• Title/Summary/Keyword: 외상간호

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Effect of Post-traumatic Stress and Ways of Stress Coping on Problem Drinking in Firefighters (남자소방공무원의 외상 후 스트레스와 대처방식이 문제음주에 미치는 영향)

  • Jeon, Kyoung-Sun;Kang, Kyung-Ah
    • Korean Journal of Occupational Health Nursing
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    • v.26 no.4
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    • pp.218-226
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    • 2017
  • Purpose: The study aimed to determine the impact of post-traumatic stress and ways of stress coping on problem drinking in firefighters. Methods: Data were collected from May 11 to June 11, 2015, in fire brigades across South Korea. Participants were 183 male firefighters who used self-report questionnaires containing questions from the Impact of Event Scale-Revised (IES-R), Ways of Coping Checklist (WCC), and Alcohol Use Disorders Identification Test (AUDIT). Data were analyzed using $x^2$ test, t-test, and logistic regression with the SPSS/WIN 21.0 program. Results: The prevalence of PTSD among firefighters was 36.7% and that of problem drinking was 39.3%. Firefighters with single (OR=0.23, 95% CI=0.038~1.321) and married status (OR=0.46, 95% CI=0.069~3.040) were less likely to have problem drinking than those who were divorced or bereavement. Those with invasion symptoms (OR=1.17, 95% CI=1.031~1.327) and hyperarousal symptoms (OR=0.85, 95% CI=0.722~0.989) were more likely to have problem drinking than those with avoidance symptoms. Conclusion: Post-traumatic stress symptom was a major risk factor that increased problem drinking, and married status reduced problem drinking. There is a need to develop post-traumatic stress symptom management program and early education content for symptom management.

Changes in Pain, Mood and Posttrauma Risk Level of Patients with Acute Hand Microsurgery (응급 수부 미세수술 후 통증, 기분 및 외상 후 위기 정도의 변화양상)

  • Kim, Min-Suk;Yoon, Soon-Young;So, Hee-Young
    • The Korean Journal of Rehabilitation Nursing
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    • v.13 no.1
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    • pp.44-52
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    • 2010
  • Purpose: The purposes of this study were to explore changes in pain, mood and the level of posttrauma risk for 2 weeks after acute hand microsurgery and determine predictors of pain 2-week after microsurgery. Method: Using a sample of 84 patients with hand microsurgery, pain, mood, and posttrauma risk were measured by the Brief Pain Inventory-Korea, the modified Profile of mood states, and the Posttrauma risk checklist at 1-day, 1-week and 2-week post-microsurgery. Repeated measures ANOVA and Multiple regression analysis were conducted to evaluate changes in pain, mood, and posttrauma risk over time after the surgery and determine predictors of pain 2-week after the surgery. Results: Pain significantly decreased (F=63.22, p<.001), mood significantly improved (F=41.04, p<.001) 2 weeks after microsurgery and interestingly, posttrauma risk significantly decreased from baseline to 1-week microsurgery but increased at 2-week after microsurgery (F=24.66, p<.001). Approximately 57% of the variance of pain 2-week post-microsurgery was explained by pain at 1-week post-microsurgery, mood and the numbers of injured fingers. Conclusion: The findings suggest the pain control for 1week after acute surgery being critical and posttrauma rehabilitation of injured finger being necessary. Developing nursing interventions is urgently needed to help individuals with impending hand microsurgery.

Reliability and Validity of the Korean Version of the Perinatal Post-Traumatic Stress Disorder Questionnaire (한국판 주산기 외상 후 스트레스장애 척도의 신뢰도 및 타당도)

