• 제목/요약/키워드: School Based Intervention

검색결과 863건 처리시간 0.033초

미국의 외래치료명령제도 및 위기대응과 국내적 시사점 (Assisted Outpatient Treatment and Crisis Intervention in USA and their Implications for Korea)

  • 박인환;한미경
    • 의료법학
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    • 제19권1호
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    • pp.23-80
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    • 2018
  • 정신질환자의 인권이라는 관점에서 우리나라의 정신질환자에 관한 법과 정책도 강제입원과 치료가 중심이 아니라, 정신질환자의 삶에 주목하여 그들의 회복(Recovery)과 사회통합(Inclusion)을 목표로 지역사회에서의 복지와 지원에 중점을 두어야 한다. 정신건강복지법으로의 개정으로 강제입원의 요건과 절차를 엄격하게 강화하였지만, 지역사회에서 정신질환자의 안정적 치료와 사회복귀를 지원할 서비스가 충분히 확보되어 있지 않다. 그 중에서도 지역사회에 복귀한 정신질환자들의 안정적인 치료의 유지와 위기상황에 빠졌을 때에 지원받을 수 있는 서비스 체계를 구축하는 것은 정신질환자의 회복과 지역사회에서 살아갈 권리를 실현하는 데에 매우 중요하다. 이 점에 있어서 미국의 외래치료명령제도와 위기대응프로그램이 많은 시사를 제공해 줄 수 있다. 먼저 미국에서의 외래치료명령제도의 발생과 최신 동향으로부터 다음과 같은 시사를 얻을 수 있다. 첫째, 미국의 AOT와 같이 외래치료명령 신청 주체를 넓게 확대하는 것, 둘째, 사법기관에 준하는 독립성을 갖춘 기관의 심의와 절차적 권리를 보장하는 것, 셋째, 실효성 확보를 위해 정신보건전달체계에도 동일한 내용의 명령을 하는 것, 넷째, 외래치료명령에서 반드시 사례관리를 포함하는 '치료계획'을 수립하는 것, 다섯째, 외래치료명령과 병행하여 동의에 기반한 외래치료지원제도를 시행하는 것, 여섯째, 대상을 자 타해행위의 이력이 있는 입원환자로 제한하지 않는 것에 주목할 필요가 있다. 나아가 지역사회에 복귀한 정신질환자가 병상(病狀)의 변화에 따라 겪게 되는 정신과적 위기상황을 안전하게 극복하기 위해서는 미국의 위기대응 프로그램과 같은 사회서비스의 제공이 반드시 필요하다. 특히 정신과적 위기상황에서 강제입원이나 자살, 중대범죄의 위험으로부터 본인과 타인을 보호하기 위해서 위기대응 프로그램은 중요한 역할을 할 수 있을 것이다. 이때 미국이 경험한 위기대응서비스 제공의 기본원칙과 다양한 형태의 위기대응 서비스가 우리나라의 제도 설계와 운영에 많은 참고가 될 것이다.

연하장애환자의 후두기능 및 연하관련 삶의 질 향상을 위한 치료적 노래부르기 중심 음악중재사례 (Therapeutic Singing-Based Music Therapy for Patients With Dysphagia: Case Studies)

