• 제목/요약/키워드: experienced violence

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외상후 스트레스장애 치료에 대한 한의학 임상연구 동향 (A Review on Clinical Research Trends in the Treatment of Post Traumatic Stress Disorder (PTSD) in Korean Medicine)

  • 주성준;권정은;권찬영;이보람;김상호
    • 동의신경정신과학회지
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    • 제30권3호
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    • pp.251-263
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    • 2019
  • Objectives: The purpose of this study was to review the clinical research trends in the treatment of post traumatic stress disorder (PTSD) in Korean medicine (KM). Methods: We searched MEDLINE, CENTRAL, EMBASE, Google Scholar and five Korean databases through May 2019, for studies on KM to treat PTSD. Clinical research that conducted KM treatment of PTSD patients were included. Two researchers independently conducted study selection and data extraction process. Results: Totally, eight studies were included in this review. Types of traumatic events that patients experienced included physical violence/threatening, traffic accidents, sexual violence and personal tragic events. KM interventions performed included acupuncture, moxibustion, herbal medicine, physical therapy, and KM-based psychotherapy. Treatment duration varied from two days to more than five months. Follow-up began at least one week to three months after the end of treatments. It was reported that the major psychological and/or somatic symptoms of PTSD, such as anxiety, depression, insomnia, and musculoskeletal pain, subjectively improved, as well as other objective outcomes: Impact Event Scale-Revised Korean version (IES-R-K), Beck's Depression Inventory (BDI), State-Trait Anxiety Inventory, Hwabyung Symptoms/characters, Electroencephalography (EEG) change, etc. Statistical studies were conducted in three studies only. Outcomes such as Visual Analogue Scale (VAS), BDI, and IES-R-K showed statistically significant improvement after KM treatments. There was no study reporting adverse events during or after the interventions. Conclusions: According to this review, diverse types of KM treatments have been used among PTSD patients in eight studies. The KM treatments effectively improved psychological and somatic symptoms of PTSD patients. However, the lack of high quality research as well as the lack of standardization of KM treatments for PTSD are limitations. Further methodologically robust clinical trials should be performed, and the standardization of KM treatments for PTSD should be sought.

지적장애인 성폭력 사건 특성과 법원의 판단 (Characteristics and Court's Decisions of Sexual Assault Case against the intellectually disabled)

  • 이미선
    • 한국심리학회지:법
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    • 제11권2호
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    • pp.211-239
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    • 2020
  • 본 연구는 지적장애인 성폭력 사건의 특성과 쟁점에 대한 법관의 판단을 확인하기 위하여 2015년부터 2018년 사이 선고된 하급심 판결문 분석을 실시하였다. 총 716건의 지적장애인 성폭력 사건에 대한 판결은 무죄 6.0%, 자유형 53.5%, 집행유예 36.7%로 나타났다. 절반 이상의 피해자는 반복적으로 피해를 경험했으며 특히 피고인이 친족이거나 아는 사람인 경우 피해가 반복되는 경향이 높았다. 전체 사건 중 절반은 피해 일시를 특정하지 못하였는데 피고인이 아는 사람이거나 피해가 반복된 경우 일시 특정에 더 어려움을 경험하였다. 지적장애인 사건의 쟁점사항은 진술의 신빙성, 사건당시 항거불능 여부 및 피고인이 피해자의 장애 인식 여부로 나타났다. 진술의 신빙성 판단 시 법관이 가장 빈번하게 사용하는 판단 기준은 진술의 일관성, 구체성, 허위 진술동기, 피해자 인지능력, 진술분석 결과 등의 순이었다. 항거불능 판단 기준으로는 피해자의 태도, 피고인의 태도, 성에 대한 지식 및 이해 순이었다. 장애인식 여부의 경우 피고인의 태도, 피해자의 언어 및 의사소통 능력, 관계지속기간, 일상생활능력 순이었다. 피해자의 장애등급과 성별에 따라 유무죄 판결 및 쟁점사항에 차이는 존재하지 않았다. 다만 피해자 연령이 13세 미만인 경우 13세 이상 피해자와 비교하여 진술의 신빙성 판단이 쟁점이 되는 빈도가 더 높은 반면 장애 인식 여부의 빈도는 유의미하게 더 낮은 것으로 나타났다. 마지막으로 본 연구의 결과에 대한 시사점 및 실무에서 활용방안에 대해 논의하였다.