  • Park, Yu Kyung;Ju, Hyeon Ok;Na, Hunjoo
    • Journal of Korean Academy of Nursing
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    • v.46 no.1
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    • pp.29-38
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    • 2016
  • Purpose: The Perinatal Post-Traumatic Stress Disorder Questionnaire (PPQ) was designed to measure post-traumatic symptoms related to childbirth and symptoms during postnatal period. The purpose of this study was to develop a translated Korean version of the PPQ and to evaluate reliability and validity of the Korean PPQ. Methods: Participants were 196 mothers at one to 18 months after giving childbirth and data were collected through e-mails. The PPQ was translated into Korean using translation guideline from World Health Organization. For this study Cronbach's alpha and split-half reliability were used to evaluate the reliability of the PPQ. Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and known-group validity were conducted to examine construct validity. Correlations of the PPQ with Impact of Event Scale (IES), Beck Depression Inventory II (BDI-II), and Beck Anxiety Inventory (BAI) were used to test a criterion validity of the PPQ. Results: Cronbach's alpha and Spearman-Brown split-half correlation coefficient were 0.91 and 0.77, respectively. EFA identified a 3-factor solution including arousal, avoidance, and intrusion factors and CFA revealed the strongest support for the 3-factor model. The correlations of the PPQ with IES, BDI-II, and BAI were .99, .60, and .72, respectively, pointing to criterion validity of a high level. Conclusion: The Korean version PPQ is a useful tool for screening and assessing mothers' experiencing emotional distress related to child birth and during the postnatal period. The PPQ also reflects Post Traumatic Stress Disorder's diagnostic standards well.

Factors Influencing Posttraumatic Growth in Survivors of Breast Cancer (유방암생존자의 외상 후 성장에 영향을 미치는 요인)

  • Park, Jin-Hee;Jung, Yong-Sik;Jung, Youngmi
    • Journal of Korean Academy of Nursing
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    • v.46 no.3
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    • pp.454-462
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    • 2016
  • Purpose: Posttraumatic growth (PTG) is defined as 'positive psychological change experienced as a result of a struggle with highly challenging life circumstances'. The purpose of this study was to identify the level of PTG and its correlates in Korean patients with breast cancer. Methods: A sample of 120 participants was recruited from outpatients, who had successfully completed primary treatment of breast cancer at a university hospital., Data were collected from June to December, 2014 using Posttraumatic Growth Inventory, Illness Intrusiveness Rating Scale, Cancer Coping Questionnaire, Revised Life Orientation Test and The Multidimensional Scale of Perceived Social Support. Results: Total score for the PTG was $79.18{\pm}17.54$ in patients surviving breast cancer. Bivariate analyses indicated that PTG was positively associated with having a religion, perceived social support, greater optimism, cancer coping, and illness intrusiveness. Results of the regression analysis showed that cancer coping (${\beta}=.29$, p=.001), optimism (${\beta}=0.28$, p=.001) and illness intrusiveness (${\beta}=0.17$, p=.037) were statistically significant in patients' PTG. Conclusion: The research findings show that the variables of cancer coping, optimism and illness intrusiveness significantly explain PTG and these psychological variables can be used to provide improvement in PTG for patients with breast cancer.

Impact of Parents' Problem Drinking on Suicidal Ideation of Their University Student Children : The Multiple Mediating Effects of Childhood Trauma, Experiential Avoidance and Depression (부모의 문제음주가 대학생의 자살생각에 미치는 영향: 아동기 외상경험, 경험회피, 우울의 다중매개효과)

  • Lee, Eun Sook;Bong, Eun Ju
    • Journal of Korean Academy of Nursing
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    • v.48 no.5
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    • pp.565-577
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    • 2018
  • Purpose: The purpose of this study was to construct and test a hypothetical model about impact of parents' problem drinking on suicidal ideation of their children who are university students and the multiple mediating effects of childhood trauma, experiential avoidance, and depression based on stress-vulnerability model. Methods: A purposive sample of 400 university students was recruited from three universities in provincial areas and the data were collected between October and November 2016. The collected data were then analyzed using SPSS 20.0 and AMOS 20.0 programs. For data analysis, descriptive statistics, factor analysis, and structural equation modeling were performed. Multiple mediating effects analysis using phantom variable and bootstrapping were implemented to verify the mediating effect of the research model. Results: We found no significant direct effect on depression and suicidal ideation of parents' problem drinking, but multiple mediating effects of childhood trauma and experiential avoidance between parents' problem drinking and depression (B=.38, p=.001). The path from parents' problem drinking to suicidal ideation was significantly mediated by childhood trauma and depression (B=.02, p=.016) and by childhood trauma, experiential avoidance, and depression (B=.05, p=.011), but experiential avoidance did not have a significant direct effect on suicidal ideation (B=.02, p=.616). Conclusions: Based on the results of this study, it can be suggested that in order to decrease depression and prevent suicide of university students, considering of parents' problem drinking and childhood trauma, intervention methods that decreased chronic use of experiential avoidance and strengthen acceptance should be developed and made available to them.

