• Journal of Korean Society of Forest Science
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• v.103 no.1
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• pp.129-136
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• 2014

This study aims to investigate the effect of frequency of using forest environment on workers' stress. Workers in medical and counseling industry, which is recently known to require heavy emotional burden and thus cause a lot of stress and burnout syndrome, participated in the study. We classified 370 subjects, who were working at medical and counseling service institutions in Seoul metropolitan area, into two groups according to frequency of using forest environment by conducting a screening survey. 69 subjects submitted written consent and were recruited for either forest therapy program or control-group test; the "high" group (n=27) at the high frequency of using forest environment and the "low" group (n=42) at the low level. We measured the level of stress by using psychosocial indicators such as Worker's Stress Response Inventory (WSRI), Recovery Experience Questionnaire (REQ), and Maslach Burnout Inventory-General Survey (MBI-GS) and biological ones such as heart rate variability (HRV), cortisol, and Natural Killer cell (NK cell). The results suggested that the level of stress differed by frequency. The "high" group showed significantly low scores in the depression and work sub-scale and the total score of WSRI, emotional exhaustion, professional efficacy and total score of MBI-GS, and high scores in the total score of REQ. Similar tendencies were observed in the most of other indicators of psychosocial measures. Regarding the biological indicators, the "high" group showed the highest SDNN, RMSSD and TP measures of HRV and NK Cell activity and the low cortisol, although the statistical power did not reach the significant level. Our results suggest that the subjects who use forest environment frequently show favorable stress level both psychologically and biologically.

• Journal of Oriental Neuropsychiatry
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• v.16 no.1
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• pp.1-17
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• 2005

Objective : This empirical research is performed to recognize diagnostic concept, pattern identification, and clinical features of Hwa-byung. In other words, the aims of this research are to examine the differences of the diagnosis between Hwa-Byung and the other psychiatric disorders, and to find out pattern identification, and clinical characteristics of Hwa-Byung for prescriptions of this syndrome. Method : In the experiment, there were participated 30 patients who were met for our criterions according to HBDIS (Hwa-Byung Diagnostic interview Schedule). These patients were diagnosed as Axis1 according to criterions of DSM-IV with administering SCID-I. OMS-prime was utilized for finding out pattern identification of oriental medicine. Symptom Check List-90-Revision(SCL-90-R), Hemilton rating Scale for Depression(HRSD), Heart Rate Variability(HRV), and Digital Infrared Thermographic imaging(D.I.T.I.) were also utilized to discover clinical characteristics of Hwa-Byung Patients. Results : 1. Regarding Sex-ratio, male subjects were 3(10%), and female subjects are 27(90%). The age of subjects ranged from 22 year old to 75 $(51.87{\pm}11.04;\:Mean{\pm}SD)$ 2. In the results of diagnosis on the basis of DSM-IV, the 17(56.67%) patients were MOD (Major Depressive Disorder), the 5(16.67%) patients were USD (Undifferentiated Somatoform Disorder), the 4(13.33%) patients were Dysthymic Disorder, the 3(10%) patients were GAD (Generalized Anxiety Disorder), and the 1(3.33%) was Panic Disorder. Two of the patients who diagnosed as MOD were diagnosed as Panic Disorder too, and one of them was diagnosed as Pain Disorder too. 3. Regarding pattern identification, Hwa-Byung is positively correlated to deficiency of Heart(心). and then to stagnancy of Liver-Gall bladder. Hwa-Byung is correlated deficiency symptom-complex rather than excessiveness symptom-complex. That is also correlated positively to Pathological heat and fire. 4. In SCL90-R, the mean of PSDI was $(75.3{\pm}10.7;\:Mean{\pm}SD)$. The each mean of the other 11 factors was distributed between50-70. 5. The mean of HRSD was $(17.9{\pm}5.6;\:Mean{\pm}SD)$ in the entire subject's group. Then the group of MDD was $20.9{\pm}4.4$ and the group of USD was $12.0{\pm}4.8$ 6. In the results of HRV. the mean of TP is $972.4{\pm}1174(Mean{\pm}SD)$, this is lower than normal range 1000-200. The other factors were within normal range. Then, there were no significant differences between them (p<0.05). 7. The temperatures of each acupoint have significant differences between HNl(印堂) and PC6(內關), between CV17(顫中) and PC6(內關), between HN1(印堂) and CV8(神闕), between CV17(顫中) and CV8(神闕) in comparison with the average of body temperature in the use of D.I.T.I. (p<0.01) 8. In the analysis of correlation between SCL-90-R, HRSD, HRV. and D.I.T.I. there were no significant results. According to results that the correlation was analyzed with only the MDD group as subjects, there was negative correlation between RMSSD of HRV and HRSD, between LF of HRV and PDSIof SCL-90-R, and between LF/HF of HRV and ANX, PSY, and PDSI of SCL-90-R. Conclusion : In the observation of clinical features of 30 cases of Hwa-Byung patients by using diverse structured tests, there could make diverse diagnosis as depressive disorder, anxiety disorder, and Somatoform Disorder. Particularly. MDD was highly distributed. Considering oriental medicine's pattern identification of Hwa-Byung, this syndrome is related strongly to Heart, and there were demonstrated deficiency symptom-complex, and Pathological heat and fire. One of the limits of this study is lack of control subject's group, therefore, in the future study, it requires reexamination through a comparative research with these data to complete this study.

