• Title/Summary/Keyword: behavioral therapy

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A Research of School Refusal on Adolescent with Psychiatric Disorders (정신병리를 가진 청소년의 등교거부 사례보고)

  • Heo, Eun-Jung;Lee, Sang-Eon;Lyu, Heui-Yeong
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.4
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    • pp.219-231
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    • 2010
  • Objectives : School refusal is usually considered as individual's behavioral problem. These days. however. the adolescents' school refusal needs some kind of medical approaches because it is related to mental disorder of the adolescents. Due to too much pressure and stress from the competition between classmates and from good performance in school. the number of adolescents who refuse to go to school is increasing. Despite this circumstance. school refusal is neither regarded as a single independent disorder nor endorsed as an officially classified disease. which makes difficult to conduct research on this issue and to establish standardized treatment for it. In addition. there is a lack of research on this topic. especially in oriental medicine. so there is no a case report or study on school refusal. This study is trying to comment on school refusal from the perspective of oriental medicine. Methods : We tried to examine the effect of oriental medicine treatment for school refusal with four adolescent cases. The patients commonly have at least more than one mental disorder (including depression disorder. anxiety disorder. and anorexia nervosa). have some problem with the relationship with their family. in particular with mother. do not have father or not be loved by their father. and have irregular eating habits. Thus. we diagnosed them as qi transforming into fire (氣鬱化矢) spleen-stomach deficiency cold (脾胃虛寒) and heart blood deficiency (心血虛) due to stress from the family issues and unhealthy eating habits. The patients received supportive therapy. family therapy. etc among many oriental mental treatments and their progress had been observed through hospitalization and outpatient treatment. Results : All four cases were reported positive progress on their symptoms and started coming back to school. We also examined whether they were well fitting into the school while they received outpatient treatment. and the results show that all four patients continue to settle down in normal school life. Conclusions : This study closely reviewed the mental disorder of school refusal cases and showed that the Oriental medical treatment was effective in helping the patients come back to school. More future research is required to better treatment for school refusal cases in oriental medicine.

Categorization of Nursing Diagnosis and Nursing Interventions Used in Home Care (가정간호에서 사용된 간호진단과 간호중재 분류)

  • Suh, Mi-Hae;Hur, Hae-Kung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.5
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    • pp.47-60
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    • 1998
  • This study was done to identify basic information in classifying nursing diagnoses and nursing interventions needed for the further development of computerized nursing care plans. Data were collected by reviewing charts of 123 home care clients who had active disease, for whom at least one nursing diagnosis was on the chart, and who had been discharged. Data included demographics, medical orders, nursing diagnoses and nursing interventions. The results of the study, which found the most frequent medical diagnoses to be cancer (40.7%) and brain injury (26.8%), showed that 'Impaired Skin Integrity'(18.3%), 'Risk for Infection'(15.0%), 'Altered Nutrition, Less than Body Requirements'(13.8%), and 'Risk for Impaired Skin Integ rity'(9.9%) were the most frequent nursing diagnoses. 'Pressure Ulcer Care'(28.4%) was the most frequent intervention for 'Impaired Skin Integrity', 'Infection Protection'(16.0%) for 'Risk of Infection', 'Nutrition Counseling'(26.8%) for 'Altered Nutrition' and 'Positioning'(22.0%) for 'Risk for Skin Integrity Impairment', Comparison of interventions with the Nursing Intervention Classification(NIC) showed that the most frequent interventions were in the domain 'Basic Physiological' (33.94%), followed by 'Behavioral'(27.8%), and 'Complex Physiological' (22.6%). Interventions related to teaching family to give care at home could not be classified in the NIC scheme. Examination of the frequency of NIC interventions showed that for the domain 'Activity & Exercise Management', 75% of the interventions were used, but for seven domains, none were used. For the domain 'Immobility Management', 93% of the times that an intervention was used, it was 'Positioning', for the domain 'Tissue Perfusion Management', 'IV Therapy' (59.1%) and for the domain 'Elimination Management', 'Tube Care: Urinary'(54.0%). The nursing diagnoses 'Altered Urinary Elimination' and 'Im paired Physical Mobility' were both used with these clients, but neither 'Fluid Volume Deficit' nor 'Risk of Fluid Volume Deficit' were used rather 'IV Therapy' was an intervention for 'Altered Nutrition, Less than Body Requirements', A comparison of clients with cancer and those with brain injury showed that interventions for the nursing diagnosis 'Impaired Skin Integrity' were more frequent for the clients with cancer, interventions for 'Risk of Infection' were similar for the two groups but for clients with cancer there were more interventions for' Altered Nutrition'. Examination of the nursing diagnoses leading to the intervention 'Positioning' showed that for both groups, it was either 'Impaired Skin Integrity' or 'Risk for Skin Integrity Impairment'. This study identified a need for further refinement in the classification of nursing interventions to include those unique to home care and that for the purposes of computerization identification of the nursing activities to be included in each intervention needs to be done.

