• 대한불안의학회지
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• 제18권2호
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• pp.101-108
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• 2022

Objective : The purpose of this study was to investigate depression, anxiety, trauma experience, and suicidal tendency among patients who were hospitalized in a community treatment center and to identify the factors that were associated with each symptom. Methods : A total of 213 patients who were hospitalized in the Tae-reung community treatment center between March 16, 2020 and April 30, 2020 were recruited into this study. A self-report questionnaire or interview by mental health professionals was used to assess PHQ-2, GAD-7, PC-PTSC and P4 screener. In 90 patients who completed the survey, multiple regression modeling was conducted to identify the burden of each psychiatric symptoms and associated demographic characteristics. Results : Female gender was significantly positively associated with GAD-7 score, score of each GAD-7 subscale of 1, 2, 3 or 4 (nervous, control of worry, worry, and trouble relaxing), and sum of GAD-7 subscale scores reflecting cognitive and emotional experience of anxiety (1. nervous+2. control of worry+3. worry+7. afraid). Previous psychiatric history and, number of counseling service used were significantly positively associated with the PHQ-2 score and the duration of isolation was significantly negatively associated with the PHQ-2 score. Conclusion : These results showed that depression and anxiety symptoms were more prevalent in COVID-19 patients at the community treatment center than in the general population. Among the demographic characteristics, female gender was positively associated with cognitive and emotional experience of anxiety. It shows the necessity of an appropriate psychiatric intervention protocol and health-policy preparation for community treatment centers.

• 농촌의학ㆍ지역보건
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• 제43권3호
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• pp.158-171
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• 2018

목적: 이 연구는 2007년 충남 태안군에서 발생한 허베이 스피리트호의 유류 유출사고에 대한 신체적, 심리적, 정신 건강영향에 대한 trauma signature (TSIG) 분석을 시도한 사례 연구이다. 대상 및 방법: TSIG 분석은 유류유출 사고와 관련된 위해 노출의 신체적, 심리적 결과를 검정하는 방법론으로 태안지역 인구에 대하여 노출된 위해 프로필(hazard profile), 노출 스트레스 마트릭스(matrix of exposure stressors), "trauma signature" 요약 등을 분석한 것으로 위해요인, 손실, 변화 요인 등에 대하여 인위적 재난에 대한 분석을 저자들이 구조화된 틀을 활용하여 분석을 시도한 사례이다. 결과: 허베이 스프리트호 유류 유출사고의 특징(signature)은 다원, 다면적이고 한국에서 역사적으로 가장 큰 해양오염 사고로 태안 지역사회 및 인접한 지역에 영향을 준 것으로 요약된다. TSIG 분석결과는 주요한 근거에 따른 신체적, 심리적, 정신적 요인에 대한 영향을 나타내었는데 이는 노출의 정도(exposure severity)에 따른 위해도, 손실, 변화의 범주에 따른 결과였다. 노출의 정도는 낮음(low)에서부터 극심(extreme)까지 그 범위가 다양하였으나 위험요인의 순위는 대부분 낮음에서 중등도(moderate)의 중증도를 보였다. 결론: 허베이 스프리트호 유류 유출사고에 대한 TSIG 분석 사례연구는 재난 상황 등에서의 TSIG 분석방법론의 적용가능성을 경험하였다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권3호
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• pp.156-167
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• 2017

Childhood exposure to intimate partner violence (IPV) and other adversities has been shown to have adverse effects on health and well-being not only in childhood but also throughout the lifespan. This paper focuses on the prevalence of childhood adversities including exposure to IPV. The intersection of adverse childhood experiences and IPV victimization/perpetration in adulthood is also explored. The neurobiology of trauma is discussed and by understanding the impact of trauma on health, it is hoped that enhancement of resilience is possible. Based on the identification of protective factors at the individual, familial, and community level, examples of interventions that encourage safe, stable, and nurturing relationships between parents and children are described.

• Journal of Trauma and Injury
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• 제34권1호
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• pp.39-43
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• 2021

Purpose: Determining appropriate ways to assess health care quality within the National Health Insurance System is of interest to both the Korean government and the medical community. However, in the trauma field, the number of indicators used to evaluate surgical quality is limited. Using data collected over 5 years at Wonju Severance Christian Hospital Trauma Center in Korea, this study aimed to determine whether the unplanned reoperation rate in the field of trauma surgery could be used to assess the quality of an institution's surgical care. Methods: In total, 665 general surgical procedures were performed at the Trauma Center in 453 patients with abdominopelvic injuries from January 2015 to December 2019. Data were collected from the Trauma Center's data registry and medical records, and included information regarding patients' demographic characteristics, the type of index operation, and the reason for unplanned reoperations. Results: A total of 453 index operations were evaluated. The proportion of patients with an Injury Severity Score (ISS) >15 was 48-70% over the 5-year period, with an unplanned reoperation rate of 2.1-9.3%. Patients had an average ISS score of 17.5, while the average Abbreviated Injury Scale Score was 2.87. Unplanned reoperations were required in about 7% of patients. The most common complications requiring reoperation were recurrent bleeding (26.9%), wound problems (26.9%), intestinal infarction (15.4%), and anastomosis site leakage (7.7%). The procedures most frequently requiring unplanned reoperations were bowel surgery (segmental resection, primary repair, enterostomy, etc.) (24.5%) and preperitoneal pelvic packing (10.6%). Conclusions: The proportion of reoperations was confirmed to be affected by injury severity.

