• Journal of Hospice and Palliative Care
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• v.4 no.1
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• pp.47-56
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• 2001

Purpose : Surveying the effects on drop the anxiety of the hospice patients in spiritual nursing intervention with a quasi-experimental design using non-equivalent contrast group non-synchronized design to try in order to give the support which provide a holistic and individualizational nursing to comfort of hospice patients. Method : The results of survey were collected from 67 patients(67 subjects comprised 37 hospice patients of the experimental group and 30s of contrast) who were given hospice care from July to September of 2000 at the General Hospital in Cheon Ju city. The tool was used Spielberger's State Anxiety Scale, and the difference in the level of dropping anxiety among patient groups was analyzed with the mean, standard deviation, $x^2-test$. t-test and paired t-test. The spiritual nursing intervention was carried out through Hymn, Scripture, prayer, the therapeutic use of self over a period of three weeks. Results : 1) In general characters, men were a many more of the objects and the average age of the experimental and contrast group was 59.6, 55.9 respectively. The family of living together was $2{\sim}3$ members of most part. 2) There were not significant differences in the general, disease and therapeutic, religional characters between the experimental and contrast group. 3) The majority of the objects were cancer patients in disease and therapeutic characters(Experimental : 92%, Contrast : 95%). 4) After the spiritual nursing intervention state anxiety of the experimental group were remarkably lower than those of the contrast (t=-5.987, P=0.000). 5) Decreasing rate in the anxiety scores of before and post facto of the experimental group were remarkably lower than those of the contrast (t=6.237, P=0.000). Conclusion : The hospice patients who were offered spiritual nursing intervention became much lower than those who were not offered it in anxiety. Spiritual nursing intervention can be suited to field with one program of an effective that that relieved their anxieties. It is not only a very short time but has quite a little findings in part of spiritual nursing intervention. Therefore, further study in this field is necessary to concrete and substantial investigate in order to more and more increasing hospice patients in 21st century.

• Korean Journal of Psychosomatic Medicine
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• v.8 no.1
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• pp.88-97
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• 2000

Objectives : This study was aimed to investigate the emotional state and personality factors of patients with vitiligo, and the impacts of clinical characteristics. Methods : Twenty one patients with vitiligo and 20 normal controls were studied. Beck Depression Inventory(BDI), Spielberg's State and Trait Anxiety Inventory(STAI) and Cattell's 16 Personality Factors Questionnaire(16-PF) were used for assessment. Statistically, t-test, Oneway ANOVA, Mann-Whitney U test and Pearson's correlation test were used. Results : The Results were as follows. 1) The comparison of total score of BDI, state anxiety and trait anxiety between the patients with vitiligo and normal controls were not significantly different. 2) In first-stratum source traits of 16-PF, normal control group was significantly higher than the patients with vitiligo in H-factor(Boldness) and I-factor(Tender-mindedness). In second-stratum source traits of 16-PF, there was no significant difference between the patients with vitiligo and normal control in all factors. 3) According to sex, the comparison of total scores of BDI, STAI between male and female patients with vitiligo were not significantly different. In the comparison of 16-PF, female patients were higher than male patients in I-factor only. 4) As according to age(under and over 30 years of age), the comparison of total scores of BDI, STAI between patients over 30 years of age and under 30 years of age were not significantly different. In the comparison of 16-PF, patients over 30 years of age were higher than patients under 30 years of age in E-, G-, L-, M-, Q2-, Q3-, IND-, SUP-, and CRE-factor. 5) As according to the presence of progression of vitiligo and the presence of visible lesion, the comparison of total scores of BDI, STAI and 16-PF were not significantly different. 6) There were no significant correlation between the duration of the vitiligo and BDI, STAI-S, STAI-T, and 16-PF. Conclusions : There were no significant difference between patients with vitiligo and normal controls on the emotional state and personality characteristics. But patients with vitiligo were more bolder and tender-minded than normal controls on 16-PF. The author propose that methods of treatment to resolve problems of the interpersonal relations will be helpful.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.1
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• pp.25-35
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• 2003

