• 심성연구
• /
• 제35권2호
• /
• pp.85-112
• /
• 2020

분석심리학은 정신건강의학과 진료실에서 만나는 환자들을 이해하는데 어떻게 도움이 되는가? 수련 중인 젊은 정신과 의사들을 교육하면서 분석심리학의 지식이 어떤 때 필요한가를 고민해 봤다. 저자가 환자를 진료하면서 흔히 접하게 되는 몇 가지 주제들을 분석심리학의 관점에서 고찰해 보았다. 우리를 찾아오는 환자들은 증상(문제점)을 가지고 온다. 고통을 느끼며 동반 된 증상은 없애야 할 병리 현상이기 전에 환자의 내면의 문제에 접근할 수 있는 중요한 통로이다. 비슷한 증상의 호소나 문제라도 그 환자가 인생의 전반기의 환자인지 후반기의 사람인지에 따라서 치료자의 접근하는 태도를 달리할 수 있다. 치료자는 환자가 말하는 내용과 거기에 더해서 말하지 못하거나 알지 못하는 부분까지를 알려고 노력해야 한다. 의식에 더해 무의식까지를 본다는 것이 전체를 보려는 분석심리학의 관점이다. 환자를 보면서 초기에 치료 방법의 적응증과 금기를 판단할 때도 진단이 중요하지만, 치료자의 경험을 포함한 능력도 치료 방법의 선택에 영향을 미친다. 환자가 호소하는 문제를 논리적으로 옳고 그름이 아닌 현상 그 자체를 사실로 인정하는 현상학적 입장을 견지하는 것도 중요하다. 그 증상이 무슨 까닭에 발생했는지 원인론적인 관점을 묻는 동시에 왜 하필이면 지금 그리고 무슨 목적으로라는 의문에 환자와 함께 치료자는 답을 찾으려 해야 한다. 치료자는 환자의 고통을 해소해주기 위해 노력하는 동시에 그 고통의 의미를 함께 찾아보고, 환자에게서 치료의 가능성을 찾으려 노력해야 한다. 환자가 말하는 것을 듣는 법부터 페르소나와 그림자를 이해하고 꿈이나 민담과 신화에 관한 관심까지 진료현장에서 분석심리학적 지식은 다각적으로 적용된다. 결론적으로 분석심리학은 실용적이며 유용한 치료적 도구로서 실제 정신건강의학과 진료실에서 폭넓게 사용 가능한 학문 분야이다. 환자를 이해하는데 또 치료자 스스로가 치료의 도구가 되려는 이의 교육과 성장에도 중요한 기회를 제공할 수 있다.

• 지역사회간호학회지
• /
• 제18권1호
• /
• pp.165-176
• /
• 2007

Purpose: The purpose of this study was to investigate the needs of home care nursing services in relation to the patients in hospital. Method: Subjects were 129 patients who admitted hospital and were selected through convenience sampling. Data were collected using the Home Health Care Need Assessment Questionnaire constructed by the Korea Health Industry Development Institute. Data were analyzed using SAS 8.12 program by applying percentage. Results: 1. According to the diagnosis of the subjects, the majority had cancer (25.0%), followed by musculoskeletal disease (15,6%), neuro/cerebral vascular disease (14.1%), digestive (10.9%) and respiratory disease (10.9%). 2. With regard to fundamental nursing service, subjects wanted to receive home care services for the following reasons: Problem identification and diagnosis (77.5%), vital sign check (49.6%); and intake and output measure (20.9%). 3. With regard to clinical laboratory tests, 62.8% wanted to receive blood tests, and followed by urine tests 26.4%, and wound drainage 26.4%. 4. With regard to medication and treatment service, 40.3% of the subjects wanted to receive intravenous fluid therapy, 26.4% intravenous antibiotics, and 26.4% the monitoring of fluid therapy. 5. With regard to therapeutic nursing service, 33.3% wanted to receive wound care, 26.4% ROM exercise, and 27.9% foley catheter change and care. 6. With regard to educational needs, 42.6% wanted education on infection monitoring, 41.4% on medication, and 34.9% on diet. 7. With regard to counseling needs, 65.9% wanted to receive telephone counseling about patient condition, 52.7% counseling about re-admission and 51.9% direct counseling about patient condition. In the group of injury and toxicity, and cardiovascular/circulatory diseases, 100% wanted telephone and direct counseling about the patient condition. Conclusion: Therefore, in order to improve the quality of hospital based home health care services, various factors that affect to the need of home health care should be analyzed and specified nursing care should be looked into.

