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우울, 불안장애 환자에서 폐경에 대한 태도 및 인식과 폐경기 증상 (Attitude and Belief About Menopause and Menopausal Symptoms in Depressive or Anxiety Disorder Patients)

  • 최인광;이문수;함병주;이화영;고영훈;조숙행
    • 정신신체의학
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    • 제18권2호
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    • pp.82-93
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    • 2010
  • 연구목적 본 연구의 목적은 정신과 중년여성 외래환자를 폐경기 상태에 따라 폐경전기, 폐경주위기, 폐경후기의 3집단으로 세분화하여 폐경기 증상을 비교하고, 폐경에 대한 태도 및 인식과 폐경기 증상 간의 연관성을 조사하며, 우울증상 및 특성불안의 심각도에 따른 폐경기 증상의 심각도를 평가하고자 하였다. 방 법 2009년 8월 17일부터 2009년 11월 28일까지 고려대학교 구로병원 신경정신과 외래를 방문하여 우울장애와 불안장애로 진단받은 40~64세의 여성 환자 152명을 대상으로 연구를 하였다. 폐경기 증상의 심각도를 평가하기 위해 폐경평가척도(Menopause Rating Scale, MRS)를 이용하였고, 폐경기에 대한 태도를 평가하기 위하여 11항목으로 구성된 자기보고식 설문지를 사용하였다. 또한 대상자의 우울, 불안증상을 평가하기 위해 Beck 우울 척도(Beck Depression Inventory, BDI), 상태특성 불안 척도(State-Trait Anxiety Inventory, STAI)가 사용되었다. 폐경기 상태에 따른 각 그룹에서의 폐경기 증상의 차이가 있는지 비교하였고, 폐경에 대한 태도 및 인식과 폐경기 증상 간의 연관성을 조사하였다. 우울증상, 특성불안의 심각도와 폐경기 증상의 관계를 살펴보았다. 결 과 폐경기 상태에 따른 폐경기 증상은 유의한 차이를 보이지 않았다. 그러나 '폐경기는 노화의 증후; 배우자들은 폐경기 여성을 매력이 없다고 느낌'의 항목에 동의할수록, '임신을 하지 않아 홀가분함'의 항목에 동의하지 않을수록 일부 폐경기 증상을 심하게 호소하여, 부정적인 폐경에 대한 태도와 폐경기 증상의 심각도 간에 유의한 연관성을 보여주었다. 그리고 우울증상과 특성불안의 수준이 높은 경우 폐경기 증상이 심한 것으로 나타났다. 결 론 본 연구에서 폐경에 대한 부정적 태도 및 우울증상, 불안은 폐경기 증상의 심각도 간에 상호연관성을 보여주었다. 따라서 임상에서 폐경기 증상에 대해 평가하고 교육을 통하여 환자들로 하여금 폐경에 관한 긍정적 태도를 갖고 폐경기 증상에 적절히 대처하도록 하는 것이 필요하다. 향후 임상에서 많은 중년여성 정신과 환자를 대상으로 하여, 정신과 치료를 지속하면서 우울증상, 불안의 호전 정도에 따라 폐경기 증상의 변화를 살펴보는 전향적인 연구가 필요할 것으로 사료된다.

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알츠하이머형 치매 및 경도인지장애 환자에서 인지기능 및 행동심리증상과 내측두엽 위축의 연관성 (Association between Cognitive function, Behavioral and Psychological Symptoms of Dementia and Temporal Lobe Atrophy in Patients with Alzheimer's Disease and Mild Cognitive Impairment)