Posttraumatic Stress Symptoms, Anxiety, and Depression after Stroke (뇌졸중 환자가 경험하는 외상 후 스트레스 증후, 불안 및 우울)

  • Yoon, Hee-Sook;Nam, Hye-Joo;Park, So-Young;Han, Jung-Hee;Jang, Song-Ja;Seong, Il-Soon;Hwang, Moon-Sook
    • Journal of Home Health Care Nursing
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    • v.15 no.1
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    • pp.5-13
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    • 2008
  • Purpose: The purpose of this study was to evaluate for the presence of posttraumatic stress disorder (PTSD)-related symptoms, anxiety, and depression after stroke. Eighty-four patients were enrolled between 2 and 12 months after their first ischemic or hemorrhagic stroke. Methods: PTSD symptoms were evaluated using the Impact of Event Scale (IES). The IES is a 15-item scale measuring intrusion and avoidance symptoms. The authors assessed mood alterations using the Hospital Anxiety and Depression Scale (HAD). The HAD is a brief, 14-item, self-reported questionnaire used to detect symptoms of anxiety (HADA) and depression (HADD). The survey data were analyzed using the SPSS 10.0 program. Frequency, mean, standard deviation, percentage t-test, and Pearson correlation coefficient were determined. Results: Twenty nine of the 84 (34.5%) patients scored higher than the cutoff for PTSD on the IES (IES>26). With use of the HAD scale, 44% of the patients reached the cutoff for anxiety ($HADA\;{\geq}8$). On the HSD scale, 44.1% of the patients reached the cutoff for depression ($HADD\;{\geq}8$). PTSD symptoms and anxiety were more frequent in women under age 39, without spouses, who had operations. Depression was more frequent in patients without spouses. There was a statistically significant correlation among posttraumatic stress symptoms, anxiety, and depression. Conclusion: There was statistically significant correlation among PTSD symptoms, anxiety, and depression in stroke patients. Therefore, it is necessary to develop nursing intervention for stroke patients with these clinical manifestations.

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Influential Factors of Post-Traumatic Stress Disorder in Survivors of Intensive Care Units (중환자실 생존자의 외상 후 스트레스장애 발생정도와 영향요인)

  • Kim, So Hye;Ju, Hyeon Ok
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.1
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    • pp.97-106
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    • 2020
  • Purpose: This study was conducted to investigate the incidence and associated factors with post-traumatic stress disorders (PTSD) in patients with intensive care units (ICU) admission experience. Methods: This study is a retrospective observational study using self-reporting questionnaire. Patients who were admitted to ICU more than 72 hours and agreed to participate were enrolled in this study. PTSD were assessed by Korean version of post-traumatic diagnosis scale, and PTSD was defined as 20 points or more. Medical records of participants were reviewed to identify influencing factors of PTSD. To analyzed the data, descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test and gamma regression were utilized using SPSS/WIN 23.0 program. Results: A total of 128 patients participated in the study. Mean age of participants was 58.3±11.7 years and 50 patients (39.1%) were female. Mean duration of ICU stay was 8.43±8.09 days and PTSD was diagnosed in 12 patients (9.4%). In the results of a Gamma regression analysis, Psychiatric history (B=1.09, p=.002), APACHEII score (B=.04, p=.005), CPR experience (B=1.65, p=.017) and physical restraint (B=.68, p=.049) were independently associated with PTSD occurrence. Conclusion: The results of this study suggest that a various factors influencing PTSD should be identified to prevent PTSD in patients who requires ICU care. In addition, post-ICU care programs are required to assess and reduce PTSD.

