• 제목/요약/키워드: Stress in Clinical Practice

검색결과 306건 처리시간 0.025초

Coenzyme Q10: a progress towards the treatment of neurodegenerative disease

  • Kumar, Peeyush;Kumar, Pramod;Ram, Alpana;Kuma, Mithilesh;Kumar, Rajeev
    • Advances in Traditional Medicine
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    • 제10권4호
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    • pp.239-253
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    • 2010
  • Coenzyme $Q_{10}$ ($CoQ_{10}$, or ubiquinone) is an electron carrier of the mitochondrial respiratory chain (electron transport chain) with antioxidant properties. In view of the involvement of $CoQ_{10}$ in oxidative phosphorylation and cellular antioxidant protection a deficiency in this quinone would be expected to contribute to disease pathophysiology by causing a failure in energy metabolism and antioxidant status. Indeed, a deficit in $CoQ_{10}$ status has been determined in a number of neuromuscular and neurodegenerative disorders. Primary disorders of $CoQ_{10}$ biosynthesis are potentially treatable conditions and therefore a high degree of clinical awareness about this condition is essential. A secondary loss of $CoQ_{10}$ status following HMG-CoA reductase inhibitor (statins) treatment has been implicated in the pathophysiology of the myotoxicity associated with this pharmacotherapy. $CoQ_{10}$ and its analogue, idebenone, have been widely used in the treatment of neurodegenerative and neuromuscular disorders. These compounds could potentially play a role in the treatment of mitochondrial disorders, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, Friedreich's ataxia, and other conditions which have been linked to mitochondrial dysfunction. This article reviews the physiological roles of $CoQ_{10}$, as well as the rationale and the role in clinical practice of $CoQ_{10}$ supplementation in different neurological diseases, from primary $CoQ_{10}$ deficiency to neurodegenerative disorders. These will help in future for treatment of patients suffering from neurodegenerative disease.

기공에 기초한 스트레스 관리 프로그램이 산모의 정서에 미치는 영향 (Effect of a Qigong-Based Stress Management Program on Emotion of Pregnant Women)

  • 이상혁;김무진행;이은희;서신영;육기환;최태규
    • 정신신체의학
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    • 제12권2호
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    • pp.135-144
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    • 2004
  • 연구목적 : 본 연구의 목적은 기공에 기초한 스트레스 관리 프로그램이 산모의 우울, 불안 등의 정서에 미치는 영향에 대하여 알아보고자 하였다. 방법: 임신 16주 이상의 산모들을 대상으로 하였다. 기공프로그램군은 8주동안, 일주일에 2번씩 기공프로그램에 참여한 52명으로 구성되었으며, 교육군은 8주동안 1주일에 1번씩 산모교육에 참여한 40명으로 구성되었다. 평가도구는 우울 수준을 측정하는 척도로서 해밀턴 우울 척도(Hamilton depression rating scale, HAMD), 벡 우울 척도(Beck depression inventory, BDI), 에딘버러 산후 우울증 척도(Edinburgh postnatal depression scale, EPDS)를 이용하였다. 불안 수준을 측정하는 척도로서 스필버거 특성 상태 불안척도-1 (Spielberger trait state anxiety inventory-1, STAI-1), 해밀턴 불안 척도(Hamilton anxiety scale, HAM-A)를 이용하였다. 기공과 교육 프로그램 시작전, 이후 2주, 4주, 8주에 걸쳐 산모의 우울, 불안 수준을 상기 척도로 측정하였다. 결과: 기공프로그램군은 프로그램 시작 전과 8주 후를 비교하였을 때 유의미하게 불안과 우울 수준이 모든 척도에서 호전되었다. 반면 교육군은 시작 전과 8주 후를 비교하였을 때 유의미한 호전은 없었다. 두 집단의 프로그램 전후 변화량을 비교한 결과 기공프로그램군이 교육군에 비하여 통계적으로 유의미한 변화를 보였다. 결론: 본 연구는 기공에 기초한 스트레스 관리 프로그램이 산모의 불안과 우울감을 조절하는데 효과적인 방법일 수 있음을 시사한다.

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국내 간호대학생의 전공만족도 관련변인에 대한 체계적 고찰과 메타분석 (A Meta-analysis of the Variables related to the Major Satisfaction of Nursing students.)

