• 제목/요약/키워드: Traumatic

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사회복지전담공무원의 이차적 외상스트레스 결정 요인 (Determinants of Secondary Traumatic Stress among Public Social Welfare Specialists)

  • 양정빈;김도윤;류순옥;김자영
    • 한국콘텐츠학회논문지
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    • 제15권11호
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    • pp.115-125
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    • 2015
  • 본 연구는 사회복지전담공무원의 이차적 외상스트레스에 미치는 결정 요인을 실증적으로 분석하였다. 연구대상은 충청남도에 재직 중인 사회복지전담공무원이며, 총 654부가 분석에 사용되었다. 분석결과, 이차적 외상스트레스를 보이는 전담공무원은 69.0%이며, 이 중 심각한 외상을 보이는 응답자는 36.9%로 조사되어 이차적 외상스트레스 정도가 상당히 심각한 것으로 나타났다. 다중회귀분석 결과, 일반적 요인에서는 성별과 근무시간이, 폭력경험 요인에서는 신체적 폭력과 위협이, 대처방안 요인에서는 문제중심적 대처, 정서완화적 대처, 소망적 사고가, 직무효능감 요인에서는 자기효능감과 집단효능감이 각각 이차적 외상스트레스에 영향을 미치는 것으로 나타났다. 연구결과를 바탕으로 클라이언트 폭력으로부터 안전한 직무 환경의 조성, 위기상황 대처능력을 향상시킬 수 있는 실무 교육 프로그램의 개발, 사회복지전담공무원들의 정신건강을 정기적으로 모니터링 할 수 있는 제도의 도입과 같은 구체적 방안들이 논의되었다.

Post-traumatic and postoperative neurosensory deficits of the inferior alveolar nerve in mandibular fracture: a prospective study

  • Yadav, Sunil;Mittal, Hitesh Chander;Malik, Sunita;Dhupar, Vikas;Sachdeva, Akash;Malhotra, Vijaylaxmy;Singh, Gurdarshan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제42권5호
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    • pp.259-264
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    • 2016
  • Objectives: We evaluated and recorded post-traumatic and postoperative neurosensory deficits of the inferior alveolar nerve (IAN) in mandibular fracture in order to identify associated risk factors. Materials and Methods: This was a prospective cohort study composed of 60 patients treated for mandibular fracture. The primary study variable was the change between the post-traumatic IAN neurosensory examination score and the score after fracture reduction. Risk factors were categorized as demographic, anatomic, fracture displacement, and treatment. Appropriate descriptive and bivariate statistics were computed. Results: Sixty patients with unilateral mandibular fracture reported within 24 hours of injury were evaluated over a one-year period. A post-traumatic neurosensory deficit was observed in 52 patients (86.7%), the percentage of which was reduced to 23.3% over the follow-up period. Abnormal postoperative neurosensory scores were significantly higher in angle fracture cases (33.3%) compared to body fracture cases (11.1%). When recovered and non-recovered neurosensory scores were compared by fracture location, 88.9% of body fracture cases showed significant recovery compared to 66.7% of mandibular angle fracture cases. Cases with less than 5 mm fracture displacement showed statistically significantly higher neurosensory recovery scores (90.6%) compared to those with more than 5 mm fracture displacement (60.7%). Conclusion: Use of a miniplate with mono-cortical screws does not play a role in increasing IAN post-traumatic neurosensory deficit. Early management can reduce the chances of permanent neurosensory deficit. Mandibular fracture displacement of 5 mm or more and fracture location were found to be associated with an increased risk of post-traumatic IAN neurosensory score worsening.