  • 정재윤;이강준;김현
    • 정신신체의학
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    • 제27권2호
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    • pp.155-163
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    • 2019
  • 연구목적 본 연구의 목적은 알츠하이머형 치매 및 경도인지장애 환자에서 내측두엽 위축 정도의 차이에 따른 중증도, 신경인지기능 및 행동심리증상을 비교하는 것이다. 방 법 본 연구는 단면 연구로서, 알츠하이머형 치매 및 경도인지장애로 진단받은 114명을 대상으로 하였다. 내측두엽 위축은 표준화된 시각 기반 척도(Scheltens scales)에 의해 평가되었으며, 대상군은 두 그룹으로 분류되었다. 중증도는 임상치매평가척도(Clinical dementia rating, CDR)와 전반적 퇴화 척도(Global deterioration scale, GDS)로 평가되었으며 신경인지기능은 한국어판 간이 블레스드 검사(The Korean version of the short blessed test, SBT-K), 한국형 CERAD (The Korean version of the consortium to establish a registry for Alzheimer's disease, CERAD-K), 행동심리증상은 한국형 신경정신행동검사(The Korean version of the Neuropsychiatric Inventory, K-NPI)로 평가되었다. 내측두엽 위축의 정도에 따른 중증도와 신경인지기능 및 행동심리증상의 차이를 분석하기 위해 독립표본 t-test를 시행하였다. 결 과 내측두엽 위축의 중증도가 높은 군은 낮은 군에 비하여 CDR, SBT-K, 그리고 CERAD-K의 하부항목 중 네가지 항목에서 유의하게 낮은 점수를 보였다(p<0.05). 결 론 내측두엽 위축과 중증도 및 신경인지기능 사이에는 유의한 양의 상관관계가 나타났으나 행동심리증상과는 유의한 상관관계가 나타나지 않았다. 내측두엽 위축의 평가는 인지장애의 진단과 치료에 잠재적 이점을 제공할 것으로 생각된다. 행동심리증상과 뇌구조의 연관성에 대해서는 추가적인 연구가 필요할 것으로 보인다.

보건소 등록 재가암환자가 지각하는 통증관리와 통증관리 방해 정도 (Pain Management in Cancer Patients Who Are Registered in Public Health Centers)

  • 최소영;장경오;박명남;류은정
    • 종양간호연구
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    • 제12권1호
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    • pp.77-83
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    • 2012
  • Purpose: This study was designed to describe outcomes of pain management, to identify pain intensity, pain management and barriers to pain management, and to test correlation among the variables in cancer patients who are registered in public health centers. Methods: By using a descriptive survey design, 3 instruments were used to collect data: the Numeric Rating Scale for pain, the Barriers Questionnaire-Korean version, and a one-item self-report tool about patient satisfaction. A sample of 190 patients with cancer was recruited from a public health center. Results: The mean rating for pain during the past 24 hours was mild and the mean score of barriers to pain management was 3.20. Patients were satisfied with pain management but they also had concerns it. A negative correlation was found among pain severity, pain relief and satisfaction of pain management. However, there was not significant correlation between the patient-related barriers to pain management and other variables. Conclusion: These results suggest that the intervention for cancer patients should focus not only on patient-related barriers to pain management, but also address health-care system related barriers.

동결견에서 수동 조작 후 관절경 검사시 보인 관절내 소견 및 임상 결과 (Intraarticular Finding and Clinical Result of Arthroscopic Diagnosis after Manual Manipulation in the Frozen Shoulder)

  • 문영래;박준광;김찬상
    • Clinics in Shoulder and Elbow
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    • 제3권1호
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    • pp.33-38
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    • 2000
  • Objectives: The purpose of this study was to grading the severity of intra-articular lesions and evaluate the effects of arthroscopic surgery after manipulation of the resistant frozen shoulder. Materials and Methods : Forty-eight cases from 44 subjects, median age of 53, who underwent arthroscopic surgery after manipulation with minimum follow-up of 12 months were chosen. The UCLA shoulder rating scale was applied, and average scale was 18.2 points. Results: Twelve cases out of our series showed as rotator cuff tear which could produce secondary frozen shoulder. In postoperative follow up, 34 subjects complained of no pain or noctalgia, 5 showed mild degree of pain, 8 with mild degree of remained limited range of motion, and only 1 with no improvement. When viewed with UCLA shoulder rating scale, the most improved aspect was pain, and satisfaction of patient was following. And final average scale was 31.9 points. Conclusion: Our study revealed that arthroscopic surgery after manipulation showed favorably high final scale and patient's satisfaction. Therefore, we recommend this modality for treatment of resistant frozen shoulder in a point of view that the diagnosis and treatment can be done simultaneously.

