• Title/Summary/Keyword: Psychological Therapy

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A Study on Hardiness, Knowledge of Menopause, Menopausal Management among Middle Aged Women (중년여성의 강인성, 폐경지식과 폐경관리에 관한 연구)

  • Shin, Hye-Sook;Kown, Sook-Hee
    • Women's Health Nursing
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    • v.5 no.2
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    • pp.247-261
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    • 1999
  • The purpose of this study was to figure out related factors to the self-reported climacteric symptoms and the relationship among the health promoting behaviors, climacteric symptoms and degree of Sanhujori, the Korean traditional postpartal care. A cross-sectional survey design was employed in this study. The subjects were 108 middle-aged women who were non-hystrectomized and ranged in age from 40 to 60 years. They were selected in seoul and Kyoung-ki province, Korea, Data were collected from Oct.25 Nov. 10, 1997 by a structured questionnaire. The instruments used for this study were the revised health Promotion Lifestyle(HPLP) developed by Walker, Sechrist & Pender, and revised Climacteric Symptoms Scale developed by Chi, Sung Ai. the data were analyzed by the SPSS/$PC^+$ program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows ; 1. The mean score of health promoting behaviors was low($2.42{\pm}0.35$). There were statistically significant differences in the score of health promoting behaviors according to the educational background, family income, marital satisfaction, whether or not taking a restorative food and degree of Sanhujori, especially the period (t=-2.07, F=2.60~7.57, p<0.05). 2. The mean score of score self-reported climacteric symptoms was 1.69%;99% of middle-aged women had symptoms. There were statically significant differences in the score of middle -aged women's self-reported climacteric symptoms according to the age, number of children, educational background, occupation, family income, marital satisfaction, whether or not receiving hormon replacement therapy (HRT) or consultation by a professional, perceived health status and self evaluation of Sanhujori(t=-2.04~3.69, F=2.87~11.63, p<0.05). 3. women's degree of Sanhujori was a positive correlation with health promoting behaviors(r=0.34, p=0.00) and negative correlation with the degree of self-reported climacteric symptoms(r=-0.19,p=0.03). 4. The influencing factors to the climacteric symptoms were self actualization, interpersonal support, and perceived health status among the health promoting behaviors with 57% of variance($R^2$=0.57). 5. The middle-aged women's type of coping pattern for the climacteric symptoms was classified as active behavioral coping, spiritual & psychological coping, and negative coping. In conclusion, to intervene the middle aged women's climacteric symptoms and develop nursing strategies for their health, health promoting behavior, especially ; self actualization, interpersonal support, and perceived health status should be considered. And, as the primary prevention strategy for women's health during the period of childbearing and also middle age, especially for the climacteric symptoms, Sanhujori should be reconsidered.

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Assessment and Treatment of Depression in the Medically III (신체질환 환자들에서 우울증의 평가 및 치료)

  • Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.2
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    • pp.111-132
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    • 2001
  • Depression in the medically ill is a common clinical problem that primary physicians and psychiatric consultants encounter. Treatment of such patients begins with a careful evaluation of the patient's medical and psychiatric conditions. The assessment of depression in the medical patients requires a multidimensional approach. Psychological instruments are also used as a method of assessment in these patients. First of all, what the therapists have to do is to find and remove organic causes. Psychosoical treatment includes dealing with the patient's resistance and despondency relevant to physical diseases. For biological treatment, it is important to select appropriate antidepressants. Therapists should be familiar with the side effects of the antidepressants as well as the patient's primary depressive symptoms, pharmacokinetics and pharmacodynamics of the available agents. In addition, special attention should be paid to the potential for drug-illness and drug-drug interactions. Tricyclic antidepressants can be still effectively used for patients with pain disorder, although a variety of new antidepressants such as selective serotonin reuptake inhibitors (SSRI), bupropion and venlafaxine could have more benefits in depression of the medically ill. However, electroconvulsive therapy can be recommended for refractory cases of depression in patients with medical illness.

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An Inquiry to the Causal Perceptions & Emotions of Rheumatoid Arthritis Patients (류마티스 관절염 환자의 원인지각에 대한 연구 - Q방법론적 접근 -)

