• 생물정신의학
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• 제18권3호
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• pp.163-167
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• 2011

Complex regional pain syndrome (CRPS) is a disease that causes chronic spontaneous pain and hyperesthesia of one or more parts of legs and arms, which is accompanied with problems of the automatic nervous system or the motor nervous system. However, up to date, it is unclear what causes the syndrome and how to diagnose and treat it. Although several treatments including medication and sympathetic nerve block are performed against CRPS, the therapeutic effect of the treatments is limited. The electroconvulsive thera-py (ECT), of which the mechanism is not clarified, is a treatment used for treatment-resistant depression. ECT is also reported to be effective against pain. Therefore, we performed the ECT for a 24-year-old female patient who has been diagnosed as CRPS. Her pain had not been much improved by medications and interventional procedures. At admission to a psychiatric ward for ECT, she com-plained of over 8 points of pain on visual analogue scale and the constrained movement around the painful part. Eight ECTs-three times a week-were performed for three weeks in hospital and then the ECT once a week was performed after her leaving the hospital. During the ECTs, pain had been reduced and the range of movement in the constrained parts had increased. Further systematic re-search is needed to confirm the effect of electroconvulsive therapy against CRPS.

• 정신신체의학
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• 제2권1호
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• pp.22-33
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• 1994

The author presented several points of experienced materials obtained from the joint meetings of consultation-liaison Psychiatric division with oncologic department in Kyung Hee University Hospital. The joint meetings which have been held regularly every other week were very helpful not only for the psychiatrist but also for the cancer department stags to manage the cancer patients actively. The joint meetings have been progressed into more cohesive and active communication as time goes by. Most of the subjects discussed in the meeting was focused on the psychological and behavioral problems of the cancer patients. Besides, the difficulties arising from the chemotherapy were discussed. Probably the most difficult task for the treatment team was to provide complete information while respecting the patient's right to deny their situation The liaison psychiatrist usually gave comments to the charge doctor and/or nusing staff how to evaluate the patient's behavior and what would be the influential factors in developing the doctor-patient relationship. It was found that many cancer patients and their family members had their own peculiar illness behavior and disease concept which led patients to take non-medical or moreover, anti-therapeutic care. The family members were found to play an influential role in the choice of treatment method and progression of the disease. Another role of the liaison psychiatrist in the oncology ward was to encourage the treatment team members. In the practical point of view, it was not easy for the liaison psychiatrist to have time regularly for the cancer patients to encourage the liaison activities. And it seems to be fundamental that the consultation fee for the liaison psychiatrist should be set up at the resonable level.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권4호
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• pp.251-257
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• 2015

Objectives : We compared the clinical presentations of manic and depressive episodes and the treatment response among children and adolescents with bipolar disorder (BD) types I and II and BD not otherwise specified (NOS). Methods : The sample consisted of 66 patients, aged between 6 and 18 years, who were admitted for BD to a 20-bed child and adolescent psychiatric ward in a university hospital located in Seoul, Korea. Results : Patients with BD type I were more likely to have lower intelligence quotients and exhibit violent behaviors during manic episodes than patients with BD type II or BD NOS and to show better treatment responses during manic episodes than patients with BD NOS. Patients with BD NOS were more likely to have an irritable mood rather than a euphoric mood during the manic phase than patients with BD type I or II and to exhibit violent behaviors during the depressive phase and chronic course than patients with BD type II. Conclusion : Pediatric BD patients are heterogeneous with respect to their clinical characteristics. Implications for the usefulness of the current diagnostic subtype categories should be investigated in future studies.