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폐경기 여성 골다공증 환자에서 갱년기지수와 골밀도 간의 상관성 연구 (A Study on the Correlation between Menopausal Rating Scale and Bone Mineral Density for Menopausal Osteoporosis Patients)

  • 곽규인;강재희;김윤주;이현
    • Journal of Acupuncture Research
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    • 제31권3호
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    • pp.25-33
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    • 2014
  • Objectives : The purpose of this study is to evaluate the correlation between bone mineral density(BMD), age, weight, visual analog scale(VAS), menopausal rating scale(MRS), and to compare the difference between BMD, age, weight, VAS, MRS according to severity of the menopausal symptoms. Methods : The participants were 62 menopausal women diagnosed with osteoporosis who visited Cheonan Oriental Hospital, Daejeon University from December, 2011 to July, 2014. Age, weight, VAS, MRS were used as an evaluation tool. Results : 1. In all 62 cases of menopausal patients diagnosed with osteoporosis, the study found a statistically significant correlation between BMD and weight, while inverse correlation between BMD and MRS index. 2. Among menopausal patients with above 9 MRS index(group B), BMD and weight showed statistically significant correlation, while VAS and MRS index showed statistically significant inverse correlation. 3. Among group B, VAS were higher compared to control group(group A). Conclusions : This study showed that as patients with severer menopausal symptoms apt to show increased VAS and decreased BMD. Therefore, long-term follow-up in patients with menopausal syndrome is needed to improve the patients' quality of life.

여대생을 대상으로 한 월경통 클리닉에 대한 임상 보고 (A Clinical Study on the Effect of Dysmenorrhea Clinic for Female College Students)

  • 김현주;손영주;이용현
    • 대한한방부인과학회지
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    • 제25권2호
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    • pp.142-153
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    • 2012
  • Objectives: The purpose of this study is to identify the clinical effects of korean medicine treatment of dysmenorrhea patients. Methods: We studied twenty-six patients who visited Oriental Hospital of ${\bigcirc}{\bigcirc}$ University from September 2011 to December 2011. Women with organic disease such as endometriosis, uterine myoma and pelvic inflammatory disease were excluded from this study. We treated them with herb, acupuncture and moxibustion for one menstrual cycle. The severity of dysmenorrhea was measured by VAS(Visual analog scale) and MVRS(Multidimensional Verbal Rating scale). Results: The mean${\pm}$Standard Error of mean(S.E) of VAS on after treatment was decreased significantly compared with that of before(p=0.00). The mean${\pm}$S.E of MVRS on after treatment was decreased significantly compared with that of before(p=0.00). Conclusions: This study shows that korean medicine treatment such as herb, acupuncture and moxibustion has remarkable effects on dysmenorrhea patients. Further study will be needed.

틱 장애에서 습관뒤집기 훈련의 임상효과 (Habit Reversal Training in Tic Disorder)

  • 홍종우;도진아;김현우;임명호
    • 대한불안의학회지
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    • 제6권1호
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    • pp.24-30
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    • 2010
  • Objectives : Tic disorder is known to be a chronic neuro-behavioral disease, cognitive behavioral treatment (CBT) strategies, like habit reversal training (HRT), are introducing recently. We report the effectiveness of HRT in Tourette disorder, which are very common in clinical settings. Methods : The DSM-IV clinical diagnosis applied by child psychiatrist. YGTSS, Kovac's children's depression inventory, Spielberger State-Trait Anxiety Inventory, Abbreviated Conners' Rating Scales, Dupaul ADHD Rating Scales are used. Ultimately, totally 10 children were evaluated. Subject group are consist of 6 boys and 4 girls, and the mean age was $10.90{\pm}1.73$ years old. This study is treatment-refractory 10 patients (from 9-14 years old) though 1 years drug treatment and psychiatric consultation were taken. We administered 5 times of HRT for 4 weeks. Results and Conclusion : There were improvement of scores in Yale Global Tic Severity Scale, Clinical Global Improvement. Our observations indicate that HRT might be effective in the treatment of Tourette disorder.

