• Title/Summary/Keyword: emotional disturbance

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NEUROPSYCHIATRIC SEQUELAE AND ITS EVALUATION IN CHILDREN AND ADOLESCENTS WITH TRAUMATIC BRAIN INJURY (외상성 뇌손상 아동의 신경정신과적 후유증 평가)

  • Kim, Hae-Gyoung;Bhang, Hyung-Suk;Park, Gwang-Soo;Wang, Mi-Rhan;Min, Seong-Ho;Park, Ki-Chang;Ahn, Joung-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.212-219
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    • 1999
  • Objective:This study is designed to get clinical guidelines for management of children with TBI by examining neuropsychiatric sequelae of TBI, determining whether the severity of TBI, type of treatment, and enviornmental factors are related to those sequelae, and defining the adequacy of public psychological tests as evaluating tools for them. Method:This is chart review of 47 children, aged 5 to 14 years, referred to a psychiatric outpatient clinic for neuropsychiatric evaluation at least 6 months after TBI. Data on the initial GCS score, associated injury, treatment type, and duration of hospital stay are obtained from medical records. EEG, MRI, intelligent test, and several psychological tests are administrated at the point of assessment. Results:1) Cognitive symptoms outnumber externalizing behavioral, emotional, and somatic symptoms, with no significant differences of frequencies of those 4 categorical symptoms between mild injury group and moderate to severe group. 2) Children treated with non-surgical method(p<0.01) complain more cognitive symptoms than the others. 3) Behavioral symptoms are related to younger age(p<0.05), and to anticonvulsant medication(p<0.05). 4) Children with associated injury complain emotional symptoms more frequently(p<0.05). 5) More somatic symptoms are presented by children with no medication(p<0.05), and with higher I.Q(p<0.05). 6) Low I.Q is correlated to low GCS score (p<0.05). Cognitive impairment is confirmed in 25 in 42 children complaining cognitive symptoms though I.Q test and BGT, whose hospital stay is longer than the others(p<0.05). 7) emotional disturbance is confirmed in 22 in 25 children showing emotional problems through psychological tests, who complain cognitive symptoms more frequently(p<0.05). Conclusion:This findings suggest that even mild TBI children need to be followed-up and treated as complaining neuropsychiatric symptoms over 6 months after injury, and shorter hospital stay is recommended for cognitive and emotional status of children, and for better evaluation of neuropsychiatric sequelae of TBI, more specific tests should be included in neuropsychological test tools.

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A STUDY OF THE EFFECTIVENESS OF THE BEREAVEMENT PROGRAM OF SEVERANCE HOSPICE (세브란스 호스피스 추후관리 프로그램의 효과에 관한 연구)

