• Title/Summary/Keyword: Severe anxiety

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Influences of Injury Severity and Age on Severe Anxiety in Posttraumatic Stress Disorder Patients with no Previous History of Psychiatric Disorders (정신건강의학과 치료 과거력이 없는 외상후 스트레스 장애 환자에서 나이와 손상 심각도가 중증 불안에 미치는 영향)

  • Park, Woon Yeong;Park, Sang Hag;Kim, Sang Hoon;Kim, Seung Gon;Park, Jung In;Choo, Il Han
    • Anxiety and mood
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    • v.9 no.1
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    • pp.54-60
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    • 2013
  • Objectives : Posttraumatic stress disorder (PTSD) is classified as an anxiety disorder. PTSD occurrence is known to be increased in middle-aged and older people, female, and individuals with a previous history of psychiatric disorders, lower education levels, low socioeconomic status, and severely injured patients. Anxiety symptoms are also related to later development of PTSD. In this study, we investigate the influences of injury severity and sociodemographic factors on severe anxiety in PTSD patients with no previous history of psychiatric disorders. Methods : Forty-one PTSD patients without previous history of psychiatric disorders were recruited from the psychiatric clinic at Chosun University Hospital. Subjects underwent psychiatric and physical examinations including the Injury Severity Score (ISS), Beck Anxiety Inventory (BAI), and Korean-Wechsler Adult Intelligence Scale (K-WAIS). We defined severe anxiety as a BAI scores of 30 or more. Logistic regression analyses and multi-step model selection were applied to identify predictive factors for severe anxiety. Results : In univariate analysis, age, ISS, and socioeconomic status were found to be significant factors. Through multivariate logistic regression analyses and a stepwise model selection, we found the combination of age and ISS to be the best-fitted model for affecting severe anxiety in PTSD patients without a previous history of psychiatric disorders. Conclusion : Our findings suggest that the combination of age and ISS could develop severe anxiety in PTSD patients with no previous history of psychiatric disorders.

Symptom Severity according to the Presence of Depressive and Anxiety Symptoms among Patients with Head and Neck Cancer (두경부암 환자의 우울과 불안증상 유무에 따른 증상의 심각성)

  • Kim, Hyun-Joo;Cho, Ok-Hee;Yoo, Yang-Sook
    • Korean Journal of Adult Nursing
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    • v.28 no.2
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    • pp.148-155
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    • 2016
  • Purpose: The purpose of this study was to compare symptom severity and the impact of presence of depressive and/or anxiety symptoms among patients with head and neck cancer (HNC). Methods: One hundred and fifteen patients diagnosed with HNC completed two questionnaires: Hospital Anxiety and Depression Scale (HADS) and the M. D. Anderson Symptom Inventory-Head and Neck Cancer (MDASI-HN). Results: Of the total sample, 55.6% reported depressive symptoms and 33% reported anxiety symptoms. Patients who reported either depressive or anxiety symptoms also had significantly more severe symptoms. The most severe symptom was dry mouth. Participants who were depressed reported that interference in the enjoyment of life due to symptoms was the most distressing whereas participants with anxiety reported symptom interference in work was of most concern. Of patients reporting moderate to severe symptoms, more than 60% reported depressive symptoms. Of patients reporting moderate to severe feelings of being distress and feeling sad, more than 70% reported anxiety symptoms. Conclusion: Patients with HNC reporting moderate to severe symptoms also report depressive and/or anxiety symptoms. The results suggest the need to develop an integrated nursing intervention of both physical and emotional symptoms for patients with HNC.

Personality Assessment Inventory Profiles of Patients with Mild and Severe Traumatic Brain Injury (경증 및 중증 외상성 뇌손상 환자의 성격평가 질문지 프로파일)

