• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.5
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• pp.394-405
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• 2019

The purpose of this study is to clarify the concept of the frail elderly and to obtain theoretical evidence. The research method was conducted using the basic principles for conceptual analysis of Walker and Avant(2005). As a Result of a review of the literature about how to utilize the concept of a frail elderly, frail elderly might be in the intermediate state of health and disease. They can be defined as physically vulnerable in the sarcopenia, inflammation, insulin resistance, and preceding advanced disease, lead to hospitalization, falls, disability, and death. The attributes were physiological, psychological, and socio-environmental and economic factors, so they had multidimensional factors. They were required the assist daily living of another person. Also, their attributes had decreased the amount of recovery time and degree, and exhaustion. The attributes of frail elderly consisted of these facts: dynamic process, multidimensional factors, dependency, vulnerability. The frail elderly was a dynamic process that involves the possibility of change to health and disease, and include physical, mental, cognitive, and social environmental factors. In addition, the frail elderly was difficulty in daily life, physical vulnerability and difficulty in adaption. In conclusion, frail elderly as defined by the results of this study will contribute to the foundation of health care systems, including community visiting nursing to understand the level of frail elderly and systemic management to do not go into long term care.

• Journal of agricultural medicine and community health
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• v.27 no.1
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• pp.21-31
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• 2002

The aim of this study was to analyse and conduct the comprehensive geriatric assessment for the elderly in rural area. The subjects were 388 older people aged 65 years or older living in the community. Data for comprehensive assessment such as physical, mental, functional, social and environmental conditions were collected from January to February, 2001 through a person-to-person interview. Of the total 388 olders, 169(43.6%) were men and 219(56.4%) were women. Mean ages of men and women were $73.5{\pm}6.4$ and $74.0{\pm}6.2$ years respectively. Three common diseases of the elderly were arthralgia(51.6%), chronic back pain(33.2%) and hypertension(18.6%), and higher in women than in men. Impairment rate of vision, hearing and bowel or bladder control was 59.0%, 20.1%, and 28.4% respectively. But that of lover extremities 3.4%. In terms of cognitive function, short term memory loss was found in 33.7% of males and 44.7% of females. The percentage of fully independent in the six ADL items was 72.2% in men and 58.9% in women. In the social supportive system, 49.5% of the elderly were living with spouse, and 22.9% living alone, 26.3% having care giver. These results will provide basic data for the development of community-based health program, which gives appropriate health service for the elderly living in the community.

• Korean Journal of Psychosomatic Medicine
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• v.13 no.2
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• pp.102-111
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• 2005

Objective : The purpose of this study was to investigate the quality of life and it's related factors in caregivers of attention deficit hyperactivity disorder patients. Methods : The subjects were 38 attention deficit hyperactivity disorder patients' caregivers(mean age : $37.5{\pm}6.5$, 38 women). Patients were diagnosed with DSM-IV-TR ADHD criteria. Korean version of WHOQOL-BREF(World Health Organization Quality of Life assessment instrument Abbreviated Version) was used for assessment. Results : 1) No significant differences were found in the score of WHOQOL-BREF, overall QOL, physical health domain, psychological domain, social relationships domain and environmental domain between caregiver and control group. 2) The score of Activity of daily living facet$(3.0{\pm}0.7\;vs.\;3.6{\pm}0.7)(p=0.008)$ and self-esteem facet $(2.8{\pm}0.7\;vs.\;3.3{\pm}0.7)(p=0.049)$ were significantly decreased in caregivers of ADHD. 3) Total score of WHOQOL-BREF(r=0.437, p=0.007) and physical health domain(r=0.370, p=0.024) were correlated with caregiver's educational age. 4) In the psychological domain, the score of self-esteem facet(r=-0.337, p=0.039) and thinking, learning, memory & concentration facet(r=-.341, p=0.036) were decreased with caregiver's age. 5) The score of environmental domain were significantly increased with caregiver's educational age (r=0.482, p=0.003), but decreased with patient's age(r=0.328, p=0.044). Conclusion : Although the quality of life in caregivers of ADHD patient had not significantly decreased than control, the quality of lift were positively correlated with educational age of caregives, and negatively correlated with chronological age of caregivers and children. Above results suggest that physicians should consider integrated approaches for caregiver's subjective quality of life in the management of ADHD.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.127-134
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• 2018

Objectives : This study aimed to identify the group with high risk of suicide in general hospital inpatient by comparing the depression, anxiety, and distress and their clinical characteristics. Methods : The study included all patients admitted to a general hospital between January 2016 and December 2017, and the final 41,249 patients were analyzed. Distress thermometer (DT) and hospital anxiety-depression scale (HADS) were used for emotional state evaluation. Group with high risk of suicide was defined as showing more than 4 in the DT and more than 8 in one of the two subscales (anxiety and depression) of the HADS. Results : Among the subjects, 3,603 patients (8.7%) met the high-risk criteria for suicide. The group with high risk of suicide experienced more severe pain than the control patient group, and it was found that there was more underlying disease. Patients who reported pain showed higher scores than those who reported no pain on the DT and HADS subscales. Conclusions : Group with high risk of suicide showed more severe pain and more underlying disease. Therefore, suicide prevention program specifically targeted for the group with high risk of suicide should be developed according to the risk of the patient evaluated at the time of the admission.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.79-88
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• 2023

