• Research in Community and Public Health Nursing
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• v.28 no.4
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• pp.524-536
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• 2017

Purpose: This study aims to examine the relationships among experiences of traumatic events, post-traumatic stress (PTS), and the needs for health promotion programs of 119 paramedics. Methods: Experiences of traumatic events, PTS, and needs for health promotion programs were measured using a structured questionnaire. The subjects were 193 paramedics in Jeju Island. Data were analyzed using descriptive statistics, t-test and $x^2$ test. Results: The most experienced event out of the 16 different traumatic events was 'retrieve a suicide's body.' A high-risk classification of PTS was observed in 36.2% of the subjects. The rates of experiences were higher than those of the actual needs for all 26 health promotion programs. The programs reported as highly needed by respondents were stress management (75.5%) followed by exercise (74.6%) and PTS management (72.5%). Subjects with longer career periods, a fire sergeant, perceived obesity, numerous experiences of traumatic events, and in the PTS risk group had a higher need for a stress management program. Conclusion: These findings indicate that a significant number of 119 paramedics experienced PTS. They also show that onsite strategic management is strongly required. In addition, implementation of health promotion programs based on the needs of 119 paramedics is highly needed.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2225-2233
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• 2013

This study was designed to identify the extent of incident shock who are in high risk of post traumatic shock stress, and analyze the related factors that affect the extent of incident shock. The subjects are 415 rescue workers from Seoul Metropolitan Fire & Disaster Headquarters, who are in high frequency of fire outbreaks and rescue mobilization. With a reliability of Cronbach's ${\alpha}$=.975, the results show invasion, avoidance, sleep disorder and emotional paralysis, dissociative symptom, hyper arousal as foremost causes respectively. Moreover, the results imply that the extent of incident shock was higher in people with more age or being married. Also, from the occupational perspective, the number of years as fire fighters, as rescue workers, mobilization and experiences at work in proportion to incident shocks has risen exponentially. It is notable that the groups who alleviate stress by consuming liquors had higher extent of incident shock. In conclusion, to deal with groups in high risk, management system and prevention care programs for incident shocks need to be introduced immediately and put into effect.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.31 no.1
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• pp.38-49
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• 2021

Objectives: This study was conducted to analyze the impact of safety/health managers' experience of trauma case on their post traumatic stress disorder and the mediation effects of job stress and the moderated mediation effects of social support. Method: Using a structured questionnaire, data were collected from 241 workplace safety/health managers with experience in trauma case. The collected data were analyzed using SPSS(IBM. Ver.26.0) and verified through SPSS PROCESS Macro (Ver. 3.4). Results: The trauma case experience and the job stress, which is a mediation variable, had a statistically significant positive effect on post-traumatic stress disorder, and the job stress had a positive mediation effect in the relationship between the trauma case experience and post-traumatic stress disorder. Social support had a statistically significant negative moderation effect in the relationship between the trauma case experience and job stress; social support had a moderated mediation effect on the indirect effect of a job stress on the post-traumatic effect through a trauma case experience. Conclusion: The above findings suggest that work-related job stress management is important in order to reduce safety/health managers' post-traumatic stress disorder caused by the experience of trauma case, and that social support is essential to reduce the job stress, which can later be used as a basis for further studies.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.1
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• pp.51-60
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• 1999

This study was designed to evaluate anxiety & depression symptoms and pressure pain threshold in patients with posttraumatic stress disorder(n=23) and to find out the relationship between the affective symptoms and the pressure pain threshold scores. And this was compared with healthy control subjects(n=18). The scores of pressure pain threshold were checked with algometer. The results were as follows : PTSD patients showed higher scores of anxiety & depression symptoms than that of the control group. In contrast with our hypothesis, pressure pain threshold in PTSD patients presented statistically significant higher scores than that of the control group. These results may be derived from following factors. First, chronic depression has influenced the pain perception of patients with PTSD rather than anxiety symptoms, second, abnormal state of the opiate system in PTSD patients, third, the sick role of the PTSD patients, fourth, the socio-environmental factor of the PTSD patients. In conclusion, affective symptoms, especially depression, were related to the chronic pain in patients with PTSD, however, the causality of elevated pressure pain threshold was uncertain in this study. To understand more clearly the relation between affective symptoms and chronic pain, it will be necessary to control the other specific factors.

