• 동서간호학연구지
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• 제27권1호
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• pp.14-21
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• 2021

Purpose: This study aims to examine the levels of posttraumatic stress disorder (PTSD), depression and social stigma among nurses caring for Corona Virus Disease-19 (COVID-19) patients. Methods: 169 nurses caring for COVID-19 patients participated in this study. Data collection was conducted at university hospitals from March 1 to August 31, 2020. Data analysis was performed for descriptive statistics, t-test, ANOVA, and Pearson correlation coefficients using SPSS/WIN 24.0 program. Results: The mean scores of PTSD, depression and social stigma were 25.16±16.80, 17.26±8.63 and 5.83±2.84, respectively. The PTSD scores were significantly different between the department (F=2.89, p=.037). Depressive scores were significantly different between the marital status (t=2.27, p=.024) and the department (F=4.91, p=.003). Social stigma scores were significantly different between age (F=6.49, p=.002), marital status (t=-3.30, p=.008), having or not having children (t=3.82, p=.001), department (F=5.82, p=.001) and clinical experience (F=7.43, p=.001). Positive correlations were found between PTSD and depression (r=.70, p<.001) and social stigma (r=.22, p<.004). Conclusion: Integrated assessment and management are required to address the psychological and emotional problems faced by nurses caring for COVID-19 patients, and active follow-up measures should be considered.

• 대한불안의학회지
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• 제15권1호
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• pp.35-44
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• 2019

Objective : The aim of this study was to investigate the individual and job related factors as risk factors for mental health of firefighters. Methods : The data of 202 fire-fighters was analyzed by using a multinomial logistic regression analysis. All participants completed self-reported questionnaires including demographics (sex, age, work duration), the Childhood Trauma Questionnaire, the Ways of Coping Checklist, the Colleague related traumatic events, the Korean occupational stress scale, the Korean Perceived Stress Scale-10, and the Beck Depression Inventory. Participants were divided into three groups according to the level of stress and depressive symptom scores: Low Stress-Low Depression (LS-LD), High Stress-Low Depression (HS-LD), and High Stress-High Depression (HS-HD). Results : A job related factor-organizational injustice-was a significant factor related to HS-LD, while individual factors such as active coping level and childhood trauma experience and a job related factor-difficult physical environment-were significantly associated with HS-HD. Conclusion : These results imply the need to take both individual and environmental approaches into account when managing the stress and depression of firefighters. More specifically, psycho-education to facilitate active coping strategy and adaptive emotional regulation at the individual level and the improvement of physical work environment of firefighters should be supported.

• Journal of Trauma and Injury
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• 제32권1호
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• pp.8-16
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• 2019

Purpose: The Essential Surgical Procedures in Trauma (ESPIT) course was developed as a model to teach necessary surgical procedures to trauma physicians. Its goals are to improve knowledge, self-confidence, and technical competence. Methods: The ESPIT course consisted of five lectures and a porcine lab operative experience. The ESPIT course has been run seven times between February 2014 and April 2016. ESPIT participants completed a questionnaire to assess self-efficacy regarding essential surgical procedures in trauma before and immediately after taking the ESPIT course. Sixty-three participants who completed both pre- and post-course questionnaires on self-efficacy were enrolled in this study. Results: The overall post-ESPIT mean self-efficacy score was higher than the pre-ESPIT mean self-efficacy score ($8.3{\pm}1.30$ and $4.5{\pm}2.13$, respectively) (p<0.001). Self-efficacy was significantly improved after the ESPIT course in general surgeons (p<0.001), thoracic and cardiovascular surgeons (p<0.001), emergency medicine doctors, and others (neurosurgeons, orthopedic surgeons) (p<0.001). The differences in self-efficacy score according to career stage (<1 year, 1-3 years, 3-5 years, and >5 years) were also statistically significant (p<0.001). Conclusions: The data of the ESPIT participants indicated that they felt that the ESPIT course improved their self-efficacy with regard to essential surgical procedures in trauma. The ESPIT course may be an effective strategy for teaching surgical procedures, thus promoting better management of traumatic injuries.