Objectives : Cancer diagnosis causes significant distress while it may also bring positive change: post-traumatic growth. This study was conducted to analyze factors that affect post-traumatic growth. Methods : Medical records of 52 cancer patients who received psychiatric treatment at a university hospital in Seoul were reviewed and the correlation between post-traumatic growth and following factors were analyzed: Resilience, Anxious thoughts and tendencies, Mindful attention awareness, Acceptance attitude Results : Using Multiple Generalized Linear model, a positive correlation was found between post-traumatic growth and resilience (B=1.45, p<0.0001), mindful attention awareness (B=0.58, p=0.0030) and acceptance attitude (B=1.29, p=0.0003), while anxious thoughts and tendencies (B=-0.84, p<0.0001) had negative association. Conclusions : Factors that have a positive impact on post-traumatic growth were resilience, mindful attention awareness, acceptance attitude and a factor with a negative impact was anxious thoughts and tendencies; Factors that impact post-traumatic growth need to be taken into account, when approaching the treatment of cancer patients.

• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.244-254
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• 1999

Objectives: This study investigated the psychological characteristics of patients with functional dyspepsia. Methods: The subjects included ninety patients with functional dyspepsia and sixty four psychiatric out-patients. We administered Minnesota Multiphasic Personality Inventory(MMPI) and Illness Behavior Questionnaire(IBQ). Results: There were no significant differences between the patients with functional dyspepsia and the psychiatric out-patients by MMPI. Two groups both showed a higher distribution in hypochondriasis, depression, hysteria subscales than in any other subscales. The patients with functional dyspepsia showed lower scores in disease conviction and affective disturbance subscales in IBQ than the psychiatric out-patients. The distribution of scores of the other IBQ subscales were similar between the patients with functional dyspepsia and the psychiatric out-patients. The patients with functional dyspepsia were divided into three groups for the Multivariate cluster analysis: normal, similar to psychiatric out-patient, and severe neurotic. The severe neurotic group showed higher scores in hypochondriasis, depression, hysteria, psychathenia, and schizophrenia subscales in MMPI and showed significant different scores in affective disturbance, disease conviction, psychological and somatic concerns, affective disturbance, denial, and irritability subscales in IBQ. Conclusion: If patients with functional dyspepsia show severe neurotic behavior, such as those in, they would need appropriate psychiatric intervention.

• Korean Journal of Psychosomatic Medicine
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• v.32 no.1
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• pp.1-9
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• 2024

Frailty is a clinical syndrome as an increased vulnerability to stressors, leading to a decrease in physiologic reserves and a decline in the ability to maintain a good homeostasis. This condition leads to an increased risk of hospitalization, disability and mortality. Frailty occurs due to various causes and requires a multidimensional approach. It is also important to detect and manage it early. Frailty is also deeply related to neuropsychiatric problems such as pain and depression. In evaluating frailty, it is desirable to comprehensively consider not only physical areas such as disease, nutrition, movement, and sensory functions, but also psychosocial areas, and representative scales include Fried's physical frailty phenotype and Rockwood's frailty index. Physical activity and appropriate protein intake are important for frailty management, and inappropriate drug use should be reduced and oral care, cognitive function, and falls should also be noted. Frailty and pain can affect each other, and pain can promote frailty. Evidence has been published that hormone and protein abnormalities, immune system activity and inflammatory response, and epigenetic mechanisms work in common in the field of frailty and pain. More extensive and high-quality research should be conducted in the future, and the quality of life will be improved if the results are applied to the suppression and treatment of old age and pain.

• Sleep Medicine and Psychophysiology
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• v.29 no.1
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• pp.15-20
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• 2022

Objectives: Suicide is the major public mental health concerns all over the world. The comparison of suicide attempters and suicide completers could be the fundamental evidence for the suicide prevention. The aim of this study is to explore the differences between suicide attempters and suicide completers in terms of the stressors, suicide methods, and psychiatric diagnosis. Methods: Two types of secondary data were collected for the analyses. Data of the suicide attempters (n = 680) were gathered by intensive reviewing the medical records of Samsung Medical Center, Seoul, Republic of Korea. Data of suicide completers (n = 11,722) were collected by the psychological autopsy data which were gathered by Korean Foundation for Suicide Prevention. Suicidal methods, psychiatric disorders and stressors before suicidal attempt were compared between suicide attempter and completers. Results: Suicide completers were older and male predominant compared to suicidal attempt. Hanging or gas intoxication were more commonly used in the suicide completion, while wrist cutting or drug intoxication were more common in suicide attempters. All types of stressors were found to be high in suicide completers than suicide attempters. However, the proportion of economic and physical stress were greater in suicide completers, while the proportion of family stress were greater in suicide attempters. According to the recorded diagnoses, the rates of depressive disorders, sleep-wake disorders, substance-related disorders were higher in suicide completers, while the rates of anxiety disorders and trauma- and stressor-related disorders, bipolar and related disorders and somatic symptom disorders were higher in suicide attempters. However, after controlling the gender and age, there were no significant differences in diagnosis between suicide attempters and suicide completers. Conclusion: These findings implicate that suicide attempters and completers differed in suicide methods and type of stress. The results suggests that economic stressors, physical illness might raise the risk of suicide completion.

