• 제목/요약/키워드: Psychological assessment

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만성 통증장애의 정신과적 치료 (Psychiatric Treatment of Chronic Pain Disorder)

  • 노승호
    • 정신신체의학
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    • 제7권2호
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    • pp.256-262
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    • 1999
  • 만성 통증은 신체적, 심리적, 사회환경적 요인들이 복합적으로 작용한 결과로서 나타나기 때문에 생물정신사회적 관점에서 접근해야 하며 치료는 다각적이고 포괄적인 체제하에서 상호 긴밀한 협력을 필요로 한다. 치료의 목표는 즉각적인 통증의 해소보다는 재활에 초점을 맞추어 환자의 활동과 기능이 증진됨에 따라 부수적으로 통증이 완화될 수 있도록 해야 할 것이다. 정신과적 영역에서 만성 통증의 치료는 정신의학적 평가로부터 시작하는데 여기에는 스트레스와 연관된 통증의 정신생리적 기전과 이상 질병행동과 관련된 조작적 조건화 기전, 그리고 증상으로서 통증을 동반하거나 만성 통증에 의해서 유발되는 정신과적 질환들에 대한 평가가 포함된다. 정신과적 치료를 약물치료와 심리적 치료로 나눌 때 약물치료에는 마약성 진통제, 비스테로이드성 소염제, 향정신성약물, 항경련제 들이 포함되는데 그 중에서도 항우울제가 가장 중요한 역할을 한다. 심리적 치료로는 역동적 정신치료와 행동치료적 방법들이 있고 행동치료적 접근법에는 자가조절기법과 조작적 조건화기법 등이 포함되는데, 환자가 갖는 대인관계의 어려움, 신체적 손상, 이상 질병행동 등을 고려하여 적절한 방법을 적용하게 된다.

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Symptom Experiences and Coping Strategies among Multi-ethnic Solid Tumor Patients Undergoing Chemotherapy in Malaysia

  • Yahaya, Nor Aziyan;Subramanian, Pathmawathi;Bustam, Anita Zarina;Taib, Nur Aishah
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권2호
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    • pp.723-730
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    • 2015
  • Background: This study was performed to assess patient symptoms prevalence, frequency and severity, as well as distress and coping strategies used, and to identify the relationships between coping strategies and psychological and physical symptoms distress and demographic data of cancer patients. This cross-sectional descriptive study involved a total of 268 cancer patients with various types of cancer and chemotherapy identified in the oncology unit of an urban tertiary hospital. Materials and Methods: Data were collected using questionnaires (demographic questionnaire, Medical characteristics, Memorial Symptom Assessment Scale (MSAS) and Brief COPE scales and analyzed for demographic, and disease-related variable effects on symptom prevalence, severity, distress and coping strategies. Results: Symptom prevalence was relatively high and ranged from 14.9% for swelling of arms and legs to 88.1% for lack of energy. This latter was the highest rated symptom in the study. The level of distress was found to be low in three domains. Problem-focused coping strategies were found to be more commonly employed compared to emotion-focused strategies, demonstrating significant associations with sex, age group, educational levels and race. However, there was a positive correlation between emotion-focused strategies and physical and psychological distress, indicating that patients would choose emotion-focused strategies when symptom distress increased. Conclusions: These findings demonstrate that high symptom prevalence rates and coping strategies used render an improvement in current nursing management. Therefore development of symptoms management groups, encouraging the use of self-care diaries and enhancing the quality of psychooncology services provided are to be recommended.

골관절염환자와 류마티스관절염 환자에게 적용한 타이치 운동프로그램(TCA)의 효과 비교연구 (The Effect of Tai-Chi for Arthritis(TCA) Program in Osteoarthritis and Rheumatoid Arthritis Patients)

