• Archives of Plastic Surgery
• /
• 제41권2호
• /
• pp.174-180
• /
• 2014

It is well known that patients with severe facial injuries accompanied by facial disfiguration are vulnerable to a poor quality of life. With the help of facial transplantation, it has become possible to achieve an optimal anatomical reconstruction. As compared to conventional methods, it can provide more desirable functional, aesthetic, and psychosocial outcomes. Face transplantation surgeons need to consider many problems associated with the criteria for selecting patients, techniques for harvesting the donor tissue, prediction of the expected functional outcomes, limitations in obtaining written informed consent for conducting the procedure, evaluation of the post-transplant immunological response and postoperative immunosuppressant requirements, psychological and social outcomes for the patients, and other concerns about funding and ethical issues.

• 정신신체의학
• /
• 제1권1호
• /
• pp.98-100
• /
• 1993

To become an effective and successful consultation-liasion psychiatrist the psychiatrist should consider two aspects of consultation before he/she meets his/her patients. First the psychiatrist should understand the internal need and psychological state of patients who visited their physician before being refered to a psychiatrist So psychiatrists should be careful in the evaluation of the patient's intention whether they are willing to accept the psychiatric treatment approach or not Second the psychiatrist should understand the situation and the physician's internal need in the consultation. Psychiatrists should recognize whether there are any factors which interfere with the mutual understanding and cooperation between physicians and psychiatrist.

• Clinical and Experimental Pediatrics
• /
• 제51권9호
• /
• pp.935-943
• /
• 2008

Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral developmental disorder characterized by a persistent pattern of inattention and/or hyperactivity, as well as forgetfulness, poor impulse control or impulsivity, and distractibility. The recommended evaluation includes documenting the type and severity of ADHD symptoms, verifying the presence of normal vision and hearing, screening for comorbid psychological conditions, reviewing the child's developmental history and school performance, and applying objective measures of cognitive function. Prevailing opinion characterizes ADHD as a disorder of executive function attributable to abnormal dopamine transmission in the frontal lobes and frontostriatal circuitry. A clearly defined etiology remains unknown, but studies suggest a strong genetic link. The aim of treatment is to decrease symptoms, enhance functionality, and improve well-being for the child and his or her close contacts. Stimulants remain the pharmacological agents of first choice for the management of ADHD, and psychosocial, behavioral and educational strategies that enhance specific behaviors may improve educational and social functioning in children with ADHD.

• Journal of Korean Neurosurgical Society
• /
• 제62권3호
• /
• pp.328-335
• /
• 2019

Epilepsy is one of the most common chronic neurological disorder affecting 6-7 per 1000 worldwide. Nearly one-third of patients with newly diagnosed epilepsy continue to have recurrent seizures despite adequate trial of more than two anti-seizure drugs : drug-resistant epilepsy (DRE). Children with DRE often experience cognitive and psychosocial co-morbidities requiring more urgent and aggressive treatment than adults. Epilepsy surgery can result in seizure-freedom in approximately two-third of children with improvement in cognitive development and quality of life. Understanding fundamental differences in etiology, co-morbidity, and neural plasticity between children and adults is critical for appropriate selection of surgical candidates, appropriate presurgical evaluation and surgical approach, and improved overall outcome.

• 재활치료과학
• /
• 제11권4호
• /
• pp.41-53
• /
• 2022

목적 : 본 연구는 정신장애인의 직업재활 평가도구를 확인하고 분석함으로써 작업치료 영역에서 임상적으로 유용하게 활용할 수 있는 정신장애인 직업재활 평가도구의 개발을 위한 기초자료로 활용하는 것이다. 연구방법 : 문헌 검색은 Pubmed 데이터베이스를 사용하였으며, 분석 내용은 개발연도, 평가방식, 문항 수, 척도, 평가 문항을 분석하였다. 분석 방법은 각 평가 항목을 기능, 내적요인, 환경, 정신증상의 4가지 범주로 구분하여 각 평가도구의 평가 요소에 대해 파악하였다. 결과 : 검색어를 통한 Pubmed 검색 시 161개의 문헌이 검색되었고, 선정 방법에 따라 Griffiths Work Behavior Scale (GWBS), Occupational Functioning Scale (OFS), Social and Occupational Functioning Assessment Scale (SOFAS), Work Ability Index (WAI), Work Behaviour Inventory (WBI), Work Environment Impact Scale (WEIS), Work and Social Adjustment Scale (WSAS)의 7개 평가도구가 선별되었다. 모든 평가도구의 평가항목은 직무와 관련된 기능평가를 포함하였으며, 각 평가도구의 목적에 따라 내적요인, 환경, 정신증상에 대한 측정이 이루어지는 것으로 나타났다. 결론 : 직업 기술은 신체, 인지, 사회기술, 대처능력 등 다양한 기능이 복합적으로 작용하는 기술이다. 따라서 본 연구에서 분석한 기능, 내적요인, 환경, 정신증상의 4가지 요소가 포함될 필요가 있으며, 평가과정에서 발생하는 물리적 제약을 보완하기 위해 ICT 융합 평가도구의 개발함으로써 보다 효율적인 정신장애인 직업재활 평가가 이루어져야 할 것이다.