• 생물정신의학
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• 제20권4호
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• pp.179-186
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• 2013

Objectives This study is designed to compare the clinical characteristics of patients with early onset schizophrenia to those of adult onset schizophrenia patients in first episode. Methods Authors reviewed medical records of 16 early-onset schizophrenia patients and 22 adult-onset schizophrenia patients who had been admitted in the psychiatric ward and diagnosed as schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, fourth Edition (DSM-IV) at Eulji University Hospital during 2004-2008. Socio-demographic data and clinical characteristics such as duration between onset and active phase, number of significant positive and negative symptoms, positive and negative symptom scores of Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S) scores, duration from onset to admission, duration of admission, and equivalent dose of antipsychotics were reviewed. These clinical characteristics of early-onset group were compared to those of adult-onset group. Correlation between age of onset and other clinical characteristics was also analyzed. Results Early-onset group showed more insidious onset pattern and had longer duration of hospitalization than adult-onset group. Early onset group also exhibited more negative symptoms, higher negative symptom scores, and higher CGI-S scores than adult-onset group after treatment. However, there were no significant differences in family history of psychosis, positive symptom frequency at discharge and equivalent dose of antipsychotics between two groups. Conclusions This study revealed that patients with early-onset schizophrenia exhibited more insidious onset, more negative symptoms, and more severe symptoms than those with adult-onset schizophrenia after treatment.

• 대한간호학회지
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• 제11권1호
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• pp.7-17
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• 1981

The purpose of this study is to investigate the relationship between family attitude about mental illness and their general characteristics. The subjects for this study were a sample of 120 families selected from psychiatric ward of one university hospital, which is one national hospital in Seoul. Data was collected from July 1th to August 10th in 3980 used by Opinion about Mental Illness Scale (O.M.I.). The materials were analized by S.P.S.S. program. The findings of the study were as follows: A. Families' attitude toward mental illness shown ay this study was more negative compared to those of Korea1 nursing professorss, nurses and nursing students. B. Variables which influence families' attitude about mental illness: 1. There is no significant between general characteristics and authoritarianism. (p＞ 0.05) 2. Benevolence (Factor B) was found to be significantly related to such variables as religion, eucation levels, existence of mental patient in their an intimate friends. (P < 0.01) Families' attitude about benevolence was mere positive in families who have not relegion or having christion beliefs: haying the higher education levels; not having a mental patient in their an intimate friends. 3. Mental health ideology (Factor C) was found to be significantly related to variable experience of mental illness. (P < 0.01). families' attitude about mental health ideology was more positive in families who had experience of mental illness. 4. Social Restrictiveness (Factor D) was found to be significantly related to variable relationship between families and patients(P<0.01). An intimate friend's attitude about mental health Ideology was mon positive than that of parent and couple. 5. Interpersonal Etiology (Factor E) was found to be significantly related to variable religion (P < 0.05). Families' attitude about interpersonal etiology was more positive in families who have relegion.

• 여성건강간호학회지
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• 제23권1호
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• pp.21-32
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• 2017

Purpose: The purpose of this study was to investigate the experience and perception of sexual harassment during the clinical practice among nursing students and to identify the relationship between these variables and self-esteem. Methods: Participants included 191 senior nursing students who voluntarily participated. Sexual harassment experiences and perceptions were measured using the tools developed by the researcher. Self-esteem was measured using self-esteem inventory developed by Rogenberg. Results: 50.8% of the participants experienced sexual harassment. Physical harassment was the most common, followed by verbal, visual and gender-role related sexual harassment. 'Blocking the way' and 'Brushing one's body on purpose' were the most common behaviors. The perception of sexual harassment severity was 3.35 out of 5 points. There were negative correlation between sexual harassment experience and self-esteem (r=-.17, p=.013). The subjects who experienced sexual harassment showed lower self-esteem score than those who did not (t=-2.10, p=.037). The main offender was a male patient in 40s, and the psychiatric ward was the most vulnerable to sexual harassment. Conclusion: Results showed that sexual harassment in clinical practice among nursing students were serious. It is necessary to develop an educational program to prepare them for sexual harassment in clinical practice.

