• 제목/요약/키워드: informed consent form

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The Art Therapy Experiences of Patients and Their Family Members in Hospice Palliative Care

  • Park, Sungeun;Song, Hyunjoo
    • Journal of Hospice and Palliative Care
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    • 제23권4호
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    • pp.183-197
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    • 2020
  • Purpose: In this study, the researchers closely investigated the psychosocial problems faced by terminal cancer patients and their family members in hospice palliative care units. Methods: The investigators conducted four sessions of art therapy intervention programs for the terminal cancer patients and their family members, carried out in-depth interviews about the influence of the cancer experience on their family function and quality of life, and analyzed their experiences using grounded theory methodology. Results: After providing autonomous written informed consent, six pairs of terminally ill cancer patients and their family members, accounting for a total of 17 participants with the inclusion of additional family members who took part sporadically, took part in the art therapy intervention and interviews. The raw data, in the form of verbatim records, were analyzed according to the procedures of grounded theory (open, axial, and selective coding). Through these processes, a total of 154 concepts, 56 subcategories, and 13 categories were identified. Families were classified into four types according to their family function, quality of life, and attitude toward death. Though the art therapy intervention, patients and their family members experienced three stages over time. Conclusion: This research focused on essential aspects of the family relationships and the art therapy experiences of terminal cancer patients and their family members through an art therapy intervention in the context of hospice palliative care. Based on these observations, the researchers constructed a theoretical rationale for art therapy interventions delivered to patients and their family members in the process of hospice palliative care.

리소스 마인드풀니스에 관한 효과성 연구 (Effect of Resource Mindfulness on Emotional State, Focusing on Anxiety and Stress Reduction)

  • 이승호;이도은;유영수;정문주;강형원
    • 동의신경정신과학회지
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    • 제35권2호
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    • pp.177-189
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    • 2024
  • Objectives: This study aimed to evaluate the impact of Resource Mindfulness on participants' emotional state, focusing on anxiety and stress reduction and to explore the importance of psychological resources in this process. The effectiveness of Resource Mindfulness was investigated through both quantitative and qualitative analyses, examining its influence on subjective distress, mindfulness, core emotions, and identification of personal resources. Methods: This study involved 27 participants, including Korean medicine students, psychological counselors, clinical psychologists, and Korean medicine specialists, who attended a 2-night, 3-day M&L psychological support education program from July 2 to July 4, 2022. Participants were informed of the study's purpose and procedures. They provided written consent. Quantitative measures included Subjective Units of Disturbance Scale (SUDS), Five Facet Mindfulness Questionnaire (FFMQ), and Core Seven-Emotions Inventory Short Form (CSEI-s). Qualitative analysis was conducted using the "Drawing the Rooms of the Mind" technique. Pre- and post-program assessments were conducted to compare changes in subjective distress, mindfulness, and core emotions. Data were analyzed using paired t-tests and qualitative content analysis methods. Results: Significant reductions in subjective distress and improvements in mindfulness components were observed. Core emotions showed significant decreases in negative emotions. Qualitative analysis revealed increased tranquility, relief, and confidence, with resourceful places often being nature-related. Conclusions: Resource Mindfulness effectively reduced anxiety and stress and enhanced self-awareness and self-efficacy. It is useful for managing various mental health issues. Further research is needed to generalize these findings.

안면미용침의 부작용 및 안전성에 대한 조사;시술자 23인을 중심으로 (A Survey of Adverse Events and Safety following Treatment of the Facial Cosmetic Acupuncture (Miso-Acupuncture))

  • 권승구;이윤규;박서영;고경모;이윤경;김재수;이봉효;임성철;정태영;이경민
    • Journal of Acupuncture Research
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    • 제25권1호
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    • pp.199-209
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    • 2008
  • Objectives : To explore the adverse events and safety following facial cosmetic acupuncture treatment (Miso-Acupuncture). Subjects and methods : This study was a retrospective survey of practitioner's reports. The practitioners worked as facial cosmetic acupuncturists, gave informed consent, and completed a case report form between July and November of 2007. On this form, practitioners were asked to report the degree of adverse events relating to the Miso-Acupuncture, the total safety of the treatment, and reasons patients gave for quitting treatment. The practitioners in this study were all Oriental Medicine Doctors(OMD) who had trained at the Miso-Acupuncture Academy for 40 hours we received 23 final report cases. Results : In this study, adverse events following Miso-Acupuncture treatment were mild bruising(15 ; 65.2%), bleeding(12 ; 52.2%), pain(8 ; 34.8%), fatigue(7 ; 30.4%), headache(5 ; 21.7%), and others(10 ; 43.5%). The average degree of adverse events was between mild and moderate, which needs no extra treatment. The total safety of treatment for 16 weeks was between safe and nearly safe, and there was no need to quit treatment in spite of mild adverse events. Eight patients(34.8%) quit treatment, almost all for personal reasons unrelated to the Miso-Acupuncture. Conclusions : These results suggest that the Miso-Acupuncture has no serious adverse events and is a relatively safe treatment.