  • Wang, Mae-Ryeon
    • The Korean Nurse
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    • v.31 no.2
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    • pp.51-69
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    • 1992
  • Grief that is not acknowledged and worked through may manifest itself in some emotional, mental or physical problem. In recent years much has been learned about coping with grief which the hospice program can utilize to help family members cope with their grief. This study was carried out to determine the helpfulness of the bereavement care of Severance Hospice and to learm more about the grief response of the bereaved. The tools used to collect data were an assessment form used in the bereavement program and the Grief Experience Inventory developed by Sanders and revised and translated 'by the researcher. Data was obtained from bereaved family members(54 for the final grief assessment and 39 for the grief response assessment) receiving bereavement follow-up, from July 1989 to March 1991. Results of the study were as follows: 1. Final Grief Assessment Regarding the resolution of their grief the majority of the bereaved accepted the reality of the death of their family member, while slightly more than three-quarters were able to express their feelings toward their loss. A large majority had returned to activities of daily living well or fairly well and had reinvested their energy in a person other than the deceased. In addition, the physical condition of the majority was good or fairly good. A majority of the bereaved considered the bereavement care to be helpful and almost three-quarters were not considered to be in need of more follow-up. 2. Grief Response Assessment Age was found to have a modoerately positive correlation to appetite disturbance(r=.41, P<.Ol) and loss of vigor(r=.37, P<.Ol) A moderately positive correlation was found between the number of contacts and sleep disturbance(r=2.38, P<.01) Significant differences were found between men and women in regard to guilt(t=2.38, P<.05), social isolation(t=2.44, P<.05) and depersonalization(t=2.07, P<.05) with men having the more intense grief. Significant differences were found in the grief responses of somatization(F=5.82, P<.001), physical symptoms(F=5.87, P<.OOl), appetite disturbance(F=4.40, P<.Ol), despair(3.79, P<,Ol), anger(Fp2.83, P<.05), social isolation(F=3.61, P<.05), guilt(F=3.62, P<.05) and depersonalization (F = 2.58, P <.05). In the first six of these grief responses mothers scored highest, followed by husbands and then wives, In the grief response of guilt, daughters scored highest and on the grief response of depersonalization sons scored highest. Only one grief response, that of sleep disturbance(t= -2.19, P<.05) was found to be statistically significant, with those family members who died at home having the higher scores. Based on the results of this study several suggestions are presented as follows: 1. Since unresolived grief can have a detrimental effect on the bereaved person's mental and phys. ical health it would be good for the nurse, to include questions related to death of family members and the bereaved person's response to the grief, in her nursing assessment. And in the case of unresolved grief the nurse should encourage the person to talk with a trusted friend or counselor and express their fellings of grief. 2. A study to determine the degree of resolution of the grief of those in the bereavement program could be carried out by use of the Grief Experience Inventory early in their bereavement and again 13 months after the death of their family member. 3. A comparison of the grief response of the bereaved in the bereavement program and bereaved not in the program could be carried out using the Grief Experience Inventory. 4. After bereavement programs have been started in other hospice programs it would be good to carry out a joint study of bereavement outcomes of those in the bereavement programs.

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A Study on the Factors related to postpartum Depression in Postpartum Women (산욕기 산모의 산후 우울증에 영향을 미치는 요인)

  • Choi, Euy-Soon;Oh, Jeong-Ah
    • Women's Health Nursing
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    • v.6 no.3
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    • pp.358-371
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    • 2000
  • The purpose of this study was to provide the basic, data for developing a program for effective prevention for Postpartum Depression (PPD) by investigating the level of PPD in postpartum 2 weeks women. The subjects were 384 women who visited obstetrical clinics for postnatal care. The data were collected from June 29. 1999 to April. 2000, using a 46-item questionnaire related to PPD, and analyzed by SAS program for t-test, ANOVA, Scheffe test, stepwise multiple regressions. The results were as follows : 1. The level of PPD according to general characteristics Women had mild PPD (Min score; 46.0, Max score; 124.0). The PPD levels were significantly differences according to religion and marital satisfaction (p<0.05). 2. The level of PPD according to obstetrical characteristics 1) Characteristics related to pregnancy The PPD levels were significantly differences according to mood change, confidence of body weight recovery, depression related to appearance change, husband's help to housework, and husband's emotional support (p<0.05). 2) Stressful events during pregnancy The PPD levels were significantly differences according to financial problem, conflict between partners, conflict between family, and husband's job change (p<0.05). 3) Characteristics related to delivery and post natal period The PPD levels were significantly differences according to baby's health state, parenting confidence, and difficulties related to postpartum care (p<0.05). 3. The variables to predict postpartum depression in postpartum women are depression related to appearance change (10.4%), parenting confidence (8.8%), husband's help to housework (2.7%), confidence of body weight recovery (2.4%), husband's job change (1.9%), baby's health state (1.9%), difficulties related to postpartum care (1.6%), mood change (1.2%), conflict between partners (0.6%), marital satisfaction (0.5%), financial problem (0.4%). The sum total of all the above variables can account for 32.4% of postpartum depression. 4. The level of PPD according to PPD factors. Women had the highest degree of PPD in biophysiological phenomena-disturbance of physical functioning factor. The factors of relationship to baby-negative feeling and cognitive phenomena-self concept disturbance were showed the lowest degree of PPD. As a result of the above findings, a systemic and individualized program is strongly recommended for PPD prevention, diagnosis, and care for PPD in postpartum women. In near future, this study should be expanded to investigate the coping skills according to the PPD levels in postpartum women.

