• 생물정신의학
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• 제6권1호
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• pp.49-66
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• 1999

Polypharmacotherapy, both psychotropic and nonpsychotropic, is widespread in various situations including psychiatric hospitals and general hospitals. As the clinical practice of using more than one drug at a time increase, the clinician is faced with ever-increasing number of potential drug interactions. Although many interactions have little clinical significances, some may interfere with treatment or even be life-threatening. The objective of this review is evaluation for drug-drug interactions often encountered in psychiatric consultation. Drug interactions can be grouped into two principal subdivisions : pharmacokinetic and pharmacodynamic. These subgroups serve to focus attention on possible sites of interaction as a drug moves from the site of administration and absorption to its site of action. Pharmacokinetic processes are those that include transport to and from the receptor site and consist of absorption, distribution on body tissue, plasma protein binding, metabolism, and excretion. Pharmacodynamic interactions occur at biologically active sites. In psychiatric consultation, these two subdivisions of drug interactions between psychotropic drugs and other drugs are likely to happen. We gathered informations of the drugs used in physically ill patients who are consulted to psychiatric department in Korea University Hospital. And we reviewed the related literatures about the drug-drug interactions between psychotropic drugs and other drugs.

• 동아시아경상학회지
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• 제10권1호
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• pp.59-69
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• 2022

Purpose - Burnouts cause the workers to quit their jobs because with the heavy workloads that the employees get subjected to, they feel that they have little control over what they have to accomplish in the workplace. The purpose of this research is to provide adequate solutions using brief consultation process, reducing negative psychological factors. Research design, Data, and methodology - The current research conducted the 'Qualitative Content Analysis' (QCA), which is one of the most employed analytical tools; it has been used widely all over the globe in various research applications in library science and information. Primarily, this analysis is often used as a method in the quantitative tool until the recent decade. Result - Based on ultimate systematic literature analysis, excessive workloads can get addressed by finding proper solutions to the issues of depression, anxiety, irritability, and discouragement. The solutions are (1) Combating Excessive Workloads using Effective Employee Selection, (2) Employee Effective training, and (3) Job redesigning. Conclusion - Selecting or recruiting employees that have skills for the given job also makes it possible for the organization to run its employees effectively and with minimal cases of workload as an organization understands the capabilities and capacities of workload an employee can complete.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3849-3854
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• 2016

Background: Breast cancer is the most prevalent malignancy in women worldwide; lack of awareness of symptoms and delay on diagnosis of breast cancer are the main causes of mortality among women. This study was conducted with the purpose of assessing the effect of educational consulting for breast self-examination (BSE) based on the health belief model (HBM) on the knowledge and performance of women over 40 years attending health care centers in Hamadan, Iran. Materials and Methods: In this quasi-experimental study, eligible women admitted to health centers in Hamadan city in 2015 were randomly assigned to intervention and control groups (n=75 in each group). The intervention group received 4 weekly sessions of breast cancer screening consulting based on the HBM. Control group received only routine care. Knowledge, HBM constructs, and BSE practice were compared between the groups before, immediately after and three months after the consultation. Results: Before the intervention, no significant differences were observed in knowledge, health belief and practice between two groups. However, after the intervention a significant difference was observed between two groups in mean scores of perceived benefits, perceived barriers, self-efficacy and the health motivations (p <0.05). Significant differences were also observed in terms of knowledge and BSE practice (p <0.01). Conclusions: The results indicate the importance of consultation on knowledge and beliefs to improve BSE performance and prevention of breast cancer in Iranian women.