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과잉치 치수 세포의 계대별 석회화 비교 (Comparison of Mineralization in Each Passage of Dental Pulp Stem Cells from Supernumerary Tooth)

  • 신지선;김종빈
    • 대한소아치과학회지
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    • 제44권3호
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    • pp.350-357
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    • 2017
  • 본 연구는 상악 정중과잉치에서 얻은 치수유래 줄기세포(human dental pulp stem cells from supernumerary tooth, sDPSCs)를 대상으로 분화능의 변화 특성을 알아보고자 하였다. 전신 병력이 없는 6세 남자아이 상악 중절치와 측절치 사이에 매복 된 과잉치를 발치하여 sDPSCs를 얻었다. 세포들을 16계대까지 배양하였고, 1 - 8계대는 Young군으로 9 - 16계대는 Old군으로 나누었다. 각 계대 배양에 소요된 시간은 Young군에서는 $2.25{\pm}0.46$일, Old군에서는 $3.25{\pm}0.46$일을 보였으며, 이는 통계적으로 유의한 차이를 보였다(p < 0.05). 각 계대 별로 세포 형태를 관찰하고 분화를 유도한 후 Alizarin-red solution 염색을 통해 골모세포(odontoblast)로 분화되는 정도를 관찰하였다. 1, 8, 9계대에서 분화제를 처리하지 않은 세포의 형태에서는 방추형의 섬유모세포와 유사한 길쭉한 형태로 과립(nodule)이 적었지만, 16계대에서는 세포의 크기가 커지고 넓적한 형태로 변하고 과립도 많아졌다. 1계대는 분화 7일부터 과립이 관찰되며, 8계대에서는 14일 동안 분화제를 처리한 후 과립이 명확히 관찰되었다. 그러나 9계대 이후에서는 과립의 빈도가 상당히 감소되었다. ARS 염색에서는 1, 8계대는 진한 붉은색으로 염색되었으나, 9, 16계대는 염색이 옅게 되었다. 이를 통해 sDPSCs는 8계대 이전의 세포를 줄기세포의 원천으로 우선 고려하는 것이 좋다고 사료된다.

Effect of Pre-Procedural State-Trait Anxiety on Pain Perception and Discomfort in Women Undergoing Colposcopy for Cervical Cytological Abnormalities

  • Baser, Eralp;Togrul, Cihan;Ozgu, Emre;Esercan, Alev;Caglar, Mete;Gungor, Tayfun
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권7호
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    • pp.4053-4056
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    • 2013
  • Background: Colposcopy is the gold standard procedure for evaluating cervical cytological abnormalities. Although it is essentially a minimally invasive intervention, referral for colposcopy may cause significant distress on patients. In this study, we aimed to determine if pre-procedural anxiety levels have a significant association with procedure related pain and discomfort in women undergoing colposcopy for evaluation of abnormal cervical cytology. We also assessed the impact of various clinical factors on anxiety, pain and discomfort in these patients. Materials and Methods: This prospective study was performed at the gynecologic oncology department of Zekai Tahir Burak Women's Health Education and Research Hospital in Ankara, Turkey between January and June 2013. After taking informed consent, State-Trait Anxiety Inventory (STAI) form and a 14-item questionnaire were filled for women who were admitted to our outpatient colposcopy unit for evaluation of abnormal cervical cytology. STAI scores were calculated for each participant. Immediately after the procedure, visual analog scale (VAS) scores for procedure-related pain and discomfort were obtained. Associations between STAI and VAS scores were investigated using correlation analyses. The effect of various contributing factors on anxiety, pain and discomfort were evaluated with linear regression analysis. The p values less than 0.05 were considered statistically significant. Results: A total of 222 women met the inclusion criteria within the study period. Mean patient age was $38.5{\pm}9.6$. Median state and trait anxiety scores were 47 and 46, respectively. Median VAS scores for pain and discomfort were 4 for both variables. State anxiety had a significant correlation with procedure related discomfort (p=0.02). Colposcopy related pain VAS scores were significantly affected by state anxiety level, marital status and prior gynecological examination (p<0.05). Colposcopy related discomfort VAS scores were significantly affected by state anxiety level, marital status, prior gynecological examination and educational status. Conclusions: Additional measures should be implemented in women that carry higher risk for experiencing pain and discomfort. Social, cultural and lifestyle issues may also affect women's experiences during colposcopy, therefore further studies are needed to define specific determining factors in various populations.

