• 대한불안의학회지
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• 제3권2호
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• pp.91-96
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• 2007

Panic disorder is a common psychiatric illness that causes considerable morbidity. However, the biological basis of panic disorder remains unclear. In this report, we present and summarize the current literature on functional neuroimaging studies related to the neurobiology of panic disorder. The findings were summarized and divided into six groups : (1) known brain structures related to anxiety, especially panic disorder ; (2) structural results ; (3) functional imaging studies at rest ; (4) functional imaging studies with challenge testing ; (5) neuroreceptor studies ; and (6) changes in the treatment of panic disorder. Based on the findings of these neuroimaging studies, it seems as though panic disorder involves the hippocampal and parahippocampal areas, including the amygdala, as well as some cortical regions, such as the temporal and prefrontal cortices. Panic disorder is known to be associated with an imbalance between the right and left hemispheres of the brain at rest or during panic attacks. During a panic attack, patients with panic disorder are likely to experience an increase in local activity in the cingulate, insula, midbrain, and so on. On the other hand, a widespread reduction in the cortical areas has also been reported in most provocation studies. Thus, panic disorder may be related to the excess activation of the fear networks in response to subtle environmental cues and insufficient inhibition from higher cortical control areas ; however ; further studies are recommended in order to fully understand the neurobiology of panic disorder.

• 대한불안의학회지
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• 제12권1호
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• pp.47-55
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• 2016

30% of patients with panic disorder (PD) show treatment-resistant and chronic waxing and waning course. Therefore, adequate treatment strategies for PD by evidence based pharmacotherapy and combined cognitive behavioral therapy (CBT) are recommended. Regarding how and why CBT for PD works, three hypotheses include the cognitive theory, anxiety control theory, and behavioral theory were discussed. The recent findings that the altered activation in frontal lobe is normalized after CBT, suggest a reduction of an altered top-down fear processing in the neural correlates of CBT in PD. In order to improve accessibility to CBT, brief CBT and internet based CBT for PD were suggested. Despite limitations of sample sizes and study design, most of studies suggest that brief CBT is more effective than control conditions, and even as equally effective as standard CBT. The evidences suggest that internet based CBT may not be significantly different from face-to-face CBT in reducing anxiety. Several advances within the field of third-wave CBT for PD have led to the development of new techniques based on mindfulness, such as mindfulness-based cognitive therapy and acceptance and commitment therapy. Based on Korean algorithm project for panic disorder, especially the psychological education and cognitive reconstruction components were recommended in CBT with PD.

• 치위생과학회지
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• 제14권3호
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• pp.411-416
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• 2014

본 연구는 임플란트 수술 시 의식하진정법이 환자의 통증과 불안에 미치는 영향을 평가하고자 2013년 6월 1일부터 8월 30일까지 천안시 일개 치과병원에 내원한 임플란트 수술환자 95명을 대상으로 조사하였다. 임플란트 수술 전과 후의 불안 및 통증의 정도를 파악하고 치과불안과 통증에 영향을 미치는 요인을 규명하기 위하여 수술 전, 후 통증(VAS)과 수술 중 불안(PQ)을 측정하고 수술 후 통증(SF-MPQ)을 측정하였다. 연구결과를 요약하면 다음과 같다. 임플란트 수술 형태의 특성에 따라 분석한 결과 수면군과 비수면군간의 통계적으로 유의한 차이를 보인 특성은 수술부위, 수술치아개수, 수술시간, 부가적인 수술형태 등이었다(p<0.001). 수술 전, 후 통증의 차이를 살펴본 결과 수술 전 예상되는 통증과 수술 후 경험했던 통증의 차이는 수면군(2.30)이 비수면군(0.98)이 비해 통계적으로 유의한 차이가 있었다(p<0.05). 임플란트 수술환자의 통증 및 불안에 영향을 미치는 요인은 성별과 연령, 임플란트 수술경험및 수술시간, PCS였으며 공통적으로 관련된 요인은 PCS였다(p<0.05). 따라서, 치과 임상에서는 임플란트 수술 전, 후 심리적인 안정을 제공할 수 있도록 여성이거나 나이가 적을수록 수술치아개수와 수술시간이 길어질 것으로 예상될 때 의식 하진정법의 추천과 정확한 정보를 제공함으로써 편안한 환경에서 치료할 수 있도록 해야 한다. 또한, 의식 하 진정법시 PCS를 통해 보다 체계적이고 객관적인 행동 전략이 필요하며, 환자관리를 위한 끊임없는 연구 및 교육프로그램 개발이 진행되어야 할 것이다.