• 한국병원경영학회지
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• 제18권1호
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• pp.59-69
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• 2013

Purpose Patients should have a regular medical check-up, the cost direct and indirect medical expenses to check the results, and revisit the hospital. Some of patients often want to use the telephone for a medical consultation, Method The subjects participating in this study were a selection 485 patients who received outpatient service in Asan Medical Center and Gangbuk Samsung Hospital. The patients's favorite method for medical check-up, time, cost, fatigue, and inconvenience, in regard with the revisit to check the examination results, were researched and analyzed on identical questionnaires about them. Results The average transportation, food expenses and opportunity costs the subjects spent was 90,400 for those from the Seoul and Gyunggi area, and 269,800 from other area. And the average required time per visit was 4.13 hours for those from the Seoul and Gyunggi area, 11.84 hours from other areas, and averagely 7.72 hours for all the subjects. More than 75% of the subjects answered that they felt tired and their work was interrupted. The subjects from both areas preferred the check by phone. Conclusion If the scope of telephone medical consultation is defined and the doctor-patient certification is possible, it can be thought as an efficient alternative of the medical check-up by revisit. It is necessary to discuss an appropriate amount of the medical check-up by phone which the same cost and effort can be allocated in.

• 생물정신의학
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• 제14권1호
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• pp.21-27
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• 2007

Objectives : As a part of plan to develop evidence-based treatment guidelines for depression that is more suitable for Korean situation, we investigate the present status and client's requirements for non-pharmacological treatment of depression in Korean clinical situation. Methods : Subjects were patients with depression in 12 university hospitals which are located in metropolises in Korea. We analyzed the records from questionnaires about current clinical status and requirements for the non-pharmacological treatment of depression in Korea. Results : 50.8% of the subjects have experienced non-pharmacological treatments for their depression. The preference of non-pharmacological treatment method of depression is exercise/interesting activity, counseling by psychiatrists and psychotherapy, and the best effective treatment method is psychotherapy (Es=4.36). Actually, the mean consultation time by psychiatrist is $11.31{\pm}7.16$ min, and the appropriate consultation time for client's situation is $18.39{\pm}8.95$ min. During consultation, patients' satisfaction measurement for psychiatrist's explanation about pharmacological treatment is $64.17{\pm}27.11$, and satisfaction measurement for psychiatrist's counseling for their depression about personal problems, resent stress, interpersonal relationship is $61.66{\pm}26.63$. Conclusion : In Korea, many psychiatrists offered biologically oriented treatment to their patients with depression, and patients' satisfaction measurement about consultation by psychiatrists is low. Many patients wanted to combined pharmacological and non-pharmacological treatment for their depression, and aspired to information about complementary and self-help treatment methods. It is necessary to develop non-pharmacological treatment guideline for depression which reflect the clinical situation in Korea and meet Korean patients' need.

• 대한한방소아과학회지
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• 제22권2호
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• pp.171-186
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• 2008

Objectives : The purpose of this study is to investigate necessity of overtime hospital business hours and patient's visiting time preferences. Methods : The study was composed of 117 children's protectors who visited the pediatrics department in Kyunghee university oriental medicine hospital between on April 14th and on July 4th in 2008. Results and Conclusions : 1. Question for asking the preference of weekdays regular consultation hours 27% of preschool children preferred time around 11 am to 12 pm, each 32% of school aged children preferred time around 3:30 to 4:30 pm, 4:30 to 5:30 pm. 2. Question for 'Have you ever experienced inconvenience for regular consultation hours' 41% of them said 'Yes', and 59% said 'No'. 3. School aged children more experienced inconvenience for regular consultation hours than preschool children, and more likely to come at overtime hospital business hours. 4. Question for 'If the hospital extends the business hours for holidays and weekdays and Saturdays, would you prefer to come at that time?' 88% of them answered 'Yes'. 5. Question for asking the preference time on weekdays, 35% of them preferred 6:30 to 7:00 p.m. 6. Question for asking the preference time on Saturdays, 44% of them preferred 1:30 to 2:30 p.m. 7. Question for 'Do you willing to pay extra charges if you visit in non office hours?' 66% were willing to pay, 24% of them said "no", 'the other opinion' is 10%.