정신질환자와 비정신질환자의 스트레스 및 그 적응방법에 대한 비교연구 (A Comparative Study on Stress and Coping Method of Psychiatric Patients and Non-Psychiatric Peoples)

  • 고성희
    • 대한간호학회지
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    • 제9권1호
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    • pp.23-29
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    • 1979
  • This study on stress and coping method of psychiatric patients and non-psychiatric peoples was applied to people who was divided into two groups from Sep. 25 to Oct. 3, 1978, One is hospitalized patients in psychiatric wards of four hospitals in Seoul. The other is inhibitants in two Dongs of Seoul, This study purposed to the identification of the difference of stressful events’numbers, the severity of stress, and difference of coping methods between psychiatric patients and non-psychiatric peoples. Two instruments are used in this study. The first one to measure stress, is Holmes & Rahe (1967)'s SRRQ (Social Readjustment Rating Questionnaire), which is amended, added or omitted through preliminary test, so that it consists of 48 items. The second one is for evaluating coping method on stress. It consists of 34 items amended through preliminary test after consideration of related literature review and survey on the basis of J.M.Bell (1977)'s“ 18-item-Questionnaire”. The materials were analyzed by S.P.S.S. Program. The results of analysis are as follows: 1. There was no significant difference in stressful event's numbers between psychiatric patients and non-psychiatric peoples (P > 0.5). 2. Psychiatric patients had higher severity of stress than non-psychiatric peoples (P < 0.5). 3. Psychiatric patients took more short-term coping methods than non-psychiatric peoples (p < 0.5).

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한국어판 야식증후군 측정도구의 신뢰도, 타당도 및 문항반응이론에 의한 문항분석 (Psychometric Properties and Item Evaluation of Korean Version of Night Eating Questionnaire (KNEQ))

  • 김범종;김인자;최희정
    • 대한간호학회지
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    • 제46권1호
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    • pp.109-117
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    • 2016
  • Purpose: The aim of this study was to develop a Korean version of Night Eating Questionnaire (KNEQ) and test its psychometric properties and evaluate items according to item response theory. Methods: The 14-item NEQ as a measure of severity of the night eating syndrome was translated into Korean, and then this KNEQ was evaluated. A total of 1171 participants aged 20 to 50 completed the KNEQ on the Internet. To test reliability and validity, Cronbach's alpha, correlation, simple regression, and factor analysis were used. Each item was analyzed according to Rasch-Andrich rating scale model and item difficulty, discrimination, infit/outfit, and point measure correlation were evaluated. Results: Construct validity was evident. Cronbach's alpha was .78. The items of evening hyperphagia and nocturnal ingestion showed high ability in discriminating people with night eating syndrome, while items of morning anorexia and mood/sleep provided relatively little information. The results of item analysis showed that item2 and item7 needed to be revised to improve the reliability of KNEQ. Conclusion: KNEQ is an appropriate instrument to measure severity of night eating syndrome with good validity and reliability. However, further studies are needed to find cut-off scores to screen persons with night eating syndrome.

한국어능력시험(TOPIK) 쓰기 평가의 채점 특성 연구 (A Study on the Features of Writing Rater in TOPIK Writing Assessment)

  • 안수현;김정숙
    • 한국어교육
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    • 제28권1호
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    • pp.173-196
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    • 2017
  • Writing is a subjective and performative activity. Writing ability has multi-facets and compoundness. To understand the examinees's writing ability accurately and provide effective writing scores, raters first ought to have the competency regarding assessment. Therefore, this study is significant as a fundamental research about rater's characteristics on the TOPIK writing assessment. 150 scripts of the 47th TOPIK examinees were selected randomly, and were further rated independently by 20 raters. The many-facet Rasch model was used to generate individualized feedback reports on each rater's relative severity and consistency with respect to particular categories of the rating scale. This study was analyzed using the FACETS ver 3.71.4 program. Overfit and misfit raters showed many difficulties for noticing the difference between assessment factors and interpreting the criteria. Writing raters appear to have much confusion when interpreting the assessment criteria, and especially, overfit and misfit teachers interpret the criteria arbitrarily. The main reason of overfit and misfit is the confusion about assessment factors and criteria in finding basis for scoring. Therefore, there needs to be more training and research is needed for raters based on this type of writing assessment characteristics. This study is recognized significantly in that it collectively examined writing assessment characteristics of writing raters, and visually confirmed the assessment error aspects of writing assessment.