• 한국학교ㆍ지역보건교육학회지
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• 제20권2호
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• pp.25-36
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• 2019

Purpose: The purpose of this study was to examine the factors affecting of health screening among persons with disabilities. Method: The study examines the factors affecting of health screening using over 20 years of age who participated in the 2017 National survey of the disabled data. Subjects were 6,332 person with disabilities over 20 years of age. Data were analyzed using descriptive statistics, X2-test, multiple logistic regression with the SPSS win 21.0 program. Results: Health screening among persons with disabilities is differentiated with education level, marital status, Subjective House economic status, Health insurance, Economic activity, Type of disability, Grade of disability, Stress recognition, Depressive symptom, Suicidal thinking, Suicidal attempt, and grade of disability. The significant predictors of the health screening were age, Subjective House economic status, Economic activity, and Grade of disability. Conclusion: We should consider age, disability level, and economic level when developing a screening program for people with disabilities. Especially, the development and promotion of the health screening program for persons with disabilities and related education are required.

• 한국간호교육학회지
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• 제29권1호
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• pp.31-60
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• 2023

Purpose: This study explored the influencing factors on suicide-related behaviors (ideation, plans, and attempts) focusing on mental health problems (anxiety, depression, and loneliness) among Korean adolescents. Methods: A secondary analysis was conducted with data from the 16th Korean Youth Health Behavior Survey collected from in 2020 by the Korea Centers for Disease Control and Prevention. Chi-square tests and multivariate logistic regression analyses were performed. Results: After the adjustment of demographic characteristics and health risk behaviors, the influences of mental health problems on suicidal ideation, plans, and attempts showed the anxiety odds ratio (OR) for severe anxiety vs. minimal (OR 4.65, 4.67, and 3.75), depression (OR 4.27, 3.69, and 4.49), loneliness (OR 2.18, 1.96, and 1.96). Health risk behaviors (violence experience, drug use, stress, smoking, and drinking alcohol) and demographic variables (gender, school record, and socioeconomic status) were also significantly associated with suicide-related behaviors. Conclusion: Anxiety, depression, and loneliness were strong predictors of suicide-related behaviors. Early detection of suicide risks through screening for comprehensive mental health problems was recommended. Suicide prevention that considers the risk factors, including mental health problems and other risk factors, needs to be developed and implemented to reduce suicide risks among adolescents.

• 대한응급의학회지
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• 제29권6호
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• pp.687-698
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• 2018

Objective: This study examined the characteristics of suicidal attempters, including pre-hospital patients and those who visited the emergency department. Methods: Suicidal attempters who had been reported to the 119 call center were selected between July 2015 and June 2016. Sex, age, place, methods of suicidal attempt, season, time, and suicide success rate were reviewed in the fire center records. Results: A total 961 suicide attempters were enrolled. Among them, 53.6% were males who had an approximately 2.6 times higher mortality than that of females (9.2%). The most preferred place to commit suicide was the home in both sexes (68.0% in male, 82.8% in female) and the most preferred methods was drug intoxication, particularly pesticide. The method with the highest mortality was hanging and the lowest was self-harm. The season of the highest mortality was spring. The success of suicide and the time variation were similar. Most of the un-transferred patients also selected fatal suicide attempts compared to transfer patients. Conclusion: Unlike previous studies, this study includes information on un-transferred patients. Overall, the probability of death was highest as more than 50 years men chose hanging as a method, which had an influence on the un-transferred patients group.

• 디지털융복합연구
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• 제16권11호
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• pp.341-352
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• 2018

본 연구는 에코붐 세대의 우울에 영향을 미치는 요인을 파악하기 위하여 시도되었다. 본 연구는 제7기 1차년도 국민건강영양조사 자료를 활용하였으며 만 24세 이상 37세 이하의 성인을 대상으로 우울 관련요인을 파악하였다. 자료 분석은 IBM SPSS 25.0 프로그램을 이용하였다. 연구 결과 에코붐 세대의 우울은 성별, 교육수준, 주택소유여부, 건강보혐종류, 경제활동상태, 종사상지위, 임금근로자의 종사상지위, 근로시간제, 정규직여부, 지각된 건강상태, 흡연, 일 관련 신체활동 여부, 자살계획여부, 자살시도여부, 스트레스, 식사 빈도, 식사 시 동반여부에 따라 유의한 차이가 있었다. 회귀분석 결과, 에코붐 세대의 우울에 영향을 미치는 요인은 성별, 정규직여부, 지각된 건강상태, 흡연, 자살계획여부, 스트레스, 일 관련 신체활동여부, 저녁식사 시 동반여부로 나타났으며 설명력은 37.8%이다. 본 연구의 결과에 따라 에코붐 세대의 우울 중재 시 성별과 일 관련 특성에 따른 접근이 필요하며 우울 예방을 위해 에코붐 세대의 생활양식을 반영한 관리 방안 모색이 필요하겠다.