• 한국융합학회논문지
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• 제1권1호
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• pp.31-39
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• 2010

이 연구의 목적은 2007년 대전시 보건소 금연 클리닉 이용자 중 금연 성공자와 금연 실패자의 일반적 특성과 흡연특성, 금연특성, 그리고 중재요인 등을 분석하여 금연 성공에 영향을 미치는 요인을 알아보고자 했다. 2007년 대전시 보건소 금연 클리닉에 등록된 2,125명을 분석하였다. 참가자의 특성파악을 위한 빈도분석과 특성에 따른 금연성공률의 유의성 검증을 위한 $X^2$-검정, 그리고 각각의 특성이 금연성공률에 미치는 영향력을 파악하기 위해 로지스틱 회귀분석을 시행하였다. 6개월간의 전체 금연 성공률은 39.8% 이었다. 금연 성공 집단에서 남자가 여자보다 더 높은 성공률을 보였다. 또 65세 이상인 집단이 40세 미만인 집단보다 더 금연 성공률이 높았다. 중구보건소가 다른 곳에 비해 높은 금연성공률을 보였다. 금연 성공률에 영향을 미치는 요인에 대한 로지스틱 회귀분석은 나이, 보건소, 2단계 니코틴 패치, 총 상담횟수와 유의성을 보였다. 금연성공률에 대한 총 상담횟수는 다른 유의성 있는 요인보다 높은 비차비를 보였다. 따라서 우리는 총 상담횟수가 금연 성공률과 높은 연관을 가지며 상담이 금연클리닉에서 중요한 역할을 할 것이다.

• 대한예방한의학회지
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• 제6권1호
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• pp.51-95
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• 2002

1. As a point at issue of occidental medicine examination, followings have been indicated, 1) Occidental medical examination is performed by mainly test and instrument and therefore, role of doctors could be excluded and it could be diagnosed only for target disease and 2) in Korea, it could not be conducted in public medical system and therefore improvement effect of public health promotion could not be made due to increase of total medical expenses and infirmity of post management. These points are substantial limit of paradigm resided in occidental medicine and also problem caused by unique characteristics of medical system of Korea. In Korea, result of occidental medical examination show increased health risk from aged thirties and major diagnosed diseases are circulatory disease or chronic disease such as hepatic, hyperlipemic, hypertensional disease and diabetes, etc. Accounting that those chronic disease make a role as major public health risk, it is difficult that medical examination by only occidental medicine make effect on public health promotion. 2. Characteristics of oriental medicine examination could be summarized as diagnosis (information acquisition based on the facts) and demonstration (speculation based on acquired information) and in addition, quadruple diagnosis, as a medical examination method, include test as well as basic examination. Accounting on oriental medical examination, principally it is performed by independent herbalist and therefore, herbalist could acquire systemic result during first medical examination. Based on the theory of inner-outer examination, oriental medical examination has a principle of universe theory, systemic analysis of quadruple diagnosis, demonstration & reasoning. In addition, root of oriental medical examination could be found in pre-disease theory, a principal theory of oriental medicine. Pre-disease service could prove the advantage of oriental medicine in medical examination activities and therefore, it is needed that content of oriental medical examination should be actualized in current medical system. 3. In this study, oriental medical examination program, comprised of pulse-diagnosis, contrast muscular taking and medical consultation of herbalist is progressed communally with occidental medical examination. As pre-examination, questionary was given of general characteristics, health promoting life style, physical constitution and subjective symptom of musculoskeletal system. In addition, post-examination notification was given to subjects about health promoting control, physical constitution regimen and management of musculoskeletal system. During this study program, verification was conducted for input of acquired information and difference of each information after analysis and in addition, performed was analysis of factor influencing health promoting life style and musculoskeletal subjective symptom and evaluation of relationship of physical constitution and health promoting life study. In addition, it was verified of difference between musculoskeletal subjective symptom and result of muscle contrast picture evaluation. 4. Evaluation of oriental medical examination model is divided into 2 categories of oriental medical examination-consultation and result evaluation -post management. Oriental medical examination-consultation demands establishment of examination system, standardization of examination and establishment of examination form and in addition, it should be admitted as enlarged examination assists systemic quadruple diagnosis of herbalist not a key of oriental medical examination. In addition, information acquisition for research purpose should be performed according to the systemic research plan based on the separation of questionary for examination purpose and research purpose. For evaluation of the result, it was concluded that needed are result evaluation meets oriental medical system and post-notification system, informing health management information, based on examination result. 5. Accounting on satisfaction for oriental medical examination model, affirmative reply was much higher (66%) than negative (8.64%). Satisfaction of each area was in order of consultation of herbalist, systemic muscle contrast taking, pulse examination, post-notification and questionary fill-up and dissatisfaction was in order of post-notification, questionary fill-up, consultation of herbalist, systemic muscle contrast taking and pulse measurement. Satisfaction for collaborative examination of occidental and oriental medicine was over 60% and over 75% hope oriental examination would be included in later medical examination program. Based on this result, collaborative examination including occidental and oriental medicine could increase satisfaction of subjects for medical examination program.