알코올중독자의 외상경험이 음주에 미치는 영향에 관한 연구 - 스트레스대처방식의 매개효과 중심으로 (Effect of the Traumatic Experiences on Drinking among Alcoholics -Mediating role of Stress Coping)

  • 우재희
    • 한국콘텐츠학회논문지
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    • 제14권10호
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    • pp.180-188
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    • 2014
  • 본 연구는 외상경험이 있는 알코올중독자들의 외상경험과 음주기대간의 관계를 살펴보고 두 변수 간에 영향을 미치는 스트레스대처방식의 매개역할을 살펴보고자 하였다. 분석결과 연령, 최종학력, 단주경험, 단주모임참여, 병식인지가 통제된 상황에서 알코올중독자의 외상경험이 음주기대에 미치는 영향에 대한 스트레스대처방식의 매개효과를 검증한 결과, 스트레스대처의 매개효과가 유의미한 것으로 나타나 가설이 지지되었다. 변수의 경로는 알코올중독자의 외상경험이 높을수록 스트레스대처방식이 낮았고(${\beta}=-.328$, p<.001), 스트레스대처방식이 높을수록 음주기대가 낮았으며(${\beta}=-.532$, p<.001), 외상경험이 높을수록 음주기대가 높은 것(${\beta}=.408$, p<.001)으로 나타났다. 통제변수 중에서는 연령이 높을수록 음주에 대한 기대가 높고(${\beta}=.153$, p<.01), 단주경험이 많을수록 음주기대가 낮았다(${\beta}=.156$, p<.05). 스트레스대처방식의 매개효과의 유의성을 살펴본 결과, 외상경험이 스트레스 대처방식을 거쳐 음주기대에 미치는 간접효과의 크기는 통계적으로 유의하였다. 이와 같은 연구결과를 바탕으로 알코올중독자의 재발을 예방하기 위한 구체적인 실천적 방안과 함의를 제시하였다.

경찰공무원에서 외상후스트레스장애와 기질 및 성격 특성의 관계 (Relationship between Temperament and Character Dimensions and Post-Traumatic Stress Disorder in Police Officers)

  • 이정현;김옥주;남윤영;신정하;이희봉;김지애;심민영
    • 대한불안의학회지
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    • 제11권1호
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    • pp.61-68
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    • 2015
  • Objective : Police officers are exposed to job-related traumatic events and have a high prevalence of post-traumatic stress disorder (PTSD). This study examined the relationship between PTSD symptoms and dimensions of temperament and character in police officers. Method : Thirty-six police officers participating in a psychological support program were enrolled. All subjects were asked to complete a demographic questionnaire, the Impact of Event Scale-Revised (IES-R), the Temperament and Character Inventory (TCI) and other self-reported symptoms scales. Results : Among all participants (age $40.8{\pm}10.2$, men 94.4%), the rate of 'post-traumatic stress symptoms group' was 47.2%. After controlling for confounding factors, lower self-directedness scores were significantly associated with higher PTSD symptoms (${\beta}=0.6$, p=0.03) in multiple regression analysis. Conclusion : Character traits, especially self-directedness, were associated with the severity of PTSD symptoms severity. These findings may provide useful information regarding personality factors related to PTSD in police officers.

외상성 신경병증성 통증의 각 임상증상에 대한 Gabapentin의 효과 (The Effect of Gabapentin for the Clinical Symptoms in the Traumatic Neuropathic Pain)

  • 김영기;조윤우
    • Journal of Yeungnam Medical Science
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    • 제21권1호
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    • pp.82-90
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    • 2004
  • 외상성 신경손상으로 인한 신경병증성 통증을 호소하는 환자에게 gabapentin을 투여하였을 때 신경병증성 통증의 각 증상 모두 유의하게 감소하였다. 신경병증성 통증의 각 증상 중 발작성 자발통이 열성 유발통보다 더욱 유의하게 감소하였다.

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Detection of Traumatic Cerebral Microbleeds by Susceptibility-Weighted Image of MRI