Objectives: The aim of this study was to investigate 1) the prevalence of depressive symptoms, 2) the severity of depressive symptoms, 3) the correlation of depressive symptoms with clinical variables, and 4) factors that contribute to depressive symptoms in patients with Parkinson's disease. Methods: One hundred eighteen patients with Parkinson's disease referred from the Parkinson's Disease Clinic of Dong-A University Hospital, Busan, Korea, completed a self-administered questionnaire package, which included basic demographic data, the Beck Depression Inventory, the Parkinson's disease quality of life questionnaire, the Symptom Checklist-90-Revision(SCL-90-R), and the Spielberger's State-Trait Anxiety Inventory. In addition, a structured interview and a complete neurological examination, including the Hoehn and Yahr stage, the motor part of the Unified Parkinson's Disease Rating Scale(some selected scales of UPDRS part III), the Schwab and England Activities of Daily Living scale(ADL), and the Korean version of Mini-Mental State Examination were performed. Results: 1) Based on BDI score, subjects were divided into four groups:severely(40.7%), moderately(13.6%) and mildly(12.7%) depressive and non-depressive(33.1%). 2) The severity of depressive symptom in Parkinson's disease was positively correlated with Hoehn and Yahr(H & Y) stage(r=0.34, p<0.0001), the severity of motor symptom(r=0.35, p<0.0001), and trait anxiety inventory(r=0.33, p<0.001). On the other hand, the severity of depressive symptom was negatively correlated with educational level(r=-0.34, p<0.001), ADL(r=-0.37, p<0.0001) and Parkinson's disease quality of life (PDQL)(r=-0.69, p<0.0001). Among several clinical variables, the PDQL was the most influential factor predicting whether the depressive symptom was present or not. Conclusion: This study suggests that depressive symptom is very prevalent among patients with Parkinson's disease. Data from this study indicate that medical staffs who take care of patients with Parkinson's disease should pay attention to finding and treating depressive symptom among their patients. With appropriate psychiatric intervention, patient's depressive symptom can be minimized or alleviated and thus, the quality of life in these patients is likely enhanced.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.11 no.2
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• pp.221-230
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• 2000

Bullying is the intentional, unprovoked abuse of power by one or more children to inflict pain on or cause distress to another child on repeated occasions. Bullying can be considered to be a form of child abuse：peer abuse. Victims suffer adverse effects in the short and long term. If bullying is regarded as a form of abuse then professionals have a duty to detect it, take it seriously, and ensure that it is deal with to reduce the child's suffering and minimize the potential long term effects. This study is aimed preliminarily the development of cognitive behavioral group therapy for school bullied. 202 normal middle school freshman responded to self report scales- Offer's Self-Image Questionnaire-Revised, Children's Depression Inventory, Spielberger State/Trait Anxiety scale, and Defining Issues Test. The data were analyzed with Pearson's correlation to test the relationship among the above 4 variables. Self Image, depression, and anxiety were correlated strongly each other. But moral development was not correlated with self image, depression, and anxiety. Five school bullied students were referred by their teacher for school maladjustment. The author tried 12 sessions of Cognitive-Behavioral group therapy and assessed their behaviors pre- and post intervention by above 4 scales. There were no significant different intervention effects statistically. But It is meaningful that improvement of psychological mindedness in diary written by subject in treatment sessions

• Journal of Hospice and Palliative Care
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• v.8 no.2
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• pp.190-199
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• 2005