• 한국수학교육학회지시리즈E:수학교육논문집
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• 제38권2호
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• pp.187-213
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• 2024

본 연구는 초등학교 6학년 학생들을 대상으로 수학 일지 쓰기 활동이 학생들의 수학불안과 수학적 의사소통 중 '쓰기' 영역에 미치는 영향을 알아보기 위한 것이다. 이를 위해 초등학교 6학년 학생 27명을 대상으로 분수·소수의 나눗셈을 학습하는 동안 14차시의 수학 일지 쓰기 활동을 실시하였다. 수학불안은 검사지를 이용하여 측정한 후 사전, 사후 결과를 통계적으로 분석하였고, 수학적 의사소통은 '쓰기' 영역에 대한 분석틀을 이용하여 양적으로 측정한 뒤 수준의 변화를 확인하였다. 또한, 연구참여자 중 13명을 면담하여 수학 일지 활동이 수학불안과 수학적 의사소통에 미치는 영향을 심층적으로 살펴보고자 하였다. 연구 결과, 수학불안의 4개의 상위 요인 중 수학교과 요인과 환경 요인에서 수학불안 감소에 유의미한 효과가 나타났다. 수학적 의사소통 중 '쓰기' 영역의 '표현'과 '설명'의 평균 수준은 점진적으로 높아지는 경향을 보였으며, 특히 교사의 구체적인 피드백이 학생들의 의사소통 수준 향상을 지원하였다. 이러한 연구 결과를 바탕으로 학교 현장에서 수학 일지 쓰기 활동의 활용 및 지도 방안에 대한 시사점을 제안하였다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권5호
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• pp.277-285
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• 2018

Chemo-mechanical caries removal methods are known to be more effective compared with conventional methods in pain reduction. $Carie-care^{TM}$, a chemo-mechanical caries removal agent, was introduced in 2010 but a systematic review of its efficacy has not yet been performed. The purpose of this study was to investigate the effectiveness of $Carie-care^{TM}$ on the outcomes of treatment of caries in children and adolescents. The primary outcome was pain while the secondary outcomes included complete caries removal (CCR), time, need for local anesthesia and behavioral response changes. A Comprehensive literature search was performed in PubMed, EMBASE, and the Cochrane Library up to 30 September 2018. The following keywords were used in the search: 'chemo-mechanical caries removal agent', 'dental caries', 'Carie-care', 'chemo-mechanical caries removal', 'chemo-mechanical caries excavation', other related keywords, and their combinations. From 942 studies identified, 16 were analyzed. Finally, 4 studies met the eligibility criteria and 260 teeth in 120 children and adolescents were included in this review. This review showed that $Carie-care^{TM}$ reduces pain during caries treatment but requires a longer time for effective treatment than conventional methods. Local anesthesia was not required in the Chemo-mechanical caries removal (CMCR) group. In addition, dental anxiety decreased compared to the control group, and co-operation was more positive. Therefore, it may be a useful alternative to conventional methods in children and adolescents, but further verification through additional studies is needed.

• 대한치과마취과학회지
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• 제2권2호
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• pp.107-113
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• 2002

Hyperventilation is defined as ventilation in excess of that required to maintain normal blood $PaO_2$ and $PaCO_2$. It is produced by several distinct causes: anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The dental fears about acute pain, needle, drill and dental surgery lead to the severe anxiety and increased blood catecholamine level. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the gentle care, two cases of hyperventilation were occurred during local anesthesia for incision and drainage of acute odontogenic infectious lesions. We suggest that the dental patients with acute odontogenic infection must be attention for the manifestation of hyperventilation, especially in the medically compromised conditions.