골프 드라이버스윙 시 지면반력 반복측정 횟수와 지면반력 특성 (Number of Trials for the Reliable Golf Swing Ground Reaction Force Data Collection and Its Characteristics)

  • 박영훈;염창홍;서국웅;서국은
    • 한국운동역학회지
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    • 제17권4호
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    • pp.115-125
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    • 2007
  • Grould Reaction force(GRF) is important in human movements and GRF measurements are one of the most frequently used tool in biomechanical studies. In the studies of the golf swing motion, people refer to GRF as weight transfer. A successful golf swing motion requires many segments activation sequences which are controled by the nerve system. Due to the inter- and intra-individual variability of the human movement and the movement strategies, reliability of the measurements are important in human movement studies. Previous golf researches were based on group studies and certain events' values were analyzed. The purposes of this study were to determine the number of trials for the reliable golf swing GRF data collection, to reveal the variability level of the meaningful components of the golf swing GRF, and to classify the types of the golf swing GRF patterns. Twenty three male professional golfers($26.4{\pm}6.6$ years, $174.3{\pm}5.2\;cm$, $71.3{\pm}6.5\;kg$) signed an informed consent form prior to participation in this study. GRFs of driver swings were collected with Kistler 9285 force platform and 9865A amplifier, and calculated by the KwonGRF program(Visol, Korea). Sampling frequency was 1080 Hz. GRF data were trimmed from 1.5 s prior to the impact to 0.5 s after the impact. The number of trials for the reliable GRF collection was determined when the change in floating mean overs the 25 % of the standard deviation of that variable. Variabilities of the variables were determined by the coefficient of variation(CV) of 10 %. The types of GRF patterns were determined by visual inspection of the peak GRF shapes. The minimum number of trials for the reliable golf swing GRF data collection was five. Ten-trial seems more conservative. The value of the peak GRF was more reliable than the value of the impact GRF. The CV of the peak GRF and impact GRF were 7.4 %, 15.2 %, respectively. Because of the +/- sigh of the peak GRF appearance time, it was impossible to calculate CV of the peak GRF appearance time. Golf swing GRF patterns were classified as sing peak type, double peak type, and plateau peak type. This classification suggests the presence of the different golf swing weight transfer strategies.

델파이 기법을 활용한 스쿠버 레스큐 교육과정의 문제점 및 개선방안 (Identifying Problems and Suggesting Improvements for the Scuba Rescue Curriculum Using the Delphi Method)

  • 한동일;장재용;이근;윤대건
    • 해양환경안전학회지
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    • 제28권7호
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    • pp.1179-1190
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    • 2022
  • 본 연구는 전문가들의 의견을 수렴할 수 있는 델파이 기법을 활용하여 스쿠버다이빙 레스큐 교육과정에서의 문제점을 분석하고 개선방안을 모색하는데 그 목적이 있다. 이를 통해 우리나라에서 이루어지는 스쿠버 레스큐 교육과정을 보다 전문적이고 체계적으로 이루어질 수 있도록 하여 참여자들이 즐겁고, 안전하게 스쿠버다이빙을 할 수 있도록 하는 기반을 위한 기초자료로 활용할 수 있을 것이다. 이에 2022년 현재 스쿠버 레스큐 교육과정에 관여하고 있는 전문가 8명을 모집단으로 선정하여 연구 참여와 관련하여 연구윤리동의서를 받은 후 실시하였다. 스쿠버 다이빙 레스큐 교육과정의 지도자, 프로그램, 시설 측면의 개선방안은 다음과 같다. 지도자 측면에서는 지도자의 능력에 대한 검증제도가 필요하고, 지도자의 역량이 강화되어야 한다고 했다. 프로그램 측면에서는 스쿠버 단체별로 최신화된 프로그램 메뉴얼을 제작하고 평가 기준을 마련해야하며, 다양한 장비를 활용한 프로그램을 개발해야 한다고 했다. 시설 측면에서는 시설 내 인공파도 장치 등을 구축해야 한다고 하였다.

