• Title/Summary/Keyword: 비약물적 치료

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The System for Inducing Sleep Using Neuro-Feedback (뉴로피드백을 활용한 수면 유도 시스템)

  • Kim, Min-Gwan;Lee, Jung-Been;Lee, Taek;Lee, Heon-Jeong;In, Hoh Peter
    • Annual Conference of KIPS
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    • 2013.11a
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    • pp.1706-1708
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    • 2013
  • 최근 규칙적인 수면을 이루지 못해 수면장애를 호소하는 사람들이 좌시하기 어려울 정도로 늘어나고 있는 추세이다. 수면장애 치료를 위한 보편적인 방법은 수면제 투여이나, 약물의 지속적인 투여로 인해 약물의 내성 및 의존성 등의 부작용이 일어날 수 있다. 따라서 근래에는 비약물적인 인지행동치료(Cognitive Behavior Therapy)를 통해 환자가 스스로 자신의 상태를 이완시킬 수 있는 훈련을 제공하고 있다. 하지만 치료를 위해서는 병원과 환자 모두 많은 시간과 비용이 든다는 문제점이 있다. 따라서 본 논문에서는 환자 혼자서도 바이오피드백 훈련이 가능하도록 하는 시스템을 제안한다. 이 시스템을 통해 좀 더 효율적인 수면장애 치료를 기대할 수 있다.

Delirium Management: Diagnosis, Assessment, and Treatment in Palliative Care (섬망의 돌봄: 완화의료 영역에서의 진단, 평가 및 치료)

  • Seo, Min Seok;Lee, Yong Joo
    • Journal of Hospice and Palliative Care
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    • v.19 no.3
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    • pp.201-210
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    • 2016
  • Delirium is a common symptom in patients with terminal cancer. The prevalence increases in the dying phase. Delirium causes negative effects on quality of life for both patients and their families, and is associated with higher mortality. However, some studies reported that it tends to remain unrecognized in palliative care setting. That may be related with difficulties to distinguish the symptom from others with overlapping characteristics such as depression and dementia, and a lack of knowledge regarding assessment and diagnostic tools. We suggest that accurate recognition with validated tools and early diagnosis of the symptom should be highly prioritized in delirium management in palliative care setting. After diagnosing delirium, it is important to identify and address reversible precipitants such as medication, dehydration, and infection. Non-pharmacological interventions including comfortable environment for the patient and family education are also essential in the management strategy. If such interventions prove ineffective or insufficient to control hyperactive symptoms, pharmacologic interventions with antipsychotics and benzodiazepine can be considered. Until now, low levels of haloperidol remains the standard treatment despite a lack of evidence. Atypical antipsychotics such as olanzapine, quetiapine and risperidone reportedly have similar efficacy with a stronger sedating property and less adverse effect compared to haloperidol. Currently, delirium medications that can be used in palliative care setting require more clinical trials, and thus, clinical guidelines are not sufficiently available. We suggest that it is warranted to develop clinical guidelines based on well-designed clinical studies for palliative care patients.

A Systematic Review of Nonpharmacological Interventions on Activities of Daily Living in Dementia (치매 환자의 일상생활 수행능력 향상을 위한 비약물 중재에 관한 체계적 고찰)

  • Koo, Seul-Gi;Park, Hae-Yean;Park, Ji-Hyuk
    • 한국노년학
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    • v.37 no.2
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    • pp.445-459
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    • 2017
  • The purpose of this study is to provide a systematic review of the nonpharmacological interventions of ADL improvement for dementia published in foreign journals for the past 10 years, and to provide general information on nonpharmacological interventions and effective intervention methods to dementia expert in clinical practice. We searched published studies in the Medline Complete, PubMed Central, and Scopus databases from January 2007 to November 2016. The main keywords used "Dementia AND (ADL OR Activities of daily living) AND Nonpharmacological interventions" and total of 9 studies were selected for analysis from 974 searched articles. The level of evidence were belonged to 3 each studies in I~III level. The mostly provided nonpharmacological interventions were exercise, the study field was variety of areas including rehabilitation(occupational therapy, physical therapy), nursing, and psychology. The Barthel Index(BI) was most frequently used assessment tools to evaluate basic activities of daily living, Cognition was most dependent variables measured with the ADL. Through this study, we provided evidence for the understanding of nonpharmacological interventions of ADL improvement for dementia. In the future, based on this study, helpful intervention needed for ADL training.