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Role of Repeated Education to the Patients with Temporomandibular Disorders (측두하악장애 치료에 있어서 반복적 주의사항 교육의 효과)

  • Ok, Soo-Min;Heo, Jun-Young;Ko, Myung-Yun;Ahn, Yong-Woo;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.69-76
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    • 2013
  • Aim : The purpose of this study was to investigate the hypothesis that treatment with self-checking behavior management program was valuable in the management of temporomandibular disorders compared with a existing method treatment group. Methods : All participants who are diagnosed with temporomandibular disorders were treated with medication and physical therapy. They came into the clinic at intervals of two weeks, three times. The signs and symptoms were assessed investigating Pain NRS(Numerical Rating Scale), MCO(Maximum comfortable opening), Noise NRS, LOM(Limitation of Mouth opening) NRS at every visit. Experimental group received instructions repeatedly by using self evaluation questionnaire. Control group was educated once at the beginning of treatment. The difference Pain NRS, MCO, Noise NRS, LOM NRS between first and second visits, first and third visits were estimated.. Result :Experimental group showed greater improvement on MCO difference after stopping medication(p=0.001). This improvements were prominent in the male(p=0.001) and the first or second decade of the patients(p=0.004). Conclusion : The present study showed that there was better result when educating repeatedly with using self evaluation questionnaire than educating once at the beginning of the treatment.

A Prediction on the Conservative Treatment Outcome of TMD Patients by Prognostic Factors (측두하악장애 환자의 보존적 치료결과의 예측에 관한 연구)

  • Lee, Hye-Jin;Park, June-Sang;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.26 no.2
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    • pp.133-146
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    • 2001
  • This study was performed to predict the conservative treatment outcome of TMD patients by investigating the prognostic factors ; symptom duration, history of previous treatment, history of previous medication, history of trauma, disability of daily activity, severity of pain, noise, limitation of mouth opening(LOM) and maximum comfortable opening(MCO). Two hundreds and fifty-four subjects were selected for this study among the TMD patients who had visited the Dept. of Oral Medicine BNUH and been treated conservatively with medication, physical therapy, behavioral treatment, and splint therapy from 1991 to 2000. The subjects were divided into two groups improved or unimproved according to the treatment response following six months of conservative treatment. Those who showed less than 1 on NAS for pain, TMJ noise, and opening limitation belonged to the improved group and those who showed more than 2 on NAS belonged to the unimproved group. The two groups were compared with respect to symptom severity, number of diagnosis, history of trauma, previous treatment, previous medication, and disability of daily activity. A prognostic equation with the factors revealed to be significantly related to the prognosis of conservative treatment was obtained. The obtained results were as follows ; 1. In improved group, mean duration of history was 12 months, mean treatment duration of a patient was 4 months an mean number of treatment was about 10 times. In other words, in unimproved group, mean duration of history was 27.4 months, mean treatment duration of patient was 10.5 months and mean number of treatment was 19 times. 2. In unimproved group, multiple diagnosis, chronicity, disability of daily activity were significantly greater than that of the improved group. 3. Patients in unimproved group revealed severe noise at first visit and smaller maximum comfortable opening comparatively. 4. Prognostic factors such as duration of treatment, number of treatment, multiplicity, and chronicity and disability of daily activity showed a significant relation in prediction of improvement. 5. Prognostic equation with significant variables is as follows ; Y = 1.984 - 0.251Noise + 0.068MCO - 0.673Multiplicity. - 0.958Chronicity - 0.065Disability. Classification accuracy of 70.3 %, sensitivity of 71.4% and specificity of 66.7% were shown. 6. Prognostic equation with all factors is as follows : Y = 1.599 - 0.038Pain - 0.256Noise - 0.006Limitation + 0.068MCO - 0.580Multiplicity - 1.025Chronicity - 0.720Disability - 0.329Medication - 0.087Treatment + 0.740Trauma. Classification accuracy of 70.3 %, sensitivity of 73% and specificity of 64.3% were shown. 7. Prognostic value of the improved group with significant factors was $1.0446{\pm}1.0726$ and prognostic value of the unimproved group with significant factors was $-0.013{\pm}1.0146$. Prognostic value of the improved group with all factors was $1.0465{\pm}1.0849$ and prognostic value of the unimproved group with all factors was $-0.057{\pm}1.0611$.

