• Perspectives in Nursing Science
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• 제10권2호
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• pp.87-96
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• 2013

Purpose: The purpose of this study was to investigate the relationships of activity status, anxiety, depression, social support, symptom experience, and functional status in patients with lung cancer based on the theory of unpleasant symptoms. Methods: The participants for this study were 101 lung cancer patients who visited the out-patient department for treatment or follow-up at one hospital in Seoul. Data were collected from January 1 to February 8, 2013 using self-reported questionnaires and clinical records. To measure variables, the functional scale and symptom scale of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30, EORTC QLQ-Lung Cancer 13, Eastern Cooperative Oncology Group Performance Status, Hospital Anxiety and Depression Scale, and Multidimensional Scale of Perceived Social Support were used in this study. The data were analyzed using SPSS 19.0 software for Windows. Results: The symptom experience showed more severity in patients with lower activity status, higher anxiety and depression. With lower activity status and social support, functional status was lower. When anxiety, depression, and symptom experience were higher, functional status was also lower. The significant factors predicting symptom experience were depression, anxiety, activity status, and social support, which explained 57.8% of the variance. Conclusion: These results suggest that psychological factors such as anxiety and depression had a negative influence on the symptom experience of lung cancer patients. Therefore, providing emotional support based on the patients' needs prior to providing symptom management could be a useful strategy for improving symptom experience and functional status.

• 동의신경정신과학회지
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• 제20권4호
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• pp.185-196
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• 2009

통제적이고 강압적인 부모의 양육태도로 유발된 내면의 불안 및 갈등이 '항문의 이상 감각'이라는 신체화 증상으로 상징화되어 표출된, 전환장애로 의심되는 7세 여환아(女患兒)에게 한약(韓藥)치료와 더불어 지언고론요법(至言高論療法)을 적용하여 약 2개월간 치료하였다. 지언고론요법(至言高論療法)은 한의학 정신요법 중 하나로 현재 임상에서 행해지고 있는 지지적 정신치료 및 행동치료와 유사하다. 의료진은 이를 본 증례의 환아(患兒)에게 2개월간 적용하여 증상이 80%이상 소실되는 긍정적인 치료 결과를 얻을 수 있었다. 아동의 심리 발달과정에서 부모의 양육태도 등과 같은 중요한 심리 환경적 요인들이 부적절하여 아동의 내면에 갈등이 생기면 심인성의 신체증상이 유발되기도 한다. 이는 전환장애의 심리기제와 매우 흡사하다 할 수 있다. 그러므로 아동의 심인성 신체 증상을 치료하는 장면에서, 우선 성장 환경의 문제점 혹은 환아(患兒)의 성격 기질적 특성을 정확히 파악하고 그에 따라 지언고론요법(至言高論療法)등과 같은 한의학 정신요법을 이용해 적절한 치료적 개입을 한다면 이른 시간 안에 효과적인 치료가 가능할 것이다. 본 증례는 그 좋은 예라 사료된다.

• 정신신체의학
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• 제28권2호
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• pp.135-142
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• 2020

연구목적 간호사의 신체화 증상과 스트레스, 우울 및 불안, 정신 증상 위험의 관계를 확인하여 정신신체의학 연구의 임상 근거를 창출하고, 신체화 증상의 의미에 대해 제고하는 것을 목적으로 한다. 방 법 서울시 내 1개 상급종합병원 외과계 중환자실 간호사 70명에게 자가기입형 도구(Perceived Stress scale, Fatigue Severity Scale, Patient Health questionnaire-15, Korean Beck Depression Inventory, Korean Beck Anxiety Inventory, Symptom Checklist-90-Revision)를 사용하여 수집한 데이터를 분석하였다. 결 과 대상자 중 12.9%가 신체화 증상을 경험하였고 피로, 낮은 에너지, 생리통, 허리 통증이 나타났다. 신체화 증상과 정신적 스트레스 인지의 통계적 관련성은 없었으나 불안한 느낌이나, 자신감의 감소는 신체화 증상의 수준과 관련이 있었다. 신체화 증상이 심한 집단은 우울, 불안을 더 많이 경험하였다. 신체적 피로가 높은 집단은 정신적 스트레스 인지의 통계적 관련성은 없었으나 긴장이나 스트레스를 느끼거나 통제력이 감소되는 경험에 영향을 미쳤다. 신체적 피로 수준의 증가는 불안과는 관련이 없었고 우울을 더 많이 경험하는 것으로 확인되었다. 신체화 수준이 높을수록 정신 증상 중 강박과 적대감이 증가하였다. 선형회귀모형에서 스트레스, 우울, 불안은 신체화 증상을 39.3%, 신체적 피로 증상을 16.1% 설명하였다. 결 론 이 연구의 결과를 바탕으로 우리는 한국 문화에서 신체화 증상의 특징으로 스트레스 인지 증상의 감소, 우울과 불안 경험, 강박 및 적대감의 동반 가능성을 추정할 수 있다. 이 연구에서 신체화와 정신 증상은 인과관계를 확인할 수 없었으나 상호관련성이 관찰되어 향후 중재 전략 마련에 참조할 수 있을 것이다.