• 대한간호학회지
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• 제12권2호
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• pp.1-26
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• 1982

The main purpose of this study was to test the effect of the structured information on the sleep amount of the patients undergoing open heart surgery. This study has specifically addressed to the Following two basic research questions: (1) Would the structed in formation influence in the reduction of sleep disturbance related to anxiety and Physical stress before and after the operation? and (2) that would be the effects of the structured information on the level of preoperative state anxiety, the hormonal change, and the degree of behavioral change in the patients undergoing an open heart surgery? A Quasi-experimental research was designed to answer these questions with one experimental group and one control group. Subjects in both groups were matched as closely as possible to avoid the effect of the differences inherent to the group characteristics, Baseline data were also. collected on both groups for 7 days prior to the experiment and found that subjects in both groups had comparable sleep patterns, trait anxiety, hormonal levels and behavioral level. A structured information as an experimental input was given to the subjects in the experimental group only. Data were collected and compared between the experimental group and the control group on the sleep amount of the consecutive pre and post operative days, on preoperative state anxiety level, and on hormonal and behavioral changes. To test the effectiveness of the structured information, two main hypotheses and three sub-hypotheses were formulated as follows; Main hypothesis 1: Experimental group which received structured information will have more sleep amount than control group without structured information in the night before the open heart surgery. Main hypothesis 2: Experimental group with structured information will have more sleep, amount than control group without structured information during the week following the open heart surgery Sub-hypothesis 1: Experimental group with structured information will be lower in the level of State anxiety than control group without structured information in the night before the open heart surgery. Sub-hypothesis 2 : Experimental group with structured information will have lower hormonal level than control group without stuctured information on the 5th day after the open heart surgery Sub-hypothesis 3: Experimental group with structured information will be lower in the behavioral change level than control group without structured information during the week after the open heart surgery. The research was conducted in a national university hospital in Seoul, Korea. The 53 Subjects who participated in the study were systematically divided into experimental group and control group which was decided by random sampling method. Among 53 subjects, 26 were placed in the experimental group and 27 in the control group. Instruments; (1) Structed information: Structured information as an independent variable was constructed by the researcher on the basis of Roy's adaptation model consisting of physiologic needs, self-concept, role function and interdependence needs as related to the sleep and of operational procedures. (2) Sleep amount measure: Sleep amount as main dependent variable was measured by trained nurses through observation on the basis of the established criteria, such as closed or open eyes, regular or irregular respiration, body movement, posture, responses to the light and question, facial expressions and self report after sleep. (3) State anxiety measure: State Anxiety as a sub-dependent variable was measured by Spi-elberger's STAI Anxiety scale, (4) Hormornal change measure: Hormone as a sub-dependent variable was measured by the cortisol level in plasma. (5) Behavior change measure: Behavior as a sub-dependent variable was measured by the Behavior and Mood Rating Scale by Wyatt. The data were collected over a period of four months, from June to October 1981, after the pretest period of two months. For the analysis of the data and test for the hypotheses, the t-test with mean differences and analysis of covariance was used. The result of the test for instruments show as follows: (1) STAI measurement for trait and state anxiety as analyzed by Cronbachs alpha coefficient analysis for item analysis and reliability showed the reliability level at r= .90 r= .91 respectively. (2) Behavior and Mood Rating Scale measurement was analyzed by means of Principal Component Analysis technique. Seven factors retained were anger, anxiety, hyperactivity, depression, bizarre behavior, suspicious behavior and emotional withdrawal. Cumulative percentage of each factor was 71.3%. The result of the test for hypotheses show as follows; (1) Main hypothesis, was not supported. The experimental group has 282 minutes of sleep as compared to the 255 minutes of sleep by the control group. Thus the sleep amount was higher in experimental group than in control group, however, the difference was not statistically significant at .05 level. (2) Main hypothesis 2 was not supported. The mean sleep amount of the experimental group and control group were 297 minutes and 278 minutes respectively Therefore, the experimental group had more sleep amount as compared to the control group, however, the difference was not statistically significant at .05 level. Thus, the main hypothesis 2 was not supported. (3) Sub-hypothesis 1 was not supported. The mean state anxiety of the experimental group and control group were 42.3, 43.9 in scores. Thus, the experimental group had slightly lower state anxiety level than control group, howe-ver, the difference was not statistically significant at .05 level. (4) Sub-hypothesis 2 was not supported. . The mean hormonal level of the experimental group and control group were 338 ㎍ and 440 ㎍ respectively. Thus, the experimental group showed decreased hormonal level than the control group, however, the difference was not statistically significant at .05 level. (5) Sub-hypothesis 3 was supported. The mean behavioral level of the experimental group and control group were 29.60 and 32.00 respectively in score. Thus, the experimental group showed lower behavioral change level than the control group. The difference was statistically significant at .05 level. In summary, the structured information did not influence the sleep amount, state anxiety or hormonal level of the subjects undergoing an open heart surgery at a statistically significant level, however, it showed a definite trends in their relationships, not least to mention its significant effect shown on behavioral change level. It can further be speculated that a great degree of individual differences in the variables such as sleep amount, state anxiety and fluctuation in hormonal level may partly be responsible for the statistical insensitivity to the experimentation.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권4호
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• pp.255-266
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• 2022