• 정신신체의학
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• 제1권1호
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• pp.101-108
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• 1993

A case of a 38 year-old woman with histrionic personality who had chronic epigastric pain, dyspepsia and alternating bowel habit for more than 10 years was presented in detail on its course of two times of admission and follow-up. The diagnosis was thought as psychophy-siological disorder or gastrointestinal motility disorder of undefined etiology rather than hypo-chondriasis or Briquet's syndrome. She was characterized by sustained illness behavior and combined several physical illnesses. i.e. tuberculosis. anemia and hepatic stone. These physical diseases led to a blurring of psychological and physical boundaries regarding symptom formation. The points on consultation from medical part to psychiatric department were discussed and the supposed causal mechanisms in non-organic functional gastrointestinal disturbances were also reviewed. Physical and psychological modalities for the treatment and the abnormal illness behavior were mainly emphasized in this case.

• 정신신체의학
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• 제12권1호
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• pp.15-22
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• 2004

연구목적: 두부 외상은 신체적 후유 증상뿐 아니라 다양한 정신 증상을 야기한다. 본 연구에서는 두부 외상 후 섬망을 보이는 환자들을 대상으로 정신과 자문을 실시하고 과다행동 증상의 유무 등의 임상 양상과 회복 기간과의 관련성에 대해 평가하고자 하였다. 방 법: 1998년부터 2002년까지 두부 외상을 주소로 신경외과에 입원한 환자들 중 섬망이 발생하여 정신과에 자문 조정이 의뢰된 45명의 환자를 대상으로 하였다. 섬망 발생 4주 후 추적 자문에서 섬망의 회복 여부에 따라 완전 관해 된 군 및 잔류 증상이 남아 있는 군으로 나누고, 두 군간의 차이를 과다행동 유무와 사회 인구학적 변수, 두부 외상 부위의 빈도에 따라 살펴보았다. 결 과: 첫 자문 주소에서 과다 행동 유무에 따라 분류해 보았을 때 4주 후의 섬망의 관해와 유의미한 관계를 보였다(p<.01). 섬망의 잔류 증상이 남아 있는 군은 완전 관해 된 군에 비해 중환자실 입원 기간 및(p<.05), 전체 입원 기간이 길었다(p<.01). 섬망 발생 4주 후 잔류 증상이 남아 있는 군은 완전 관해된 군에 비해 사고보험과의 관련성이 많았으며(p<.05), 신경 영상학적 조사에서 피질 하 회백질의 손상의 여부와 유의미한 관계를 보였다(p<.05). 결 론: 본 연구를 통해 첫 자문 의뢰 시 과다행동 유무에 따라 섬망의 회복 기간에 유의한 차이가 있었다. 또한 섬망의 회복 기간이 지연될수록 재원기간이 길어짐을 알 수 있었다. 향후 두부 외상 후 섬망 환자의 정신과적 개입에 있어 과다행동의 유무를 비롯한 임상 변수들에 대한 다각적인 연구가 필요할 것으로 사료된다.