  • 김신향;백민자
    • 한국보건간호학회지
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    • 제33권3호
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    • pp.409-419
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    • 2019
  • Purpose: Factors related to the major satisfaction of nursing students were systematically searched and quantitatively synthesized. Methods: Meta-analysis was conducted upon 47 articles in Korean master and doctorate degree dissertations and academic journals. Meta-analysis of major satisfaction-related variables was conducted using Comprehensive Meta-Analysis (CMA) 2.0 program. The effect size of the related variables was analyzed by converting the statistic r value to Fisher's Z. Results: The overall average effect size of major satisfaction was the largest effect size (ES=.49), followed by cognitive factors (ES=.58), affective factors (ES=.45), and psychomotor factors (ES=.31). The cognitive factors were in the order nursing professionalism(ES=.70), nurse's image (ES=.65), and critical thinking disposition (ES=.36). The affective factors were self-esteem (ES=.59), emotional intelligence (ES=.55), career identity (ES=.49), self-efficacy (ES=.48), college adjustment (ES=.45), practice satisfaction (ES=.45), resilience (ES=.42), (ES=.40), grit (ES=.34), and stress (ES=.26). The psychomotor factors were clinical performance ability (ES=.38) and career search behavior (ES=.31). Conclusion: The results of this study are valuable when giving consideration to the variables related to nursing students' major satisfaction, for developing a strategic model to enhance the satisfaction of nursing students.

Safety and antifatigue effect of Korean Red Ginseng capsule: A randomized, double-blind and placebo-controlled clinical trial

  • Yang, Yi;Wang, Hong;Zhang, Ming;Shi, Mengxue;Yang, Cailing;Ni, Qiang;Wang, Qi;Li, Jing;Wang, Xuemei;Zhang, Chen;Li, Zhi
    • Journal of Ginseng Research
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    • 제46권4호
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    • pp.543-549
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    • 2022
  • Background: In physical activity or labor, the human body is in a state of high intensity stress, and all parts or physiological functions of the body respond positively to maintain or balance the need for movement. The human body has many physiological changes in the process of movement, and fatigue is the external manifestation of various complex changes inside the human body. Fatigue is also a physiological mechanism of self-protection after the body reaches a certain level of activity, which can prevent the occurrence of life-threatening excessive functional failure. The generation of fatigue is a very complex process, and its mechanism has not been concluded yet. Therefore, it is an important work to search and screen the effective components of natural plants that have anti-fatigue effect and to explore their mechanism. Methods: This was a 8-week, randomized, double-blind, placebo-controlled clinical trial. A total of 110 subjects who passed physical examination were included according to the scheme design, and randomly divided into a test group which was given KRG and a placebo control group. The calculation is carried out according to the standard of sub-high-intensity exercise test. Results: There was no adverse effect on safety index of subjects after taking red ginseng capsule. After KRG treatment, subjective strength grade is significant lower than placebo treatment. Blood lactic acid content is significantly get lower after trial in KRG group, and significant lower than placebo group. Creatine phosphokinase(CK) content is significantly get lower after trial in KRG group, and significant lower than placebo group. Conclusion: According to the criterion in the test scheme, the result shows that KRG is helpful on relieving physical fatigue.

병원 간호사의 자기효능감에 대한 개념분석 (Concept Analysis of Clinical Nurse's Self-Efficacy)

  • 김수진;윤소연;이보람;홍진하;황도연;유슬기;신나연
    • 디지털정책학회지
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    • 제2권3호
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    • pp.25-32
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    • 2023
  • 본 연구는 병원 간호사의 자기효능감에 대한 개념과 속성을 분석하는 것으로 간호학에서의 병원 간호사의 자기효능감 개념과 관련된 이론적 기초를 마련하는 것이다. Walker 와 Avant의 개념분석 방법을 적용하여 병원 간호사의 자기효능감에 대한 개념 분석을 하였다. 간호사로 하여금 스스로 임상 환경에서 오는 스트레스와 역경, 그로부터 수반되는 부정적 감정을 이겨낼 수 있다는 믿음과 기대를 갖게 하는 것, 간호사 자신에게 간호업무 수행 능력이 있다고 믿게 하여 명확한 방향성을 가질 수 있게 하는 것, 임상에서 일어나는 여러 상황을 통제할 적합한 판단력이 있다고 믿게 하여 업무를 속행 할 수 있게 하는 것, 간호 업무에 대한 적극적 참여를 통해 도전적인 목표 의식을 갖게 하고 미래를 위한 동기를 부여하는 것, 간호사 개인적 측면에서부터 환자나 병원 조직까지 다방면에 연쇄적으로 영향을 끼치는 것의 다섯 가지 속성으로 규명되었다. 본 연구를 통하여 자기 효능감 개념이 간호사 개인의 발전에서 끝나는 것이 아니라 직무 성과와 조직 몰입을 이끌어 내 병원이라는 조직에 영향을 미친다는 점, 임상에서 가장 중요한 환자 안전에 영향을 미치는 요인을 공고히 하기 위한 추가적인 연구가 필요할 것으로 생각된다.