  • Kim, Boon-Han;Jung, Yun
    • Journal of muscle and joint health
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    • v.6 no.2
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    • pp.226-241
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    • 1999
  • This study was undertaken to find out the causal perception of rheumatoid arthritis patients, and to understand the typology. The Q-population consisted of 236 statements of causal perception were collected. Thirty eight Q-samples of causal perception were selected. The P-sample for this study were made up of 28 first visiting female rheumatoid arthritis patients from a rheumatoid arthritis specialty hospital. Each respondent responded Q-set of causal perception according to 9-point scale. The result of Q-sorting were coded and analyzed using QUANL PC program. 1) Typological Observation on Causal Perception (1) Physical Fatigue Type : Type 1 perceived that the illness occurred due to excessive work requiring physical labor or strain that had occurred from not resting after excessive physical labor, therefore, thinking the origin of the illness was from physical strain. (2) Physical origin Type : Type 2 perceived that the major cause for the illness is not only excessive physical labour but also fecundity and old age. (3) Causality to Environment Type : Type 3 perceived that rheumatoid arthritis occurred from injury to the joints or bad and humid weather. (4) Conscience of Guilty Type : Type 4 consisted of people with guilty conscience for lack of religious commitment. They perceived that the illness was a punishment from God for not praying or because of bad luck. (5) Rationally Perceiving Type : People who belong in type 5 perceived the cause of illness in light of scientific facts such as genetics, unbalanced diet or lack of exercise. (6) Psychological Stress Type : People who belong in type 6 believed that excessive stress was the cause of the illness. 2) Emotions of Rheumatoid arthritis patients Rheumatoid arthritis patients' positive emotions included determination, courage, coping, acceptance, hope, and adoption ; and their negative emotions were prostration, worry, stupor, conflicts, grievance, giving-up, resignation, depression, loss, solitariness, fear, anxiety, avoidance, anger and loneliness. Rheumatoid arthritis patients experience different level of emotions from their suffering experience from the severe pains. Rheumatoid arthritis patients also experience negative emotions when they could not perform self-care and lose their self-esteem from painful suffering ; however, they regain positive emotions when they recover from pain with the use of drugs, physical therapy or exercise. Their emotional states are closely connected to level of and presence of pain.

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Model Development of Nursing Care System for Women's Health : Based on Nurse-Midwifery Clinic (여성의 건강을 위한 간호전달체계 모형개발 - 조산원 중심으로 -)

  • Park, Yeong-Suk
    • Women's Health Nursing
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    • v.5 no.1
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    • pp.133-145
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    • 1999
  • The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

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An Analysis of Resourcefulness Research (자원동원성 연구논문 분석)

  • Suh, Soon Rim;Lee, Eun Ok;Kim, Jung Hee
    • Korean Journal of Adult Nursing
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    • v.13 no.1
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    • pp.15-28
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    • 2001
  • The purpose of this study was to identify the trends of resourcefulness researche studies for suggesting the future direction of study. Study design, types of subjects, measurement tools, study concept, and outcome were examined by reviewing 61 research studies published from 1980 to 1999. The results were as follows: 1. There were 24 works in the 1980s and 37 works in 1990, according to the published year of resourcefulness study. Nonexperimental studies like descriptive study, correlational study and comparative study were more frequent than experimental studies. 2. Research studies that consisted of 30- 100 subjects were the most numerous with 27 studies in all. The majority of study subjects was shown as healthy students and depressive patients. 3. Most studies used Rosenbaum's Self Control Schedule(SCS) for assessing resourcefulness. Reliabilities of resourcefulness researches were cronbach ${\alpha}=.70$ or more. According to statisitical tests done for internal validity, SCS was negatively correlated to maladaptation. Factor analysis revealed that the most parsimonious structure was 3 to 6 factors. The total communality variance in the SCS was about 40 %. Other tools used with the SCS were about coping, depression, satisfaction of life and symptoms, self management and health promotion. 4. In correlational studies, concepts like depression, anxiety, and psychological symptoms were related to resourcefulness negatively. Adaptive functioning, life satisfaction and self achievement had positive correlations to resourcefulness. 5. Studies on comparison between a healthy person and depressive patient or smoker and non-smoker were done. There were coping, depression, symptom, self efficacy, health problem and self-control as comparative concepts. 6. Study subjects consisted of depressive patients in 9 of 18 experimental studies. The majority of studies were done with cognitive-behavioral therapy as an experimental intervention. The most effective treatment was revealed in high resourcefulness group. Since the above findings, resourcefulness research increased since 1980 and mostly non-experimental design for quantitative study were done. In the field of nursing, research about resourcefulness was in an initial stage. It is expected that further research needed to be done. Recommendations on the basis of the present research suggest that it is necessary to replicate studies, develop nursing intervention enhancing resourcefulness and apply it to patients with chronic diseases including cancer.