• 지역사회간호학회지
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• 제19권1호
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• pp.36-45
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• 2008

Purpose: This study was to estimate the prevalence of dementia in order to estimate the associations of dementia with its risk factors in the community elderly. Methods: The multistage random cluster sampling method was used to select the subjects. The response rate was 94.3%. For the 1st stage screening survey, the Korean-version Mini-Mental State Examination (K-MMSE) and the Bathel Index of activities of daily living (ADL) and instrumental activities of daily living (IADL) were used as primary screening tools. At the 2nd stage. diagnoses were confirmed according to the Clinical Dementia Rating Scale (CBR) and Computer Tomogram (CT). Results: Age-sex adjusted prevalence (%) [95% CI] of dementia was 6.25% [4.47-7.83] (male 4.21% [2.40-6.02]; female 8.28% [5.71-10.85]). Four statistically significant risk factors of the dementia were identified: age 70-74 (OR=1.367), age 75-79 (OR=1.712), age 80-84 (OR=2.465), age 85 over (OR=7.363) illiteracy (OR=3.827); unconsciousness after head injury (OR=3.383), and no exercise (OR=2.188). Hosmer and Lemeshow goodness-of-fit index of dementia risk model was E (legit of dementia)= -4.337+$0.312^*Age(70{\sim}74)+0.538^*Age(75{\sim}79)+0.902^*Age(80{\sim}84)+1.996^*Age$(85over)+$1.342^*$Illiteracy+$1.219^*$Unconsciousness after head trauma+$0.783^*$No exercise. We confirmed that the overall prevalence of dementia in adults aged 65 and older was 94.3%. The risk factors of dementia were explained by age, illiteracy unconsciousness after head trauma and no exercise. Conclusion: These data have been used to estimate the incidence of dementia in elderly community population and to manage the possible role of risk factors as predictors of dementia.

• Journal of Trauma and Injury
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• 제35권2호
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• pp.99-107
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• 2022

Purpose: The term "intentional injuries" refers to a spectrum of injuries resulting from self-inflicted injuries, interpersonal violence, and group acts of violence. Intentional injuries are underreported in Saudi Arabia. This study aimed to analyze and evaluate the characteristics of intentional injuries in patients who presented to the emergency department of a primary trauma center in Medina, Saudi Arabia in 2013. Methods: A prospective cohort database analysis of the clinical patterns and treatment outcomes of 252 patients who had intentional injuries between January and December 2013 was done. Results: The proportion of trauma patients with intentional injuries was 1.3%. The mean age was 34.2±9.4 years, 141 patients (56.0%) were male, and 111 (44.1%) were female (male to female ratio, 1.27:1). The majority (n=159, 63.1%) of injuries occurred at night. Most occurred outside the home (n=180, 71.0%). Financial problems (n=62, 24.6%) and social disputes (n=61, 24.2%) were the most common reasons. Sharp objects (n=93, 36.9%) were the most common weapons used. The head and neck were the most commonly injured areas (n=63, 54.4%). Superficial cuts (n=87, 34.5%), were the most common type of injury. Suturing of wounds (n=54, 21.4%) and surgical debridement (n=47, 18.7%) were the most commonly performed modalities of management. Conclusions: We conclude that intentional injuries in Saudi Arabia are a health care hazard that is, unfortunately, underreported. The clinical pattern is similar in most aspects to international reports but differs in certain features due to the specific religious and conservative characteristics of the community. Nationwide clinical studies are strongly recommended.

• 인지과학
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• 제26권2호
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• pp.167-207
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• 2015

본 연구는 외상후 스트레스 장애(Posttraumatic stress disorder, PTSD)가 등장한 이후 현대 사회에서 외상 및 고통을 인식하고 이에 대응하는 방법을 조명하였고, 한국 사회의 외상 인식과 대응 방식을 검토하면서 외상 회복을 위한 대안 패러다임의 원칙을 제시하였다. 외상은 기억을 매개로 만성적인 고통을 야기하는 외부 스트레스 사건으로서, 미국정신의학회는 1980년 정신장애 진단 및 통계 편람에서 외상후 스트레스 장애를 공식 인정하였다. 외상후 스트레스 장애 진단의 개발은 피해자에게 도덕적 정당성을 부여하였고, 성공적인 치료 개입의 길을 열었으며, 신경생리학과 인지신경과학 분야에서 연구 성과 축적에 기여하였다. 그러나 이와 동시에, 고통에 대한 인식이 협소해졌고, 기술 개입의 한계를 넘어서는 대응 방안의 중요성이 간과되고 있다. 특히 한국사회의 분리와 부인의 역사적 맥락, 의료 및 전문가 중심 관료주의 기저에는 외상을 개인의 문제로 치환하려는 전략이 발견된다. 따라서 사회적 고통으로서 외상을 인식하고 대안 패러다임을 모색할 필요가 있다. 이 글은 진실 규명과 정의 회복, 회복 주체로서 생존자와 공동체의 책임, 최신 생물-심리학적 성과의 생태학적 적용, 그리고 회복이란 무엇인가에 관한 지속적인 논의를 중시하는 대안 패러다임의 원칙을 제시하였다.