  • Park, Jong-Hwa;Park, Seung-Won;Kang, Suk-Hyung;Nam, Taek-Kyun;Min, Byung-Kook;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • 제46권4호
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    • pp.365-369
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    • 2009
  • Objective : Susceptibility-weighted image (SWI) is a sensitive magnetic resonance image (MRI) technique to detect cerebral microbleeds (MBLs). which would not be detected by conventional MRI. We performed SWI to detect MBLs and investigated its usefulness in the evaluation of mild traumatic brain injury (MTBI) patients. Methods : From December 2006 to June 2007, twenty-one MTBI patients without any parenchymal hemorrhage on conventional MRI were selected. Forty-two patients without trauma were selected for control group. According to the presence of MBLs, we divided the MTBI group into MBLs positive [SWI (+)] and negative [SWI (-)] group. Regional distribution of MBLs and clinical factors were compared between groups. Results : Fifty-one MBLs appeared in 16 patients of SWI (+) group and 16 MBLs in 10 patients of control group [control (+)], respectively. In SWI (+) group, MBLs were located more frequently in white matters than in deep nucleus different from the control (+) group (p<0.05). Nine patients (56.3%) of SW (+) group had various neurological deficits (disorientation in 4, visual field defect in 2, hearing difficulty in 2 and Parkinson syndrome in 1). Initial Glasgow Coma Scale (GCS)/mean Glasgow Outcome Scale (GOS) were $13.9{\pm}1.5/4.7{\pm}0.8$ and $15.0{\pm}0.0/5.0{\pm}0.0$ in SWI (+) and SWI (-) groups, respectively (p<0.05). Conclusion : Traumatic cerebral MBLs showed characteristic regional distribution, and seemed to have an importance on the initial neurological status and the prognosis. SWI is useful for detection of traumatic cerebral MBLs, and can provide etiologic evidences for some post-traumatic neurologic deficits which were unexplainable with conventional MRI.

탈구를 동반한 족관절 골절에서 수술적 치료 후 최소 2년 추시 결과 (Operative Treatment of the Ankle Fracture with Dislocation: Minimum 2-year Follow Up Results)

  • 조승환;이준영;조성원;박치형
    • 대한족부족관절학회지
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    • 제17권1호
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    • pp.28-33
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    • 2013
  • Purpose: In previous study, the frequency of osteoarthritis and discomfort were high in ankle fracture-dislocation but detail results about ankle fracture-dislocation has rarely been investigated. In this study, we retrospectively analyze the outcome of the operative treatment of ankle fracture with dislocation for over-2 years follow up. Materials and Methods: There were 47 cases of ankle fracture-dislocation in our hospital from March 2007 to May 2010. We investigated 20 patients who underwent operation and were possible for over-2 years follow up. The result was estimated with the direction of dislocation, fracture type, the time of bone union and post-traumatic osteoarthritis with plain radiologic images. In clinical assessment, we statistically evaluated the function and pain through AOFAS score and Olerud & Molander scoring system. Results: By Lauge-Hansen classification, there were 13 cases(65%) of pronation-external rotation and 6 cases(30%) of supination-external rotation, 1 case(5%) of supination-adduction. AOFAS score was 85.5, and Olerud & Molander score was "excellent" in 8 cases, "good" in 5 cases, "fair" in 3 cases and "poor" in 4 cases. Postoperative complications in 4 cases revealed post-traumatic arthritis. All kinds of lateral dislocation of ankle fracture was 15 cases and the most common. Of these, all 3 cases, anterolateral dislocation showed post-traumatic osteoarthritis. Conclusion: In ankle fracture-dislocation, post-traumatic osteoarthritis occurred in 4 of 20 patient(20%). Especially, the possibility of post-traumatic osteoarthritis was more in cases of anterolateral or lateral dislocation. So, it must be needed that deliberate examination, for example, preoperative MRI and sufficient explanation to patient. Also, we have to follow up the patients carefully.

여성알코올중독자의 외상경험과 재발위험성의 관계에서 문제중심대처, 정서중심대처, 음주기대의 매개효과 (Mediating Effects of Problem Focused and Emotion Focused Coping, Drinking Anticipation Between the Female Alcoholics Traumatic Experienced and Their Warning of Relapse)