통증의 기억과 선행진통 (Memory of Pain and Preemptive Analgesia)

  • 송선옥
    • Journal of Yeungnam Medical Science
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    • 제17권1호
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    • pp.12-20
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    • 2000
  • The memory of pain can be more damaging than its initial experience. Several factors arc related the directions of pain memory: current pain intensity, emotion, expectation of pain, and peak intensity of previous pain. The possible mechanisms behind the memory of pain are neuroplastic changes of nervous system via peripheral and central sensitization. Peripheral sensitization is induced by neurohumoral alterations at the site of injury and nearby. Biochemicals such as K+, prostaglandins, bradykinin, substance P, histamine and serotonin, increase transduction and produce continuous nociceptive input. Central sensitization takes place within the dorsal horn of spinal cord and amplifies the nociceptive input from the periphery. The mechanisms of central sensitization involve a variety of transmitters and postsynaptic mechanisms resulting from the activations of NMDA receptors by glutamate. and activation of NK-1 tachykinnin receptors by substance-P and neurokinnin. The clinical result of peripheral and central sensitization is hyperalgesia, allodynia, spontaneous pain, referred pain, or sympathetically maintained pain. These persistent sensory responses to noxious stimuli arc a form of memory. The hypothesis of preemptive analgesia is that analgesia administered before the painful stimulus will prevent or reduce subsequent pain and analgesic requirements in comparison to the identical analgesic intervention administered after the painful stimulus, by preventing or reducing the memory of pain in the nervous system. Conventionally, pain management was initiated following noxious stimuli such as surgery. More recently, however many have endorsed preemptive analgesia initiated before surgery. Treatments to control postsurgical pain are often best started before injury activates peripheral nociceptors and triggers central sensitization. Such preemption is not achieved solely by regional anesthesia and drug therapy but also requires behavioral interventions to decrease anxiety or stress. Although the benefit of preemptive analgesia may not be obvious in every circumstance, and in many cases may not sufficient to abolish central sensitization, it is an appropriate and human goal of clinical practice.

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신규졸업간호사의 전환충격 영향요인 (Factors influencing the transition shock of newly-graduated nurses)

  • 문길제;조무용
    • 한국간호교육학회지
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    • 제28권2호
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    • pp.156-166
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    • 2022
  • Purpose: The purpose of this study was to identify factors that can affect transition shock in newly-graduated nurses. Methods: The first descriptive written survey was conducted on 450 graduate students from five nursing colleges. After their employment, the second survey was conducted on 316 participants who had responded to the first survey. A total of 158 respondents were used for the final analysis. Data were analyzed using an independent t-test, ANOVA, Tukey test, Pearson's correlation coefficient, and hierarchical multiple regression analysis with the SPSS Win 25.0 Program. Results: The average age of the participants was 24.25±4.47. Of the participants, 126 (79.8%) were satisfied that they had majored in nursing. The average score for transition shock was 2.61±0.55 points. Factors influencing the transition shock of newly-graduated nurses were the working department, working period, and working environment. The more positively the newly-graduated nurses perceived the nursing work environment, the less of a transition shock they experienced. Grade point average, clinical competence, confidence in performing core nursing skills, and nursing professionalism did not affect their transition shock. It could be confirmed that there is a gap between college nursing education and the clinical field. Conclusion: In order to reduce the transition shock of newly-graduated nurses, it is necessary to improve the nursing work environment and apply educational and emotional support strategies according to the characteristics of each work department and the period of work.

암환자의 성정(性情)과 심욕(心慾) 조절 방법에 대한 문헌적 고찰 (A literature study on the controlling methods of Seong-Jeong (性情) and covetous desire (心慾) for patients with cancer)

  • 전현진;오현주;이수경
    • 사상체질의학회지
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    • 제30권4호
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    • pp.11-21
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    • 2018
  • Objective The management of psychological distress in patients with cancer is a major concern in clinical practice. In this paper, we discussed how to apply the controlling methods of Seong-Jeong (性情) and covetous desire (心慾) of Sasang constitutional medicine to patients with cancer. Methods We investigated the controlling methods of Seong-Jeong (性情) and covetous desire (心慾) through the literature of " Gyukchigo (格致藁)", "Donguisusebowon-Sasangchobongyun (東醫壽世保元 四象草本卷)", "Donguisusebowon (東醫壽世保元) and "Dongmuyougo (東武遺稿)", and presented the controlling methods of Seong-Jeong (性情) and covetous desire (心慾) for patients with cancer based on the clinical experience. Results We identified the equilibrium and harmony (中節) of sorrow-anger-joy-pleasure (喜怒哀樂) is the basis of treatment and suggested 'understanding of the others (知人)', 'understanding of the diseases (知病)' and 'knowing and acting (知行)' as methods to control of Seong-Jeong (性情) and covetous desire (心慾). The 'understanding of the others (知人)' and 'understanding of the diseases (知病)' could reduce the psychological distress. The 'knowing and acting (知行)' encourages the patients to overcome the covetous desire (心慾) and have a positive attitude to life and disease. Conclusion The controlling method of Seong-Jeong (性情) and covetous desire (心慾) of Sasang constitutional medicine could help cancer treatment controlling the psychological distress of patients with cancer, and could impact positively on the view of life and disease.