Purpose: Objectives of this study was to investigate the level of anxiety and depression according to the stages of autologous and allogeneic hematopoietic stem cell transplantation (HSCT). It would be provide the basis for effective psycho-emotional nursing intervention. Methods: We report on 52 patients, including 19 with autologous HSCT, and 33 with allogeneic HSCT from August 2002 to August 2003, at a university hospital. Spielberger's State-Trait Anxiety Inventory and Jung's Depression Inventory were used to measure levels of anxiety and depression, respectively, at admission time, the day before HSCT, and discharge time. Data was analyzed using SAS program that included Chi-square test, Fisher's exact test, repeated measures ANOVA and Stepwise multiple regression analysis. Results: In all stages of HSCT, the level of anxiety of patients who underwent allogeneic HSCT was significantly higher than that of autologous HSCT (P=0.047). The depression at the day before HSCT was significantly higher than that at admission. The major variable affecting anxiety in autologous HSCT was depression. Specially depression and gender were significant predictors to explain anxiety in allogeneic HSCT at admission time (61%). Experience of relapse and gender were significant predictors to explain anxiety in allogeneic HSCT at discharge time (36%). Conclusion: We recommend that the anxiety and depression be researched during the stages of allogeneic HSCT, specifically in the day before HSCT. It is necessary to develop an effective psycho-emotional nursing intervention according to the stages of HSCT.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.2
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• pp.165-173
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• 2004

Objectives: Diabetes mellitus is a heterogeneous, chronic, progressive disease characterized by hyperglycemia and abnormality in protein, carbohydrate, fat metabolism. Recent studies have reorted two times prevalence of depression in individuals with diabetes compared to individuals without diabetics. This study was designed to investigate glycemic controls, anxiety, alexithymia, stress responses between depressed diabetic patients and non-depressed diabetic patients. Methods The subjects were 60 diabetic patients(mean age : $50.3{\pm}9.7$ years, 31 men and 29 women) who were confirmed to have diabetes depending on the laboratory findings as welt as clinical symptoms at the St. Vincent Hospital Diabetes Clinic, from Mar. 2004 to Sep. 2004. Laboratory test including, blood chemistry. glycated hemoglobin, urinalysis for proteinuria and Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI), Toronto Alexithymia Scale(TAS) and Stress Response Inventory(SRI) were used for assessment. Based on BDI scores, all diabetics were divided into 13 depressed-diabetics group(above 20 point) and 47 non-depressed group(below 20 point). We compared demographic data. glycemic controls, STAI, TAS and SRI scores between two groups by independent t-test. Results : 1) Depressed diabetic groups were 13(mean age : $55.4{\pm}7.2$ years, 7 men and 6 women) and non depressed groups were 47(mean age $48.9{\pm}9.8$ years, 24 men and 23 women). In depressed diabetics, compared with non-depressed group, manifested aged(p=0.031), but other demographic data showed no difference between two groups. 2) No significant differences were noted in FBS, PP2h, Hb A1C, total cholesterol, HDL-cholesterol, SGOT/SGPT, BUN levels between depressed and non-depressed groups. But, blood creatine levels of depressed group were significantly increased than non-depressed group(p=0.026). 3) No significant differences were found in the score of STAI, STAI-S, STAI-T, TAS between depressed and non-depressed groups. 4) The SRI scores of depressed groups were significantly higher than non-depressed groups$(59.7{\pm}24.9\;vs.\;31.5{\pm}22.0)(p=0.000)$. Conclusion : The above results suggest that depressed diabetic patients are have more stress responses and higher blood creatine levels. However, there were no differences in laboratory data related to glycemic controls, and anxiety. alexithymia levels between two groups. We suggest that physicians should consider integrated approaches for psychiatric problems in the management of diabetes.

• Sleep Medicine and Psychophysiology
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• v.9 no.1
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• pp.61-67
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• 2002

Objectives: This study is aimed at measuring psychophysiological responses using a biofeedback system in healthy people to obtain basic normative data for biofeedback research and treatment. Methods: Ninety-six healthy volunteers (55 males and 41 females : average age $30.4{\pm}8.0$) without any history of major medical or psychiatric illnesses participated in this study. Psychophysiological responses were assessed using the ProComp+ and BioGraph program (ver. 2.1) with regard to forearm and frontal electromyography (EMG), electrodermal response (EDR), and skin temperature. They were measured in 3 phases (baseline, stress, and recovery phases), respectively. Beck depression inventory and Spielberger state and trait anxiety inventory were used to measure mood states. We compared psychophysiological responses according to age and gender differences, respectively and examined the relationship between mood states and psychophysiological measures. Results: People in their twenties showed higher EDR levels in the 3 phases than those of other age groups. Female subjects showed higher frontal EMG levels in the 3 phases compared with male subjects. There was no significant correlation between biofeedback measures and mood states in these subjects. Conclusion: We present normative data of psychophysiological responses measured by a biofeedback system in healthy people. These results suggest that gender and age should be considered as important variables in assessing psychophysiological responses using a biofeedback system.