• Nutrition Research and Practice
• /
• 제4권2호
• /
• pp.163-172
• /
• 2010

The purposes of this study were to assess hospital foodservice quality and to identify causes of quality problems and improvement strategies. Based on the review of literature, hospital foodservice quality was defined and the Hospital Foodservice Quality model was presented. The study was conducted in two steps. In Step 1, nutritional standards specified on diet manuals and nutrients of planned menus, served meals, and consumed meals for regular, diabetic, and low-sodium diets were assessed in three general hospitals. Quality problems were found in all three hospitals since patients consumed less than their nutritional requirements. Considering the effects of four gaps in the Hospital Foodservice Quality model, Gaps 3 and 4 were selected as critical control points (CCPs) for hospital foodservice quality management. In Step 2, the causes of the gaps and improvement strategies at CCPs were labeled as "quality hazards" and "corrective actions", respectively and were identified using a case study. At Gap 3, inaccurate forecasting and a lack of control during production were identified as quality hazards and corrective actions proposed were establishing an accurate forecasting system, improving standardized recipes, emphasizing the use of standardized recipes, and conducting employee training. At Gap 4, quality hazards were menus of low preferences, inconsistency of menu quality, a lack of menu variety, improper food temperatures, and patients' lack of understanding of their nutritional requirements. To reduce Gap 4, the dietary departments should conduct patient surveys on menu preferences on a regular basis, develop new menus, especially for therapeutic diets, maintain food temperatures during distribution, provide more choices, conduct meal rounds, and provide nutrition education and counseling. The Hospital Foodservice Quality Model was a useful tool for identifying causes of the foodservice quality problems and improvement strategies from a holistic point of view.

• The Journal of Korean Physical Therapy
• /
• 제23권5호
• /
• pp.29-34
• /
• 2011

Purpose: The purpose of this study is to evaluate the short term effects of the traction and decompression device, which is a newly developed domestic medical device, on pain and functional activity in patients with chronic low back pain with or without radicular pain. Methods: Forty patients with chronic low back pain were included and allocated to decompression (n=20) and traction groups (n=20). They received decompression or traction therapy for 20 minutes a day, 3 days per week for two weeks. For evaluating pain and functional activity, a visual analogue scale (VAS) for low back pain and the Oswestry back pain disability index (ODI) were obtained on pre-treatment, and at 6, 12 and 15 days after treatment. Patients'satisfaction levels were measured 15 days after treatment. Results: VAS was significantly decreased at 12 days and 15 days post-treatment compared to pre-treatment in both groups (p<0.05). ODI was significantly decreased at 12 days and 15 days post-treatment compared to pre-treatment in the decompression group (p<0.05). However, there was no significant difference between the two groups in the VAS and ODI scales (p>0.05). Patients' satisfaction levels were significantly higher in the decompression group than in the traction group (p<0.05). Conclusion: These findings suggest that decompression therapy might be effective for increasing functional activity in patients with low back pain and could provide patients with higher satisfaction than traction therapy. This study provided validity data for the therapeutic effects of the decompression device in patients with low back pain and it will be useful for medical cost development and patient education of this device.

• 재활치료과학
• /
• 제4권2호
• /
• pp.84-91
• /
• 2015

본 연구는 해외 많은 분야의 재활에서 적용되고 있는 peer mentor 프로그램을 국내에 연구적, 임상적으로 도입하여 뇌졸중 환자의 정신적, 신체적 회복을 돕는 방법을 소개하고자 하였다. 두 집단 실험 설계로 뇌졸중이 발생한지 3-6개월인 환자들을 대상으로 설계하였다. 동료멘토는 뇌졸중이 발생한지 2년이 지난 외래 환자로 서로 다른 회복수준을 보이는 환자들로 구성하고, 프로그램을 운영하기에 앞서 참가자들에게 심리적, 평가적, 정보적인 도움을 주는 방법과 프로그램 운영 방법에 대해 교육한다. 한국판 노인 우울 척도 단축형 (Geriatric Depression Scale Short Form-Korea Version; GDSSF-K)을 사용하여 프로그램 참가자들의 심리적 요인을 측정하고, 뇌졸중 영향척도(Stroke Impact Scale; SIS)를 통해 회복수준을, 노인 상지 기능평가도구(Upper Extremity Function Test for the Elderly; TEMPA)을 사용하여 신체적 요인을 측정한다. 본 연구를 토대로 연구를 진행하고자 하는 연구자는 본 연구에서 제안한 방법과 더불어 뇌졸중 환자의 회복에 더 효과적인 프로그램 적용 방법에 대한 모색이 필요할 것이다.

• 재활치료과학
• /
• 제9권4호
• /
• pp.21-31
• /
• 2020

목적: 회상하기는 알츠하이머 치매 환자에게 심리적 측면에서 안정을 찾는 방안이면서 동시에 자신의 과거를 기억하면서 자신에 대해서 정확하게 표현하면서 의사소통에 대해 접근하는 방법이다. 따라서, 이 연구는 알츠하이머 치매노인에게 회상하기 프로그램에 적응하여 의사소통 능력의 효과를 알아보고자 한다. 연구방법: 본 연구는 70세 노인 중 알츠하이머 치매(Alzheimer's dementia; AD) 노인 4명을 대상으로 사전-치료-사후 평가 단계를 구성하여 실시하였다. 결과: 첫째, 의사소통 요소 중 회화항목 영역에서 중재 후에 향상되었다. 둘째, 의사소통 요소 중 인지력 인식 영역에서 중재 후에 향상되었다. 셋째, 의사소통 요소 중 커뮤니케이션 영역에서 중재 후에 향상되었다. 결론: 이 연구에서는 회상하기 프로그램이 알츠하이머 치매 노인이 의사소통능력의 향상에 긍정적 영향을 미쳤다. 회상하기 프로그램을 바탕으로 추후 치매 노인의 의사소통 능력을 향상시키는데 많은 도움이 될 것으로 사료된다.