• 한국치위생학회지
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• 제13권1호
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• pp.136-145
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• 2013

Objectives : The goal of this study is to investigate how occupational stress affects temporomandibular disorders (TMD), dry mouth and oral symptoms. Methods : For this study, workers from 5 areas were selected and the survey was carried out from June 1st to 30th, 2012. A total of 410 questionnaires were analyzed. Results : The analysis of the structural model shows that occupational stress has no significant influence on temporomandibular disorder and dry mouth symptoms, but does affect other oral symptoms. The results also reveal that dry mouth symptom and temporomandibular disorder both have a significant effect on oral symptoms. Conclusions : Oral symptoms and job stress appeared to directly and indirectly influence the psychological and social factors of job stress. A systemic investigation on the improvement of oral health in workers is urgently required.

• Journal of Neurogastroenterology and Motility
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• 제24권4호
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• pp.536-543
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• 2018

Culture forms an integral aspect of environmental factors which influences disease presentation and clinical outcomes in functional gastrointestinal disorders (FGIDs). In this review, the role of culture in FGIDs in the East is briefly explored with regards to symptom presentation and diagnostic issues, lifestyle and cultural habits, epidemiology, and healthcare seeking behavior. In both functional dyspepsia and irritable bowel syndrome, symptom presentation and disease sub-typing in Asians are known to differ from their Western counterparts, possibly relating to cultural dietary practices and from cultural perception of symptoms. Dietary patterns, together with defecating practices are explored as factors contributing to a lower prevalence of constipation in the East. An urban-rural difference in the prevalence of FGIDs in Asia is attributed to a change in dietary patterns in rapidly developing urban communities, together with an increased level of psychological morbidity. Lastly, cultural attitudes towards traditional/local remedies, variation in healthcare systems, anxiety regarding organic disease, and religious practices have been shown to influence healthcare seeking behavior among FGID patients in the East.

• 종양간호연구
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• 제12권4호
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• pp.297-304
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• 2012

Purpose: This study was to identify the symptom severity, interference and their psychological predictors in thyroid cancer patients hospitalized for radioactive iodine administration. Methods: One hundred seventy-seven thyroid cancer patients admitted to the isolation room for Iodine ($I^{131}$) therapy were recruited. Subjects were asked to complete the questionnaire on core symptoms, thyroid cancer symptoms, interference, depression and state anxiety in the evening after receiving radioactive iodine therapy. Data was analyzed using frequency, percentage, mean, Pearson's correlation, and multiple regression with SPSS vs. 19. Results: Lack of appetite, drowsiness, sleep disturbance, fatigue, and nausea were the 5 most core symptoms. More than 20% of patients experienced moderate to severe thyroid cancer symptoms including feeling cold, hoarseness, swallowing difficulty, and feeling hot. More than 30% of subjects experienced moderate to severe interferences in mood, general activity, and 22% in walking. Depression and state anxiety were identified as predictors of core symptoms, thyroid symptom severity and interference. Conclusion: Nursing interventions to reduce the symptom severity and interference need to be developed by considering thyroid cancer patients' depression and anxiety when hospitalized in the isolation room for radioactive iodine administration.

• 대한간호학회지
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• 제32권5호
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• pp.643-653
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• 2002

The purpose of this study was to identify factors that influence the functional status of chronic lung disease patients. Method: A descriptive, correlational study design was used. The study was conducted at the outpatient respiratory clinic of the large university hospital in Korea. A convenience sample of 128 chronic lung patients (age = 64.2 yrs; 106 COPD, 17 bronchiectasis, 5 DILD) with mean FEV1 64.4 % predicted. Functional status was measured with SIP. Physical variables (FEV1% predicted, dyspnea, fatigue, pulmonary symptom distress), psychological variables (mood, stress), and situational variable (sleep quality) were examined. Dyspnea was measured by the BDI, fatigue was measured with the MFI. Mood was measured with the modified Korean version of POMS. Sleep quality was measured with the Pittsburgh Sleep Quality Index. Potential independent variables for the regression were age, gender, years since diagnosis, FEV1% predicted, dyspnea, fatigue, pulmonary symptom distress, stress, and sleep quality. Result: In general, functional status was relatively good. In regression analysis, functional status were significantly influenced by dyspnea, mood, age and fatigue. These variables explained 70 % of the variances in functional status. Conclusion: The results suggest that psychophysiologic symptom management should be a focus to enhance the functional status in this group.