  • Kweon, Seok-Joon;Rho, Seung-Ho
    • Korean Journal of Biological Psychiatry
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    • v.12 no.1
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    • pp.20-31
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    • 2005
  • Objectives:This study was designed to investigate the characteristics of personality changes and emotional distress using the Personality Assessment Inventory (PAI) in patients with traumatic brain injury(TBI), divided into mild (MTBI) and severe (STBI) groups according to the severity of injury. Methods:The subjects were consisted of 25 patients with MTBI, 25 patients with STBI, and 25 normal controls. They were interviewed with the PAI. The data were analyzed by ${\chi}^2$ test, analysis of variance and Tukey test. Results:The results were the followings. First, Negative Impression in validity scales was elevated above cutoff point(T score 70) in both MTBI and STBI groups. Second, the clinical scales of which scores elevated above the cutoff point were Somatic Complaints, Anxiety, Anxiety-Related Disorders, Depression, and Schizophrenia in the MTBI, and Somatic Complaints and Depression in the STBI. Third, the clinical subscales above the cutoff point were Conversion, Somatization, Health Concerns, Affective Anxiety, Physiological Anxiety, Traumatic Stress, Cognitive Depression, Affective Depression, Physiological Depression, Thought Disorder, and Affective Instability in the MTBI, and Health Concerns, Cognitive Depression, Affective Depression, and Physiological Depression in the STBI. Fourth, Suicide Ideation in treatment scales was the only scale above the cutoff point in the MTBI and the others of the treatment and interpersonal scales in the MTBI and all of these scales of the STBI were not elevated above the cutoff point. Fifth, the scales of which scores showed significant difference between the MTBI and the STBI were Somatic Complaints, Anxiety, Depression, and Suicide Ideation, the subscales were Conversion, Somatization, Health Concerns, Affective Anxiety, Physiological Anxiety, Physiological Depression, and Psychotic Experiences. Conclusion:These results suggest that the patients with MTBI had more somatic and anxiety symptoms, depressed mood, and suicidal ideation than the patients with STBI. These characteristics are generally consistent with clinical observation and findings from previous studies of the patients with TBI, and the PAI seems to be a beneficial adjunctive assessment tool for the evaluation of patients with traumatic brain injury.

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Predictive Factors of Supportive Care Needs in Patients with Hematologic Malignancy (혈액암 환자의 지지적 간호 요구도 예측요인)

  • Jung, Ah-Rang;Yi, Myung-Sun
    • Korean Journal of Adult Nursing
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    • v.23 no.5
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    • pp.460-471
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    • 2011
  • Purpose: This study was designed to investigate the levels of anxiety, depression, physical symptoms, and supportive care needs in patients with hematologic malignancy and to identify predictive factors of supportive care needs. Methods: The data were collected from 100 subjects undergoing treatments during 2010 in Korea. The questionnaires included the Hospital Anxiety-Depression Scale, the M. D. Anderson Symptom Inventory, and the Supportive Care Needs Survey-Short Form 34. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation, and stepwise multiple regression. Results: Forty percent of the subjects had anxiety and 58% had depression. Thirty-eight percent of the subjects reported to have moderate-to-severe levels of physical symptoms. The most severe physical symptom was lack of appetite, followed by fatigue and pain. In terms of supportive care needs, the health system and information domain showed the highest among all domains. Supportive care needs had a significant positive correlation with anxiety, depression, and physical symptoms. And its predictive factors were identified as anxiety, physical symptoms and marital status, with the explanatory power of 48.9%. Conclusion: These findings demonstrate that anxiety and physical symptoms should be assessed and treated to meet the supportive care needs of patients with hematologic malignancies.

Transition of Symptoms and Quality of Life in Cancer Patients on Chemotherapy (항암화학요법 시행 초기 암환자의 증상 및 삶의 질 변화 양상)

  • Kim, Min-Young
    • Journal of Korean Academy of Nursing
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    • v.39 no.3
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    • pp.433-445
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    • 2009
  • Purpose: The purpose of this study was to assess changes in pain, fatigue, anorexia, anxiety and quality of life(QOL) in patients with cancer who were on chemotherapy. Methods: Symptoms and QOL were examined both before chemotherapy and after 2 cycles of chemotherapy. The participants were 76 cancer patients receiving chemotherapy in one of 7 hospitals. Results: The patients experienced a mean of 2.22-2.23 symptoms out of 4 symptoms. Patients who were female, or suffered from breast or colorectal cancer experienced more symptoms. Fatigue at present, and most severe fatigue and anorexia in the previous 3 weeks increased significantly. Anxiety and QOL decreased significantly after 2 cycles of chemotherapy. Number of symptoms, anorexia at present, most severe anorexia in past 3 weeks, and anxiety had negative correlations. QOL before chemotherapy showed a positive correlation with QOL after 2 cycles of chemotherapy. In a regression analysis, anxiety, QOL at baseline, income, and the most severe pain in the past 3 weeks were significant predictors of QOL. Conclusion: Physical and psychological factors were significant predictors of both QOL and each subscale, and these factors correlated with each other. These results demonstrate the needs for early assessment and intervention from the start of chemotherapy to decrease symptoms and improve QOL.

A Case of Child Seperation Anxiety Disorder with Severe Weight Loss and School Refusal (심한 체중감소 및 등교거부증을 보인 분리불안장애 아동 1례)

  • Jang, Sang-Ruyl;Park, Hyung-Bae
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.226-236
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    • 1993
  • Seperation anxiety disorder(SAD) is characterized by excessive anxiety about being apart from the individuals to whom a child is most attached. We noticed a case of a 13 year old boy's SAD with symptoms of nausea/vomiting, stomachache, school refusal, and severe weight loss. His mother was overanxious and overdependent but her dependency was frustrated due to family problem. We investigated this case from a point of developmental aspect and family dynamics and tried to attempt therapeutic approach.