  • 우재희
    • 한국콘텐츠학회논문지
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    • 제13권4호
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    • pp.230-238
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    • 2013
  • 본 연구는 신체적, 성적 학대의 외상경험이 있는 여성알코올중독자들의 외상경험과 외상 후 스트레스 증상에 초점을 맞추어 알코올중독 재발위험성에 영향을 미치는 매개변인을 파악하여 여성알코올중독자들을 재발에 이르게 하는 스트레스대처와 음주기대의 심리적 요인을 이해하고, 알코올중독 사회복지 실천현장의 실천적 방안을 모색하는데 그 목적을 두고자 하였다. 분석결과 첫째, 연구대상자의 신체적, 성적 외상경험관련 특성은 18세 이전 지인에 의한 신체적 성적 학대경험이 18세 이후의 경험보다 많았다. 둘째, 연구모형의 분석에서 총 10개의 직접경로 중 8개의 경로가 통계적으로 유의하였고, 셋째, 매개변수를 통한 간접영향에 대한 검증결과 외상 후 스트레스 증상, 문제 중심 대처, 정서 중심 대처, 음주기대를 매개로 하는 6개의 간접경로 중 4개의 경로가 유의하였다. 이와 같은 연구결과를 바탕으로 여성 알코올중독자의 재발을 예방하기 위한 구체적인 실천적 방안과 함의를 제시하였다.

임상에서 흔히 접하는 외상성 손상에 대한 봉독약침요법의 체계적 문헌고찰 (Systematic Review of Bee Venom Therapy for Traumatic Injury)

  • 이재은;이치호;이은정;이정민;오민석
    • 한방재활의학과학회지
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    • 제26권3호
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    • pp.67-77
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    • 2016
  • Objectives To evaluate the evidence supporting the effectiveness of Bee Venom therapy for traumatic injury. Methods We conducted search across 3 electronic databases (Pubmed, CAJ and Oasis) to find clinical trials that used Bee Venom therapy as treatment for traumatic injury. The methodological quality of RCTs (Randomized controlled clinical trials) were assessed using the Cochrane Risk of Bias (RoB) tool, while NRCTs (Non-Randomized controlled clinical trials) were assessed using the Cochrane Risk of Bias Assessment tool for Non-randomized Study (RoBANS) tool. Results Among 87 articles that were searched, 10 RCTs and 19 NRCTs were finally selected. Among 19 selected studies, all studies showed that Bee Venom therapy has significant effect on traumatic injury. Conclusions Our systematic review found encouraging but limited evidence of Bee Venom therapy for traumatic injury. We recommend clinical trials which compare the effectiveness of Bee Venom therapy with other pharmacopuncture therapies to clarify the effectiveness of Bee Venom therapy from other pharmacopuncture therapies.

두부외상 환자에서 전두엽 손상과 신경인지기능 변화에 따른 주관적인 증상 연구 (The Study of the Subjective Symptoms according to Frontal Lobe Damage and Change in Neurocognitive Function in Traumatic Head Injury Patients)

  • 김준원;한덕현;기백석;박두병
    • 대한불안의학회지
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    • 제8권1호
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    • pp.31-40
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    • 2012
  • Objective : The purpose of this study was to analyze the correlation between symptom severity and neurocognitive factors in traumatic head injury patients. In addition, the effect of frontal lobe damage on these parameters was examined. Methods : We selected 18 patients who had brain damage for the moderate to severe traumatic brain injury (MSTBI) group, and 17 patients who met the diagnostic criteria for post-traumatic stress disorder (PTSD) without the finding of brain damage for the comparison group. For the evaluation of neurocognitive function, K-WAIS, Rey-Kim Memory Test, K-FENT, WCST, and MMPI-2 were used. Results : The results of the comparison (using the malingering scale) revealed that the values of PDS and PK, which express the severity of symptoms, and the values of the validity scale F, F (B), and F (P) were significantly higher in the overly-expressed group. F (B) in overly-expressed group and PK, Pt, and Sc in the properly-expressed group had significant correlation with the severity of symptoms. F (B), S, and Stroop error inhibition in PTSD, and PK, Pt, Sc, and MQ in MSTBI had significant correlation with the severity of symptoms. The results of the comparison based on the finding of frontal lobe damage revealed that PDS, EIQ, and MQ ware significantly higher in the group without brain damage. Conclusions : It was revealed that each neurocognitive factor was correlated with the severity of symptoms. There was a decrease in complaints or symptoms reported by the frontal lobe injury group, and this is believed to be due to degenerative change in the personality and emotional functioning of these patients following frontal lobe damage.