• Journal of Oral Medicine and Pain
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• 제11권1호
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• pp.67-78
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• 1986

This study was attempted to identify the emotional characteristics of temporomandibular disorder patients. The author applied one of the self-report modes of psychological measurement, Symptom Chechlist-90-Revision. The subjects were 219 TM disorder patients who visited the Department of Oral Diagnosis and Oral Medicine, Seoul National University Hospital during the period from December 1985 to September 1986. All the patients were divided into subgroup according sex, age, duration of symptoms, presence or absence of T-scores of each symptom dimension and global index. The obtained result were as follows : 1. Mean value of T-scores of each symptom dimension and global of the overall patients was within normal range. The two higher mean values of T-scores among 9 symptom dimensions were those of SOM and ANX. 2. Mean values of T-scores of females were higher than those of males in the O-C, DEP, ANX, HOS, PSY dimensions and all global indices, and there was a significant difference in the distribution of T-scores of the SOM dimension between males and female(P<0.05). 3. There was no significant difference between the subgroup under 30 years and the subgroup 30 years or older. 4. The subgroup with symptoms for 6 months or longer showed the higher mean values of T-scorers in the SOM, O-C, I-S, DEP, ANX, PHOB, PAR, PSY dimensions and all global indices compared with the subgroup with symptoms for shorter than 6 months. 5. The subgroup with pain showed the higher mean values of T-scores in all the symptom dimensions except the PAR in comparison with the subgroup with other complaints than pain, and there was a significant difference in the distribution of T-scores of the PST index between the pain subgroup and the non-pain subgroup(P<0.05). There was a significant difference in the distribution of T-scores of the PHOB dimension between the high-school graduates subgroup and the college graduates subgroup(P<0.05).

• Journal of Oral Medicine and Pain
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• 제22권2호
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• pp.359-371
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• 1997

Stress is recognized as a major predisposing and/ or precipitating factor in long-lastig intractable chronic pain, such as temporomandibular disorders, headache, and other psychophysiological disorders. So it is necessary to detect physical and psychological changes induced by stress as soon as possible for positive treatment outcome. This study was performed to investigate the occurrence rate of stress symptoms according to anatomic region, type of symptom, and other personal and social factors. 859 subjects from general population answered the stress symptom questionnaire devised by the author and composed of 50 items. Data from the questionnaire were analyzed statistically with SPSS program and the results obtained were as follows : 1. Oral symptom which showed the highest frequency rate of 38.8% was vesicular lesion of the lip and cheek. The other symptoms with more 20% occurrence rate were ulcerative leion of lip and cheek, toothache, paresthesia of teeth, eruption of tongue, tongue coating and taste change in descending order. 2. In extraoral symptoms, ？데 disturbance was the item which showed the highest frequency rate of 62.0%, and the items for stiffness of suboccipital region and neck, headache, facial swelling, furuncle of face were answered more than 45% of the subjects whereas only 14.0% of the subjucts complained jaw pain under stress. 3. The better one who thought his or her health status was, the fewer items were answered and the difference of symptom frequency by dwelling place and by having hobby were shown in extraoral symptoms only. 4. For relief of stress symptoms, 79.2% of the subjects replied only to take a rest whereas not more than 13, 5% of the subjects visited dental clinic. Correlationship between symptom sites were very high.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1905-1909
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• 2013

Objective: The aim of the current study was to evaluate changes in treatment outcomes in terms of health-related quality of life (HRQoL) and symptom burden at zero, one, three, and six months after an initial diagnosis of colorectal cancer. The demographic and clinical characteristics that account for outcome changes in patients were investigated using a repeated measures framework. Methods and Materials: A cohort study was performed of 134 colorectal cancer patients followed from diagnosis to 6 months post-treatment in Central Taiwan. HRQoL and symptoms were assessed at diagnosis and one, three, and six months thereafter. The Functional Assessment of Cancer Therapy-Colon (FACT-C) questionnaire, VAS pain, and the Memorial Symptom Assessment Scale (MSAS) were used for data collection. A generalized estimating equation (GEE) was applied for statistical analysis. Results: The majority of the patients were male (55%) and married (91.5%). The mean age was 60.4 years (SD = 11.71). Most were diagnosed stage III and IV colorectal cancer (54.5%). All underwent surgery; some also received chemotherapy (CT) or concurrent chemoradiation therapy (CCRT). The results of the GEE showed that overall, the HRQoL, pain, and symptoms of the patients significantly improved over the treatment period. Patients with stage IV disease who had received surgery and CCRT showed the worst HRQoL. Females, patients with comorbidity, and stage IV patients had higher pain scores over time. Female and stage IV patients had more severe physical symptoms, whereas stage II and IV patients had worse psychological symptoms over time. Conclusion: The patients' HRQoL, pain, and symptoms significantly improved over the 6-month treatment period. Certain patient and clinical variables accounted for changes in treatment outcomes regarding HRQoL and symptom burden in colorectal cancer patients.