• Korean Journal of Head & Neck Oncology
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• v.10 no.1
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• pp.13-24
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• 1994

Despite optimal local therapy such as surgery and/or radiotherapy, the long term outcome is poor for patients with advanced squamous cell carcinomma of head and neck, due to frequent loco-regional recurrence and distant metastases. We studied to determine whether the combination chemotherapy, especially as an adjuvant chemotherapy, would improve the survival of these patients. Between January, 1986 and December, 1992, 57 patients with previously untreated, locally advanced squamous cell arcinoma of head and neck were assigned to receive 2-3 cycles of induction chemotherapy consisting of 5-fluorouracil(F) and cisplatin(P) every 3 weeks and standard local therapy such as surgery and/or radiotherapy followed by adjuvant chemotherapy with the same FP regimens. Of the 57 enroled patients, 45 patients were evaluable. The obtained results were as following: 1) Among 45 evaluable patients, 18 patients finished all treatment protocol including adjuvant chemotherapy and 27 patients had no adjuvant chemotherapy. The difference of age, sex, performance status, disease stage, and tumor differentiation was not significant statistically between adjuvant chemotherapy group and no-adjuvant chemotherapy group. 2) After induction chemotherapy, 7/45(15.4%), 30/45(67%) achieved complete remission and partial remission respectively with 82.4% overall response rates in entire patients. 3) The 4year progression free survival was 43.3% in adjuvant chemotherapy group and 24.1% in no-adjuvant chemotherapy group(p>0.05). The 4year overall survival was 56.9% and 25.5% respectively(p>0.05). There was no significant different in the patterns of local recurrence and distant metastasis between the two groups. 4) Adverse reactions from combination chemotherapy included nausea, vomiting, mucositis, diarrhea and hematologic bone marrow depression. These were mild and tolerated by patients, and these was no episode of any life threatening toxicities. In conclusion, adjuvant chemotherapy after induction chemotherapy and local therapy did not show statistically significant survival improvement, but there was trend of prolongation of survival when compared to no adjuvant chemotherapy. Thus, large scale phase III randomized controlled studies are strongly recommended.

