied. We assessed the blood thyroid hormone level, the Brief Psychiatric Rating Scale (BPRS) scores on the day of admission and discharge, admission period, dose of administered antipsychotics, and the number of antipsychotic combinations. The collected data were subsequently analyzed using the Kruskal-Wallis test and Pearson's chi-square test. Results The percentage of schizophrenia patients who presented with abnormal thyroid hormone level was 24.6%. High total triiodothyronine (TT3) (p = 0.003), low TT3 (p = 0.001), and high free thyroxine (fT4) (p < 0.001) groups showed a higher BPRS score on admission than did the normal thyroid hormone group, while thyroid stimulating hormone (TSH) levels were not significantly correlated with the severity of symptoms. Furthermore, thyroid hormone was not associated with the treatment response assessed by the rate of BPRS score reduction, admission days, use of clozapine, and dose of antipsychotics. Conclusions The TT3 and fT4 hormone levels were significantly associated with the severity of symptoms in schizophrenia patients. These relations suggested that thyroid dysfunction may be associated with the severity of schizophrenia. And hence, further analysis of the results of the thyroid function test, which is commonly used in cases of psychiatric admission, is required.

Psychopharmacotherapy for Psychiatric Patients during Pregnancy and Lactation Period (임신과 수유중인 정신과 환자의 약물치료)

  • Kim, S. Peter
    • Korean Journal of Biological Psychiatry
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    • v.3 no.2
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    • pp.156-161
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    • 1996
  • Many pregnant women have to receive psychotropic medication during pregnancy and lactation period, despite the proven and assumed risks to the fetus ar neonate. A brief summary of drug metabolism and pharmacodynamics is given. Principles and quidelines of using psychotropic agents during pregancy and lactation period are presented for psychotic disorders, bipolar affective disorders. depression and anxiety disorders, with due consideration for relative benefits and risks of choosing among psychotropic drugs and alternative treatments.

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A Study on Nurses한 and Patients한 Perceptions of Psychotropic Medication (향정신성 약물치료에 대한 간호사와 환자의 지각 비교 연구)

  • 이평숙
    • Journal of Korean Academy of Nursing
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    • v.24 no.1
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    • pp.47-57
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    • 1994
  • The purpose of this study was to examine nurses’ perceptions of medication treatment for psychiatric patients and to compare these perceptions with the perceptions held by the patients. The methodology used in this study was a descriptive design with semi-structured and open-ended interviews. This study used a convenience sample of 112 nurses who worked in, and 209 patients who were under psychiatric treatment, in four hospitals attached to a university and one national mental hospital in the city of Seoul. The collected data were analyzed by SAS, using percentages for descriptive purposes, and t-test or x$^2$ for comparing the variables. The results were as follows : 1. There was no significant differences between nurses’ and patients’ perceptions on the extent to which patients complied with their medication treatment. Generally speaking, the mean compliance scores for both nurses and patients was high(nurse : (equation omitted)=3.70, Patient : (equation omitted)=3.76). 2. There was a significant difference in nurses’ and patients’ perceptions on the reasons why patients do not take medication. The nurse group indicated that the patients did not take medication because of the “worry about side effects or habituation(49.53%)”, “boredom from long-term use of medication(26.17%)” and “distrust toward medical staff(12.15% )”, but the patient group indicated that they “did not want to be dependent on medication (25%)”, “forgot to take medication(19.7%) and “worried about side effects or habituation(15.91%). 3. As for the necessity of medication, both groups showed some different responses. Even though both groups were aware of the necessity of taking medication, the patient group(21.53%) showed a more negative response. As (or the effects of medication, both groups (nurses and patients ) showed positive responses. However, the nurse group showed a higher positive response (91.07% ) than the patient group(74.16%), 5. Both the patient and nurse group indicated that the most helpful element for the patient’s life under psychiatric treatment was interviews and conversations with therapists and nurses. However, the nurse group showed a higher response(70.15%) than the patients group(47.15%). According to the patient group, family support for the patient was another important factor for psychiatric treatment and daily struggles. In conclusion, as there were differences between the perception of nurses and patients, the nurse must consider the patients’ subjective perceptions first. They should also revaluate their false belief and prejudice concerning the patients’ perceptions. Such information can provide a base to be applied by the nurses in devloping effective mutual relationships with patients which can in turn help in compliance with medication regimen. As it was confirmed that medication was the most important factor in the patients’ recovery, a thorough education program on the therapeutic effect of medication and the necessity of their continued use after discharge is also needed.

