• 비만대사연구학술지
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• 제1권2호
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• pp.74-77
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• 2022

Treatment of obesity includes diet therapy, exercise therapy, cognitive behavioral therapy, drug therapy, and bariatric surgery. Most obese patients lose weight by combining diet, exercise, cognitive behavioral therapy or medication. But, in some cases, only one of these treatments is preferred. A 56-year-old male patient had a body mass index (BMI) of 33.1 kg/m² and a waist circumference of 108 cm. He had been treated for hypertension; diabetes and dyslipidemia were diagnosed but not treated. However, at the initial visit to treat obesity, he was diagnosed with type 2 diabetes mellitus and dyslipidemia again. So he decided to treat these two diseases with drugs first and modify his lifestyle. He started walking more than 20,000 steps every day and then he really walked about 15,000 steps every day during 5 months, although diet calorie or alcohol drinking amount was not significantly decreased. After about 6 months, the patient's weight decreased by 10.1 kg, the BMI decreased by 4.1 kg/m², the waist circumference decreased by 10 cm, the glycated hemoglobin (HbA1c) decreased by 4.59%, the visceral fat area decreased by 115 cm², and the subcutaneous fat decreased by 38 cm². As a result of body composition analysis, muscle mass increased by 1.2 kg, and the percentage of body fat decreased by 10.4%. The walking exercise does not have any space restrictions and has high accessibility by using a mobile phone app. Therefore, considering the patient's situation, it would be better to treat obese patients by first recommending walking exercises and increasing the number of steps to lose weight and improve the comorbidities.

• 디지털융복합연구
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• 제12권8호
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• pp.423-430
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• 2014

본 연구의 목적은 뇌졸중 동물 실험 모델에서 환경 강화는 기능 회복을 향상 시키고 이로 인하여 뇌에 형태학적, 생화학과 행동에서 특징적인 변화와 그 효과들을 소개하고, 뇌졸중 환자에 환경 강화의 적용은 재활치료 및 작업치료를 포함한 다양 치료와 전 임상 실험의 중요성을 설명하고자 한다. 이 종설 논문에서는 주로 뇌졸중 동물 실험 모델에서 환경 강화로 인한 기능적 회복에 대한 효과와 신경 친화성 물질, 특정 단백질의 발현 및 임상 적용 사례 등의 연구 결과들을 소개하였다. 마지막으로 임상에서 뇌졸중 환자에게 환경 강화의 적용 가능성과 작업치료 및 재활치료의 관점에서 설명하였다.

• 지역사회간호학회지
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• 제22권4호
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• pp.365-376
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• 2011

Purpose: The purpose of this study was to investigate the patterns of smoking relapse and to identify risk factors related to smoking relapse among those successful in smoking cessation at the smoking cessation clinics of public health centers. Methods: Data were collected from 1,705 six-month quitters and analyzed by the Kaplan-Meier analysis and the Cox proportional hazard model. Results: The rate of smoking relapse was 38.2% in 1 year, 44.4% in 2 years, and 47.8% in 5 years. The vast majority of relapse (62.3%) occurred within the first six months after quitting. The risk factors related to smoking relapse were age (HR 1.964: 95% CI 1.545, to 2.497), nicotine dependence (HR 1.293: 95% CI 1.087 to 1.539), problem drinking (HR 1.497: 95% CI 1.116 to 2.008), behavioral therapy type (HR 1.398: 95% CI 1.193 to 1.638), and nicotine replacement therapy type (HR 1.363: 95% CI 1.077 to 1.724). Conclusion: For reducing smoking relapse, it is necessary to develop a smoking relapse prevention program for the first six months after quitting and to strengthen behavioral therapy in the course of smoking cessations clinics.

• 대한간호학회지
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• 제45권2호
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• pp.169-182
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• 2015