  • 여명선;김수지
    • 재활복지
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    • 제22권1호
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    • pp.169-194
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    • 2018
  • 본 연구는 세 명의 연하장애환자들을 대상으로 후두관련기능의 개선을 목표로 한 치료적 노래부르기 중심의 음악중재를 시행하고, 각 사례 별로 관찰된 변화를 기술한 개별 사례연구이다. 중재는 개별 세션의 형태로 매 회기 30분, 주 3회씩 총 12회기 동안 진행되었으며, 시행된 프로그램은 호흡근 이완, 구강근육운동, 후두상승 유지를 위한 발성과 치료적 노래부르기 등의 순서로 구성되었다. 대상자들의 연하 및 말하기 기능, 삶의 질 등의 변화를 알아보기 위해 매 회기 후두교호운동속도, 최대발성시간, 음성 질 관련 항목 등을 측정하였고, 중재 전후로 설문을 통해 삶의 질을 평가하였다. 중재 과정에서 대상자의 기능적 특성에 따라 구분되는 변화의 양상이 관찰되었고, 중재 후에는 모든 대상자의 후두교호기능 및 음성 질 지표 측정값에 변화가 있었으며, 연하관련 삶의 질 평가점수도 증가하였다. 본 연구를 통해 치료적 노래부르기 중심의 음악중재프로그램이 다양한 원인에 의한 연하장애환자들의 후두관련기능 및 삶의 질 영역에 공통적으로 혜택을 줄 수 있다는 점과, 중재 시 대상자의 기능적 특성에 따라 고려해야 할 부분에 대해 구체적으로 알 수 있었다.

자기결정성 이론 기반 동기면담 유턴 프로그램이 청소년 금연에 미치는 효과 (Effectiveness of the Self-determination Theory based a Motivational Interviewing YOU-TURN Program for Smoking Cessation among Adolescents)

  • 하영선;최연희
    • 대한간호학회지
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    • 제45권3호
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    • pp.347-356
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    • 2015
  • Purpose: In this study, the effectiveness of a motivational interviewing smoking cessation YOU-TURN program for adolescents was examined. The program was based on the self-determination theory. Methods: The study was carried out with a nonequivalent control group pretest-posttest design. Participants in the present study were 136 high school students living in D city. The students were assigned to the experimental group (n=52) who participated in the motivational interviewing smoking cessation YOU-TURN program based on self-determination theory, or to the control group (n=84) who participated in a general smoking cessation program. Data were collected from September 1, 2013 through April 30, 2014. Collected data were analyzed using SPSS PC+ 21.0 with Chi-square test, Fisher's exact test, t-test, Mann-Whitney U test, Repeated Measures ANOVA, and MANOVA-Wilk's Lambda. Results: The experimental group had a significant increase in basic psychological needs, and duration of quitting-smoking in comparison with the control group. The experimental group had a significant decrease in cigarettes smoked per day and cotinine in urine in comparison with the control group. Conclusion: The motivational interviewing YOU-TURN program, when delivered to adolescents who smoked, was effective in discouraging smoking, and can be utilized as an effective nursing intervention for adolescents who smoke.

초등학교 저학년 부모를 위한 자녀성교육프로그램의 개발 및 효과 (Development and Effects of a Children's Sex Education Program for the Parents of Lower Elementary Grade Students)

  • 이은미;김현례
    • 대한간호학회지
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    • 제47권2호
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    • pp.222-232
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    • 2017
  • Purpose: This study was done to develop a children's sex education program for the parents of lower elementary grade students and to evaluate its effects on sexual knowledge, gender role attitude, parent efficacy for child's sex education, and marital consistency. Methods: A quasi-experimental with a non-equivalent control group pretest-posttest design was used. The participants were 29 couples (58 parents, experimental group=28, control group=30) from G city. The 5-week (5-session) program was developed based on 'A theory of protection: parents as sex educators' and used the case-based small group learning method. Data were collected during July and August 2015. The characteristics of the program developed in the present study were a theoretical-based, client-centered, multi-method. Results: After the intervention, the experimental group showed a significant improvement in sexual knowledge, gender role attitudes, parent efficacy for child's sex education, and marital consistency, compared to the control group. The effect sizes of the program were .64 (knowledge), .65 (gender role attitudes), and .68 (parent efficacy). Conclusion: The results of this study provided implications for the parents as effective sex educator and the role expansion of school health nurses.