  • 이혜영;서문자
    • 근관절건강학회지
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    • 제10권2호
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    • pp.188-202
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    • 2003
  • The aim of study was to investigate the effects of 12 forms of Sun-style Tai-Chi for arthritis(TCA) on physical symptom(pain, tenderness, swelling fatigue, and blood pressure), physical function(balance, flexibility, grip strength) and social-psychological health status in osteoarthritis(OA) patients and rheumatoid arthritis(RA) patients. This study was done with one group pretest-posttest design. A total 21 arthritis patients(6 OA patient and 15 RA patient) participated in 60 minute session consisting of warm-up exercise 12-main movement including qigong, and cool-down exercise twice a week for 6weeks. Physiological and social-psychological variables were measured before and after TCA 12 form. The researcher who completed a Tai Chi workshop for exercise leaders in Australia and Seoul taught the Tai Chi movement step by step until the patient felt comfort enough to perform them correctly by themselves during the first 4 weeks. At the last 2 weeks, the subject perform 10-15set of these at a session with traditional music to help patients move in a slow tempo. TCA 12 forms program showed significant improvement in fatigue(p=0.039) of rheumatoid arthritis patient and pain(p=0.006), fatigue(p=0.013), tenderness(p=0.032), flexibility(rt arm up, p=0.014, If arm up, P=0.003), grip strength(rt hand, p=0.002, If hand, P=0.003) of osteoarthritis patients. With assessment by Arthritis Impact Measurement Scale 2 questionnaire(AIMS2), physical component(0.002) and social interaction(0.025) on osteoarthritis patients were significantly improved. Evaluation of the participants about TCA exercise noted that the exercise was fairly easy(23.6%), moderately difficult(57.1%), and fairly difficult(14.3%). Considering the result of this study, TCA exercise program was more effective in pain, tenderness, grip strength, flexibility, and physical and social interaction on osteoarthritis patients than rheumatoid arthritis patients. Tai-Chi for arthritis 12 form was an appropriate intensity exercise for osteoarthritis patients.

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치매 환자에서 뇌 자기공명영상의 특징과 비정형 항정신병 약제 사용여부의 상관 관계 (Association between Characteristics of Brain Magnetic Resonance Imaging and Atypical Antipsychotics Use in Dementia Patients)

  • 최종택;김지원;노양호;류석환;우성일;한상우;황재욱
    • 생물정신의학
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    • 제20권3호
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    • pp.97-103
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    • 2013
  • Objectives We aimed to identify the neuroimaging marker for prediction of the use of atypical antipsychotics (AAP) in dementia patients. Methods From April 2010 to March 2013, 31 patients who were diagnosed as dementia at the psychiatric department of Soonchunhyang University Hospital, completed the brain magnetic resonance imaging scan and cognitive test for dementia. Ten patients were treated with AAP for the improvement of behavioral and psychological symptoms of dementia (BPSD) and the other 21patients were not. Using T1 weighted and Fluid Attenuated Inversion Recovery (FLAIR) images of brain, areas of white matter (WM), gray matter (GM), cerebrospinal fluid (CSF) and white matter hyperintensities (WMH) have been segmented and measured. Multivariate logistic regression models were applied for assessment of association between AAP use and the GM/WM ratio, the WMH/whole brain (GM + WM + CSF) ratio. Results There was a significant association between AAP use and the GM/WM ratio (odds ratio, OR = 1.18, 95% confidence interval, CI 1.01-1.38, p = 0.037), while there was no association between AAP use and the WMH/whole brain ratio (OR = 0.82, 95% CI 0.27-2.48, p = 0.73). Conclusions The GM/WM ratio could be a biological marker for the prediction of AAP use and BPSD in patients with dementia. It was more likely to increase as dementia progress since atrophy of WM was more prominent than that of GM over aging.

Ten Year Literature on Psychological and Behavioral Interventions Against Cancer: a Terms Analysis

  • Feng, Rui;Chai, Jing;Wang, De-Bin;Xia, Yi;Cheng, Peng-Lai;Dai, Zhao-Yang
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권10호
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    • pp.5171-5176
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    • 2012
  • We here performed a systematic review of PBIC literature using terms analysis in a hope of both identifying potential trends and patterns and exploring methods leveraging traditional literature reviews in this specific area. Articles meeting inclusion criteria were retrieved from PUBMED and translated into dichotomized article records representing presence or non-presence of MeSH terms and a metric consisting of numbers of times of co-occurrence between all pairs of terms identified using a self-designed program. The occurrence of and relations among the terms were calculated and visualized using Excel2007 and UCINET respectively. A total of 1,742 terms were identified from 997 articles retrieved. Put in a descending order, the lines representing the times of term occurrence formed a typical hyperbolic curve; when plotted along the x-axis of whole MESH terms, the lines clustered within four specific regions. Comparison of term occurrence between 2002 and 2011 revealed priority changes in population and subjects (from general groups to priority groups), intervention approaches (from medicine to exercise and psychotherapy), methodology and techniques (from cohort studies to randomized controlled trials) and outcomes (from health and mental health to quality of life, depression etc.). Networks of the terms featured a number of closely linked groups of topics including method and questionnaires, therapy and outcomes, survival management, psychological assessment and intervention, behavioral intervention (individual and community oriented). Terms analysis revealed interesting trends and patterns about PBIC publications and both the analysis methods and findings have implications for future research and literature reviews.