• 한국융합학회논문지
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• 제11권12호
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• pp.261-274
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• 2020

트라우마 초점의 인터넷 기반 인지행동치료(internet-based cognitive-behavioral therapy with a trauma focus: iCBT-T)의 개발 및 효과 검증 연구가 서구에서 활발하게 진행되고 있는 것에 비해, 한국 사회에서는 관련 연구가 최근에야 시작되었다. 본 연구의 목적은 iCBT-T 프로그램 개발과 운영의 고려사항을 제안하는 것이다. 먼저, iCBT-T와 관련된 선행 연구를 고찰한 후, iCBT-T 프로그램을 개발하기 위해 정신건강 지식과 ICT 기술을 융합하는 모형을 제시하였다. 그런 다음, iCBT-T의 초점과 표적 집단, 개입의 유형(오픈 액세스 vs. 안내형), 회기 수, 윤리적 이슈, 전문적 지원 및 이용자의 참여를 포함한 실질적 고려사항을 다루고, iCBT-T에서 인터넷 매체의 한계를 보완하기 위한 방법들을 제안하였다. 트라우마 초점의 인지행동치료와 ICT 기술의 융합 모델이 트라우마 사건을 경험한 많은 이용자들의 정신건강의 향상에 기여할 수 있는 프로그램 개발을 촉진하기를 기대한다.

• 대한두개안면성형외과학회지
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• 제23권2호
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• pp.89-92
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• 2022

Post-traumatic pseudoaneurysms of internal maxillary artery are rare, but may be life-threatening. When arterial damage leads to pseudoaneurysm formation, delayed intractable epistaxis can occur. We report our experience with the diagnosis and management of a ruptured internal maxillary arterial pseudoaneurysm that was discovered preoperatively in a patient with a zygomaticomaxillary complex (ZMC) fracture. He presented to the emergency room with epistaxis, which ceased shortly, and sinus hemorrhage was observed with a fracture of the posterior maxillary wall. The patient was scheduled for open reduction and internal fixation (ORIF) of the ZMC fracture. However, immediately before surgery, uncontrolled epistaxis of unknown origin was observed. Angiography indicated a pseudoaneurysm of the posterior superior alveolar artery. Selective endovascular embolization was performed, and hemostasis was achieved. After radiologic intervention, ORIF was successfully implemented without complications. Our case shows that in patients with a posterior maxillary wall fracture, there is a risk of uncontrolled bleeding in the perioperative period that could be caused by pseudoaneurysms, which should be considered even in the absence of typical symptoms.

• 대한정형외과학회지
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• 제54권2호
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• pp.91-99
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• 2019

대부분의 환자는 관절경적 회전근 개 봉합술 후 통증이 완화되고 기능적 호전을 보이지만 일부 환자는 수술 후에도 증상이 지속된다. 재파열은 생물학적, 기술적, 외상적 요인이 복합적으로 작용하여 발생한다. 회전근 개 봉합술 후 재파열이 지속되는 통증의 원인일 수도 원인이 아닐 수도 있다. 따라서 이런 환자들의 평가 및 치료는 난해하여 철저한 문진, 이학적 검사, 적절한 영상 검사를 통해서 통증의 원인에 대한 분석이 이루어져야 한다. 재봉합술의 시행 여부는 환자의 나이, 기능적 요구도 회전근 개의 상태, 수술 전 관절 운동 범위, 삼각근의 상태, 관절과 상완 관절의 관절염의 유무에 따라 결정되어야 한다. 성공적인 재봉합술은 술기뿐만 아니라 수술 전 환자 교육 또한 중요하다.

• 대한조현병학회지
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• 제20권2호
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• pp.37-43
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• 2017

Objectives : This study was aimed to investigate the associations of childhood trauma with psychopathology and clinical characteristics in patients with schizophrenia. Methods : This study enrolled 66 inpatients with schizophrenia. Korean Childhood Trauma Questionnaire (K-CTQ) and Life Event Questionnaire (LEQ) were administered to assess childhood trauma. Psychopatholgy and clinical characteristics were assessed with the Positive and Negative Syndrome Scale (PANSS), Beck Depression Inventory (BDI), Korean Version of Internalized Stigma of Mental Illness (K-ISMI), Perceived Stress Scale (PSS), and visual analogue scale of EuroQoL-5 Dimension Index (EQ-5D). Results : Total scores on K-CTQ were positively associated with scores on the BDI, K-ISMI, PSS, and PANSS and negatively associated with the score on the EQ-5D. Among subscales of K-CTQ, emotional abuse was significantly associated with all measures for psychopathology and clinical characteristics. Patients with physical abuse (36.5%), emotional abuse (30.2%), or bullying (30.6%) according to the LEQ showed sighificanlty higher the ISMI score and lower EQ-5D score. Emotional abuse and bullying were also significantly associated with higher scores on BDI and/or PSS. Conclusion : Our results suggest that childhood trauma negatively influences on internalized stigma, depression, perceived stress and quality of life in patients with schizophrenia. Clinicians should carefully evalute and manage childhood traumatic experience of patients with schizophrenia.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.376-384
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• 2023