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Psychosocial Outcome after Head Injury (두부외상후 심리사회적 예후)

  • Park, Ki-Chang;Kim, Hun-Joo
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.196-202
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    • 2000
  • Objective : This study was designed to evaluate the relationship between the initial neurosurgical or psychosocial factors and the psychosocial outcome. Patients and Methods : We analyzed 123 head-injured patients who were referred to the department of psychiatry for the evaluation of psychosocial function. We analyzed initial neurosurgical variables such as Glasgow Coma scale(GCS) score, skull fracture, CT finding, and psychosocial outcomes with regards to psychosis, personality change, depression, anxiety and IQ on Intelligence Scale. Results : Patients with mild head injury(GCS score 13-15, N=94, 76.4%) had better recovery rate on Glasgow Outcome Scale(GOS), less personality change than those with moderate or severe head injury. However, depression, anxiety and intelligence were not significantly different between two groups. The skull fracture(N=37, 30.1%) did not influence on the psychosocial outcome with reference to personality change, depression, anxiety and intelligence. The patients with abnormal CT findings(N=64, 52%) had lower recovery rate on GOS, more frequent tendency in psychosis, personality change and severe depression, less frequent in anxiety and mild depression, than patients with normal CT finding. However, levels of intelligence were not different between two groups. The patients with industrial accidents(IA) had lower educational level, milder head injury, more delay for the psychiatric evaluation (longer treatment period) than those with motor vehicular accidents(MVA). The psychosocial outcome with reference to personality change, depression, anxiety, intelligence were not different between two groups. Conclusion : These findings indicate that the more severe initial trauma, the poorer psychosocial outcome. However, it was frequently observed that patients with mild head injury suffered from mild anxiety and depression. Therefore mild head injury appeared to be more complicated by psychosocial stressors. The patients with IA, despite the fact that initial head injury was mild, required longer treatment period than MVA.

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Patients' Anxiety in Intensive Care Units and Its Related Factors (중환자실 환자의 불안 정도와 불안에 영향하는 요인 분석)

  • Koh, Chin-Kang
    • Journal of Korean Academy of Nursing
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    • v.37 no.4
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    • pp.586-593
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    • 2007
  • Purpose: The purpose of this study was to describe patients' anxiety in the ICU and to investigate related factors on the anxiety level. Methods: An exploratory cross-sectional survey design was used. Forty-eight patients participated in the study. Questionnaires were asked to patients who had been cared in the ICUs. Results: Related to the anxiety level, the mean of the total anxiety score was 5.47, and 60% of the patients had moderate or severe level of anxiety. Patients from the coronary care unit had a significantly higher level of anxiety than those from surgical intensive care unit or pulmonary surgery care unit. Moreover, significantly different levels of anxiety were found among patients who had been stayed for 2, 3, or 4 days. Conclusion: Patients who were from the coronary care unit or had been stayed longer (up to 4 days) in the ICU were significantly associated with higher anxiety level.

Effect of Depression and Anxiety on Symptoms in Thyroid Cancer Patients Undergoing Radioactive Iodine($I^{131}$) Therapy (고용량 방사성요오드($I^{131}$)치료를 받는 갑상선암 환자의 우울, 불안이 증상에 미치는 영향)

  • Chun, Nami
    • Asian Oncology Nursing
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    • v.12 no.4
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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.

A Study on Dental Anxiety Scale of 1,041 Dental Patients. (치과진료에 관한 환자의 불안도에 관한 연구)

  • 강재호;정성창
    • Journal of Oral Medicine and Pain
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    • v.5 no.1
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    • pp.11-16
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    • 1980
  • It is generally accepted that dental procedures can be the causes of dental anxiety, and dental anxiety is described as a significant influence on physical reactions, which may complacate the dental treatment, and there has been much emphasis in the control of it. So it is very useful for dentists to know the degree of anxiety of their patients for the treatment planning and prevention of unexpected emergent state which may be caused by severe anxiety. For the study of the degree of the dental anxiety, 1,041 patients of the Dept. of Oral Diagnosis of S.N.U. hospital and some private clinics were evaluated for dental anxiety by means of dental anxiety scale questionaire. The results were as follows : 1. The mean value of 517 male patients and 524 female patients were are $9.31\pm2.76 and 12.01\pm2.78$ in respective. 2. There was no significant alteration by age and educational backgrounds. 3. Four male patients and nineteen female patients achieved scores ranging from 17 to 20 which have been known to dental phobics.

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