• 한국언론정보학보
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• 제80권
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• pp.167-192
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• 2016

본 연구의 목적은 세월호 참사로 인한 사회적 트라우마 현상을 분석하고, 미디어를 통한 트라우마 테라피의 의미와 한계가 무엇인지를 탐구하는 데 있다. 이를 위해 융의 집단 무의식과 원형, 개성화의 개념을 적용했고, 세월호 참사의 유가족, 심리상담 전문가, 일반인 자원봉사자와 일대일 심층인터뷰 및 초점집단인터뷰를 진행했다. 그 결과, 연구참여자들은 일차적/이차적 피해 경험에 따라 고립감, 불안 등 각기 다른 형태의 사회적 트라우마를 겪고 있으나, 공동체로서 사회적 트라우마를 함께 극복해나갈 수 있는 가능성을 나타냈다. 둘째, 연구참여자들의 일상생활에서 죽음과 삶, 애도와 기억 등의 원형이 표출되고 있었다는 점, 또한 테라피 활동을 통해 다양한 원형들의 상징이 포착되었다는 점을 확인했다. 마지막으로, 세월호 참사 피해자들을 대상으로 한 미디어 테라피 프로그램은 여러 측면에서 한계가 있지만 시간과 장소에 구애받지 않는 공예 활동의 테라피 효과가 높다는 점은 디지털 미디어를 통한 트라우마 테라피의 가능성을 시사한다. 본 연구는 사회적 트라우마의 문제점을 드러내고 개성화를 통한 치유와 미디어 테라피의 가능성을 고찰하기 위한 기초 자료를 제시했다는 점에 의의가 있다.

• 사회복지연구
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• 제43권1호
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• pp.249-273
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• 2012

본 연구는 응급구조원, 사상 사고를 경험한 지하철승무원, 아동보호전문기관 사회복지사를 대상으로 직종, 심리적 고통, 대리 외상, 일반적 특성에 따른 외상 후 성장을 비교 분석한 연구이다. 분석 결과 첫째, 대리 외상은 세 집단 모두 위험 수준으로 높게 나타났고 특히 지하철승무원의 대리 외상이 높았으며, 외상 후 성장은 사회복지사가 가장 높고 지하철승무원이 가장 낮았다. 둘째, 대리 외상과 외상 후 성장은 상관관계가 유의한 것으로 나타났으며 특히 침습과 회피의 하위항목이 외상 후 성장과 상관관계가 높았다. 셋째, 외상 후 성장에 영향을 미치는 요인은 직종, 침습, 회피, 종교, 성별의 순서로 크게 나타났다. 본 연구에서는 이 결과를 바탕으로 대리 외상 위험 직종에 대한 정신건강서비스 제공과 외상 후 성장의 치료적 적용을 제언하였다.

• 대한간호학회지
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• 제53권5호
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• pp.500-513
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• 2023

Purpose: Women are more vulnerable to post-traumatic stress (PTS) than men, causing several health problems. Nurses should understand and work with women who have experienced trauma and provide interventions to promote their physical, social, and mental health. Methods: This quasi-experimental pilot study used a one-group pre-test/post-test design. Data were collected from 14 women recruited between December 2019 and May 2020 from a self-sufficiency support center in South Korea for sexually-exploited women who had experienced trauma. The program consisted of six one-on-one intervention sessions per week for six weeks. Each session averaged 60~120 minutes. Participants were assessed at pre-test, post-test, and one-month follow-up. Changes in outcome variables over time were analyzed using the Wilcoxon signed-rank and Friedman tests. Results: The caring program for health promotion was divided into six sessions: understanding the self, sharing traumatic events and negative emotions, reframing the meaning of traumatic events, identifying thoughts and physical and emotional responses, developing health promotion activities, and maintaining a positive attitude during the process of change. As a result of the caring program, PTS (F = 36.33, p < .001), depression (F = 24.45, p < .001), health-promoting behaviors (F = 7.06, p = .004), and self-esteem (F = 19.74, p < .001) among the participants differed significantly at pre-test, post-test, and follow-up. Conclusion: This study provides foundational information for the implementation of a theory-driven program by nurses in clinical and community settings to provide comprehensive care for women who have experienced trauma.