• Anxiety and mood
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• v.2 no.1
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• pp.39-44
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• 2006

Objective : Chronic posttraumatic stress disorder (PTSD) is defined by the coexistence of symptoms (reexperiencing, avoidance and hyperarousal), persisting for more than months or years that causes significant impairment in social occupational functioning. This study was conducted to evaluate the effects of terazosin on posttraumatic nightmares which is one of chronic PTSD symptoms. Methods : Twenty patients with chronic PTSD and severe trauma-related nightmares were treated with terazosin (3-7 mg/day) for 8 weeks. Recurrent distressing dreams item of the Clinician administered PTSD Scale (CAPS), Total CAPS score, Clinical Global Impressions-Severity Scale (CGI-S) and Clinical Global Impressions-Change Scale (CGI-C) were performed at baseline, 4-week and 8-week. Mississippi Scale for Combat-Related PTSD and Combat Exposure Scale (CES) were used to evaluate PTSD symptom pattern and degree of exposure. Results : Significant decrease in recurrent distressing dreams item, reexperiencing, avoidance and hyperarousal symptom score and total CAPS score were at 4-week and 8-week treatment compared to baseline (recurrent distressing dreams item : $2.70{\pm}1.88$ and $1.25{\pm}1.49$ ; reexperiencing, avoidance and hyperarousal symptom score : $2.30{\pm}2.49$, $1.20{\pm}1.05$, $3.10{\pm}1.68$ and $4.00{\pm}3.59$, $1.55{\pm}1.50$, $5.60{\pm}3.23$ ; total CAPS score : $8.20{\pm}6.26$ and $5.40{\pm}5.89$). There were significant correlation between dosage of terazosin and improvement of PTSD symptoms. Adverse effects such as fatigue and orthostatic hypotension were showed, which were mild and self-limited. Conclusion : These results suggest that terazosin may improve severe trauma-related nightmares and overall PTSD symptoms. Randomized controlled study with more subjects would be necessary in the future.

• Anxiety and mood
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• v.3 no.1
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• pp.41-45
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• 2007

Objective : The present study investigates patterns of consumption of alcohol, cigarettes, and over the counter drugs (OTC) in Korean patients with PTSD and psychiatric patient controls and healthy controls from multicenter hospital samples. Method : Data were collected from 18 hospitals nationwide. Patients with PTSD were compared with nonpsychotic psychiatric disorders control and healthy control subjects on psychometric measures of consumption of alcohol, cigarettes, and OTC drugs. Result : Ninety-three patients with PTSD, 73 patients with psychiatric disorders control, and 88 healthy control subjects were enrolled. There were significant differences in the frequency of alcohol drinking among the three groups ($X^2$=12.93, df=6, p=0.044). Only 3.2% of healthy control subjects drank alcohol more than 4 times a week, but 43.9% of PTSD group and 46.5% of mental disorder controls drank alcohol more than 4 times a week, respectively. Regarding cigarette smoking, there were no differences among the three groups. There were significant differences in uses of OTC drugs among the three groups; 16.7 % in the PTSD group, 14.9% in the psychiatric control group and 1.3% in the heath control group, respectively ($X^2$=11.31, df=2, p=0.004). Conclusion : In this study, patients with PTSD showed significant differences in the frequency of consumption of alcohol and OTC drugs, as compared with healthy controls. However, there were no differences between the PTSD and psychiatric patient control groups. Since all subjects were enrolled from hospital based sample, results may differ in the community samples. Further studies will be needed for the evaluation of substance uses in these groups.

• Anxiety and mood
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• v.3 no.2
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• pp.104-109
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• 2007

Objective : In the present study, we evaluated the differences between the skin electric conductance of patients with posttraumatic stress disorder (PTSD) and normal controls in order to determine the possibility of using skin electric conductance as a diagnostic measure. Method : The PTSD group included 14 subjects who were diagnosed with PTSD in St. Mary's Hospital after a motor vehicle accident, and the normal control group included 12 healthy subjects. The conductivity and capacitance of both groups were measured twice, and the data from each group was compared. Results : There was no significant difference in gender, but the patients in the PTSD group were significantly older than those in normal control group. The activity (conductivity) between the left head-left hand, right hand-right head, and right head-left head was significantly elevated in the PTSD group as compared with the normal control group. In addition, the reactivity (capacitance) between the right head-left head, left head-left hand, right hand-left hand, right hand-right foot, right foot-left foot, and left foot-left hand was significantly elevated in the PTSD group. Conclusion : In this study, the skin electric conductance of the patients with PTSD was significantly elevated in comparison with that of the healthy subjects. Although there were some limitations of this study, the results of this study suggested that skin electric conductance can be used to evaluate elevated psychophysiological responses in patients with PTSD. Future studies with more subjects and more structure are needed in order to confirm our results.