Purpose: This study was a meta-analysis designed to identify effects of Cognitive Behavioral Therapy (CBT) interventions in alleviating main symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among school-aged children in Korea. Methods: Examination of several databases including Research Information Sharing Service, Korean Studies Information Service System, Data Base Periodical Information Academic and hand-searched article references, resulted in identification of 1,298 studies done between 2000 and 2013 of which 21 met the inclusion criteria. Comprehensive Meta-Analysis version 2.0 was used to analyze effect sizes, explore possible causes of heterogeneity, and check publication bias with a funnel plot and its trim-and-fill analysis. Results: Overall effect size of CBT intervention was large (g=1.08) along with each outcome of self-control (g=1.26), lack of attention (g=1.02), social skills (g=0.92), and hyperactivity (g=0.92). For heterogeneity, moderator analysis was performed, but no significant differences were found between the RCT (Randomized Controlled Trials) group and the NRCT (Non RCT) group. Also, meta-regression was performed using sample size, number of sessions, and length of session as predictors, but no statistically significant moderators were found. Finally, a funnel plot along with trim-and-fill analysis was produced to check for publication bias, but no significant bias was detected. Conclusion: Based on these findings, there is clear evidence that CBT intervention has significant positive effects on the main symptoms of school-aged children suffering ADHD. Further research is needed to target diverse age groups with ADHD along with more RCT studies to improve the effectiveness of the CBT intervention.

• 한국사회복지학
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• 제60권2호
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• pp.175-209
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• 2008

임상실천의 평가를 위한 도구로 단일체계설계를 강조하는 본 연구는 우울증 치료를 위해 정신과 병원에 입원한 3명의 클라이언트들에게 인지행동치료를 제공하고 개입의 효과성을 평가하기 위해 AB 설계를 사용하였다. 본 연구에 참여하기로 동의한 3명의 클라이언트는 모두 약 2주간의 기초선 단계와 약 3주간의 개입단계에 참가하였다. 평가결과의 타당성을 높이기 위해 다각적 측정원칙을 적용하였고, 기초선 단계와 개입단계 동안 수집된 자료는 시각적인 방법과 통계적인 방법으로 분석되었다. 시각적 분석의 정확성을 높이기 위해 추세선, 추세지수 등과 같은 방법을 활용하여 분석한 결과, 클라이언트 3명의 우울증상이 개입단계에서 모두 나아진 것으로 나타났으며 이러한 개선은 통계적으로도 유의미하였다. 본 연구는 모니터링, 클라이언트를 실천과정에 적극적으로 참여시킬 수 있는 기회 제공, 자료분석의 용이성을 임상실천평가를 위해 단일체계설계를 사용함으로써 얻게 되는 장점으로 들고 있다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제29권2호
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• pp.73-79
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• 2018

Objectives: The overuse of the Internet among adolescents has increased dramatically in recent years, leading to pathological or problematic Internet use. Cognitive behavioral therapy (CBT) is known to be effective for the treatment of problematic Internet use, particularly for adolescents. The aim of the present study was to evaluate the therapeutic efficacy of group CBT for problematic Internet use in adolescents. Methods: A total of 17 patients aged 12-17 years who met Young's diagnostic questionnaire criteria of problematic Internet use participated in a school-based eight-session group CBT program. The level of problematic Internet use among participating students was measured using Young's Internet Addiction Scale (IAS). Depression and anxiety levels were evaluated using the Children's Depression Inventory (CDI) and the State-Trait Anxiety Inventory (STAI), respectively. Each construct was assessed at baseline, immediately after the intervention, and at a one-month follow-up visit. Statistical significance was based on a p-value of <0.05. Results: Immediately after the program, the IAS, CDI, and State Anxiety Inventory (SAI) scores were significantly lower than before the program. At the one-month follow-up assessment, the IAS scores remained low, and the CDI and SAI scores were even lower than immediately after the program. Conclusion: Group CBT was effective for adolescents with problematic Internet use, and was also demonstrated to improve depression and anxiety.

• 가정과삶의질연구
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• 제26권2호
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• pp.13-24
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• 2008

The aim of the present study was to develop a cognitive-behavioral group therapy program for social anxiety in Korean adolescents and to examine its efficacy through pre-, post- and 2-year follow-up tests. The program included cognitive restructuring, exposure training and social skills training. KSAS-A and SASC-R were administered to 588 1st grade middle-school female students to assess their social anxiety levels. On the basis of double criteria procedure(top 10% scores on both scales), 59 students were selected initially. Individuals currently receiving clinical treatment were excluded. Finally, 40 students were selected and randomly assigned to either a treatment group or a wait-list control group. The program consisted of 12 weekly sessions, approximately 1.5-2 hours in duration. Whereas pre- and post-tests were administered to both groups, follow-up tests were administered to the treatment group only. The collected data were statistically analyzed through independent t-test and paired t-test. The results of the study were as follows: 1) At post-test students in the treatment group showed a very significant reduction in social anxiety and fear of negative evaluation by others in comparison with those in the wait-list group. 2) At post-test students in the treatment group showed a significant reduction in negative automatic thoughts in comparison with those in the wait-list group. 3) At post-test students in the treatment group showed a significant improvement in overall social skills in comparison with those in the wait-list group. 4) At post-test students in the wait-list group showed a significant increase in both social anxiety and negative automatic thoughts in comparison with those in the treatment group. 5) At 3-month, 1-year and 2-year follow-ups, the program's effectiveness was maintained.

