• 제목/요약/키워드: psychological crisis

검색결과 113건 처리시간 0.026초

노년기 정신장애의 전기경련치료 (Electroconvulsive Therapy for Psychiatric Disorders in Elderly Adults)

  • 주은정;김희철;강웅구;이남영;박승현;김정민;김용식;정인원
    • 생물정신의학
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    • 제27권2호
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    • pp.42-57
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    • 2020
  • Electroconvulsive therapy (ECT) is indicated for various mental disorders (e.g., major depressive disorder, schizophrenia, and bipolar disorder) and the behavioral and psychological symptoms of dementia in elderly patients. Furthermore, ECT is a useful first-line treatment in emergency and crisis situations such as suicide risk, violent behavior, catatonia, and food refusal, which are more frequent in elderly patients. ECT is also effective in the treatment of the motor symptoms of neurological disorders, such as Parkinson's disease and Huntington's disease. Due to the high risk of various physical diseases, the comorbid physical conditions of elderly patients should be individually controlled to optimize ECT treatment. Compared to young adults, in elderly patients the seizure threshold is higher, the seizure duration is shorter, and the anesthetic dose is lower. On the contrary, the response rate in the elderly is both faster and higher. Considering potential cognitive decline and the prevention of further deterioration of cognitive function in elderly patients, in the absence of significant comorbidities, twice weekly sessions and right unilateral electrode placement with a lower seizure threshold and less cognitive effect are preferred to bilateral electrode placement, which has a high risk of adverse cognitive effects. After an acute course of ECT, continuation and maintenance of ECT, combined with prescription of therapeutic drugs, may prevent possible relapse or recurrence of mental disorders. In conclusion, ECT can be used to treat mental disorders in elderly adults, with safety and effectiveness comparable to that in young adults.

COVID-19 상황에서 간호학생의 대학생활적응 영향요인 (Influencing Factors of Nursing Students' College Life Adjustment in COVID-19)

  • 안혜란;이지영
    • 융합정보논문지
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    • 제11권3호
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    • pp.34-45
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    • 2021
  • 본 연구는 코로나19(COVID-19)라는 위기 상황에서 간호학생의 전공선택동기, 학업 스트레스, 자기효능감 및 대학생활적응 정도를 파악하고, 대학생활적응에 영향을 미치는 요인을 파악하기 위한 서술적 조사연구이다. 2개 지역의 간호학생 243명을 편의모집하였고, 수집된 자료는 SPSS for Windows Ver. 22.0을 이용하여 기술통계, t-test, ANOVA, Scheffé test, Pearson's correlation coefficient, Multiple linear regression으로 분석하였다. 연구결과 전공선택동기와 자기효능감은 높을수록, 학업스트레스는 낮을수록 대학생활적응이 높은 것으로 나타났다. 대학생활적응에 영향을 미치는 요인은 자기효능감, 전공선택동기, 한 달 용돈 금액 순으로 나타났으며, 대학생활적응에 대한 이들 변수의 설명력은 65.6%로 나타났다. 이에 간호학생의 대학생활적응을 높이기 위해서는 자기효능감을 높여주기 위한 대학생활적응 프로그램의 개발 및 적용이 필요하다.

회장루 보유자의 마음챙김명상을 접목한 회복탄력성 증진 프로그램 개발 및 효과 (Development and Evaluation of Resilience Enhancement Program Applying Mindfulness Meditation in Patients with Ileostomy)

  • 신지혜;최자윤
    • 대한간호학회지
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    • 제51권3호
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    • pp.334-346
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    • 2021
  • Purpose: The purpose of this study was to develop a resilience enhancement program applying mindfulness meditation (REP-MM) and evaluate the effects of the program on post-traumatic stress (PTS), resilience, and health-related quality of life (HRQoL) in patients with ileostomy. Methods: The REP-MM was developed by combining the resilience enhancement program with mindfulness meditation according to four patterns. The program was developed through identifying patients' needs, reviewing relevant literature, developing a preliminary program, and testing content validity and user evaluation. The participants were 55 patients with ileostomy. We conveniently assigned 27 patients to the experimental group and 28 to the control group. The study was conducted in conducted in a hospital from January 22 to May 30, 2019. The REPMM was provided to the experimental group, and conventional ileostomy care was provided to the control group using a nonequivalent control-group pretest-posttest design. Results: ANCOVA revealed that the levels of PTS (F = 321.64, p < .001), resilience (F = 111.86, p < .001), and HRQoL (F = 31.08, p < .001) in the experimental group were higher than those in the control group when comparing pretest to posttest changes. Conclusion: The REP-MM is effective in PTS, resilience, and HRQoL in patients suffering from post-stoma creation crisis. The REP-MM can induce positive self-recognition changes in patients with ileostomy through dispositional, situational, relational, and philosophical interventions. We suggest nurses reduce PTS and improve resilience and HRQoL in patients with ileostomy.