Background: A previous study reported the effectiveness and patient satisfaction in the dental emergency unit (DEU) of the Pitie Salpetrière Hospital in Paris before coronavirus disease 2019 (COVID-19). The same methodology was used during the COVID-19 pandemic to compare pain, anxiety, and patient satisfaction during the two periods. Methods: This prospective study was conducted in 2020 (NCT04354272) on adult patients. Data were collected on day zero (D0) on site and then by phone during the daytime on day one (D1), day three (D3), and day seven (D7). The primary objective was to assess the pain intensity at D1. Secondary objectives were to assess pain intensity at D3 and D7, anxiety intensity at D1, D3, and D7, and patient satisfaction. Patients were evaluated on a 0-10 numeric scale on D1, D3, and D7; mean scores were compared with non-parametric statistics (ANOVA, Dunn's). Results: A total of 445 patients were given the opportunity to participate in the study, and 370 patients consented. Seventy-one were lost during follow-up. Ultimately, 299 patients completed all the questionnaires and were included in the analysis. In the final sample (60% men, 40% women, aged 39 ± 14 years), 94% had health insurance. The mean pain scores were: D0, 6.1 ± 0.14; D1, 3.29 ± 0.16; D3, 2.08 ± 0.16; and D7, 1.07 ± 0.35. This indicates a significant decrease of 46%, 67%, and 82% at D1, D3, and D7, respectively, when compared to D0 (P < 0.0001). The mean anxiety scores were D0, 4.7 ± 0.19; D1, 2.6 ± 0.16; D3, 1.9 ± 0.61; and D7, 1.4 ± 0.15. This decrease was significant between D0 and D7 (ANOVA, P < 0.001). Perception of general health improved between D1 and D7. The overall satisfaction was 9.3 ± 0.06. Conclusion: DEU enabled a significant reduction in pain and anxiety with high overall satisfaction during COVID-19, which was very similar to levels observed pre-COVID-19 pandemic.

• 대한간호학회지
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• 제34권6호
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• pp.1069-1080
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• 2004

Purpose: The purpose of this study was to develop a socioculturally-appropriate psychosocial intervention program for Korean patients with breast cancer and test its effects on stress, anxiety, depression, and coping strategies. Methods: One group pretest and posttest design was used to test the effects of the intervention. A post-intervention interview was conducted to refine the nature of the intervention. A convenience sample of 10 breast cancer survivors was recruited from the outpatients clinics. Psychosocial intervention was developed to provide the health education, stress management, coping skill training and support weekly(90min) for 6 weeks. Results: There was a significant decrease in stress scores following the intervention(Z= -2.388, p=0.017). However, no significant changes were noted in the use of problem-focused and emotion-focused coping strategies, nor in the changes of anxiety and depression levels. Content analysis of interview data revealed six clusters; changes in perception, changes in problem solving approaches, changes in anger management, changes in life pattern, social support and reduction of perceived stress. Conclusions: Based on quantitative and qualitative data, we recommend the refinements of the intervention in the following areas for future studies: 1) duration, activities, and progression of psychosocial intervention; 2) research design and sample size; and 3) measurements.

• Human Ecology Research
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• 제54권5호
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• pp.475-485
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• 2016

This study explored mothers' and grandmothers' perception regarding child rearing practices as overprotective behaviors for first to third grade levels of elementary school. The study was conducted on 202 mothers and grandmothers of first to third grade elementary school students. Questionnaires were made with 40 questions on overprotection behaviors selected from the existing questions for preschooler, high grade elementary students, and youth. The questionnaires were distributed to target subjects to answer how they would perceive when each of question is applied to their lower grade elementary students. Based on the collected responses and the factor analysis, it was found out that the overprotective behaviors were classified into four factors such as "reduction in independence," "over-sensitiveness to safety," "interference in daily life," and "health anxiety." There were significant differences in the perception of the overprotective behavior by the subjects depending on the generations, features of children and mothers. This study focused on the lower grade elementary school students who have been removed from studies due to the lack of intervention measures. It has the implication in that the findings of the study can give the basic data for the development of the scale on overprotective behaviors in lower grade elementary school students.