• Journal of agricultural medicine and community health
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• v.20 no.2
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• pp.175-185
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• 1995

This study is to compare family support and mental health between the rural and the urban elderly. In order to do that I collected the data through questioning 238 people in 3 urban areas in Busan and 201 people in 9 rural areas near Daegu. The degree of their family support is 36.70 on the average in the rural area and 40.77 in the urban area. The degree of family support of urban elderly is a little higher. According to general characters between the differences of family support in both areas, in the rural area there are differences in sex, age, whether they have a spouse or not, education level, financial state, number of children, number of co living, status of co living, subjective health status, amount of pocket money and how much they are participating in leisure activity. In the urban area there are differences in sex, whether they have a spouse or not, religion, financial state, number of co living, status of co living, subjective health status, amount of pocket money, how much they are participating in leisure activity and house pattern. In the stepwise multiple regression analysis the main variables that affect degree of family support in the rural area are age, whether they have a spouse or not and financial state which account for 33% of the total variance and in the urban area are subjective health status, financial state, whether they have a spouse or not and number of co-living which account for 35%. Health status is better in the urban area(average 36.87) than in the rural area(57.42). In each item the people whose mark was more than 75%(low) have Depression 8.4%, Somatization 8.0% in the urban area and Somatization 8.5%, Depression 8.5%, Anxiety 4.0%, Phobic anxiety 4.0%, Obsessive compulsive reaction 2.5%, Hostility 2.0%, Paranoid ideation 2.0%, Psychoticism 1.5% and Interpersonal sensitivity 1.5% in the rural area. In the mental health condition, on the basis of 4 points in both areas, the average is Somatization(rural : 1.69, urban : 1.51), Depression (rural : 1.64, urban : 1.37) and Obsessive compulsive reaction(rural : 1.33, urban : 0.99). According to the differences between mental health conditions by general characters, in the rural area the differences are presented in sex, age, whether they have a spouse or not, religion, education level, financial state, number of children, status of co living, subjective health status, amount of pocket money and how much they are participating in leisure activity, in the urban area the differences are presented in sex, whether they have a spouse or not, religion, financial state, number of co living, status of co living, subjective health status, house pattern, amount of pocket money and how much they are participating in leisure activity. In the stepwise multiple regression analysis the main variables that affect mental health condition in the rural are family support degree subjective health status, religion sex, age and financial state which account for 43% of the total and in the urban area are family support degree, subjective health status and financial state which account for 51%. In the matter of family support degree and mental health condition the rural area was -0.4555, of urban area was -0.6446. The rural area that has a high percentage in family support degree and mental health condition Depression was -0.5036, Psychoticism was -0.4265 in the urban area Psychoticism was -0.6452, Depression was -0.5955. Family support has a great influence on mental health of old people and family support and mental health condition can be different according to living area. So in their problems nursing intervention through family and nursing strategies according to living area should be established.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.1
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• pp.34-41
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• 2021

Objectives : The purpose of this study is to investigate the characteristics of depressive patients who admitted to general hospital. We examined the clinical characteristics of patients who were referred to the Department of Psychiatry as depressive symptoms, according to the type of consultation request, and comparing 'with re-consultation' and 'without re-consultation' groups. Methods : We performed a retrospective chart review of 4,966 inpatients who were referred to the Department of Psychiatry from August 2005 to December 2011. Results : For about 6 years, among the inpatients referred for psychiatric consultation, a total of 647 patients were referred for depressive symptoms, accounting for 13.82% of the total consultations. The average age of depressive patients was 58.6 years, which was higher than the average of 56.4 years of overall patients. Among the depressive patients, 275 patients were included in 'with re-consultation' group and there was no statistically significant difference when comparing 'with re-consultation' group and 'without re-consultation' group. However, there was a difference in the tendency of the two groups in the type of consultation request. 'With re-consultation' group was in the order of frequency of consultation type 3-2-1, whereas the 'without re-consultation' group was in the order of frequency of consultation type 2-3-1. Conclusions : The group of inpatients who were referred for depressive symptoms in general hospital showed the largest proportion of the group of patients referred to the Department of Psychiatry. 'With re-consultation' group had a higher rate of re-consultation due to the occurrence of new symptoms after hospitalization compared to 'without re-consultation' group. Therefore, doctors in each department and psychiatrists should pay attention to the depressive symptoms of inpatients and actively discuss treatment plans to improve the quality of medical services, identify risk factors, and make efforts to intervene early if necessary.