1인 독거가구 중 우울증 유병과 자살생각에 영향을 미치는 요인 (Factors associated with the Prevalence of Depression and Suicidal Ideation among Single-Person Households)

  • 김재현
    • 한국콘텐츠학회논문지
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    • 제22권1호
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    • pp.611-619
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    • 2022
  • 본 연구는 2017년, 2019년 국민건강영양조사 자료를 활용하여 1인 독거가구 중 우울증 및 자살생각에 영향을 미치는 요인에 대하여 분석하였다. 분석에 포함된 변수는 인구사회, 경제학적 변수, 건강상태 및 건강행동 변수를 고려하였다. 분석결과 우울증 유병은 활동제한 여부(OR: 4.753, p-value: <.0001), 현재흡연 여부(OR: 2.013, p-value: 0.044)와 통계적으로 유의한 관련성이 있었고, 자살생각은 가구소득(OR: 3.526, p-value: 0.043), 주관적 건강상태(OR: 2.945, p-value: 0.007), 활동제한(OR: 2.263, p-value: 0.003), 현재흡연 여부(OR: 2.000, p-value: 0.023)와 통계적으로 유의한 관련성이 있었다. 이처럼 1인 독거가구는 그 자체로 심리적 불안감을 가질 수 밖에 없고, 사회경제적, 신체적으로 위기에 처하여 정신건강 문제를 일으킬 수 밖에 없으므로 지역사회에서 사회적 네트워크 시스템을 구축하여 이들을 조기에 발견하여 적절한 중재를 통해 비관적 결과로 이어지지 않도록 해야할 것이다.

코로나 19 시기 워킹맘의 일과 가정의 양립 경험에 대한 근거이론적 접근 (Grounded Theoretical Approach of Working Moms' Work and Family Balance Experience during the COVID-19 Pandemic)

  • 손영미;황혜영
    • 한국심리학회지 : 문화 및 사회문제
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    • 제28권3호
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    • pp.441-481
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    • 2022
  • 본 연구는 코로나 19 시기 워킹맘의 일과 가정의 균형과 관련된 경험을 탐색하고자 하였다. 이를 위해 1명 이상의 초등학생 이하의 자녀를 둔 시간제와 전일제 워킹맘 17명을 연구 대상자로 모집하여 심층면접을 실시하였다. 심층면담 내용을 근거이론 방법으로 분석한 결과 106개의 개념, 50개의 하위범주, 24개의 범주가 도출되었다. 코로나 19 시기에 워킹맘이 일과 가정을 양립하는 과정에서 경험하는 중심현상은 '신체적, 정서적 소진', '역할 갈등 상황에서의 불안감과 죄책감', '워킹맘이 겪는 일자리 위기', '가족 갈등 심화'로 나타났다. 워킹맘이 시간의 흐름에 따라 중심현상을 극복하여 일과 가정의 양립을 이루는 과정은 '충격과 혼란 단계', '고군분투 단계', '적극적 대처와 타협 단계', '수용 단계', '외상 후 성장 단계'의 5단계로 파악되었다. 이러한 연구 결과를 바탕으로 코로나 19 시기 워킹맘의 일과 가정의 양립 경험에 대한 논의와 후속 연구를 위한 제언을 서술하였다.

코로나19로 인한 원격 교육에서 인지된 유용성과 인지된 사용용이성, 자기효능감, 우울이 대학생들의 학습만족도와 학업 지속의향에 미치는 영향에 관한 연구 (A Study on the Influence of Perceived Usefulness, Perceived Ease of Use, Self-Efficacy, and Depression on the Learning Satisfaction and Intention to Continue Studying in Distance Education Due to COVID-19)