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The Bibliogrphical Study on the Allergic Rhinitis (알레르기性 鼻炎에 對한 文獻的 考察)

  • Kim, Hyun-Ah;Jung, Ji-Chun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.7 no.1
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    • pp.53-84
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    • 1994
  • The study has been carried out to investigate of the Allergic Rhinitis by referring to 87 literatures. The results were as follows; 1. In oriental medical science, Allergic Rhinitis is belong to the category of the 'BiGu'(鼻구) 'GuChe'(구체). The 'Gu'(구) of the BiGu means watery rhinorrhea, the 'Che'(체) of the GuChe means sneezing. 2. The cause of a disease summarize the weak of Lung, Spleen and Kidney, and invasion into the nasal cavity of PoongHan etc a wrong air. Sometimes the pathologial change appear PoongHan changeHwa(風寒化火), HwaYeol is hidden in the inside(火熱內伏). The contributing factors are found a season(spring, winter), an abnormal weather(運氣 : 少陰 少陽 陽明 司天, 歲金不及), an emotional stress, an external wound of the harmful air, a food allergens and fatigue, a contact of substances, a sunlight etc. 3. Predominant symptoms are watery rhinorrhea, sneezing and nasal obstruction. Sometimes accompanic symptoms are nasal bleeding, mucopurulent rhinorrhea, olfactory disturbance, nasal polyp, rhinolalia clausa, respiratory disfunction etc. 4. The treatment-methodes is as follows, OnBoPaeJang GeoPoongSanHan(溫補肺臟 祛風散寒), GeonBilkGi(健脾益氣), BoSinNabGi (補腎納氣). The treatmentherbs is as follows, OnBoJiLuDan GaGam(溫補止流丹 加減), OkByeongPoongSan plus ChangIJaSan GaGam(玉屛風散合 蒼耳子散 加減), BoJungIkGiTang GaGam plus SoCheongLyongTang(補中益氣湯加減 配合 小靑龍湯), SinGiHwan GaGam(腎氣丸加減), GaeJiTang(桂枝湯) etc. 5. The external treatment is as follows, JeokBi(滴鼻), ChuiBi(吹鼻), SaekBi(塞鼻), stick and herbs-injection on the acupuncture-point, pressure ear acupuncture-point, herbs-pillow etc. 6. The acupuncture-moxa treatment is as follows, the methodes of cure apply TongJoGyeongGi(通調經氣), SanTongBiGui(宣通鼻竅) etc. Predominent acupuncture-points are YoungHyang(迎香), InDang(印堂), BiTong(鼻通), SangSeong(上星), HabGok(合谷) and so on. As mentioned above, from now on, it's need to the oriental medical scientific study of the Immunity and Allergy and to the external treatment's application for the ascent of the treatment-effect of the allergic disease.

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Studies on the Treatment of Irritable Bowel Syndrome(IBS) in Oriental Medicine (하부위장관 기능장애 치료의 한의학적 접근방법에 관한 연구)

  • Lee, Gun-Up;Won, Jin-Hee;Moon, Gu;Moon, Seok-Jae;Ryu, Su-Taek
    • The Journal of Internal Korean Medicine
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    • v.21 no.1
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    • pp.162-168
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    • 2000
  • Irritable Bowel Syndrome(IBS) is the most common disease in the western male, and it is founded in $70{\sim}80%$ patient who has Gastrointestinal trouble. It is characterized by the formation of disorders of Gastrointestinal tract, for example, constipation, diarrhea, abdominal pain& discomfort, stool urgency, and so on. The etiology of IBS is uncertain, but the majority of patients has emotional problems. The aims of this study are to investigate and summarize the current trends of treatment for IBS so as to suggest the effective and available way to treat this disease. In Oriental Medicine, the IBS is recognized as Stagnation of the Iiver-qi(肝氣鬱結), Incoordination between the liver and the stomach(肝胃不和). So the point of treatment of IBS is Invigorating the spleen and relieving the depression of Iiver-qi(疏肝健脾), Regulating the function of the liver and the flow of qi(調肝理氣), Regulating the stomach and lowering the adverse flow(和胃降逆), and the treatment can be approached in several ways through herb drugs, acupuncture. Some of the herb drugs have substances which promote gastric and small intestinal emptying. Acupuncture and moxibustion therapies stimulate the meridian points of LR(足厥陰肝經), ST(足陽明胃經), LI(手陽明腸經), SI(手太陽小腸經) and is reported to be effective for releafing syndromes. Anal therapy, attachment of herb drug to umbilicus are annunced as the effective treatments. So, this study of the approach and application of these treatments on IBS would be necessary.