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일부 중학생들의 자살생각 및 그의 관련요인 (Factors related to Suicide Ideation among Middle School Students)

  • 배상윤;윤현숙;조영채
    • 한국산학기술학회논문지
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    • 제16권1호
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    • pp.544-554
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    • 2015
  • 본 연구는 중학생들의 자살생각 및 그의 관련 요인간의 관련성을 파악하여 자살생각에 유의하게 영향을 미치는 요인들을 규명하고자 시도하였다. 조사대상은 경인 지역의 4개 중학교에서 임의로 선정된 재학생 975명으로 하였으며, 자료수집은 2013년 5월 1일부터 6월 30일까지의 기간 동안에 무기명 자기기입식 설문지(self-administrated questionnaire)를 통해 이루어졌다. 연구결과, 자살생각이 높은 위험 군으로는 여성 군, 흡연경험 군, 음주경험 군, 비만하다고 생각하는 군, 식사를 규칙적으로 하지 않는 군, 주관적 건강상태가 좋지 않다고 생각하는 군, 가정 분위기가 좋지 않은 군, 가정생활 만족도가 낮은 군, 학년이 낮은 군, 친구와 관계가 좋지 않은 군, 학교폭력을 경험한 군, 학교생활 만족도가 낮은 군, 절망감 수준이 높은 군, 사회심리적스트레스 수준이 높은 군, 우울수준이 높은 군이 선정되었다. 특히 이들 변수 중 절망감 수준은 자살생각에 크게 영향을 미치는 변수로 지적되었다.

관통성 손상에 의한 심장내 이물 - 수술 치험 1례 - (Intracardiac Foreign Body by Penetrating Cardiac Injury)

  • 정진용
    • Journal of Chest Surgery
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    • 제23권5호
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    • pp.929-935
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    • 1990
  • Violence in our society, combined with improving transport system, resulted in increased numbers of patients with cardiac wounds reaching the hospital alive. Most patients with penetrating cardiac injury, rather than blunt injury, present with a syndrome of either hemorrhagic shock or cardiac tamponade. And they should be operated upon as soon as possible. Often the atrioventricular valves and other important cardiac structures are also damaged by the penetrating instruments or missile. Both intracardiac communications and atrioventricular fistulas may result in significant left-to-right shunts accompanied by congestive heart failure, necessitating surgical correction. Usually, retained cardiac foreign bodies, which are almost always bullets or fragments of missiles, may lie within a cardiac chamber or in the myocardium. Emboli of bullets or other missiles from distant sites to the right side of the heart are numerous enough to require attention. Recently we experienced a case with intracardiac foreign body due to penetrating cardiac injury. A 19 year-old man was admitted to our hospital due to penetrating anterior chest wound by iron segment. The roentgenogram of the chest revealed a radio-opaque metallic shadow in left lower chest around the cardiac apex, mild blunting of left costophrenic space, but no cardiomegaly. During operation the foreign body was noted to be present in the cardiac chamber by the portable C-arm fluoroscopy. But during the manipulation it moved into left inferior pulmonary vein from left ventricle by way of left atrium. So we could manage to remove it from left inferior pulmonary vein by direct approach to the vein. It was iron segment, sized 0.lcm x0.6cmx0.5cm, with sharp margins. The patient had an uneventful postoperative recovery except for chylopericardium and was discharged.

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일 지역 고등학생의 성문제 행동 (Sexual Problem Behaviors in High School Students)

  • 김현옥;박광숙;전미숙
    • 한국간호교육학회지
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    • 제13권2호
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    • pp.257-265
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    • 2007
  • Purpose: This study was done to investigate sexual problem behaviors of high school students in one province, North Cholla. Method: The participants in this research were 951 high school students, grades 1, 2 and 3, chosen at random in big cities, small towns and rural areas of North Cholla Province. Result: The routes for sexual knowledge acquisition were through a peer group or an older member(35.8%), internet(29.8%), classes and the teacher at school(18.8%), multimedia(8.4%) and parents (7.2%). The percentages for domains of sexual problem behaviors were masturbation 36.7%, sexual impulse 35.6%, voyeurism 12.6%, sexual violence 9.6%, transvestism 4.1%, prostitution 3.5%, exhibitionism 3.1%, and pregnancy of a female student 0.6%. Sexual problem behaviors experienced by 30% or more of the students were reported as the experience of the desire to embrace, the desire to kiss, the desire to touch a friend's body of the opposite sex, masturbation and the desire to sleep with a friend of the opposite sex. The biggest sexual problem behaviors for the students were sexual impulses toward friends of the opposite sex and masturbation. These experience rates were higher for boys than for girls(p<.05), higher vocationally than academicly(p<.05), and higher in the largest cities than smaller cities and rural area(p<.05). Conclusion: These findings suggest that systematic programs that focus on a problem solution method should be developed for sexual problem behavior prevention.