Development of a Community-Based Approach to Opisthorchiasis Control

  • Duangsong, Rujira;Promthet, Supannee;Thaewnongiew, Kesorn
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.7039-7043
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    • 2013
  • A liver fluke, Opisthorchis viverrrini (OV), is the major cause of the high incidence of cholangiocarcinoma in North-eastern Thailand. The prevalence of OV infection remains high in various parts of the country, especially in wetland rural areas where a large proportion of the community work in agriculture and continue the traditional practice of eating raw or uncooked cyprinoid fish products. The national control program seems to have had little impact in many of these areas, and it has been difficult to make precise assessments of the overall effectiveness of the program. Therefore there is a need for a community-based approach to prevent infection with the parasite, ideally involving as many players as possible. Here we document an attempt to assess the best means to prevention on the basis of a community intervention in three villages in north-east Thailand, with participation of representatives of Health Promotion Hospitals of the Ministry of Public Health with dedicated staff, but also school teachers, independent government sponsored village health volunteers, and housewives responsible for cooking and diet selection. An action plan was followed, allowing detailed discussions of practical proposals, their introduction and then repeated reflection and further proposals at the individual village level.

노인 당뇨병환자의 스트레스 지각, 스트레스 대처방식, 자가간호행위 및 당화혈색소와의 관계 (The Study Related to Perceived Stress, Stress Coping Method, Self-Care Behavior and Hemoglobin $A_1c$ of Elderly Diabetic Mellitus Patients)

  • 박미연;김경희
    • 기본간호학회지
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    • 제15권2호
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    • pp.186-194
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    • 2008
  • Purpose: The purpose of this studγ is to understand relations among perceived stress, stress coping method, self-rare behavior and Hemoglobin $A_1c$ of elderly diabetic mellitus patients. Method: Participants were 128 patients who were under medical treatment in outpatient department at C university hospital. The collected data were analyzed using technical statistics, frequency, percentage, T-test, ANOVA and person's correlation coefficient by SPSS 12.0. Result: There were positive correlation between self-care behavior and coping method based on emotions under the lower category of stress coping method. Hemoglobin $A_1c$ of patients had a negative correlation with physical exorcise of self coping method under the lower category. Perceived stress had also a negative correlation with emotions as coping method in the lower category and medication of self-care behavior. Conclusion: It was noted that elderly diabetic mellitus patients didn't much use a coping method based mainly problems and another method based emotions in case of perceived stress. The findings of this study will be useful for developing an nursing intervention program focused on elderly diabetic mellitus patients.

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마음챙김기반 스트레스 완화 프로그램이 소아·청소년 정신질환자 어머니의 지각된 스트레스 및 우울에 미치는 효과 (The Effect of Korean Mindfulness-based Stress Reduction Program on Perceived Stress and Depression for Mothers of Children and Adolescents with a Mental Disorder)

  • 김현숙;김성재
    • Perspectives in Nursing Science
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    • 제16권2호
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    • pp.65-74
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    • 2019
  • Purpose: This study applied the Korean Mindfulness-Based Stress Reduction (K-MBSR) program for mothers of children and adolescents with mental illnesses, and verified its effectiveness on perceived stress and depression based on the Middle-range theory of caregiver stress. Methods: A quasi-experimental, non-equivalent control group pre-post test design was used. The K-MBSR program was reconstructed with experts' advice to adjust subjects' characters. Using a group approach, sessions were conducted once a week for six weeks, and each session took 2.5 hours. Results: The experimental group did not show a significant decrease in perceived stress than the control group. However, the experimental group showed a significant decrease in depression than the control group. Conclusion: The K-MBSR program was effective for depression. Future studies on high-stress groups or with an extended program are necessary to clarify the effects of the K-MBSR program on perceived stress. These results are consistent with the middle-range theory of caregiver stress, the theoretical framework of this study. When caregivers have similar inputs, proper intervention can change the control process. Further, it can be assumed that this change positively affects the output.