Psychiatric Treatment of Chronic Pain Disorder (만성 통증장애의 정신과적 치료)

  • Rho, Seung-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.256-262
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    • 1999
  • Because chronic pain disorder may has multiple causes or contributing factors, including physical, psychological, and socio-environmental variables, the treatment of patients with the disorder requires biopsychosocial approaches in a multidisciplinary setting. In treating chronic pain, it is important to address functioning as well as pain, and treatment should be to increase functional capacity and manage the pain as opposed to curing it. Therefore treatment goal should be adaptation to pain or minimizing pain with corresponding greater functioning. Treatment begins with the initial assessment, which includes evaluation of psychophysiologic mechanisms, operant mechanisms, and overt psychiatric comorbidity. Psychiatric treatment of the patients requires adherence to sound pharmacologic and behavioral principles. There are four categories of drugs useful to psychiatrist in the management of chronic pain patients : 1) narcotic analgesics, 2) nonsteroidal antiinflammatory drugs, 3) psychotropic medications, and 4) anticonvulsants, but antidepressants are the most valuable drugs in pharmnacotherpy for them. Psychological treatments tend to emphasize behavioral and cognitive-behavioral modalities, which are divided into self-management techniques and operant techniques. Psychodynamic and insight-oriented therapies are indicated to some patients with long-standing interpersonal dysfunction or a history of childhood abuse.

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고지혈증의 원인과 치료 - 고지혈증과 식사요법

  • Jang, Yun-Jeong
    • The Monthly Diabetes
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    • s.285
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    • pp.30-34
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    • 2013
  • 고지혈증의 치료를 위해서는 올바른 식사와 생활습관의 수정이 필요하다. 미국 당뇨병학회(American Diabetics Association, ADA)는 당뇨병환자의 고질혈증의 치료를 위해 생활습관 조정, 신체 활동 증가, 체중 감소, 금연과 함께 개인별 상황을 고려한 영양적 중재를 권하고 있고, 국립 콜레스테롤 교육 프로그램(National Cholesterol Education Program, NCEP)에서 제정한 고지혈증 치료지침서(Adult Treatment Panel III, ATP III)에서는 비약물 요법의 중요성을 강조하면서 식사요법 및 생활습관의 개선(therapeutic lifestyle change, TLC)으로 고지혈증의 치료를 시작하여 6주 이상 실시한 후에 효과가 없을 때는 약물치료를 하도록 권하고 있다. 따라서 고지혈증 개선을 위해 바람직한 식사 원칙에 대하여 자세히 알아보고자 한다.

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의학 - HIV 치료의 최신지견

  • Bang, Ji-Hwan
    • RED RIBBON
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    • s.82
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    • pp.20-21
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    • 2009
  • 강력한 항레트로바이러스 치로(highly active antiretroviral therapy, HAART)의 도입으로 HIV 감영인의 기대여명(life expectancy)이 비감염인과 큰 차이가 나지 않을 정도로 향상된 것은 널리 알려진 사실이다. 하지만 평생 동안 약물을 복용해야 하며, 이에 따른 약물 부작용, 약제 내성, 경제적 손실, 불편함 등이 문제가 되고 있으며, 이를 극복하기 위한 다양한 치료법에 대한 연구가 진행 중이다. 이 글에서는 최근 발표되거나 진행 중인 새로운 치료 방법에 대해 간단히 알아보고자 한다.