잠재프로파일분석(LPA)을 활용한 PTSD 증상과 외상 후 성장 수준의 양상: 폭식, 비자살적 자해, 문제성 음주행동에서의 차이 (Latent Profile Analysis of PTSD symptoms and PTG among Adults in South Korea: the Differences in Binge Eating, Non-Suicidal Self-Injury, and Problem Drinking Behaviors)

  • 이덕희;이동훈;정하영
    • 한국심리학회지 : 문화 및 사회문제
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    • 제25권4호
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    • pp.325-351
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    • 2019
  • 본 연구는 외상 사건을 경험한 국내 성인의 외상 후 스트레스(Post Traumatic Stress Disorder) 증상과 외상 후 성장(Post Traumatic Growth) 양상을 토대로 잠재계층(latent class)을 도출하고, 각 집단 구분에 영향을 미치는 특성을 탐색하며, 집단에 따른 자기파괴적 행동의 차이를 탐색함으로써, 외상 사건을 경험한 개인에 대해 보다 심층적으로 이해하고자 한다. 이를 위해 본 연구에서는 DSM-5 진단기준에 해당하는 외상 사건을 경험한 국내성인 860명을 대상으로 잠재프로파일분석(Latent Profile Analysis)과 R-3STEP 방식을 이용하였다. 집단 예측 변인으로 개인의 인구사회학적 변인(성별, 연령, 최종 학력, 종교유무, 종교활동 정도, 월 평균 소득)과 사회적 고립, 외상 경험 빈도가 포함되었으며, 종속변인으로 자기파괴적 행동(폭식 정도, 비자살적 자해 유무, 음주의 양, 음주 형태, 음주로 인한 정신 사회적 문제)을 포함하였다. 연구결과 집단은 '저PTSD/중 PTG집단', '저 PTSD/고 PTG집단', '고 PTSD/고 PTG집단'으로 분류되었다. 또한 성별, 최종학력, 사회적 고립, 외상 노출 빈도가 집단 예측 변인으로 영향을 미치는 것으로 나타났으며, 폭식 정도, 비자살적 자해 유무, 음주 형태, 음주로 인한 정신사회적인 문제에서 집단 간 차이가 있는 것으로 나타났다. 마지막으로 본 연구의 결과를 바탕으로 논의와 시사점을 제시하였다.

간호대학생의 건강증진행위 예측모형 (A Predictive Model of Health Promotion Behavior in Nursing Students)

  • 오재우;문영숙
    • 디지털융복합연구
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    • 제12권10호
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    • pp.391-403
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    • 2014
  • 본 연구는 간호 대학생을 대상으로 Pender(1987)의 건강증진모형과 선행연구의 문헌고찰을 기초로 간호대학생의 건강증진행위를 설명하고, 이들의 영향요인을 파악하여 건강증진행위를 촉진하는 효과적인 간호중재방법 개발에 기틀을 제공하고자 시도되었다. 연구대상은 임상실습을 한 경험이 있는 간호 대학생 204명을 대상으로 하였으며 자료수집기간은 2014년 4월 1부터 5월 30일까지 시행하였으며, 최종 204부를 자료의 분석대상으로 하였다. 수집된 자료는 SPSS, LISREL을 이용하여 빈도분석, 백분율, ANOVA, t-test, 상관관계 분석을 하였고, 가설검정은 경로분석을 하였다. 가설모형의 전반적 지수는 ${\chi}^2=.06$(p=.812), df=1, ${\chi}^2(df)=.000$, GFI=0.97, AGFI=1.0, SRMR=.002, NFI= 0.947, NNFI=0.957, RMSEA=0.016, CN=266으로 좋은 부합도를 보였다. 모형에서 제시된 가설 검증 결과를 보면 건강증진행위에 영향을 미치는 변수는 지각된 장애성, 지각된 자기 효능감, 지각된 사회적 지지로 나타났고, 임상실습 스트레스, 지각된 건강상태, 강인성, 지각된 유익성은 건강증진행위에 영향을 미치지 못하였다.