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Dysphagia Rehabilitation Treatment for Children With Feeding Disorder : A Systemic Review (섭식장애가 있는 아동의 연하재활치료 : 체계적 고찰)

  • Jeon, Joo Young;Park, Hae Yean
    • The Journal of Korean Academy of Sensory Integration
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    • v.19 no.1
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    • pp.39-53
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    • 2021
  • Objective : The purpose of this study was to systematically review dysphagia rehabilitation treatment for children with feeding disorders. Methods : The articles evaluated in this study were collected from the PubMed, Medline Complete, and CINAHL databases and subsequently reviewed using the PRISMA flow chart and PICOS approach. A total of 13 papers were analyzed for study quality, disease groups, evaluation tools, interventions, and post-intervention effects. Results : Of the reviewed papers, six (46.15%) related to autism spectrum disorder (ASD) and seven (53.85%) to cerebral palsy (CP) with age ranges of between 2 and 8 years for the ASD studies and between 12 months and 18 years for CP. In evaluating the types of feeding disorder involved, the ASD group exhibited predominantly behavioral conditions while the CP subjects had a larger number of functional oral and swallowing issues. In terms of interventions, behavior modifications were used most frequently with ASD while oral-sensory motor, texture modifications, and electrical stimulation were applied at the same frequency with children with CP. All interventions were found to be effective. Conclusion : In this study, research into children with feeding disorders was reviewed according to condition, evaluation tool, and method of intervention. It is expected that this review can be used as basic data for developing a protocol that will allow clinicians to efficiently apply condition-specific interventions for eating disorders without resorting to trial and error.

A Case Study on the Improvement of Sociality in Convergence Theater Education : Focusing on a Theatrical Camp Milmi-ri Village School (융합연극교육의 사회성 발달 증진 효과사례 분석 : 연극캠프 밀미리 마을학교를 중심으로)

  • Kim, Jung-Sun;Bae, Jin-Sup
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.6
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    • pp.221-233
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    • 2019
  • The purpose of this study tries to show the effectiveness of integrated theater education for low-grade students who lack social skills with the direction of art education based on 'theatrical and educational theater' and 'theater therapy' in the revised curriculum in 2015. To do this, the researcher organized a theater camp organized by the social, cultural and arts education institute in Seoul for a total of 12 low-grade elementary school students for four weeks, and had a presentation session. In addition, the researcher observed the behavioral changes of the participating children to verify the social development of the theater education and after the conclusion, the final results were obtained through the in-depth interviews of the participants' parents and teachers. As a result, it was found that Social Skills Rating System(SSRS)' test, teachers' observation logs, interviews, and responses of participating children, which are the main subjects of this activity, had a great effect on improving their sociality and relationship. Therefore, the researcher tried to prove through this paper that theater education is effective in enhancing social skills as creative, personality and convergence education in preparation for the 4th industrial era and that it is important to solve communication problems such as the absence of human relationships.

The effectiveness and safety of acupuncture combination treatment on smoking cessation: A protocol for systematic review (금연에 대한 침술 병용 치료의 효과 및 안전성 : 체계적 검토를 위한 프로토콜)