수입의류와 국산의류에 대한 소비자의식 연구 - 서울지역 대학생을 중심으로 - (A Study of Consumer's Consciousness on Imported Apparel and Domestic Apparel - Centering around College Students of Seoul area -)

  • 이인자
    • 복식
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    • 제32권
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    • pp.201-211
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    • 1997
  • In light of the problem of imported apparel that tends to increase rapidly this study was intended to inquire into the assessment of male and female college students about the brands of imported apparel relative to dom-estic apparel based on quality perception price pirceptionand social psychological perception. And it is concerned with making a compara-tive study of the difference in consumer's con-sciousness of clothing between subjects by dividing them into the group of preference for imported apparel the group of non-preference for it on the basis of their ratings. As a consequence the following study results were obtained. 1) As a result of comparing college students' ratings for quality perception price perception and social psychological perception of impor-ted apparel all three factors were shown to have the high average value in care of the group of preference for imported apparel and to have a significant difference between groups. 2) As a consequence of making a compara-tive study of the difference in the clothing at-titude between groups the group of prefer-ence for imported apparel showed the high av-erage value about brand preference and identi-fication clothing involvement and interper-sonal perception through clothing and to hjave a significant difference with the group of pref-erence for imported apparel in terms of the peripheral environment and the place of pur-chase. 3) As a result of making a comparison of the difference in demographic factors between groups it was analyzed that female clollege students especially college women in the departments of art and physical education had the higher preference for imported apparel. And it was shown that they had the higher preference for imported apparel the greater amount of pocket money they had. Broader and deeper studies are required to be made about imported apparel in a multifaceted way. Therefore follow-on studies will have to be actively conducted such as a study of con-sumer's evaluation about imported apparel and domestic apparel charged at th same range of prices and a study of the difference on con-sumer's consciousness of imported apparel found over age span of consumers.

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Sub-Health Status Survey and Influential Factor Analysis in Chinese during Coronavirus Disease 2019 Pandemic

  • Pan, Yanbin;Yan, Jianlong;Lu, Wanxian;Shan, Miaohang
    • 대한간호학회지
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    • 제51권1호
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    • pp.5-14
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    • 2021
  • Purpose: This study aimed to investigate sub-health status (SHS) of people living in China during the Coronavirus disease 2019 (COVID-19) COVID-19 pandemic. COVID-19 is a severe acute respiratory syndrome coronavirus (SARS-CoV) infection-induced acute infectious disease, which is featured by universal susceptibility and strong infectivity, and SHS (a status of low quality health) refers to a status of low-quality health. COVID-19 has gradually developed into a global pandemic, making the public in a high stress situation in physiological, psychological and social states in the short term. Methods: From March 6 to 11, 2020, a large-scale cross-sectional survey was conducted by convenient sampling, and SHS assessment scale was used in the questionnaire. The ordinal logistic regression analysis was used to identify the factors affecting SHS. Results: In this study, 17,078 questionnaires were delivered with 16,820 effective questionnaires collected, and 10,715 subjects (63.7%) were found with SHS, with moderate SHS primarily. Physiological sub-scale scored the highest, followed by psychological and social sub-scales. Ordinal logistic regression analysis indicated that man, only-child, workers and farmers were risk factors of SHS. Protective factors of SHS included living in rural areas and townships, laid-off retirees and education degree. Conclusion: It shows many people in China place in a poor health status during COVID-19 pandemic. It is necessary that relevant departments pay more attention to people with poor health such as men, only-child, urban people, workers and farmers, and groups with high education degree during and after pandemic stabilization.

Analysis of Concordance Between Parent Proxy and Child Self-report of KIDSCREEN-10 Health-related Quality of Life Questionnaire in an Elementary School-based Wellness Program: A Pilot Focus Group Study