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Effects of Non-pharmacological Interventions on Primary Insomnia in Adults Aged 55 and Above: A Meta-analysis (수면장애가 있는 중장년 환자에게 적용한 비약물적 중재의 효과: 메타분석)

  • Kim, Ji Hyun;Oh, Pok Ja
    • Korean Journal of Adult Nursing
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    • v.28 no.1
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    • pp.13-29
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    • 2016
  • Purpose: This study was performed to evaluate the effects of non-pharmacological interventions on sleep disturbance amongst adults aged 55 and above. Methods: PubMed, Cochrane Library, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms including non-pharmacological interventions and presence of insomnia. Non-pharmacological interventions included cognitive behavioral therapy, auricular acupuncture, aromatherapy, and emotional freedom techniques. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.3 program of Cochrane Library. Results: Sixteen clinical trials met the inclusion criteria with a total of 962 participants. Non-pharmacological interventions was conducted for a mean of 5.5 weeks, 7.7 sessions, and an average of 70 minutes per session. The effects of non-pharmacological interventions on sleep quality (ES=-1.18), sleep efficiency (ES=-1.14), sleep onset latency (ES=-0.88), awakening time after sleep onset (ES=-0.87), and sleep belief (ES=-0.71) were significant, and their effect sizes were ranged from moderate to large. However, the effects on total sleep time and insomnia severity were not significant. Conclusion: The findings of the current study suggest that non-pharmacological interventions have a positive impact on attitudes and beliefs about sleep, sleep quality, sleep duration, and sleep efficiency. Therefore, the findings of the study provide an evidence to incorporate various non-pharmacological interventions into nursing practice to improve both sleep quality and quantity in patients with insomnia.

A Comparison of Nursing Interventions with Terminal Cancer Patients in a Hospice Unit and General Units (호스피스 병동과 일반병동의 말기암환자의 간호중재 비교)

  • Ro, You-Ja;Han, Sung-Sook;Yong, Jin-Sun;Song, Min-Sun;Hong, Jin-Ui
    • Korean Journal of Adult Nursing
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    • v.14 no.4
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    • pp.543-553
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    • 2002
  • Purpose: The purpose of the study was to compare symptoms, medical therapies, and nursing interventions with terminal cancer patients during the last four weeks of their lives in a hospice unit and general units. Method: For the descriptive survey study, data were collected by reviewing the medical records of 243 patients who died of terminal cancer at K hospital in Seoul. The data was analyzed by using Chi-square test and t-test. Result: The study findings are summarized as follows: There were higher frequencies in physical symptoms of constipation, itching sensation, pain, sleeping disturbance, soreness and dysuria for those patients in the hospice unit than those patient in general units. All emotional symptoms were recorded significantly higher for those patients in the hospice unit than those in general units. Regarding the major medical interventions, pain management was used more significantly for those patients in the hospice unit, but antibiotic therapy and resuscitation were used more significantly for those patients in general units. Conclusion: The hospice unit provided more comprehensive nursing interventions including psychological, spiritual, and family cares as well as physiological care for terminal cancer patients. The facts showed that those patients who would need hospice care in general units should be referred to the hospice unit at an appropriate time.