Purpose: The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity. Methods: In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients' mode of transport. Results: This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder. Conclusions: This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.

• 한국심리학회지ㆍ일반
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• 제36권2호
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• pp.241-270
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• 2017

본 연구는 성인 1,000명을 대상으로 트라우마 이전(pretrauma)의 성격적 특성인 성격 5요인, 외상 후 인지, 반추, PTSD 증상, 외상 후 성장간의 구조적 관계를 살펴보자 하였다. 이를 위해 본 연구에서는 성격 5요인이 외상 후 인지와 침습적 반추를 거쳐 의도적 반추에 영향을 주는 경로가 포함된 가설적 연구모형과 침습적 반추에서 의도적 반추로 가는 경로가 제외된 경쟁모형을 각각 설정하였다. 연구결과 첫째, 외향성, 우호성, 성실성은 외상 후 성장과 PTSD 증상 간에 외상 후 인지 및 반추의 매개효과가 유의하지 않았다. 둘째, 개방성은 PTSD 증상 및 외상 후 성장으로 가는 경로에서 침습적 반추와 의도적 반추가 순차적으로 매개하는 것으로 밝혀졌다. 셋째, 신경증적 경향성은 PTSD 증상 및 외상 후 성장으로 가는 경로에서 외상 후 인지, 사건관련 반추가 순차적으로 매개하는 것으로 밝혀졌다. 본 연구결과는 외상 후 성장모델의 인지과정을 지지하는 것으로 나타났다. 본 연구의 결과에 근거하여 의의와 한계점에 대하여 논의하였다.

• 사물인터넷융복합논문지
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• 제8권5호
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• pp.63-70
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• 2022

본 연구는 연구자가 정신건강사회복지 전문가로서 신개념의 전문적인 정신건강 모바일 서비스 플랫폼을 개발하고 상용화시켜 새로운 도전을 하기까지의 전 과정에서의 실제경험을 질적연구방법인 자문화기술지를 통해 자료를 수집하고 분석한 연구이다. 본 연구의 결과는 다음과 같다. 첫째, 우리나라 국민들 중에는 정신건강 이슈에 직접 노출되어 전문적인 의료서비스를 받아야 하는 사람들도 있으나 치료적 개입 수준을 요하지는 않지만 일반적인 정신건강 서비스에 대한 욕구를 가진 대중들 또한 상당히 많다는 것이다. 둘째, 현대사회의 특성을 고려하고 특히 코로나-19와 같은 감염병 팬더믹 상황에서 모바일을 활용한 다양한 정신건강 서비스 플랫폼을 선호하는 대중들이 많아 지고 있다는 것이다. 셋째, 전 세대에서 가족문제, 스트레스, 대인관계, 직업 등에서의 정신건강 관련 이슈들을 많이 호소하고 있고 이와 같은 문제들이 우울이나 불안, 중독 및 외상후스트레스장애 등의 정신병리와 연관되어 자해나 자살사고와 같은 또 다른 정신건강 문제들과 잣은 빈도로 언급되고 있다는 것이다. 넷째, 청소년들이 다양한 정신건강관련 이슈들에 노출되어 있다는 것과 무엇보다 자해 및 자살사고와 같은 심각한 정신건강 문제들을 호소하고 있었다. 다섯째, 전문적인 정신건강 서비스를 전달하는데 있어 모바일 기기를 통한 온라인에서의 서비스 제공과 오프라인에서의 서비스 제공이 가능한 역량을 갖춘 정신건강전문가들이 필요하다는 것이다. 마지막으로 본 연구 결과를 바탕으로 향후 정신건강서비스 제공과 관련한 정책 및 실천적 제언과 후속 연구에 대한 방향성을 제언하였다.