  • Choi, Bongsam
    • 한국전문물리치료학회지
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    • 제28권2호
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    • pp.146-153
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    • 2021
  • Background: Researchers have previously commenced examining the degree of concordance between parent proxy and child self-reports on health-related quality of life (HRQOL) of many disease and impairment populations. Objects: To explore the differences between parent proxy and child self-reports on the HRQOL using Korean version of KIDSCREEN-10 questionnaires for applying to elementary school children and their parents who participated for a school-based wellness program. Methods: The focus groups were recruited for a school-based wellness program by implementing the following wellness services: 1) referring to a screening session for detecting potential posture-related musculoskeletal problems and 2) recommending home exercise programs. Before a primary field testing for the program, two focus groups were formed with a group of 9 parents and their 9 elementary school children aged 8-10 years of age. The parent proxy and child self-report versions of KIDSCREEN-10 questionnaires were administered to both groups after completion of the wellness program. Item level Rasch rating scale analysis was applied to compute logit scales of KIDSCREEN-10 questionnaire. Intraclass correlation coefficients (ICCs) and scatterplot of item difficulty between two reports were analyzed. Results: For fit statistics of parent proxy report, all items except 4 items (i.e., psychological well-being, mood/emotions, self-perception, parent relation) were found to be acceptable. For fit statistics of child self-report, all items except 3 items (i.e., psychological well-being, autonomy and home life) were acceptable. The relationship between two reports using ICCs were ranging from weak to very strong at p = 0.05 (i.e, ICCs = 0.011 to 0.905). Scatterplot analysis between two reports showed a major disparity on self-perception item at 95% confidence intervals. Conclusion: Both item level analyses and ICC comparisons provided a disparity between parent proxy and child self-reports of the HRQOL on self-perception item after competing a school-based wellness program. Therapist should consider the item as part of the HRQOL assessment.

Factors associated with the decision to undergo risk-reducing salpingo-oophorectomy among women at high risk for hereditary breast and ovarian cancer: a systematic review

  • Park, Sun-young;Kim, Youlim;Kim, Sue
    • 여성건강간호학회지
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    • 제26권4호
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    • pp.285-299
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    • 2020
  • Purpose: This systematic review aims to identify factors associated with risk-reducing salpingo-oophorectomy (RRSO), including the uptake rate and decision timing, among women at high risk for hereditary breast and ovarian cancer (HBOC). Methods: We found 4,935 relevant studies using MEDLINE, Embase, CINAHL, and PsycINFO on July 6, 2020. Two authors screened the articles and extracted data. Twenty-four studies met the inclusion criteria. Quality assessment of articles was conducted using the Risk of Bias for Nonrandomized Studies tool. Results: Five types of factors were identified (demographic factors, clinical factors, family history of cancer, psychological factors, and objective cancer risk). The specific significant factors were older age, having child(ren), being a BRCA1/2 carrier, mastectomy history, perceived risk for ovarian cancer, and perceived advantages of RRSO, whereas objective cancer risk was not significant. The uptake rate of RRSO was 23.4% to 87.2% (mean, 45.2%) among high-risk women for HBOC. The mean time to decide whether to undergo RRSO after BRCA testing was 4 to 34 months. Conclusion: RRSO decisions are affected by demographic, clinical, and psychological factors, rather than objective cancer risk. Nonetheless, women seeking RRSO should be offered information about objective cancer risk. Even though decision-making for RRSO is a complex and multifaceted process, the psychosocial factors that may influence decisions have not been comprehensively examined, including family attitudes toward RRSO, cultural norms, social values, and health care providers' attitudes.

Mediating effect of negative perceived stress on the relationship between premenstrual syndrome and emotional eating

  • Yesol Um;Jisun Lee
    • Nutrition Research and Practice
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    • 제17권2호
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    • pp.330-340
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    • 2023
  • BACKGROUND/OBJECTIVES: Emotional eating is one of the eating behaviors in which negative emotions affect eating. During the luteal phase, premenstrual syndrome (PMS) and its associated psychological and physical symptoms can appear in some women, and a few of them suffer from premenstrual dysphoric disorder (PMDD), a severe form of PMS. Some women diagnosed with PMS/PMDD experience emotional eating during the luteal phase, which may be a coping mechanism for psychological stress. This study aimed to investigate how PMS/PMDD and negatively perceived stress are related to emotional eating. SUBJECTS/METHODS: A total of 409 women aged 20 to 39 yrs with a body mass index (BMI) ranging from 18.5 to 29.9 kg/m2 participated in this study. Participants who responded to all the questions of the Shortened Premenstrual Assessment Form, Negative Perceived Stress Scale, and Emotional Eater Questionnaire were divided into a PMDD and a non-PMDD group according to the cut-off value for PMDD diagnosis. Independent t-tests and mediation analyses were performed to compare the 2 groups. RESULTS: No significant differences between the 2 groups were found in terms of BMI; however, the average values for emotional eating, PMS, and negative perceived stress of the PMDD group were significantly higher than those of the non-PMDD group. Only negative perceived stress had a significant effect on emotional eating in the non-PMDD group. In the PMDD group, PMS was statistically significant for both negative perceived stress and emotional eating mediated by negative perceived stress. Consequently, it appeared to have a partial or complete mediation depending on the independent variable for the PMDD group. CONCLUSIONS: This study highlights the importance of managing negative perceived stress to control emotional eating in PMS/PMDD for improved women's health.