• 생물정신의학
• /
• 제22권3호
• /
• pp.128-134
• /
• 2015

Objectives To examine the relationship between health-related quality of life (HRQoL) and body mass index (BMI) of obese children. Methods This cross-sectional study included 387 children. HRQoL was measured with the PedsQLTM 4.0 Generic Core Scale. BMI was classified according to the World Health Organization Asia-Pacific obesity guidelines. Psychosocial factors (body image, self-esteem, and depression/anxiety) were also measured. Data were analyzed using one-way analysis of variance, Pearson's correlation and Path analysis. Results Obese participants reported lower score for physical evaluation, self-esteem, appearance evaluation component of body image, total HRQoL score, and physical/emotional/social function components of HRQoL ; they reported higher score for depression/anxiety. In addition, results indicated that as BMI increased, appearance evaluation, total HRQoL score, and social function component of HRQoL dropped. Path analysis revealed that BMI did not directly affect HRQoL ; however, BMI directly affects body image and self-esteem, indirectly mediates depression/anxiety, and thereby impacts on an individual's HRQoL. Conclusions Body image and self-esteem, rather than BMI itself, have more influence on HRQoL. This reinforces the importance of therapeutic intervention to enhance body image and self-esteem among obese children.

• 가정간호학회지
• /
• 제22권2호
• /
• pp.216-227
• /
• 2015

Purpose: This study aimed at understanding terminal care provided in nursing homes. Method: An interview survey with staff in charge of terminal care was conducted in 97 nursing homes using questionnaires. The questionnaire was reviewed by 3 experts and pretested at 5 facilities. Data were analyzed using descriptive statistics, chi-square test, and Fisher's exact test. Result: Dyspnea was the most prevalent symptom predicting death. The most prevalent services were vital sign check for physical care, providing services by talking despite an unconscious state for psychosocial care, and respecting the faith of the elder for spiritual care. Employment of a registered nurse showed a significant difference in tube feeding (p=.035), analgesic administration (p=.022), informing the elder of end-of-life state (p=.020), helping an elderly person say good-byes through a visit with friends and acquaintances (p=.023), and helping express feelings related to death (p=.002). Lack of service was noticed for elderly resident, family, and staff after death of an elder. Problems related to terminal care were indifference of family members, difficulty in obtaining medical prescription, difficulty in predicting death, and so forth. Conclusion: Terminal care must be improved by making specific guidelines and it must become a part of nursing home evaluation.

• The Journal of Korean Physical Therapy
• /
• 제22권3호
• /
• pp.37-44
• /
• 2010

Purpose: The purpose of this study was to describe the functional (mobility, self-care, social ability) and health-related quality of life in children with cerebral palsy (CP). Methods: A cross- sectional survey of 202 children with CP, mean age $5.91{\pm}1.57$ years, was carried out using the Gross Motor Function Classification System (GMFCS), Gross Motor Function Measure (GMFM), Pediatric Evaluation of Disability Inventory (PEDI), and Child Health Questionnaire (CHQ). Results: The functional assessment of children with CP showed that a more severe GMFCS level was associated with lower functional abilities (p<0.05). The health-related quality of life assessment showed that psychosocial well-being was less impaired than physical well-being. The internal consistency of the three instruments was satisfactory (cronbach's ${\alpha}$>0.80). The three different scales were correlated from moderate to strong (r=0.44 to 0.92). It was also found that mobility, tone distribution, and the parents' education level exerted a significant effect on the quality of life of children with CP (p<0.05). Conclusion: These findings suggest that children with CP have reduced function and quality of life and these are influenced by various factors. However, planning and application of various task-oriented functional interventions to childhood CP may be useful.

• 수면정신생리
• /
• 제8권1호
• /
• pp.5-10
• /
• 2001

The prevalence of insomnia and the degree of impairment due to insomnia is greater than in the of young. The cause for insomnia in the elderly are various factors among the elderly is known to be high including medical, psychiatric, drug issues, circadian rhythm changes, sleep disorders, and psychosocial. So the careful evaluation to find the cause of insomnia is needed for the eldery. Treatment options for insomnia include behavior modification and pharmacotherapy. Outcome data from previous studies indicate that behavioral approaches produce reliable and durable therapeutic benefits, as evidenced by improved sleep efficiency and continuity and enhanced satisfaction with sleep patterns. Treatment methods such as stimulus control and sleep restriction, which target maladaptive sleep habits, are especially beneficial for older insomniacs, whereas relaxation-based interventions aimed at decreasing arousal, produce more limited effects. Cognitive and educational interventions are instrumental in altering age-related dysfunctional beliefs and attitudes about sleep. The choice of hypnotics is based on matching the nature of the insomnia to the hypnotic agent. The ideal agent has rapid onset, duration of action that lasts through the night but no residual daytime effects, and no adverse effects. The key for the healthcare professional is finding the appropriate treatment or treatment combination, including behavioral modification and pharmacotherapy. When hypnotics are indicated, the most appropriate short-acting agent should be considered.

• International journal of advanced smart convergence
• /
• 제11권2호
• /
• pp.194-204
• /
• 2022

This study is a one-group pretest-posttest design to evaluate the effect of problem-based learning (PBL) for patient safety on self-leadership, patient safety competencies, and reflective thinking of nursing students. The research was conducted from March 2 to April 15, 2022, in which 57 nursing students participated. PBL for patient safety was examined in a total of 8 sessions in the order of motivation, problem identification, task performance planning, problem-solving methods, summary and solution, presentation, and evaluation. The following topics of patient safety were selected for each team: nursing records, high-alert medication, medication error and intravenous fluid regulation, blood transfusion care, fall, bedsore, infection control, and pain management. We provided feedback on the learning process and outcomes of nursing students. According to the results, self-leadership showed a statistically significant improvement in self-expectations (t=2.60, p=0.01), goal setting (t=2.84, p<0.01), self-reward (t=3.32, p<0.01), and self-criticism (t=2.32, p=0.02). Patient safety competencies showed a statistically significant improvement in patient safety knowledge (t=13.05, p<0.001) and patient safety skills (t=4.87, p<0.001) but not in reflective thinking. The results prove that PBL for patient safety is an effective teaching-learning strategy to improve self-leadership and patient safety competencies. Future studies must develop and validate specific and long-term teaching-learning methods to improve reflective thinking.