• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.95-101
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• 2021

Patients complaining with somatic symptoms are very common in clinical practice, and are often consulted to medical department. But it is difficult to treat well. The treatment of somatic symptom disorder is multi-modal as none of the methods on their own provide a satisfactory outcome. The treatment of somatic symptoms disorders is complicated by lack of boundary, conceptual clarity, and overemphasis on psychosocial causation and effectiveness of psychological treatments. In clinical practice all classes of psychotropics are used to treat somatic symptoms disorder. Drugs such as tricyclic antidepressants, serotonin reuptake inibitors(SSRI), serotonin and noradrenalin reuptake inhibitors (SNRI), atypical antipsychotics are studied. The evidence indicates that these drugs are effective in somatic symptom disorders. All classes of antidepressants seem to be effective against somatic symptom disorders. SSRIs are more effective against hypochondriasis and body dysmorphic disorder, and SNRIs appear to be more effective than other antidepressants when pain is predominant. The author suggest that psychiatrists should know how to treat patients complaining with somatic symptoms by using not only psychotherapeutic approach but also pharmacological treatment. It will be helpful to reduce suffering and increase quality of life of these patients.

• Journal of Preventive Medicine and Public Health
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• v.11 no.1
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• pp.110-122
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• 1978

A study on the morbidity of syphilis among 729 workers in Po Hang and Ul San Industiral Complexes at the routine periodical examination was performed. In addition to the morbidity, factors related to the disease infection such as educational level, religion, preventive measures taken by the workers, history of urethritis, and so on were studied and analysed to check significant relation. The results were as follows: 1. VDRL and RPR tests were undertaken to determine the sensitivity and specificity of RPR test which was utilized for all the workers studied. It revealed 86.4% of sensitivity and 87.7% of specificity from RPR test, and 81.8% of sensitivity and 90.1% of specificity from the VDRL test compared with RPCF test. There were 87.4% of agreement rate between RPR and VDRL. Actually, RPR was more sensitive but less specific than VDRL, and found to be a satisfactory screening test for syphilis especially in the fields. 2. Among the workers in Po Hang Area 24.0% of them revealed reactive result, and in Ul San Area 5.2% revealed reactive result showing 4.6 times of risk among workers in Po Hang Area. 3. There were no statistically significant differences between RPR reactive rates and personal characteristics such as educational level, religion, history of urethritis experience, history of coitus with prostitute, and preventive measures of V.D. taken by workers if evaluated by area of Po Hang and Ul Srn separately. 4. V.D. could be encountered as an occupational disease in certain conditions of working places and the psychosocial problems of workers. And so, it is necessary that all the workers working in special estates such as in Po Hang Industrial Complex should be checked to be screened out by RPR test at periodical examinations and part of pre-employment examination also should include RPR test to be compared with. Regardless of the workmen's compensation, establishment of V.D. treatment clinic or system for such industrial workers is urgently needed. Health education regarding V.D. is another subject to be performed.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.39.1-39.6
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• 2016

Background: Temporomandibular joint (TMJ) ankylosis in children often leads to facial deformity, functional deficit, and negative influence of the psychosocial development, which worsens with growth. The treatment of TMJ ankylosis in the pediatric patient is much more challenging than in adults because of a high incidence of recurrence and unfavorable growth of the mandible. Case report: This is a case report describing sequential management of the left TMJ ankylosis resulted from trauma in early childhood. The multiple surgeries including a costochondral graft and gap arthroplasty using interpositional silicone block were performed, but re-ankylosis of the TMJ occurred after surgery. Alloplastic TMJ prosthesis was conducted to prevent another ankylosis, and signs or symptoms of re-ankylosis were not found. Additional reconstruction surgery was performed to compensate mandibular growth after confirming growth completion. During the first 3 years of long-term follow-up, satisfactory functional and esthetic results were observed. Conclusions: This is to review the sequential management for the recurrent TMJ ankylosis in a growing child. Even though proper healing was expected after reconstruction of the left TMJ with costal cartilage graft, additional surgical interventions, including interpositional arthroplasty, were performed due to re-ankylosis of the affected site. In this case, alloplastic prosthesis could be an option to prevent TMJ re-ankylosis for growing pediatric patients with TMJ ankylosis in the beginning.