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Heart Rate Variability of Korean Generalized Anxiety Disorder Patients (한국 범불안장애 환자의 자율신경심장기능)

  • Choo, Chung-Sook;Lee, Seung-Hwan;Kim, Hyun;Lee, Kang-Joon;Nam, Min;Chung, Young-Cho
    • Korean Journal of Biological Psychiatry
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    • v.12 no.1
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    • pp.13-19
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    • 2005
  • Objective:The purposes of this study were to investigate heart rate variability(HRV) in patients with generalized anxiety disorder(GAD) compared with major depressive disorder in Korea. Methods:Fifty-six GAD patients(20 male and 36 female) was classified into their comorbid psychiatric illness. Among them, Twenty-five patients(10 male and 15 female) who do not have any psychiatric comorbidity were compared with 30 major depressive disorder patients(12 male and 18 female). Clinical symptoms, HRV and MMPI were analysed between two group. Results:Comorbid psychiatric illnesses of GAD were ranked into no diagnosis(44.6%), MDD(32.1%), panic disorder(10.7%), social phobia(5.3%), PTSD(1.7%), OCD(1.7%), MDD+panic disorder(1.7%) and MDD+specific phobia(1.7%). GAD patients showed low functioning in HRV, but degree of decreasing HRV is not so severe compared with MDD patient. Balance of sympathetic and parasympathetic nerve tone is more severely impaired in GAD patients compared with MDD patient. The score of MMPI did not reveal any differences between two groups. Conclusions:The result showed that HRV can differenciate GAD and MDD patients. GAD patients could show decreased HRV functioning, less than MDD patients. But autonomic imbalance could be more severe in GAD than MDD patients.

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The Effects of Abdominal Meridian Massage on Constipation in Institutionalized Psychiatric Patients Taking Antipsychotic Drugs (항정신 약물을 복용하는 시설거주 정신과 환자의 변비 완화를 위한 경락마사지 효과)

  • Kim, Inja;Cho, Yu Na
    • Korean Journal of Adult Nursing
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    • v.19 no.5
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    • pp.127-137
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    • 2007
  • Purpose: It was investigated if abdominal meridian massage has effects on constipation in institutionalized psychiatric patients taking antipsychotic drugs. Methods: According to the constipation screening tests, 22 patients were selected as subjects. One group pre and post repeated measurement design was used. Constipation was operationalized as perceived constipation, frequency of defecation, frequency of bowel sound, and number of medicine taken to relieve constipation. Abdominal meridian massage was given for two weeks, 10-15 minutes each time and 10 times in total. Results: Perceived constipation, frequency of bowel sound, and number of medicine taken were significantly improved after massage. Except for number of medicine taken, the effects on perceived constipation and frequency of bowel sound were found to be persistent 2 weeks after massage. Conclusion: Based upon these results, abdominal meridian massage was recommended as independent nursing intervention for the relief of constipation in psychiatric patients who taking anti-psychotic drugs. Further studies to investigate the maximal duration time of effects and whether the effects of intermittent application of this method is more beneficial than the continuous application of this method are necessary.