침치료 직 후 자가 설문지를 이용한 침반응(針感)과 부작용에 대한 단면적 연구 (Short Tenn Reactions to Acupuncture Treatment and Adverse Events Following Acupuncture in Korea a Cross-sectional Survey of Patient Reports)

  • 박성욱;정우상;문상관;고창남;조기호;김영석;배형섭;박정미
    • 대한한의학회지
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    • 제28권2호통권70호
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    • pp.66-79
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    • 2007
  • Objectives : To explore the type and frequency of short term reactions, de Qi associated with acupuncture treatment and to determine the incidence of adverse events following acupuncture in Korea. Subjects and methods : This study is a retrospective and cross-sectional survey of patient reports. 1095 subjects, 585 of out-patients of the Oriental Medicine of Stroke & Neurological Disorders Center, East-West NEO Medical Center of Kyunghee University and 510 of out-patients of the Department of Cardiovascular & Neurologic Diseases (Stoke Center), Hospital of Oriental Medicine, Kyunghee Medical Center, from June through November of 2006, who had acupuncture, gave informed consent and completed one survey form. On this form, patients were asked to report short term acupuncture reactions, de Qi, patient satisfaction measurement (using VAS), and adverse events relating to acupuncture treatment. The acupuncturists of this study are Korean Medicine Doctors (KMD) who had worked as practitioners for 3-30 years or more. Results : The average age of the 1095 subjects was 58 years old. Positive short term acupuncture reactions after treatment were reported by 878 (80.2%), negative short term acupuncture reactions by 75 (6.8%) and no reactions were reported by 142 (13.0%). The most common positive short term acupuncture reactions were feeling 'relaxed', 472 (43.1%), followed by feeling 'less pain' 90 (8.2%), 'energized' 16 ( 1.5%), 'tingling' 16 (1.5%), 'heat feeling or Cold feeling' 10 (0.9%), and others 274 (25.0%), respectively. Negative short term acupuncture reactions were feeling 'pain' 37 (3.4%), tiredness 24 (2.2%), dizziness 9 (0.8%), and others 5 (0.2%), respectively. Traditionally described needling sensations of de Qi refer to a patient's response to distention, pulling, soreness, heaviness, numbness. 39.7% of subjects reported de Qi during needling, experiencing 'distention' 333 (30.4%), 'soreness' 52 (4.7%), 'pulling' 22 (2.0%), 'heaviness' 18 (1.6%), and 'numbness' 10 (0.9%) respectively. Positive short term acupuncture reactions and de Qi rate were the highest in the less than 40 years group (83/96 86.5%, 50/96 52.1%). No acupuncture reactions were highly seen in the over 70 years old group (31/187, 16.6%). Patient satisfaction level using VAS was a comparatively high $72.9{\pm}19.9$. Adverse events were only bleeding in 92 (8.4%) of the total subjects. High sensitive acupoints were 95 points as GV26 (54 times), LI4 (54 times), ST36 (53 times), GB20 (37 times), HT8(34 times), LV3 (29 times), SI3 (29 times), and LI11 (27 times) in order. Main impressions were stroke patients 430 (16.9%), headache 185 (16.9%), hypertension 97 (8.9%), and dizziness 85 (7.8%). Conclusions : Although 8 different Korean Medicine Doctors participated in this research, we obtained similar results from each. There were no significantly different results between the two hospitals. Short term acupuncture reactions and de Qi were most related to age. Except for bleeding there were no adverse events relating to acupuncture treatment in this study. We consider acupuncture treatment as very safe depending on practitioners. Positive short term acupuncture reactions after treatment were 12 times higher than negative short term acupuncture reactions. Subjects were comparatively satisfied with acupuncture treatment.