  • 김효정
    • 디지털산업정보학회논문지
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    • 제18권1호
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    • pp.79-91
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    • 2022
  • In this study, the effects of self-efficacy, perceived usefulness, perceived ease of use, and depression on college students' academic persistence in the COVID-19 epidemic and the resulting non-face-to-face education situation were identified as mediating effects on learning satisfaction. In the second semester of 2020, a survey was conducted on students enrolled in a four-year university in Daegu and the data were statistically analyzed. The path coefficient was estimated by the Smart PLS bootstrap method and the significance of the path coefficient was verified. The Sobel Test was conducted to verify the mediating effect of academic continuity intention as a parameter. The research results can be summarized as follows. First, it was found that self-efficacy and perceived usefulness had a significant influence in the relationship with learning satisfaction. Second, the relationship between learning satisfaction and academic continuity intention was found to have a significant influence. Third, depression and ease of use did not show any significant influence in the relationship between learning satisfaction. Finally, a Sobel Test was conducted to verify the mediating effect of academic continuity intention with self-efficacy, usefulness, ease of use, and depression as independent variables and learning satisfaction as parameters. As a result of both regression analyses, it was found that β values decreased, and learning satisfaction had a mediating effect. As a result of this study, it is suggested that research to increase learner satisfaction and develop various contents to increase the effectiveness of education that can increase self-efficacy and perceived usefulness should be conducted in parallel. I think this study can be used as basic data in establishing measures to continue studying for college students in natural disaster situations or psychological crisis situations called COVID-19.

정신건강복지센터 간호사의 자살예방 지식 및 기술, 자살에 대한 태도와 자살예방업무 소진의 관계: 혼합연구방법의 적용 (Relationships among Knowledge and Skills about Suicide Prevention, Attitudes toward Suicide, and Burnout of Suicide Prevention Work of Nurses at Mental Health Welfare Centers: A Mixed Methods Study)

  • 동희라;서지민
    • 대한간호학회지
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    • 제52권1호
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    • pp.80-91
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    • 2022
  • Purpose: This study aimed to identify relationships among knowledge and skills about suicide prevention, attitudes toward suicide, and burnout of suicide prevention work of nurses at mental health welfare centers. Methods: An explanatory sequential mixed-method research was conducted. For the quantitative study, the subjects (nurses) were 133 nurses executing suicide prevention work. The data were analyzed using the SPSS 25.0 program. For the qualitative research, 13 nurses with high burnout scores were interviewed. The data were analyzed using theme analysis method. Results: Quantitative results showed the average burnout of suicide prevention work was 54.62 ± 12.51. The burnout of suicide prevention work had significant correlations with attitudes toward suicide (r = .30, p < .001) and suicide prevention skills (r = - .18, p = .037). Qualitative results showed six themes related to burnout of suicide prevention work. They were 'feeling a lack of confidence in one's suicide counselling skills', 'feeling of the limits of one's ability to cope with a suicide crisis', 'feeling regret for not being able to help the clients', 'being over-empathetic to the clients', 'Not being able to understand the clients because the subjects (nurses) opposes committing suicide', and 'thinking that the suicidal thoughts of suicide attempters do not improve'. Conclusion: To reduce burnout of nurses' suicide prevention work at mental health welfare centers, there is a need to develop an educational program considering nurses' attitudes toward suicide and one to enhance their confidence in suicide prevention skills.

Association between Changes in Daily Life during the COVID-19 Pandemic and Depressive Symptoms in Korean University Students

  • Young-Mee Kim;Sung-il Cho
    • 한국학교보건학회지
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    • 제36권3호
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    • pp.103-112
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    • 2023
  • Purpose: The COVID-19 pandemic, which emerged in late 2019, had a profound impact on global public health and disrupted the daily lives of people worldwide. Particularly, university students faced a challenging situation as their university life underwent a drastic transformation due to long-term remote learning and isolation measures. This study aimed to investigate the relationship between changes in daily life during the 2020 COVID-19 pandemic and depressive symptoms among university students aged between 19 and 29 in Korea. Methods: We analyzed data from the nationally representative 2020 Community Health Survey (CHS). Among the 229,269 participants, 9,279 university students aged 19-29, either enrolled or on leave, were selected. After excluding 401 cases with missing values, the final sample comprised 8,878 individuals. Using multivariate logistic regression with a complex sample design, we explored the association between daily life changes during the COVID-19 pandemic and depressive symptoms. Results: Changes in daily life during the COVID-19 pandemic was associated with depressive symptoms in Korean university students aged 19 to 29, even after adjusting for sociodemographic characteristics, health-related factors, and COVID-19-related aspects (OR=1.28, 95% CI=1.09~1.50). Conclusion: Our study suggests that when examining the impact of COVID-19 on health issues, it is crucial to consider the changes in daily life caused by the pandemic. These findings can provide insights into the psychological well-being of university students during times of crisis.