• 대한조현병학회지
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• 제22권2호
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• pp.51-55
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• 2019

Objectives: Late-onset schizophrenia (LOS, age at first onset ≥40 years) is characterized by including predominance of women, better premorbid social adjustment and lower severity of positive/negative symptoms. However, few studies have been conducted on LOS, especially in Asian countries. This study aimed to examine the clinical features of LOS in comparison with early-onset schizophrenia (EOS). Methods: By retrospectively reviewing medical records, we assessed demographic data and clinical features of 76 LOS (20 males) and 357 EOS (144 males) who admitted to the psychiatric ward of a general hospital. Results: The mean ages of onset were 47.3±5.1 (LOS) and 25.7±6.5 (EOS) years. There were significantly more women in LOS (73.7%) than EOS (59.6%). Significantly more LOS patients had a marital (88.2% vs. 25.8%) and employment history (28.9% vs. 13.1%) than EOS. Patients with LOS had fewer negative (14.3±9.0 vs. 19.9±9.3), general psychopathology score (36.9±11.1 vs. 42.3±13.9) than EOS patients. Conclusion: In line with previous studies, this study demonstrated that LOS patients have better premorbid social adjustment. Our finding also replicates previous findings that LOS patients differ from EOS in predominance of women and relative lack of negative symptoms. These results suggest that LOS may be a distinct subtype of schizophrenia.

• 한국사회복지학
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• 제55권
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• pp.231-254
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• 2003

본 연구는 장애의 특성상 인권보장이 '다수의 안전'이나 '치료적 이득'과 갈등이 있을 수밖에 없는 정신장애인의 인권 보장과 제한을 일반적으로 어떻게 이해하는지를 알아보고자 하는 것이다. 따라서 일반인 10명, 전문가 9명, 정신장애인 6명을 대상으로 각 권리(존엄성 존중, 차별대우 받지 않을 권리, 자발적 입원보장, 자유로운 환경보장)별로 문제영역(장기입원, 운전면허취득제한, 강제입원, 통신의 자유제한)을 구체화하여 면담하였다. 면담내용을 질적 분석한 결과 조사대상자들이 권리보장과 제한을 이해하는 두 가지 차원을 발견하였다. 첫 번째 차원은 권리보장과 제한을 다수에 미치는 긍정적 결과를 중심으로 정당화하느냐 아니면 인권존중의 보편적 원리를 내세워 권리중심으로 정당화하느냐 하는 것이다. 두 번째 차원은 권리보장과 제한의 판단주체를 공식적 체계에 두느냐 아니면 비공식적 체계에 두느냐 하는 것이다.

• 한국의료질향상학회지
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• 제9권2호
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• pp.116-133
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• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.

• 한국산학기술학회논문지
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• 제20권7호
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• pp.393-405
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• 2019

본 연구는 폭력경험으로 인한 정신과병동 간호사의 소진을 감소시키고 문제 중심의 표준화된 폭력대처 중재방안을 수립하기 위해 폭력경험, 폭력대처, 사회적지지가 소진에 미치는 영향요인을 파악하기 위한 서술적 조사연구이다. 연구 대상자는 정신과 병원에서 근무하는 임상경력 1년 이상인 병동 간호사 204명이었다. 자료수집기간은 2018년 7월 1일부터 8월 31일까지 구조화된 설문지로 시행하였다. 수집된 자료는 SPSS program을 이용하여 평균, 표준편차, t-test, ANOVA, Pearson's Correlation coefficient, Multiple Regression으로 분석하였다. 연구결과는 다음과 같았다. 정신과병동 간호사는 언어적 폭력 92.2%, 신체적 위협 92.2%, 신체적 폭력 75.5%를 경험하고 있었다. 대상자의 폭력경험과 폭력대처(r=0.15. p<.027), 폭력경험과 소진(r=0.16, p<.017)은 정적 상관관계, 폭력대처와 사회적지지(r=0.30, p<.001)는 정적 상관관계, 사회적지지와 소진(r=-0.28, p<.001)은 부적 상관관계를 나타냈다. 또한 소진에 영향을 미치는 요인으로 간호직 만족도, 사회적지지, 신체적 폭력경험이 나타났다. 소진을 설명하는 회귀모형은 약 33.3%의 설명력을 나타내었다. 그러므로 정신과병동 간호사의 폭력경험을 낮출 수 있는 예방교육과 사회적지지 강화를 위한 체계마련 및 간호직 만족도를 향상시키는 환경을 조성한다면 소진을 감소시켜 양질의 간호를 제공할 수 있으리라 생각된다.