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An Analysis of Related Factors for Major Nursing Diagnoses Identified for Instituionalized Elders (일 시설노인에게 나타난 주요 간호진단의 관련요인 분석)

  • Hur, Hea-Kung;Park, So-Mi;Kim, Gi-Yon;Shin, Yun-Hee;Yim, Eun-Shil
    • Korean Journal of Adult Nursing
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    • v.15 no.1
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    • pp.126-136
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    • 2003
  • Purpose: The purpose of this study was to analyze related factors for major nursing diagnoses used in caring for institutionalized elders. Method: This study was a descriptive study. The participants were 92 residents in a long-term care facility in Wonju, selected by convenience sampling. The instrument was a checklist designed on the basis of the related factors suggested by NANDA (1997) and a literature review. Data was collected by chart review, observation, and interviews with the participants. Data was analyzed using descriptive statistics with the SPSS WIN program. Result: The most frequent nursing diagnosis was 'risk for injury', 'self-esteem disturbance', 'activity intolerance', 'impaired phyical mobility', and 'powerlessness'. The most frequent component for related factors for the five component for each nursing diagnosis was the physical component, followed by the social component. Common related factors for the nursing diagnoses were 'pain', 'change of emotional state/disorder', 'cognitive disorder', 'change of physical structure and function', and 'physical impairment', and 'immobility'. Conclusion: The results of this study can contribute to the development of appropriate nursing intervention programs for elders (eg. 'Injury Prevention Programs', 'Self-esteem Improvement Programs' etc.). Clinical guidelines that gerontological nurses can use to accurately assess health problems and select appropriate nursing interventions may be developed.

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Research of Education Program for Autistic Children the Clay (흙 놀이를 통한 유아자폐증치료과정 연구)

  • Kim, Sung-Min
    • The Journal of the Korea Contents Association
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    • v.9 no.3
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    • pp.91-98
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    • 2009
  • The structure of modern society are complex, fast, overflowing of individualism and losing of independence through the standardization of human relationship. The frequency increased that children watch television and play computer game alone through this structure. Also, the mental disorder like as autism tend to be increase for childhood because, parents overprotect, unmethodical bringing up children, emotional disturbance and effect of genetic. Therefore, research and case study of art therapy publish that illustrates a tendency of developing and growing. On the base of this situation art therapy realize more important than before and gain power. Therefore, this research consider that clay therapy effect for autistic just children and investigate function of catharsis through the case study. Also, make study that social rappot and function of catharsis develop for children who has autism. The suggest effect of synergy which come from clay therapy(education of ceramic) and development of education program.

Literatural Study on Tae-yeul (태열(胎熱)에 관한 문헌적(文獻的) 고찰(考察))

  • Gu Jin-Suk;Kim Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.1
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    • pp.235-253
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    • 2001
  • Tae-yeul is the baby's disorder inheritted by its mother during fregnancy. This is due to its mother's overeating hot, fatty food and taking harmful medicine. So internal physical fever is accumulated in mother's body, and it heats up the placenta and the umbilical cord. Generally, this disorder means the skin disease that is occurred from $2{\sim}5$ months to 1 year after birth. It is specialized by the dirty oozing, a severe itching and the rash at its head and face. It is similar in its symptoms such as atopic dermatitis in western medicine. Recently, this disease has the increasing tendency of prevalence rate because of the bad atmosphere and the invironmental pollution. The results were summerised as follows; 1, 2, 3, 4 1. The causes of Tae-yeul are summarized by fragnat woman's contacting a cool air, overating a hot and toxic food and taking emotional shock. 2. The symptoms of Tae-yeul are the edema on upper eyelids, stifling convulsions, flush, the fever of one side body, the asthma of sputum increase, the yawing of the tired mind, the bowl complaint, the red urine and urination disturbance. 3. In the treatment method of Tae-yeul, its mother feed her milk after taking a madicine. So one must expect to be treated slowly. If one tries to treat it with a cool madicine quickly, it can cause vomitting or a serious disorder. 4. In the prescription of Tae-yeul, they used a Moktongsan, a Chiwhnagtang, an Yangyoubang, a Tojuksan, a Whangyunsan, a Juryungtang and a Kamdutang, etc.. For the method of cleaning face or bathing, they used Sasungsan, Whanbaekpijuntang. 5. Tae-yeul including Naesun, Taelyumchang, yousun, etc. is similar to the atopic dermatitis of western medicine in its symptoms.

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