• Journal of Digital Convergence
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• v.13 no.6
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• pp.235-246
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• 2015

After kidney transplantation, immunosuppressive medication is essential to enhance the quality of life and survival of the transplanted patient. To promote the medication adherence, subjects are required to have converged attitude with open mind. Medication adherence will depend on the attitude of the psychosocial characteristics and treatment guidelines. The purpose of this study was to identify the specific types and characteristics of medication adherence in the view of kidney transplanted patients. Q-methodology, a technique for extracting subjective opinions, was used. Forty participants completed the Q-sort activity, rating each statement relative to the others. The collected data were analyzed by QUANL PC program. Four types of medication adherence of kidney transplanted patients were identified: 'positive lifestyle management type', 'vigilant appearance management type', 'somber oblivion type', 'vigilant family support type'. Through the identification of attitudes to medication adherence, repeated and individualized medication adherence program will help to prevent graft rejection.

• Asian Oncology Nursing
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• v.12 no.2
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• pp.186-193
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• 2012

Purpose: The purpose of this narrative study was to understand how family caregivers interpreted themselves life during caring for dying patients with gliobalstoma, and how they integrated these experiences into their personal biographies. Methods: Three family caregivers were recruited for the study. Data were collected through a series of audio-taped unstructured interviews and conversations with participants. The interviews and observation were conducted between October and November, 2011. Data were analyzed using psychosocial analytical methods that combined case based, in-depth staged analysis of narratives. Results: The life experiences of the family caregivers with a dying family member were summarized as, in their own voices, 'the repetition of gliobalstoma,' 'a smart patient,' 'being obsessed with rehabilitation treatment,' 'the frustration from nothing but just looking at the suffering of the patient,' and 'a stubborn son'. Conclusion: Caregiving was characterised by various roles and life changes from the moment of diagnosis. Family caregivers of brain tumor reported experiences similar to those described by caregivers of people with other cancers. What differed for this group was the rapidity of change and the need for immediate information and support to assist with caring for a person with high-grade glioma.

• Anxiety and mood
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• v.7 no.2
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• pp.101-106
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• 2011

Objectives : The aim of this study was to investigate whether and how the symptoms of adult attention deficit hyperactivity disorder (ADHD) affect the stress and depressive symptoms in Korean soldiers. Methods : Data were collected on 131 subjects through self-report using the Korean Adult Attention-Deficit/Hyperactivity Disorder Scale (K-AADHDS), Center for Epidemiological Studies Depression Scale (CES-D), Korean Wender Utah Rating Scale (K-WURS), and the Brief Encounter Psychosocial Instrument (BEPSI-K). Student t-tests, Pearson Correlation, Logistic regression, and Path analysis were performed. Results : The scores related to adult ADHD symptoms on the K-AADHDS and K-WURS were correlated with stress scores on the BEPSI-K (r=0.529, p<0.001 and r=0.484, p<0.001) and with depressive symptoms on the CES-D (r=0.686, p<0.001 and r=0.628, p<0.001). Scores related to adult ADHD on the K-AADHDS were the most significant risk factors for stress (O.R=1.198, 95% CI=1.104-1.299), and depressive symptoms (O.R=1.306, p95% CI=1.112-1.534). Path analysis on depressive symptoms showed that adult ADHD symptoms affected stress and depressive symptoms. Conclusion : The results suggest that it may be important to consider the evaluation and treatment of adult ADHD in soldiers. Prospective studies with larger numbers of subjects are warranted to further explore the relevance of the present results.

• The Korean Journal of Pain
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• v.31 no.3
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• pp.155-173
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• 2018

Chronic postsurgical pain (CPSP) is an unwanted adverse event in any operation. It leads to functional limitations and psychological trauma for patients, and leaves the operative team with feelings of failure and humiliation. Therefore, it is crucial that preventive strategies for CPSP are considered in high-risk operations. Various techniques have been implemented to reduce the risk with variable success. Identifying the risk factors for each patient and applying a timely preventive strategy may help patients avoid the distress of chronic pain. The preventive strategies include modification of the surgical technique, good pain control throughout the perioperative period, and preoperative psychological intervention focusing on the psychosocial and cognitive risk factors. Appropriate management of CPSP patients is also necessary to reduce their suffering. CPSP usually has a neuropathic pain component; therefore, the current recommendations are based on data on chronic neuropathic pain. Hence, voltage-dependent calcium channel antagonists, antidepressants, topical lidocaine and topical capsaicin are the main pharmacological treatments. Paracetamol, NSAIDs and weak opioids can be used according to symptom severity, but strong opioids should be used with great caution and are not recommended. Other drugs that may be helpful are ketamine, clonidine, and intravenous lidocaine infusion. For patients with failed pharmacological treatment, consideration should be given to pain interventions; examples include transcutaneous electrical nerve stimulation, botulinum toxin injections, pulsed radiofrequency, nerve blocks, nerve ablation, neuromodulation and surgical management. Physical therapy, cognitive behavioral therapy and lifestyle modifications are also useful for relieving the pain and distress experienced by CPSP patients.