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Clinical pharmacogenetics (임상약물유전학)

  • 권준택
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1997.11a
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    • pp.81-85
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    • 1997
  • 인체에 투여된 약물의 반응은 개체간에 현저한 차이가 있으며 특히 환자에게 투여된 약물의 효과가 상이하게 나타남으로써 치료의 실패나 흑은 약물의 유해작용으로 나타나기도 한다. 이러한 개체 상호간의 약물반응의 차이는 환경적인 요소, 영양학적인 요소, 연령, 병용한 다른 약물 및 이미 앓고 있는 질병 등에 의해서도 영향을 받으나 특히 유전적으로 결정된 약물대사 능력의 차이에 의해서도 기인된다. 이러한 측면에서 약물 대사의 유전적인 다양성과 비정상적인 반응을 다루는 약물유전학의 중요성은 최근 두드러지게 대두되고 있다. 특히 유전적인 요인으로 개체간의 차이는 효소의 유전적인 결핍과 관련이 있으며 이 결핍은 생체이물질에 대한 반응의 다양성을 설명할 수 있는 약물대사 능력의 다형성에 기인한다. 또한 약물반응의 다양성은 인종간, 특히 동양인과 서양인에서의 약물반응에서도 차이가 있어 각 인종간의 약물반응의 차이에 대한 연구와 이의 원인규명에 대하여 많은 관심이 집중되고 있다. 이와 같은 견지에서 약물용량과 약물반응, 특히 약동학적 변화의 인종간의 차이와 각 개인의 차이 및 이의 원인에 대하여 살펴보고자 한다.

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An Integrated Literature Review of Non-pharmacological Intervention in Older Adults with Mild Cognitive Impairment (국내외 경도인지장애 노인의 비약물적 중재에 대한 통합적 문헌고찰)

  • LEE, JUNGEUN
    • Journal of Digital Convergence
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    • v.19 no.3
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    • pp.471-482
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    • 2021
  • We aimed to provide evidences for developing non-pharmacological intervention in older adults with Mild Cognitive Impairment(MCI) by integrated literature review. The final 16 papers were selected as a result of an integrated literature analysis. All of them are focused on strengthening cognitive activities, while Korean studies have often merged emotional activities such as music therapy and laughter therapy rather than physical activities such as exercise therapy, international studies have combined physical activities rather than emotional activities. The effects of non-pharmacological intervention differed according to the outcome variables. The primary variables were cognitive function and depression, and secondary variables were found to have effects on physical function, activities of daily living (ADL), and self-efficacy. This study contributes to a multidisciplinary approach that can be applied in the clinical field through the development of various non-pharmaceutical intervention for the prevention of dementia in the older adults with MCI.

Well-being of young and middle aged diabetic patients with medication according to combination of non-pharmacological treatment: a path analysis (청장년층 약물치료 당뇨환자의 비약물적치료 병행 여부에 따른 웰빙: 경로분석)

  • Kim, Sun-Kyung;Kim, Yu-Mi;Kim, Sun-Ae
    • Journal of the Korea Convergence Society
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    • v.11 no.6
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    • pp.401-410
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    • 2020
  • The purpose of this study was to investigate predictors and mediating effects of physical activity and nourishment regulation on well-being among young and middle aged patients on DM medication and to compare between those with non-pharmacological treatment and those without. Data were obtained from 2017 community health survey including 1,480 DM patients with oral medication in the age between 20 and 49. Using SPSS 25.0 and AMOS 25.0, path analysis was performed to explore the association between personal factors (socio-economic status, health habit, eating habit and compliance of health examination) and well-being, along with mediating effects of physical activity. Results demonstrated the different mediating role of physical activity. In medication only group, there was no direct effect of physical activity and no indirect effect of personal factors. Direct effect of physical activity and indirect effects of predictors were found in those with non-pharmacological treatment group. When developing strategies to enhance well-being of young and middle aged diabetic patients, proper reflection of their age specific traits and disease management capability are essential.