Effects of Resilience, Post-traumatic Stress Disorder on the Quality of Life in Patients with Breast Cancer (유방암 환자의 회복탄력성과 외상후 스트레스가 삶의 질에 미치는 영향)

  • Ha, Boo Young;Jung, Eun Jung;Choi, So Young
    • Women's Health Nursing
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    • v.20 no.1
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    • pp.83-91
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    • 2014
  • Purpose: The purpose of this study was to identify relationships of resilience, Post-Traumatic Stress Disorder(PTSD), and quality of life of breast cancer patients. The findings from this study would provide baseline data needed for nursing intervention. Methods: A sample of 129 breast cancer patients was recruited from three hospitals in J and C cities in Korea. The survey was conducted with participants by utilizing self-reported questionnaires. Results: Quality of life showed statistically significant differences on religion (t=2.11, p=.033) and hobby (t=2.79, p=.006). Resilience and PTSD had a negative correlation (r=-.22, p=.010). Resilience and quality of life of the participants had a positive correlation (r=.58, p<.001), whereas PTSD and quality of life had a negative correlation (r=-.45, p<.001). Significant predictors of quality of life were resilience and PTSD. These variables explained 44.9% of the variance in quality of life. Conclusion: Findings indicate that as resilience of breast cancer patients rose higher and PTSD got lower, their quality of life increased. Based on these results, nursing interventions directed towards improving resilience and relieving PTSD is proposed.

Post-Traumatic Stress Disorder Symptoms and Quality of Life of Patients with Coronary Artery Disease (관상동맥질환자의 외상 후 스트레스장애 증상과 삶의 질)

  • Lee, Seung Ah;Kang, Jiyeon
    • Journal of Korean Critical Care Nursing
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    • v.12 no.1
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    • pp.82-93
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    • 2019
  • Purpose : The purpose of this study was to investigate the degree of post-traumatic stress disorder (PTSD) symptoms and the effect of PTSD on quality of life (QoL) among coronary artery disease (CAD) patients. Methods: The participants were 135 CAD patients who visited outpatient clinics in a university hospital in B city of Korea. Their PTSD symptoms and QoL were measured by structured questionnaires and analyzed with multiple hierarchical regression analysis. Results: Among the 135 participants, 20.7% were classified as moderate risk, and 3.7% as high risk for PTSD. PTSD symptoms were significantly higher in participants who were diagnosed with CAD within 6 months (t=26.02, p<.001). The physical component of health-related QoL was influenced by gender (${\beta}=-.25$, p =.003), recurrence of CAD (${\beta}=.21$, p =.008), and PTSD symptoms (${\beta}=-.33$, p <.001). The mental component of health-related QoL was influenced by religion (${\beta}=-.17$, p =.044), body mass index (${\beta}=.17$, p =.033), and PTSD symptoms (${\beta}=-.37$, p <.001). Conclusion: Patients who had had a CAD diagnosis for less than 6 months were found to be vulnerable to PTSD, and PTSD was found to have a negative impact on the physical and mental components of their QoL. It is necessary to develop an intervention program for the effective prevention and management of PTSD symptoms in patients with CAD.

Post-traumatic Stress Disorder and Burnout of Healthcare Providers who cared for Patients with Coronavirus Disease-19 (COVID-19) in a Tertiary General Hospital (코로나바이러스감염증 환자를 돌본 일개 상급종합병원 의료인의 외상 후 스트레스 장애와 소진)

  • Kim, Kyung Deok;Yi, Young Hee
    • Journal of Korean Critical Care Nursing
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    • v.15 no.3
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    • pp.101-114
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    • 2022
  • Purpose : This study aimed to identify post-traumatic stress disorder (PTSD) and burnout experienced by healthcare providers who cared for patients with Coronavirus Disease 2019 (COVID-19) and their influencing factors. Methods : Data were collected from 135 healthcare providers who cared for patients with COVID-19 in a tertiary general hospital from June 8 to September 2, 2021, using a questionnaire. Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, t-test, ANOVA and Scheffe's test, Pearson's correlation coefficients, and multiple regression were used for analysis using SPSS/WIN 27.0. Results : Participants' average PTSD score was 9.31 ± 11.80, and 8.9% were in the high-risk group. Participants' average burnout score was 51.77±21.28, and 62.2% were at high risk. PTSD scores differed significantly according to participants' age, education, job, position, and current workplace. Burnout scores differed significantly according to their age, gender, marital status, parental status, and education. There was positive correlation between participants' PTSD and burnout. The factors influencing participants' PTSD were term of self-isolation and age (R2=.09). There were no significant influencing factors on participants' burnout. Conclusion : This study reconfirmed that healthcare providers who cared for patients with COVID-19 experienced both PTSD and burnout, suggesting that interventions are needed such as regular pre-training or simulation training and establishing a support system.