  • In Suh Choi;Won-Suk Sung;Min-gi Jo;Jung-Hyun Kim;Yeon-Cheol Park;Eun-Jung Kim;Yong-Hyeon Baek;Geun-Woo Kim;Byung-Kwan Seo
    • Journal of Convergence Korean Medicine
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    • v.3 no.1
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    • pp.5-13
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    • 2022
  • Objectives: Smoking had a long negative impact on public health. The ingredients of a cigarette are major risk factors for several diseases. Owing to the problems about economic and quality of life, we need to ensure smoking cessation (SC). There are several approaches for SC including pharmacological therapy, nicotine replacement therapy, education, and behavioral intervention. However, due to some limitations, other alternative approaches are gaining popularity. Acupuncture has been reported to have few side effects and be more effective than some conventional treatments in several articles. However, there are no systematic reviews on the comparison of acupuncture combination treatment with other conventional monotherapies. Methods: Randomized controlled trials that used acupuncture as an adjunct treatment for SC will be searched and data will be summarized according to the predefined criteria. The primary outcome will be the abstinence rate, and secondary outcomes will be adverse events and biochemical indicators. We will use Review Manager to perform a meta-analysis, Cochrane Collaboration Risk of Bias tool for the risk of bias assessment, and the Grades of Recommendation, Assessment, Development and Evaluation approach to determine the quality of evidence. We will investigate the efficacy and safety of acupuncture combination treatment for SC with this study. Ethics and dissemination: This study will provide reliable clinical evidence on additional effect of acupuncture on smoking cessation. We will publish our results in a peer-review journal.

Effects of Family-Centered Intervention for Children with Autism Spectrum Disorder in South Korea: A Systematic Review - Focusing on Parent Education and Parent Coaching - (국내 자폐스펙트럼장애 아동에 대한 가족 중심 중재 효과: 체계적 고찰 - 부모 교육 및 부모 코칭 중심으로 - )

  • Choi, Yoon-Mi;Yoo, Eun-Young
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.3
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    • pp.65-78
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    • 2023
  • Objective : In this study, we aimed to investigate the effectiveness of family-centered intervention conducted with caregivers of children with autism spectrum disorder (ASD) in South Korea through a systematic literature review. Methods : Previous studies published from 2011 to 2021 were searched through RISS, KISS, and DBpia. The search terms applied included "autism spectrum" OR "general developmental disorder" OR "high-functioning autism" OR "Asperger's" AND "parent education" OR "family-centered intervention" OR "parent coaching" OR "parent training" OR "family participation." A total of 11 experimental studies were chosen based on the selection criteria. Results : According to the findings on the general characteristics of the study participants, intervention strategies, and effects of the intervention, it was observed that the majority of children with ASD who participated in the study were preschool-aged, and the majority of participating caregivers were mothers. The effects of family-centered interventions were evident in both children and parents. In children, the most significant effects were observed in interaction and communication skills. In parents, a reduction in parenting stress and an improvement in parenting efficacy were observed. The intervention strategies employed in the study varied, with sensory integration intervention, responsive communication, and interaction-centered intervention being the most commonly used, followed by developmental-centered intervention, positive behavior support (PBS), and parent-mediated intervention based on pivotal response treatment (PRT). Conclusion : The results of this study are significant in that they confirm that family-centered intervention is effective not only in improving the functioning of children with autism spectrum disorder, but also in reducing parenting stress and enhancing parenting efficacy, and provide evidence for clinical use.

Clinical Parameters Predicting Responsiveness to Treatment in Enuresis Patients (야뇨증 치료반응 예측에 관계하는 평가지표)

  • Lee, Kang-Gyoon;Lee, Hyun-Jung;Lim, Yun-Ju;Kwon, Duck-Geun;Kim, Eun-Jin;Pai, Ki-Soo
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.272-279
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    • 2007
  • Purpose : We tried to find out the clinical parameters which predict the outcome of treatment in children with enuresis. Methods : Enuresis patients who visited our hospital during 2003-2007 were included. Parameters such as age, gender, height, weight, minimal voided volume, maximal voided volume, maximum functional bladder capacity, frequency of voiding, urine S,G. before and after sleep were measured and an enuresis diary was also recorded. The reduction in wetting frequencies were classified into three groups; none(<50%), partial(50-90%) and complete(90%) response groups. We also compared the 'initial responders' who showed improvement(${\ge}50%$) during the 2 weeks of evaluation and behavioral therapy to the 'initial non-responders'. Results : Parameters mentioned above showed no significant relation to the treatment out-come. The response rate during the 2 weeks of the evaluation period was 32%(49/151) [complete in 1.3% (2/151), partial in 29.6% (47/151)]. Two-months' treatment responses were complete in 14(40%), partial in 19(54.3%) and none in 2(5.9%) responders(n=35), while they were 10(13.5%), 46(62.2%) and 18(24.3%), respectively in the non-responders(n=73) (P<0.05). Conclusion : We suggest that initial 'responsiveness' can be used as a predictor for good treatment outcome in patients with enuresis.

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