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What Event-Related Potential Tells Us about Brain Function: Child-Adolescent Psychiatric Perspectives

  • Kim, Ji Sun;Lee, Yeon Jung;Shim, Se-Hoon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.32 no.3
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    • pp.93-98
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    • 2021
  • Electroencephalography (EEG) measures neural activation due to various cognitive processes. EEG and event-related potentials (ERPs) are widely used in studies investigating psychopathology and neural substrates of psychiatric diseases in children and adolescents. The present study aimed to review recent ERP studies in child and adolescent psychiatry. ERPs are non-invasive methods for studying synaptic functions in the brain. ERP might be a candidate biomarker in child-adolescent psychiatry, considering its ability to reflect cognitive and behavioral functions in humans. For the EEG study of psychiatric diseases in children and adolescents, several ERP components have been used, such as mismatch negativity, P300, error-related negativity (ERN), and reward positivity (RewP). Regarding executive functions and inhibition in patients with attention-deficit/hyperactivity disorder (ADHD), P300 latency, and ERN were significantly different in patients with ADHD compared to those in the healthy population. ERN showed meaningful changes in patients with anxiety disorders, such as generalized anxiety disorder, separation anxiety disorder, and obsessive-compulsive disorder. Patients with depression showed significantly attenuated RewP compared to the healthy population, which was related to the symptoms of anhedonia.

A Study of the Attitudes of Nursing Students toward Their Clinical Affiliation in a Mental Hospital (정신과간호 실습에 대한 간호 학생들의 태도 조사연구)

  • 김소야자
    • Journal of Korean Academy of Nursing
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    • v.3 no.3
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    • pp.15-26
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    • 1973
  • (Directed by Professor Hong, Shin Yong) Today, over seventy five Percent of the schools of nursing in Korea Provide a psychiatric experience in the basic curriculum. The psychiatric presents numerous major problems of adjustment to the student. The importance of positive attitudes toward the nursing care of psychiatric patients is recognized by the nursing profession. The purpose of this study was to determine the expressed attitudes of fifty-three nursing students toward their psychiatric affiliation. An attempt, also, was made to determine what implications these attitudes revealed relative to future program planning for students during the psychiatric nursing affiliation. A questionnaire, a Korean translation of the "psychiatric Nursing Attitude Questionnaire" by Milder Elizabeth Fletcher, was administered to fifty-three nursing students from three schools of nursing in Seoul, Who had completed a four-week psychiatric affiliation in a large mental hospital during Mar. 19, 1973 to May 19, 1973. The questionnaire of 100 statements was administered in the following way: (1) Part 1, Preconceptions. was. given in individual conferences with each subject, during the first few days of their affiliation, and again during the final week of the affiliation. The responses to Part Ⅰ were oral. (2) Part Ⅱ , Expectations, Part Ⅱ, Personal Relations, Part Ⅳ, Personal Feelings, and Part V , Attitudes and Activities of Patients were given to all of the subjects in a group meeting during the second week of the affiliation, and again. during the fourth week at the termination of the affiliation. Responses to Parts B, B, n, and f, wire written. Each of the 100 statements of the questionnaire was considered to be either Positive or Negative. A favorable response was assigned the Positive value of land an unfavorable response was assigned the Negative value of O. The coefficient of correlation was computed between the two sets of scores for the fifty-three nursing students., The mean score, the standard deviation, and the differences in the means on each of the five parts of the questionnaire were computed and the relationships calculated by a t-test. The results. of the study were as follows: 1. There was no significant correlation between the two sets of scores for the fifty-three nursing students during the four-week psychiatric affiliation. (r=573) 2. There was no significant difference in the mean scores between the first and final tests for any of the five parts of the questionnaire. 3. The Part.1, Preconceptions, data indicated nursing students enter the psychiatric affiliation with certain attitudes and preconceptions toward tile psychiatric affiliation which affect their psychiatric nursing experience, 4. The Part Ⅰ, Expectations, data indicated inappropriate expectations of students related to lack of experience, Lack of pre-psychiatric affiliation orientation, lack of social understanding, and feelings of insecurity. 5. The Part Ⅲ, Personal relations, data indicated some students have negative attitudes in personal relations with normal people in respect to psychological security and social responsibilities. 6. The Part Ⅳ, Personal feelings, data indicated nursing students have psychological insecurity & inappropriateness. 7. The Part Ⅴ, Attitudes and activities of patients, data indicated nursing students have negative attitudes of fear and frustration due to the psychotic behavior of certain patients in certain situations. 8. The data indicated preconceptions are predominate in unfavorable attitudes of students toward psychiatric nursing affiliation. Further researches indicated in the following areas: 1. Because of the limited number of students in this study, similar studies should be performed with larger groups for further validation of the results. 2. Because of the findings concerning the influence of the opinions of people in close contact with the students, similar studies of the attitudes of the staff in nursing schools, attitudes of graduate nurses and attitudes of the public should be done to determine weakness and strengths of present programs.