• 대한간호학회지
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• 제53권5호
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• pp.538-555
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• 2023

Purpose: This qualitative study used interpretative phenomenological analysis and photovoice methods to explore the meaning of non-suicidal self-injury experienced by adolescents. Methods: Participants were adolescents enrolled in middle and high schools in Gyeonggi-do and Jeollabuk-do who were selected through snowball sampling. Six participants had repeatedly engaged in self-injurious behavior for over a year. Data were collected through in-depth interviews and the photovoice method between November 2020 and July 2021. The collected data were analyzed using six steps of interpretative phenomenological analysis. Results: The results yielded 5 main themes and 18 subthemes. The main themes were 'a silent cry to an indifferent world', 'a heartache that one endures with scars', 'an inescapable cycle', 'filling the space in one's heart', and 'healing the wounds'. The study findings revealed that the self-injurious behavior of adolescents began as a consequence of feeling lost and struggling with conflicts at home and school, which helped them relieve tension and pain. Nonetheless, inflicting self-injury only left signs of regret and remorse, which became a trace that the participants wanted to hide. However, the wounds healed after receiving attention and support from others. They were determined to stop engaging in repeated self-injurious behaviors and made efforts to do so. Conclusion: This study can be used as a basis for the development of educational programs to prevent non-suicidal self-injury in adolescents. Additionally, it can inform nursing interventions that focus on building support systems to help adolescents who attempt self-injury.

• 대한임상독성학회지
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• 제14권1호
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• pp.37-46
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• 2016

Purpose: This study was designed to determine the factors hindering psychiatric intervention for suicide attempters in the emergency room (ER). Methods: Participants were 299 patients aged 18 years or older admitted to the ER for suicidal drug overdose between July 2012 and June 2014. Patients were divided into two groups according to whether they had received psychiatric treatment in the ER. Medical histories and follow-up treatments were determined by examining patients' medical records and through phone surveys, and were then compared using ${\chi}^2$-test and Fisher's exact test. In addition, the rate of satisfaction of the treatment group and the reasons for their dissatisfaction were also determined. Results: The treatment and non-treatment groups comprised 135 (45%) and 164 patients (55%), respectively. Factors influencing participation in psychiatric intervention were previous history of suicide attempts (p=0.004), history of psychiatric disorder (p<0.001), time of day (p=0.039), and day of the week (p=0.040) of arrival in the ER. Whether or not the patient received follow-up psychiatric treatment was not significantly relevant (p=0.300). Of the 82 patients who participated in the treatment satisfaction survey, 50.2% reported being unsatisfied, mainly because of unfriendly medical personnel (36.6%), discomfort regarding other people's perceptions (24.4%), and cursory care (14.6%). Conclusion: To raise the participation rate of psychiatric consult, cooperation with psychiatry at night and on weekends is required, and incorporation of patients without previous history of suicidal attempt or other psychiatric disorder is important. Resolution of complaints toward psychiatric consult in suicide attempt survivors is also required.

• 정신신체의학
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• 제23권2호
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• pp.100-106
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• 2015

연구목적 한국에서 자살률의 높은 상승은 주로 남성과 노인에 집중되어 있다. 특히 65세 이상 노인 인구에서의 자살률은 OECD 가입 국가들 중 가장 높았다. 이 연구는 응급실에 내원한 노인 자살시도자들의 인구사회학적 특징과 임상적 특징을 알아보기 위하여 실시되었다. 방 법 2013년 6월과 2015년 7월까지 인제의대 일산백병원의 응급실을 방문한 총 336명의 20세 이상 성인과 노인 자살시도자들을 대상으로 실시되었다. 자살시도자들의 의무기록을 후향적으로 분석하여 노인과 성인의 사회인구학적, 임상적 특징을 비교 분석하였다. 결 과 연구기간 동안 71명의 노인, 265명의 성인 자살시도자들이 응급실을 내원하였다. 노인 자살시도자들의 자살방법은 약물중독, 몸맴, 자상, 투신 순이었으며 성인보다 상대적으로 높은 치명도를 나타내었다. 또한 과거 정신과 장애는 노인 자살시도자들보다 성인 자살시도자들에서 더 흔하였다. 결 론 본 연구 결과는 응급실을 내원한 노인 자살시도자들의 임상적 특징을 제시하고 있으며, 이를 통해 노인 자살시도자들이 높은 치명도를 보이는 자살시도방법을 사용하는 것을 알 수 있었다. 향후 효과적인 노인 자살방지 프로그램 개발을 위한 더 많은 연구가 필요할 것이다.

• 대한임상독성학회지
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• 제19권1호
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• pp.8-16
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• 2021

Purpose: This study was conducted to analyze the social factors influencing the 'authenticity of suicidal ideation' based post-suicidal care programs in emergency departments (EDs). Methods: This retrospective study was an analysis using the data of patients who had attempted suicide and visited the ED in tertiary urban hospitals from January 1, 2016, to December 31, 2018. The variables examined included gender, age, history of previous psychiatric disease, suicide method, and the number of previous attempts. Univariate and multivariate logistic regression analyses were conducted to identify factors influencing the registration rate for the community-based post-suicide care program. Results: Overall,1,460 suicides were analyzed, 177 (1.16%) showed a high authenticity of suicide. The social factors influencing the authenticity of suicide intent were the unmarried status of men and women, joblessness, history of mental illnesses, more than two previous suicide attempts, the influence of alcohol, and an attempt to commit suicide after midnight more specifically between 24:00 to 6:00 hours in the morning (p<.05). The factors influencing the severity of the condition of high authenticity suicide patients were low Glasgow coma scores (12 points or less), lactate levels, and oxygen saturation observed in the patients who were admitted to the intensive care unit for treatment and died (p<.05). Conclusion: The need for evidence-based preventive measures and early assessment tools at the emergency medicine level is emphasized to reduce the rate of suicide attempts. If the results of this study are used in the management of suicide prevention, the evaluation of the authenticity of suicide intent will be more likely to be made at the emergency medicine level, allowing the severity to be assessed earlier.