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기존의 치료에 반응하지 않는 다발성 간전이 대장암 환자에서 방사선조사와 병합한 수지상세포 면역치료의 1, 2상 임상시험 (A Phase I/II Trial of $DCVac/IR^{(R)}$ Dendritic Cell Immunotherapy Combined with Irradiation in Cases of Refractory Colorectal Cancer with Multiple Liver Metastases)

  • 최영민;이형식;권혁찬;한상영;최종철;정주섭;김창원;김동원;강치덕
    • Radiation Oncology Journal
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    • 제26권2호
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    • pp.104-112
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    • 2008
  • 목적: 기존치료에 반응하지 않는 다발성 간전이를 동반한 대장암 환자에서 방사선치료와 병합한 수지상세포 면역치료의 독성과 반응도를 조사하였다. 대상 및 방법: 2004년 5월부터 2006년 11월까지 다발성 간전이가 동반된 대장암 환자들 중에서 항암화학 요법에 반응하지 않은 환자 중 지원자를 대상으로 연구를 시행하였다. 본 임상 시험에 대하여 동아대학교병원과 부산대학교병원의 임상윤리심의위원회의 허가를 획득하였고, 동의서에 서명한 환자들을 임상 시험의 대상으로 등록하였다. 환자의 말초 혈액으로부터 수지상세포를 추출하여 배양하였다. 임상시험 일자에 맞추어서 $6{\times}10^6$개의 수지상세포를 바이알(0.5 ml)에 넣어서 디씨백/아이알 주사를 만들었다. 수지상세포 면역치료는 2주 간격으로 간전이암조직에 3회 주사하고, 5주에 내약성 평가를 하였다. 내약성 평가를 통과한 환자에게는 8주에 4번째 수지상세포 면역치료를 하였다. 병의 악화가 없거나 임상시험에 대한 환자의 동의 철회가 없는 경우에는 5, 6번째 수지상세포 면역치료를 각각 12, 16주에 시행하였다. 방사선치료는 수지상세포 면역치료를 주사할 간전이암 부위에 주사하기 전일 및 당일에 4 Gy씩을 조사하였다. 내약성 평가는 $3{\times}10^6$개의 수지상세포로부터 시작하여, $12{\times}10^6$개의 수지상세포까지 시행하였다. 내약성 평가의 최대 내성 용량으로 추가 임상시험을 하였다. 수지상세포 면역치료 주사를 맞은 모든 환자들에서 안전성 평가를 하였다. 4회 이상 주사를 맞은 환자들을 대상으로 10주에 치료 반응을 평가하여 유효성을 조사하였다. 결과: 임상시험에 등록한 24명 중 22명에서 수지상세포 면역치료를 시행하였다. 내성약 평가에는 14명이 등록하여 11명에서 평가를 완료하였다. 시험약과의 관련성이 있을 것으로 생각되는 grade 3 이상의 약물반응으로 인한 이상반응은 없었다. $12{\times}10^6$개의 수지상세포를 내성용량으로 확인하였고, 내성용량인 $12{\times}10^6$개 수지상세포 면역치료를 이용하여 8명에서 추가로 시험을 하였다. 치료에 대한 환자들의 내성은 양호하였고, grade 3을 초과하는 치명적인 부작용은 발생되지 않았다. 4회 이상의 수지상세포 면역치료 주사를 받은 환자가 17명이었고, 이 중의 15명에서는 종양의 반응도 평가가 이루어졌다. 본 연구의 목적은 안전성 평가이지만, 면역치료의 유효성 평가를 위해, 방사선치료와 수지상세포 면역치료 주사가 시행된 부위 외의 간전이암에서 반응도를 조사 하였다. 면역치료의 반응은 평가가 이루어진 환자들에서 정지성 병변이 4명, 진행성 병변이 11명 이었다. 결론: 수지상세포 면역치료와 병행한 방사선치료는 이론적으로 국소 및 전신 제어에 상승효과가 있을 것으로 기대할 수 있다. 하지만 기존 치료에 반응하지 않는 매우 진행된 직장암 환자들을 대상으로 한 본 연구에서는 방사선 치료와 병합한 수지상세포 면역치료로 인한 심각한 부작용의 발생은 없었다는 결과와 4예에서의 정지성 병변의 관찰을 보고한다. 수지상세포의 최대 투여 용량, 적절한 투여 방법, 적절한 방사선의 양, 방사선과 수지상 세포의 적절한 투여 간격 등에 관한 추가 연구를 통하여, 향후 제 2상, 3상 시험으로서의 진행 여부에 긍정적인 결과를 얻을 수 있다고 판단한다.