• 디지털콘텐츠학회 논문지
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• 제18권3호
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• pp.443-455
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• 2017

본 연구는 청소년 우울증 측정 및 관리를 위한 스마트폰 어플리케이션 콘텐츠 개발(박정선 외, 2016) 연구의 후속 연구로, 인지행동치료이론에 기반하여 스마트폰 어플리케이션을 설계하고 구현했다. 이 앱은 우울증에 대한 분석과 간편하고 연속적인 자기점검을 가능하게 하며, 이를 통해 우울의 단발적 분석 및 진단이 위주였던 이전 앱과 달리 심리 상태의 지속적 관리가 가능하도록 하였다. 더불어 실질적인 상담 서비스가 연계되도록 하였다. 이러한 목표를 달성하기 위해 청소년 우울증에 대한 선행연구 뿐만 아니라, 우울증 관련 모바일 어플리케이션을 조사하였다.

• 여성건강간호학회지
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• 제27권4호
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• pp.337-347
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• 2021

Purpose: This study presents the development of a group video communication-based cognitive behavioral therapy (CBT) program for depressed pregnant women. It also provides the results of a preliminary test of its effects on their depression, automatic thoughts, and dysfunctional attitudes. Methods: In this quasi-experimental single-group pre- and posttest design study, 13 pregnant women participated in a 4-week, eight-session group CBT program, based on Beck's cognitive theory and using video communications from November 2020 to January 2021. Pregnant women between 14 and 32 weeks who were members of an online maternity and parenting community and residing in the cities of Changwon and Gimhae, Korea, were invited to voluntarily participate. Trained nurses led CBT sessions of 3-4 participants per group via video communication. Participants were assessed pre- and postintervention with self-report questionnaires for measurement of depression, automatic thought, and dysfunctional attitude after normality test according to the Shapiro-Wilk test of the variables. The data were analyzed using paired t-test and Pearson correlation coefficients. Results: Depression (t=7.90, p<.001), automatic thoughts (t=4.89, p<.001), and dysfunctional attitudes (t=2.42, p=.032) significantly decreased after the 4-week online program. There were statistically significant correlations among the three variables. Conclusion: This program was found to be effective in reducing depression, automatic thoughts, and dysfunctional attitudes. Above findings suggest that a group CBT program using video communication can be an effective therapeutic modality that helps pregnant women at risk for depression alleviate their negative emotions related to depression.

• 대한한의학회지
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• 제43권2호
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• pp.75-91
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• 2022

Objectives: The purpose of this overview was to summarize the evidence regarding the effectiveness of Cognitive Behavioral Therapy (CBT) for sleep disorders through systematic reviews (SRs) and meta-analyses (MAs). Methods: An overview of systematic review was conducted according to the study protocol (reviewregistry1320). A comprehensive literature search was performed using three databases (Pubmed, Cochrane Central Register of Controlled Trials, and Web of Science) and three Korean databases (KoreaMed, KMbase, and ScienceON). Final studies were selected by three authors according to inclusion and exclusion criteria, and data needed for analysis were extracted by a pre-planned extraction framework. Methodological quality of systematic review was assessed using the 'Assessment of multiple systematic reviews 2 (AMSTAR2)'. Results: Fourteen SRs and MAs were included, of which eleven SRs were performed MAs. Twelve studies studied insomnia among sleep disorders, and the rest are nightmares and sleep disturbances with PTSD. Ten studies reported the effect of CBT on sleep disorders measured by insomnia severity index (ISI) and sleep onset latency (SOL), and all reported a significant improvement effect. Eight studies reported the effect of CBT on sleep disorders measured by wake time after sleep onset (WASO), and seven studies reported a significant improvement effect. The methodological quality of the studies evaluated with AMSTAR 2 was mainly low or very low because of omission of protocol registration and excluded study list. Conclusions: Practical guidelines and studies show that CBT is effective for sleep disorders, but access to CBT needs to be improved.