• Sleep Medicine and Psychophysiology
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• v.4 no.2
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• pp.172-180
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• 1997

Objects : This study was carried out to investigate characteristics of patients who need hypnotics on the night before elective surgery as well as contributing variables for the necessity of hypnotics. Methods : After reviewing the clinical charts of patients who were scheduled to receive surgery by general anesthesia the following day, researchers had semi structural interviews with patients. In addition, Spielberger's State-Trait Anxiety Inventory(SSTAI), Beck Depression Inventory(BDI), Zung's Self-Rating Pain and Distress Scale(ZPDS), and Presleep and Postsleep Questionnaires were administered to patients. A total of 167 patients, who gave reliable information, were divided into two groups based on subjective judgement regarding the necessity for hypnotics on the night before surgery; 29 eligibles for hypnotics and 138 non-eligibles for hypnotics. Demographic and clinical characteristics of patients, some possible factors affecting sleep, psychological characteristics of patients and daytime status and nighttime sleep before surgery were compared between the two groups. In addition, discriminant function analysis was done to find the variables which would best discriminate among patients who differ in terms of necessity for hypnotics on the night before surgery. Results : There was no difference in demographic and clinical characteristics between the two groups; however, the satisfaction level with ward environment was significantly lower in the eligible group for hypnotics than the non-eligible group. Psychologically, the eligible group for hypnotics, compared to the non-eligible group, showed significantly more severe depression, pain, and distress; whereas anxiety level was not different between the two groups. For nighttime sleep before surgery, the eligible group for hypnotics, compared to the non-eligible group, expected poorer sleep before retiring and in fact, reported poorer sleep the following morning. In discriminant function analysis, 'expectation for sleep' and 'pain and distress' were the most potent contributors to discriminate the necessity of hypnotics. Conclusion : For the improvement of the patient's sleep on the night before elective surgery, giving hypnotics and/or analgesics should be determined by patient's opinion about the necessity of the drugs rather than by the therapist's own judgement or any other objective indices.

• Sleep Medicine and Psychophysiology
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• v.11 no.1
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• pp.29-36
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• 2004

Objectives: Sound and light (SL) stimulation has been used as a method to induce some useful mental states in the fields of psychology and psychiatry. It is believed that sound and light entrainment device (SLED) has some specific effects through synchronization of EEG in patients who use it. Theta frequency is believed to stimulate deep relaxation and short term memory processing. This study was conducted to evaluate if 4-10 Hz SL stimulation can induce relaxation and improve short term memory function. Methods: Ten medical students with no medical or psychiatric problems participated in this study. Subjects were randomly divided into two groups. One group was applied with real SLED was applied to one group (R group) and pseudo SLED to the other group (P group). The two groups were exposed to SL stimulation with SLED 15 minutes a day for 5 days, and after two days rest the two groups were switched over. The Korean Wechsler Adult Intelligence Scale (K-WAIS), Academic Motivation Tests (AMT), Test Anxiety Scale (TAS), Korean Auditory Verbal Learning Test (K-AVLT), and digit span were used to evaluate short term memory. Spielberger's State-Trait anxiety inventory and heart rate variability (HRV) test were used to evaluate degree of relaxation. Results: Compared with S group, R group showed a significant improvement in K-AVLT and digit span after a single application of SL stimulation. But 5-day long application did not reveal any differences between the two groups. A significant change in HRV was observed in 5-day long application of SL stimulation after being switched over to other SLED. Conclusion: This pilot study suggests that 4-10 Hz SL stimulation has some positive influences on short term memory and relaxation.