• 대한불안의학회지
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• 제4권2호
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• pp.111-120
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• 2008

Objective : This study investigated the temperament and character traits associated with suicide attempts in patients with mood disorders. Methods : The temperament and character inventory (TCI) was administered to 150 patients who visited psychiatric clinics seeking treatment for mood symptoms. The patients were divided into three groups as follows : non-suicide ideation, suicide ideation and suicide attempt. We also gathered socio-economic data in order to rule out confounding variables. MANOVA was performed to analyze differences in personal temperament and character scores on the TCI between the three groups. Results : The self-directedness and cooperativeness subscales of the TCI are most influenced by the clinical symptoms rated by Beck Suicide Ideation Scale and Hamilton Depression Rating Scale. In the temperament scale, the suicide attempt group scored higher on the novelty seeking and harm avoidance items than the other two groups. The specific temperaments associated with suicidal behavior in patients with depression are impulsivity (NS2) and anticipatory anxiety or pessimism (HA1). Conclusion : In this study, we found that more risky patients who had previously attempted suicide had a temperament of impulsivity or pessimism. This finding suggests that a more cautious approach is needed to assess mood disorder patients with impulsive or pessimistic temperaments in order to prevent suicide attempts.

• 정신신체의학
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• 제28권1호
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• pp.8-19
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• 2020

연구목적 본 연구에서는 정신과 외래 환자 중 자살 고위험 집단인 자살 사고, 자살 시도, 비자살적 자해 및 일반 정신과 환자 집단의 감별 시 MMPI-2-RF가 변별 도구로써 활용될 수 있는지 알아보고자 하였다. 방 법 모든 대상자는 한양대학교 구리병원에 정신과적 진료를 내원한 환자로, 정신건강의학과 전문의로부터 DSM-5에 근거한 진단을 받았고, 이들의 의무기록을 후향적으로 검토하여 네 집단(자살 사고, 자살 시도, 비자살적 자해, 통제집단으로 일반 정신과 환자)으로 분류하였다. 총 112예가 분석에 포함되었다. 수집된 자료를 분석하기 위해 기술 통계 분석, 성별을 공변인으로 한 다변량 공분산분석(MANCOVA)를 통해 집단 간 차이를 알아보고자 하였다. 결 과 연구 결과, 비임상군인 대학생을 대상으로 한 기존 선행 연구와 마찬가지로, 임상군인 정신과 외래 내원 환자들 중에서도 자살 고위험군이 저위험군에 비해 높은 정서적/내재화 문제(EID), 무력감/무망감(HLP), 자살/죽음 사고(SUI), 의기소침(RCd), 인지적 증상 호소(COG), 냉소적 태도(RC3), 역기능적 부정 정서(RC7)와 부정적 정서성/신경증(NEGE-r) 점수를 보였다. 하지만 자살에 대한 위험성이 높은 환자들을 자살 사고, 자살 시도, 비자살적 자해를 시도하는 개인들 총 세 집단으로 나누어 분석하였을 때, 세 집단 모두를 변별할 수 있는 변인은 관찰되지 않았다. 다만, 자살 시도 집단 및 비자살적 자해 집단이 일반 정신과 환자 집단에 비해 높은 행동화/외현화(BXD), 반사회적 행동(RC4), 공격성(AGG) 등을 보였으나, 자살 사고 집단과 일반 정신과 환자 집단 사이에는 유의한 차이가 없었다. 결 론 본 연구는 MMPI-2-RF가 임상군인 정신과 외래 내원 환자들 중 자살 위험이 높은 환자들을 자살사고, 자살 시도, 비자살적 자해 세 집단으로 구분했을 때, 이 세 집단을 변별할 수 있는 유용한 진단적 도구로써 기능할 수 있는지 확인해보고자 하였으나, 세 집단 모두를 변별해주는 요인은 관찰되지 않았다. 이에, 세 집단 간변별에는 MMPI-2-RF가 진단적으로 유용하지 않을 것으로 시사된다. 다만, 자살 사고 집단에서는 차이가 나타나지 않았으나 자살 시도 및 비자살적 자해 집단에서는 통제군인 일반 정신과 환자들에 비해 높은 공격성과 행동화가 나타나, 자살 사고가 실제 자살 시도로 이행되는 과정에서 이러한 지표들이 위험성을 판단할 수 있는 조기변별 지표로서 기능할 수 있을 것으로 보인다.