VR 콘텐츠가 재한 중국인 유학생 아증후군적 우울 상태에 미치는 영향 연구 - 주의력회복이론을 기반으로 - (A Study on the Effect of VR Content on Sub-Syndromatic Depression of Chinese Students in Korea - Based on Attention Restoration Theory (ART) -)

  • 정선요;이연우;김치용
    • 한국멀티미디어학회논문지
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    • 제25권1호
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    • pp.124-134
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    • 2022
  • Based on existing research, the psychological state of Chinese students has become a very significant issue that needs to be resolved. In addition to paying attention to the daily life and study of Chinese students, the psychological problems of Chinese students are also worthy of attention. At the same time, if the existing psychological problems are not resolved in time, serious consequences may result. Based on the ART(Attention Restoration Theory) theory, this article uses VR (Virtual Reality) content as a medium, uses 3D modeling software to build a healing scene that helps Chinese students improve their psychological and emotional state, and presents it in a VR device. To achieve the purpose of improving the psychological and emotional state of Chinese students. According to experimental tests, the VR recovery scene constructed by this method can help improve the psychological mood of Chinese international students who already have subliminal depression. The results of independent sample T-tests after data analysis experiments show that after the intervention of the experiment, the depression of the experimental group is significantly improved compared to the control group. It is proved that the method in this study is effective for the mentality and emotion of Chinese international students who have subliminal depression. There is a significant improvement effect.

The Effect of Side-Step Tasks Based Circular Training Program on Balance and Gait in Stroke Patients

  • Sang Jun Son;Joong-Hwi Kim
    • Physical Therapy Rehabilitation Science
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    • 제11권4호
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    • pp.384-390
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    • 2022
  • Objective: The purpose of this study was to investigate the effect of the side-step tasks based circular training program (STCT) on balance and gait characteristics in stroke patients. Design: A randomized controlled trial Methods: Twenty-four stroke patients were randomly divided into two groups of twelve patients each. One group was applied with the STCT whereas the other group was treated with conservative physiotherapy (CP). The ability of gait was measured in 10m walking test and stride length on both side using BTS G-WALK (BTS Bioengineering S.p.A, Italy) and the ability of balance was measured in Berg Balance Scale (BBS) and Timed Up and Go Test (TUG). Results: The STCT group was significant differences in the balance parameters of BBS and TUG (p<0.05) and showed significant differences in gait variables in 10m walking speed, stride length of affected and non-affected side after the experiment before and after the experiment (p<0.05). In addition, the STCT group showed a significant difference in BBS compared to the control group (p<0.05). Conclusions: The results of this study confirmed that the side-step tasks based circular training program (STCT) improves balance and walking ability in stroke patients. STCT is expected to be used as a useful intervention method for stroke rehabilitation.

가족기능성과 학교적응유연성의 관계에서 청소년 스마트폰 중독의 매개효과 검증 (Mediating Effect of Adolescents' Smart-Phone Addiction in the Relationship between Family Function and School Adjustment Resilience)

  • 고재수
    • 한국콘텐츠학회논문지
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    • 제14권6호
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    • pp.140-151
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    • 2014
  • 본 연구는 가족기능성과 스마트폰 중독이 학교적응 유연성에 미치는 영향과 스마트폰 중독이 매개효과를 가지는지를 알아보기 위해 구조방정식 모형을 사용하여 검증하였다. 조사대상자는 부산지역 초등 5, 6학년과 중학교 1, 2, 3학년을 대상으로 설문지를 통해 자료를 수집하였으며, 자료수집 기간은 2013년 3월 한 달 동안 이루어졌다. 연구결과, 가족기능성은 스마트폰 중독에 부적(-)영향을, 학교적응 유연성에는 정적(+)영향을 미치는 것으로 나타났으며, 스마트폰 중독은 가족기능성과 학교적응 유연성 간의 관계에서 부분매개 효과를 가지는 것으로 나타났다. 이러한 연구결과를 중심으로 청소년 스마트폰 중독에 대한 사회적 관심제고를 위한 방안과 함께 스마트폰 중독의 예방 및 치료적 개입을 위한 가정 및 학교에 대한 개입 방안을 제언하였다.