청소년 자살에 대한 고등학교 교사의 지식과 오해 (High school teachers' knowledge and misconception on youth suicide)

  • 이승연
    • 한국심리학회지 : 문화 및 사회문제
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    • 제13권2호
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    • pp.97-117
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    • 2007
  • 본 연구는 현재 우리나라의 고등학교 교사들이 자살 위험을 보이는 학생들을 사전에 식별하여 적절한 중재활동으로 연결시킬 수 있는지를 알아보고자 하였다. 이를 위해 390명의 남녀 교사들을 대상으로 설문지를 실시하여, 청소년 자살과 관련된 요인들에 대한 교사들의 지식수준과 자살에 대한 오해에 대해 살펴보았다. 또한 자살 위험성이 있는 학생들이 식별되었을 때, 그들이 일반적으로 취하는 중재방법들에 대해서도 알아보았다. 본 연구에서 교사들은 자살위험이 있는 학생들을 식별해 낼 수 있을 만큼 자살관련요인에 대한 충분한 지식을 갖고 있지 않았으며, 대부분이 스스로 그러한 학생들을 선별해 낼 수 있다고 믿지 않았다. 자살에 대한 오해는 우려만큼 많지 않았지만, 몇몇 오해들은 자살의 중재와 관련하여 여전히 문제로 남아 있었다. 한편, 교사들의 중재방법은 주로 교사들 개인에 의한 전략들로 이루어지며, 매우 제한적이었다. 효과적인 청소년 자살예방을 위하여 자살관련요인과 즉각적인 중재전략들에 초점을 둔, 교사들을 위한 자살예방 교육이 시급하다.

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여성의 고위험 임신에 대한 경험 (Womans experience of Risk Situation on the High-Risk Pregnancy)

  • 김경원;이경혜
    • 여성건강간호학회지
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    • 제4권1호
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    • pp.161-178
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    • 1998
  • In spite of the great progress of the theory and skill of the Nursing Care & Medical area in relation to pregnancy, nurses in clinics face up to many challenges in maternity nursing care areas. The reason is that the mobility and mortality of mothers was sharply decreased and the unknown high-risk diseases of pregnancy woman in the past is made public. That's why it is difficult to meet the pregnancy woman in natural process from pregnancy to delivery in recently. Admission rooms are filled with high-risk pregnancy women. As a matter of fact, we have done nursing care into the surface symptoms and diseases of high-risk pregnancy women so far. We have been indifferent to a long period hospitalization, separation from family, and conflict of repeated examination. Therefore, it is widely spread to understand the emotional conflict experienced by high-risk pregnancy women and to need for nursing intervention to bring up about emotional support and the ability of perception in psychological crisis. Although the pregnancy woman judged in high-risk should carry out normal task of pregnancy, she have to be confronted with secondary risk situation. The health of self & fetus threatened by the risk situation could be decreased through care plan, but psychological stress increases. Therefore, the pregnancy brings into non-control state. It is important to ask that what the hospitalized pregnancy women in high-risk think of themselves status. Because misunderstanding or serious anxiety of themselves status put into mother and fetus in danger. And adaptation mode makes all the difference. I would like to consider how nurses could deal with this high-risk circumstances in the position of pregnancy woman on the basis of the above fact. This study uses phenomenological method to suggest the basis material for nurses to do nursing intervention in view of pregnancy woman. Because this method understands the nature of true life of pregnancy woman throughly. The phenomenological method is the sources to describe or explain affluently the process generated in confirmation areas and environment and is the application for readers to understand and recognize clinic reality and then apply this method to reasoning study place or other places. Specifically, the phenomenon study method, one of the phenomenological method, is applied. The use of that method is to describe and generalize the experience in environment exactly. The study of this study is as follows : Among 187 descriptive stamens from 8 study participants are classified into 42 theme cluster at the stage of the first analysis. Those theme is categorized into 8 sub-subjects such as anxiety of uncertainty, foreknowledge about risk circumstance, will power about overcome, unsettled feeling about hospital, relief, optimistic thought, family support, and indifferences. At the last stage of analysis, those things are categorized into 3 subjects. When high-risk pregnancy woman foretell the situation, they feel unsettlement about uncertainty and untrust feeling about hospital. But they are ease with family support and hospital support. On the other hand, they express indifferent 3-way structure response to the situation having will of overcome and exceeding optimistic thought. In those statements, the experience by pregnancy woman shows 3 respect subjects. 1. They are anxious of this situation and are in desperation and don't recognize their role to be carried out 2. They think of this situation as normal process of pregnancy and are not concerned that this can give themselves and fetus fatal damage. 3. The pregnancy women will never confront this situation. This study shows the pregnancy woman has anxiety and optimistic relief about the situation, and ignores and optimistic relief about the situation, and ignores many things. Therefore, nurses in clinic should give pregnancy woman knowledge and information about the high-risk and help them to deal with the situation spontaneously. High-risk pregnancy woman should have the care plan in respect of the right perception. And the nurse know that their support help out pregnancy woman overcome the crisis in this respect of the special nursing intervention.

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