• 가정간호학회지
• /
• 제15권2호
• /
• pp.67-74
• /
• 2008

Purpose: We analyzed the need for home care services and awareness of U-healthcare in nurses of the Catholic Parish Home Care Center to link the ubiquitous health care system and the home care. Methods: We recruited 46 nurses from a home care center in the catholic parish of the C medical center from April 4th to June 8th, 2007. Results: The highest needs were 'assessment and diagnosis of the problem', 'management of hypertension & diabetes patients', 'counseling of the patient', and 'counseling of major caregiver and family problems'. Therapeutic nursing showed the highest needs in bedsore care. Nurses want hospital medical records available through the ubiquitous health care system. Conclusion: Home care services are supported from the agency, with high needs in assessing and diagnosing the problem, counseling, and managing of hypertension & diabetes patients. Education and public relations efforts on the U-healthcare system should improve system awareness.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제43권3호
• /
• pp.166-170
• /
• 2017

Objectives: To define the risk of occult cervical metastasis of maxillary squamous cell carcinoma (SCC) and the therapeutic value of elective neck dissection (END) in survival of clinically negative neck node (cN0) patients. Materials and Methods: Sixty-seven patients with maxillary SCC and cN0 neck were analyzed retrospectively, including 35 patients with maxillary gingiva and 32 patients with maxillary sinus. Results: Of 67 patients, 10 patients (14.9%) had occult cervical metastasis. The incidence of occult cervical metastasis of maxillary gingival SCC was higher than that of maxillary sinus SCC (17.1% and 12.5%, respectively). The 5-year overall survival rate was 51.9% for the END group and 74.0% for the non-END group. The success rate of treatment for regional recurrence was high at 71.4%, whereas that for local or locoregional recurrence was low (33.3% and 0%, respectively). Conclusion: The incidence of occult cervical metastasis of maxillary SCC was not high enough to recommend END. For survival of cN0 patients, local control of the primary tumor is more important than modality of neck management. Observation of cN0 neck is recommended when early detection of regional recurrence is possible irrespective of the site or T stage. The key enabler of early detection is patient education with periodic follow-up.

• BMB Reports
• /
• 제57권2호
• /
• pp.98-103
• /
• 2024

The mammalian sirtuin family (SIRT1-SIRT7) has shown diverse biological roles in the regulation and maintenance of genome stability under genotoxic stress. SIRT7, one of the least studied sirtuin, has been demonstrated to be a key factor for DNA damage response (DDR). However, conflicting results have proposed that Sirt7 is an oncogenic factor to promote transformation in cancer cells. To address this inconsistency, we investigated properties of SIRT7 in hepatocellular carcinoma (HCC) regulation under DNA damage and found that loss of hepatic Sirt7 accelerated HCC progression. Specifically, the number, size, and volume of hepatic tumor colonies in diethylnitrosamine (DEN) injected Sirt7-deficient liver were markedly enhanced. Further, levels of HCC progression markers and pro-inflammatory cytokines were significantly elevated in the absence of hepatic Sirt7, unlike those in the control. In chromatin, SIRT7 was stabilized and colocalized to damage site by inhibiting the induction of γH2AX under DNA damage. Together, our findings suggest that SIRT7 is a crucial factor for DNA damage repair and that hepatic loss-of-Sirt7 can promote genomic instability and accelerate HCC development, unlike early studies describing that Sirt7 is an oncogenic factor.

• Physical Therapy Rehabilitation Science
• /
• 제13권1호
• /
• pp.113-123
• /
• 2024

Objective: The study analyzed the awareness of physical therapists regarding correct breathing methods and the effect of breathing training on patients. Design: A cross-sectional survey study. Methods: Physical therapists who agreed to participate in the study, held a license as a physical therapist, and had training or experience in breathing were included as subjects. A total of 136 questionnaires were collected, out of which 129 were analyzed. The questionnaire consisted of 26 items, divided into several sections covering awareness of breathing methods, breathing and muscles, breathing and mind, breathing and movement, perception of mouth breathing and nose breathing, experience applying respiration as a treatment, perception of breathing and treatment, awareness of breathing and pain, awareness of breathing and chronic diseases and prevention, perceptions related to breathing and sleep, and educational background. Results: The study found that most therapists were aware of diaphragmatic breathing, but not Lamaze breathing. 76.7% claimed to that there is a correct breathing method, and the majority were aware of the reasons for correct breathing. The majority believed in the therapeutic effect of breathing, with core exercise breathing training being the most commonly used in therapy. 81.7% of therapists had taught a specific breathing method to a patient, and diaphragmatic breathing was the most provided treatment. There was no significant difference in perception according to clinical experience, but there was a significant difference in perception according to educational background. Conclusions: The study provided clinical background on Physical Therapists' belief on correct breathing method, and uses of breathing training during treatment. The results suggest there is a need for a coherent education on breathing method and techniques among Physical Therapists.