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잠재계층분석(LCA)을 이용한 청소년-또래 비행의 유형과 특성 (Typologies and Characteristics of Adolescent-Peer Delinquency using Latent Class Analysis)

  • 박지수;김하영;유진경;한윤선
    • 아동학회지
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    • 제38권2호
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    • pp.165-176
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    • 2017
  • Objective: Delinquent peers are important predictors of adolescent delinquent behavior. Few studies have classified individuals into groups based on patterns of delinquent behavior among youth and their peers. This study identified latent groups based on adolescent-peer delinquency and examined psychosocial characteristics of each latent group. Methods: First, the study employed latent class analysis based on a nationally representative data of South Korean middle school students (N = 2,277). Both adolescent and peer delinquent behaviors comprised 13 items in the questionnaire that was self-reported by adolescents. Second, the study used multivariate regression models to analyze psychosocial symptoms of latent groups and conducted Wald tests to compare differences among latent groups. Results: Patterns of adolescent-peer delinquency were classified into six latent groups. "Mutual total delinquent group (1.2%)" showed high rates in most delinquent experiences. "Mutual status delinquent group (5.7%)" mainly experienced status delinquency, "Mutual violence delinquent group (5.3%)" showed high rates of violent delinquency. "Peer-only total high delinquent group (3.8%)" reported friends to have engaged in all types of delinquency and "Peer-only total medium delinquent group (11.8%)" reported peer involvement in multiple status and few violent delinquency. Finally, "low risk group (72.2%)" reported low rates of delinquency for themselves and their friends. Regression analysis showed that every "mutual" delinquent group presented significantly worse psychosocial problems than the "low risk group." Conclusion: Using person centered latent class analysis, this study classified six latent classes while considering both delinquent agents and various types of delinquency and investigated specific groups with greater risk of psychosocial problems.

이직의도가 있는 임상간호사의 소진경험에 관한 현상학적 연구 (Phenomenological Study on Burnout Experience of Clinical Nurses Who have Turnover Intention)

  • 김증임;손행미;박인희;신희진;박지현;조미옥;김성의;유미옥
    • 여성건강간호학회지
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    • 제21권4호
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    • pp.297-307
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    • 2015
  • Purpose: This study was aimed to understand the meaning and essentials of the experience of burnout for hospital nurses with turnover intention. Methods: The design was a qualitative research of phenomenological study. Participants: Seven hospital nurses who had worked over three years and had experiences of turnover intention in a hospital with over 400 beds were included. Results: Nine meaningful themes related to burnout experiences and four theme clusters of 1) battery warning sounds almost out; 2) the player who hit the drum and double-headed drum; 3) the target flying arrow without a break; and 4) the pendulum swaying to turn over. Registered nurses (RNs) felt burnout with an overload of work and by the thought that it was illegal action for registered nurses to receive insufficient rewards for their work. RNs also experienced there were no problem solving strategies to verbal violence by patient and medical team. Conclusion: The findings show that burnout experiences for those who had turnover intention was developed from the insight that insufficient training to do work independently with over-load for nurses was not ethical. It suggests that it is necessary to rethink training systems for nursing and hospitals to relieve turnover intention.