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Effects of Song Discussion on Depression and Rehabilitation Motivation in Stroke Patients (노래 가사 토의가 뇌졸중 환자의 우울 및 재활동기에 미치는 효과)

  • Jung, Yong Ra
    • Journal of Music and Human Behavior
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    • v.12 no.1
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    • pp.43-64
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    • 2015
  • This study investigated the effects of song discussion on depression and rehabilitation motivation in stroke patients. Older adults with chronic stroke participated in this study: nine for the experimental group and eight for the control group. The experimental group was divided into three subgroups and participated in 12 sessions over 6 weeks. Target lyrics were selected by the investigator among popular songs from the participants' young adulthood. The song-based discussion was facilitated to address issues targeted at supportive, insight-focused, or reconstructive stage. The control group was provided with delayed intervention. At pre and posttest, the short form of Geriatric Depression Scale and the Rehabilitation Motivation Scale were measured. The experimental group showed significantly decreased depression and significantly increased rehabilitation motivation (p < .01), while the control group showed no significant changes. Positive changes were also observed in all subcategories of rehabilitation motivation in the experimental group, particularly in significantly increased task-oriented motivation and decreased amotivation. This study suggests that song discussion will be effectively applied in rehabilitative settings to address psychological issues of older adults with stroke.

The Analysis of Research Trend about Management of Low Back Pain (요통관리에 관한 연구동향 분석)

  • Hyun, Kyung-Sun
    • The Korean Journal of Rehabilitation Nursing
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    • v.1 no.1
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    • pp.51-60
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    • 1998
  • The result of studying papers about management of lower back pain published in domestic and foreign nursing and medical magazines in these 10 years is as follows ; 1. General characteristic of lower back pain ; 1) In sex distribution, there were more men than women in 5 papers and more women than men in 4 papers among 9 papers surveryed. 2) In age distribution, thirties to forties of patients had more lower back pain as surveyed by general hospitals and fifties to sixties of patients had more lower back pain as surveyed by oriental medical hospitals. 3) In cause factor, there were 50 to 65% of sprain, 32 to 44% of herniated intervertebral disc and 13 to 29% of degenerative changes. 4) In symtom distribution, there were 26 to 57% of lower back pain, 42 to 65% of lower back pain with radiating pain and 34 to 99% of paravertevral muscle spasm. 5) In period of pain management distribution, 18 to 40% of patients experienced pain for less than 6 months and 59 to 82% of them experienced pain for more than 6 months in 3 papers among 4 papers. 6) In surveying the treatment, 66 to 88% of patients had conservative treatment and there were treatments of general hospital, oriental medicine, self remedy and traditional practice in conservative treatment. 7) In job distribution, 12 to 50% of them were housekeepers, 23 to 31% office workers, 4.6 to 36% blue color workers and 11 to 15% students. 2. As psychological character lower back pain paients had anxiety, depression, anger-hostility, phobic anxiety, neurasthenia, hypochondriasis, and interpersonal sensitivity. 3. To distinguish the cause of lower back pain, plain lumbar roentgenogram, straight leg rasing test, eletromyelogic findings, somatosensory evoked potentials CT and MRI were performed. 4. To relieve lower back pain. epidural adhesiolysis, epidulal injection of local anesthetic in mixture with steroid, lumbar spinal root block, low level laser therapy, acupuncture like transcutaneous nerve stimulation(AL TENS), topical capsaicin and lumbar orthotics were used in medical field, and relaxation technique was used in nursing field. 5. Mckenzie's extension exercise and William's flexsion exercise for lower back pain were used in medical field and Yoga exercise was applied in nursing field. 6. The more school education and self efficacy were high, the better they had active coping lower back pain positively and the less self efficacy was the more they had serious pain. As a result of studying the paper there have been very little research for lower back pain in nursing fields of Korea and foreign countries. Because 60 to 80% of population expeience lower back pain at least more than once, it is necessary to develop the study and clinical practice for management of lower back pain.

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A Case Report on Panic Disorder Patient Using the 'MRM (Mentalizing the Rooms of Mind)' and Korean Medicine Therapy (한의치료와 '마음의 방 그리기'를 활용한 공황장애 치험 1례 보고)