• Anxiety and mood
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• v.4 no.2
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• pp.142-147
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• 2008

Objective : Evidence from recent studies supports the role of genetic factors in the development of Posttraumatic Stress Disorder (PTSD). The primary aim of this study is to investigate the association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. The second aim is to examine the association between the DRD2 TaqI A polymorphism and clinical symptoms in patients with PTSD. Methods : We recruited 189 Vietnam veterans for participation in this study, among whom 99 were PTSD patients and 90 were control subjects. The presence of the DRD2 TaqI A polymorphism was determined by polymerase chain reaction (PCR). Several standardized research scales were used in the clinical assessment of PTSD, including the Combat Exposure Scale (CES), Clinician Administered PTSD Scale (CAPS), Beck Depression Inventory (BDI), and Clinical Global Impression (CGI). Results : There was no significant difference in the distribution of the DRD2 genotype, frequency and prevalence of the A1 allele, or the frequency of heterozygotes between the patients with PTSD and the controls. In the PTSD group, the patients with the A1 allele (A1A1, A1A2) scored higher on the CAPS-total (p=0.044), CAPS-avoidance symptoms (p=0.016) and BDI (p=0.024) than those without the A1 allele (A2A2). Conclusion : We could not find an association between the dopamine D2 receptor (DRD2) TaqI A polymorphism and PTSD. However, the A1 allele of DRD2 seemsto influence avoidance symptoms in patients with PTSD.

• Anxiety and mood
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• v.8 no.2
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• pp.93-98
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• 2012

Objective : Cortisol, a product of hypothalamus-pituitary-adrenal axis (HPA axis), is one of our defensive mechanisms in response to stress. The level of cortisol in the saliva is a major biomarker of the stress response by HPA axis and shows diurnal variation. We measured salivary cortisol level and its diurnal variation to compare the pattern of changes by degree of burn and Clinician-Administered PTSD Scale (CAPS) score. Methods : We measured the salivary cortisol levels of 37 subjects hospitalized in the burn center at our facility from March to June 2012. Salivary cortisol levels were measured at 6 : 00 AM and at 7 : 00 PM. All subjects were tested for CAPS to evaluate the severity of posttraumatic stress disorder and the Hamilton Depression Rating Scale to evaluate and to control the coexisting depression. Results : Factorial ANOVA test revealed that there was a statistically significant difference in terms of the effect of the interaction between the degree of burn and the patient's CAPS score. Unlike the mild burn group, in the severe burn group, the patients who had a low CAPS score didn't show a normal diurnal variation and the patients who had a high CAPS score showed the normal diurnal variation. After a few months follow up, we found a greater degree of psychiatric complications in severe burn patients that had a lower cortisol stress response. Conclusion : We suppose that the disappearance of the stress response changes in salivary cortisol seen in the severe burn group may be caused by an impaired stress response. Through followed observation of the subjects, this disruption of cortisol response may cause psychiatric problems afterwards.

• Journal of Korean Society of Transportation
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• v.28 no.5
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• pp.17-29
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• 2010

The main objective of this study is to consider the necessity of introducing owner expenses in estimating the cost of traffic accidents, as is done in some advanced countries. It is known as "owner cost" in the U.S, "enterprise project price" in Japan, and "human cost" in the U.K. To achieve this, the seriousness and present state of post-traumatic stress disorder (PTSD) of traffic accident offenders, which is generally not observed when traffic accidents occur, are evaluated; countermeasures reflecting personal characteristics are prepared according to degree of affliction. The results could be summarized as follows. First, the present condition and seriousness of PTSD from traffic accidents that has been estimated only within the accidents offenders are evaluated through a survey. Second, a distinction analysis model is developed. 'Insomnia caused by accidents' and 'mental daunting in accident situations or similar ones during driving' are chosen as the variables of the discriminant. Third, as a result of the construction of an Ordered Probit Model to comprehend the seriousness of PTSD, the variables turns out in the order of 'seriousness of the most damaged victim, 'nightmare about the accident', 'insomnia experience', 'mental daunting during driving', 'gender', and 'major driving area'. Finally, the cures reflecting characteristics of gender and region are suggested, which are preferred for degree of seriousness of PTSD. The analysis shows that the method to minimize the damage, such as decline of work efficiency, by moving ahead the rehabilitation of the offenders would be suggested and this could minimize the direct and indirect damages that could happen to business owners for whom the drivers work.