• Journal of Korean Clinical Nursing Research
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• v.14 no.3
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• pp.99-115
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• 2008

Purpose: The purpose for this study was to identify the present state of Clinical Nurses with Expanded Role (CNERs) and provide basic data to refine the roles of CNERs. In this study, CNREs refers to nurses who perform techniques traditionally done by doctors and use titles such as clinical nursing specialist, educator with consultation, research assistant, coordinator, physician assistant and special examiner. Method: This study was conducted from September 1 to November 12, 2007. Data from 684 nurses from 38 hospitals who responded to the questionnaire were analyzed with descriptive statistics using the SPSS 14.0 program. Results: The mean percentage of time spent was, for direct practice, 41.1%, for education and counseling, 22.8%, for consultation and coordination, 10.4%, for research, 6.8%, for administration, 8.9% and for other activities, 10.0%. The most frequently implemented CNERs, activities included consultation and education for patients and their families, counseling by telephone, history taking, physical examination, reading examination results, psychosocial assessment, managing treatment, input of prescriptions, and writing up patient records, Although not frequently performed, nurses in some fields carried out invasive procedures and prescribed medication and laboratory tests. Conclusion: Although the number of hospital CNERs are rapidly increasing, there is still confusion about the title and framework as well as standards. Furthermore, because some nurses are prescribing medication and laboratory tests as well as performing techniques not traditionally done by nurses, there is an absolute need for a legalized system and systematic education system for the safety of patients who are being cared by all CNERs.

• Journal of Korean Academy of Nursing
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• v.37 no.1
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• pp.72-80
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• 2007

Purpose: This study was to analyze the trend of research on intervention for patients with metabolic syndrome. Method: Using Pubmed, Medline, and CINAHL search engines, a randomized controlled trial(RCT) researching titles such as 'metabolic syndrome', 'intervention', 'lifestyle modification', or 'community-based' were collected. A total of 16 researches were analyzed based on the guidelines of the National Cholesterol Education Program - Adult Treatment Panel(NCEP-ATP III). Results: 1) The total period of the intervention was from 12 to 24 weeks, the frequency was 3 to 5 times per week, and the duration of each session was from 45 to 60 minutes. The types of intervention included exercise, diet, and medication. Among these types, diet was performed most frequently. 2) The outcomes of the intervention was measured with physical aspects such as anthropometric measures, body composition, or biological markers. No studies have evaluated psychosocial outcomes such as quality of life. 3) In terms of effectiveness of the intervention, anthropometric indicators, body composition, or serological markers showed positive effects, whereas results on endothelial or urine indicators were inconsistent. Conclusion: Methodological research developing comprehensive therapeutic lifestyle modification programs and intervention studies are needed for patients with metabolic syndrome. In addition, effects should be evaluated with multidimensional perspectives.

• Korean Journal of Social Welfare
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• v.39
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• pp.238-265
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• 1999

The purpose of this study was to examine the degree of depression in housewives and to analyze the effects of psychosocial factors on the depression. Especially the focus was on the differences in the degree of depression and the influencing factors on depression between those in early adulthood and those in middle adulthood The subjects consisted of 130 early adulthood housewives and 142 middled adulthood housewives. They asked to complete several self-report measures that were used to assess the variables of interest. The result indicated that the depression in housewives were serious enough to arouse social workers' attention. The average housewives were suffered from mild depression, and 17.1% of the housewives were in need of professional treatment. There was no significant difference in the degree of depression between the early adulthood housewives and the middle adulthood housewives. There were, however, differences in the factors which explain and predict the depression between these two groups. The results of step-wise multiple regression analysis indicated that the factors which predict the depression for the early adulthood housewives were self-esteem, conflict with the spouse, experience of painful events, age, and conflict with the children. On the other hand, the factors which predict the depression for the middle adulthood housewives were self-esteem, conflict with the spouse, job, and income. Implications of the findings for social work interventions were discussed.