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Predictors of Posttraumatic Stress in Psychiatric Nurses (정신과 병동 간호사의 외상 후 스트레스 영향요인)

  • Yeo, Hyun Ju
    • Korean Journal of Occupational Health Nursing
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    • v.26 no.3
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    • pp.125-132
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    • 2017
  • Purpose: This study was performed to identify the impact of aggressiveness of patients and a sense of coherence on posttraumatic stress in psychiatric nurses. Methods: After collecting data from 162 psychiatric nurses, we carried out a t-test, ANOVA, Pearson's correlation coefficient, and multiple regression using IBM SPSS Statistics 19.0. Results: The mean score of posttraumatic stress was $20.75{\pm}16.59$ points. Verbal aggression, aggressiveness about property, aggression toward oneself, and aggression toward others had a positive correlation with posttraumatic stress, while a sense of coherence had a negative correlation with post-traumatic stress. It was concluded that the significant predictors of posttraumatic stress in psychiatric nurses were aggression toward oneself, a sense of coherence, and aggression toward others, all of which accounted for 38.9% of the variability. Conclusion: The results of this study indicate that the factors influencing posttraumatic stress in psychiatric nurses were aggression toward oneself, aggression toward others, and a sense of coherence. Therefore, education programs should be developed in consideration of the fact that aggressive behavior against the patient himself and against others intensify the posttraumatic stress of the psychiatric nurse, but the integration force mitigates it.

Exploring Decision-Making Factors of Psychiatric Nurses in the Application of Seclusion and Restraint: Applying Focus Group Interviews (정신간호사의 격리·강박 적용에 대한 의사결정 요인 탐색: 포커스 그룹 인터뷰 적용)

  • Park, Kyung Hwan;Jang, Mi Heui
    • Journal of Korean Academy of Psychiatric and Mental Health Nursing
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    • v.27 no.4
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    • pp.380-393
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    • 2018
  • Purpose: The purpose of this study was to explore psychiatric nurses' decision making in the use of seclusion and restraint (SR). Methods: Data were collected using focus group interviews. Two focus group interviews were held with a total of 10 psychiatric nurse participants. All interviews were recorded and transcribed, and data were analyzed using qualitative content analysis. Results: Eleven categories emerged from three main themes. All the themes describe factors that participants took into account when deciding whether to implement SR: 1) Personal factors area: 'Personal attributes of nurses,' 'Attitude of nurses regarding SR,' 'Nurses' physical and emotional states,' 'Negative experiences of nurses related to SR'; 2) Relational factors area: 'The level of cooperation between nurses and doctors,' 'Role models created by seniors and colleagues,' 'The level of support by nursing assistants,' 'Therapeutic relations with patients'; and 3) Environmental factors area: 'Poor nursing work environment,' 'Atmosphere of ward regarding SR,' and 'Social atmosphere to raise alarm about SR.' Conclusion: These findings should be considered in the evaluation of the use of SR in psychiatric hospital settings and appropriate strategies used to help minimize the use of restraint.