  • Kim, Jeesu;Cheong, Moon Joo;Lee, Ga-Won;Lyu, Yeoung-Su;Kang, Hyung Won
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.3
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    • pp.197-211
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    • 2020
  • Objectives: The purpose of this study was to introduce the progress of treatment and improve clinical use after conducting Mentalizing the Rooms of Mind, the main technique of Mindfulness & Loving Beingness psychotherapy, for a patient with panic disorder. Methods: We conducted a Mentalizing the Rooms of Mind for 10 sessions on an age 23 female diagnosed with panic disorder based on the DSM-5 diagnostic criteria. After receiving consent from the subject, through chart review, the progress of treatment was observed focusing on the MMPI-2 and CSEI-s (The Core Seven Emotions Inventory-short form) conducted pre- and post-treatment. This study was approved by the Institutional Review Board of Wonkwang University Sanbon Hospital (WMCSB202007-55). Results: 1. The MMPI-2 clinical scales of an age 23 female with panic disorder showed a 7 (Pt)-1 (Hs)-3 (Hy) profile pre-treatment, but for post-treatment, the scale showed 1 (Hs)-3 (Hy) profile, and the 7 (Pt) scale showed significant decline. In the MMPI-2 reconstructed clinical scales, RC7 (Dysfunctional Negative Emotions) and RC8 (Aberrant Experiences) showed significant decline. 2. In the pre- and post-treatment MMPI-2 content scales, Anxiety, Fears, Obsessiveness, Social Discomfort, and Work Interference scores decreased, showing overall positive stability. On the MMPI-2 supplementary scales, the Anxiety and Post-Traumatic Stress Disorder scores decreased, and the Ego Strength increased, resulting in improved overall psychological adaptation. 3. Pre- and post-treatment of an age 23 female with panic disorder, CSEI-s showed significant decline of 恐, 驚, 悲, and 思. So it seems that the emotions caused by Chiljeongsang (七情傷) were more stable than before treatment. Conclusions: As shown above, the treatment of panic disorder through Mentalizing the Rooms of Mind, a major technique of Mindfulness & Loving Beingness psychotherapy, showed positive changes in MMPI-2 as well as improvement of the subjective symptoms. Thus, Mentalizing the Rooms of Mind has high clinical use, and it seems that it is necessary to create a manual for this in the future.

Depression during Pregnancy and the Postpartum (임신 및 산후 우울증)

  • Kim, Youl-Ri
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.1
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    • pp.22-28
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    • 2007
  • The pregnancy and postpartum period appear to be a time of heightened vulnerability for the development of major depression in some women. Postpartum depression affects 10% of women within a few weeks immediately postpartum. Postpartum depression is associated with disturbances in the mother-infant relationship, which in turn have an adverse impact on the course of child cognitive and emotional development. Depression during pregnancy is also common, although it has been relatively neglected. Psychopathological symptoms during pregnancy have physiological consequences for the fetus. Understanding the aetiology of perinatal depression requires integrating of multiple psychosocial and biological risk factors. The treatment of depressed pregnant women requires skilled decision making by psychiatrists. Risk-benefit analysis is appropriate method for intervention fur depression in pregnancy. Effective treatments for depression in pregnancy include psychotherapy, antidepressant medication and electroconvulsive therapy. In treatment of postpartum depression, the biological, psychological, and social interventions are included. Prescribing antidepressants(such as fluoxetine), estrogen in severe and chronic cases, and counselling can be effective for improving maternal mood and aspects of infant outcome. Ongoing research is directed to further elucidating neurohormonal and psychosocial contributions to depression during pregnancy or postpartum. Screening for risk factors and symptoms for depression need to be incorporated into antenatal and pediatric clinics.

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A Shared Electronic Medical Record for Lung Cancer Clinic (폐암 클리닉을 위한 공유 전자의무기록)

  • Kim, Kyu-Sik;Park, Eun-Sun;Kim, Seung-Seok;Kim, Hyung-Woo;Kim, Young-Chul;Bom, Hee-Seung;Ahn, Sung-Ja;Na, Kook-Joo;Kim, Yun-Hyeon;Kim, Yu-Il;Lim, Sung-Chul;Moon, Jai-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.480-486
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    • 2005
  • Since the year 2000, lung cancer has become the leading cause of cancer death in South Korea as in many other parts of the world. The current multidisciplinary approach for lung cancer includes a wide range of modalities, not only surgery, radiotherapy, medical drug therapy but also pain control, as well as social and psychological support. Therefore, thoracic surgeons, radiologists, nuclear medicine specialists, anesthetists, psychologist, nurses and social workers as well as medical doctors care for lung cancer patients. Sharing a common treatment protocol and optimal communication are vital aspects of shared care both from a medical and cost-effectiveness point of view. We developed a shared electronic medical record (SEMR) for treating patients with lung cancer in a university hospital to facilitate the sharing protocols and communications between doctors involved in a lung cancer clinic. A SEMR system was developed within a order communication system(OCS) for a lung cancer clinic. The records of radiological, laboratory and pathological studies as well as the records of surgery, chemotherapy, and radiotherapy were stored and presented to all doctors who treat the same patient. Every doctor was allowed to change his/her own records. They could review other doctor s records but could not alter them. With the SEMR, it was expected that the time to complete the medical records for one patient could be reduced because it was easy to review all the data from the other doctors who share the same patient. In addition, the confidence of the doctors who share a common treatment protocol would be higher. Therefore, a shared electronic medical record is expected to improve the quality of patient care.