복강내 종양으로 오인된 외상성 혈종: 증례보고 (Traumatic Organized Hematoma Mimicking Intra-peritoneal Tumor : A Case Report)

  • 박종민;김성엽;정일용;김우식;신용철;김영철;박세혁
    • Journal of Trauma and Injury
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    • 제26권4호
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    • pp.300-303
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    • 2013
  • Blunt abdominal trauma is commonly encountered in the emergency department. The lack of historical data and the presence of distracting injuries or altered mental status, from head injury or intoxication, can make these injuries difficult to diagnose and manage. We experienced a case of traumatic organized hematoma misdiagnosed as intra-peritoneal tumor with intestinal obstruction. A 52-year-old homeless male patient who have chronic alcoholism was admitted via emergency room with infra-umbilical abdominal pain. At admission, he was drunken status and so we could not be aware of blows to the abdomen. He had a unknown large operation scar on mid abdomen. A computed tomography (CT) scan showed the intestinal obstruction of the ileum level with 5.5cm sized mesenteric tumor. We performed adhesiolysis and widely segmental resection of small bowel including tumor with side-to-side anastomosis due to great discrepancy in size. He stated later that he was a victim of the violence before 3 weeks. A final pathologic report revealed well encapsulated, traumatic mesenteric hematoma with organizing thrombi, ischemia and abscess formation with multiple adhesion bands. Finally, the patient was discharged without complications on postoperative day 14.

러시아 제국의 이단아 남서문학 - 오데사 문학에 나타난 유대인, 피카로(picaro), 언어를 중심으로 (Southwestern Literature as Heresy of the Russian Empire)

  • 이은경
    • 비교문화연구
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    • 제38권
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    • pp.215-243
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    • 2015
  • This paper looks at the literary mood of southwestern Russia in the late Russian Empire, while examining the writers of this area and their literary tendencies. Southwestern literature was formed in the late Russian Empire, and prospered centering around Odessa. Because of the uniformity in the Soviet culture, however, it could not stay alive but disappeared in the history of Russian literature. Odessa, the center of southwestern literature was a multiracial region unlike other Russian cities. A unique culture was created, therefore, combining the western European culture and local ethnicity. Jews in Odessa could enter into the Russian society and assimilate naturally. They could utilize their talents as a strength to enrich the Russian culture without giving up their cultural heritage. For example, in lingual aspects, using Yiddish was not against the Russian culture. In addition, it contributed to interesting new coinages and led to efforts among writers to minimize the gap between the two languages. Many Jewish writers showed special interest not only in Yiddish but also in French, German and other languages. Therefore, they took the lead in translating and introducing west classics. As evident in the way Yiddish language was formed, mixing their language with other languages enabled jews to soak their way into other cultures naturally. Their yearning for the Russian and western European cultures, combined with their unique sense of humor, led to generic twists and problematic experiments. From another point of view, it is also unusual that southwestern literature diversified locational settings and heroic characters in literary works. European style heros, appearance of multiracial people, pain or waggery experienced by Jews in their assimilation process, thrilling revenge to unfair violence of Russians, and espiegle swindlers are the new domains that southwestern literature pioneered. In summary, southwestern literature was formed in a heterogeneous cultural climate, which was entirely different from the Russian Empire. In this regard, it was in deviation from the Russian literary tradition. From the Soviet point of view, it existed as a heresy which was against the Russian Empire.

장애인 취업의사에 영향을 미치는 요인으로서 가족의 긍정적 의사표현, 사회적 관계망 그리고 장애정체감의 역할 (A Study on the determinants of intent to work of people with disabilities: Uncovering the roles of positive expressions from family members, social network, and disability identity)

  • 김재엽;이진석;오세헌
    • 사회복지연구
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    • 제45권2호
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    • pp.147-172
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    • 2014
  • 본 연구는 장애인들의 취업의사에 영향을 미치는 주요 요인으로서 가족의 긍정적 의사표현, 사회적 관계망, 그리고 장애정체감의 경로를 분석하는 데에 목적이 있다. 이를 위해 2010년 전국가정폭력 실태조사 자료 중 장애인관련 시설을 이용하는 성인장애인 453명을 대상으로 수집된 자료를 바탕으로 구조방정식 모형을 사용하여 주요 변수들의 인과관계를 검증하였다. 연구결과에 의하면, 가족원의 장애인에 대해 긍정적 의사표현의 빈도가 높을수록 장애인의 장애정체감과 취업의사가 증가되었다. 또한 사회적 관계의 빈도가 높을수록 장애인의 장애정체감이 상승되었으나 취업의사에는 직접적으로 영향을 미치지 않는 것으로 나타났다. 마지막으로 장애정체감은 취업의사를 결정하는 주요 요인으로서 파악되었다. 이상의 연구결과를 바탕으로 장애인의 낮은 취업의사로 인한 사회통합의 문제를 완화하고 예방하기 위한 개입 방안을 제언하였다.