• Korean Journal of Psychosomatic Medicine
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• v.8 no.2
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• pp.201-211
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• 2000

Objectives : The purpose of this study was to determine the validity and reliablity of the Korean version of the Global Assessment of Recent Stress(GARS) Scale developed for assessing the severity of current perceived stressors, and then to use the scale in clinical practice. Methods : The questionnaire was completed by 215 healthy subjects. A comparison was made regarding the perception of stressors among 242 patients(71 with anxiety disorder, 73 with depressive disorder, 47 with somatoform disorder, and 51 with psychosomatic disorder) and 215 healthy subjects. Factor analysis was done using oblique rotation after maximum-likelihood factor analysis. Results : Factor analysis yielded 1 subscale. Reliability was computed by administering the GARS Scale to 69 healthy subjects during a 2-week interval. Test-retest reliability for 8 items and the total score was significantly high, ranging between 0.85-.95. Internal consistency was significant(Cronbach's a for 7 items : .86). Convergent validity was computed by correlating the 8 items and the total score with the total score of the stress response inventory(SRI), the perceived stress questionnaire(PSQ), and the somatization, anxiety, depression, hostility subscales and general indices of the symptom checklist-90-revised(SCL-90-R). The correlations were all at significant levels. Discriminant validity was computed by comparing the 8 item scores of the patient and control groups. Significant differences were found in area relevant to sickness or illness and the overill global area. The patients with anxiety disorder were significantly higher in area relevant to sickness or illness than the healthy group, whereas the patients with depressive disorder was significantly higher in the overall global score than healthy group. The depressive disorder group was the highest in overall global score of the GARS scale among 4 patient groups, and showed a significant higher scores in interpersonal relationship and overall global area than the psychosomatic disorder group. Conclusions : These results indicate that the Korean version of the GARS scale is highly reliable and valid, and that it can be utilized as an effective measure of perceived stressors for research in stress-related fields. It is suggested that depressive disorder patients are more likely to perceive recent stressors than psychosomatic disorder patients.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.2
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• pp.203-212
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• 1999

Objectives : "Alexithymia" mean literally "no word for mood(or emotion)". It is not only a marked constriction in emotional functioning but a deficit in their cognitive processing. We designed this study to investigate the level of alexithymia, psychopathology and personality factors of patients with somatoform disorder and with diabetes mellitus. Methods : The subjects were consisted of patients with somatoform disorder(N=20), patients with diabetes mellitus(N=20), and normal control(N=20). The level of alexithymia, psychopathology and personality factors were assessed by the Toronto Alexithymia Scale(TAS), the Symptom Checklist 90-Revision(SCL 90-R), and the Sixteen Personality Factor Questionnaire(16-PF). And we compared demographic characteristics, psychopathology and personality factors among three groups, and assessed the relationship between alexithymia and psychopathology, and between alexithymia and personality factors. Results : The results were as follows. 1) Patients with somatoform disorder showed significantly higher TAS scores compared to patients with diabetes mellitus and the normal control group. 2) Patients With somatoform disorder showed significantly higher scores of somatization, anxiety scales than patients with diabetes mellitus and the normal control group, and showed significantly higher scores of obsessive-compulsive, depression, phobic anxiety, psychoticism scales than the normal control group by the SCL-90-R. 3) The normal control group showed high intelligence scores only as compared to patients with somatoform disorder by the 16-PF. 4) A significant relationship was found between TAS scores and psychopathology in patients with somatoform disorder. 5) All three groups did not shown any correlation between TAS and 16-PF. Conclusion : Patients with somatoform disorder showed higher TAS scores and more multiple psychopathology than patients with diabetes mellitus and the normal controls. A significant relationship was found between TAS scores and psychopathology in patients with somatoform disorder. We suggest that the therapeutic approach to patients with somatoform disorder to express emotions and manage psychopathology, and that the treatment methods of patients with diabetes mellitus aims to improve firstly physical conditions are more helpful.

• Journal of Korean Academy of Nursing
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• v.22 no.4
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• pp.506-525
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• 1992

Older people, because of the psychological and physiological changes related to the aging process are more vulnerable to experiencing powerlessness than any other age group. This self destructive cycle of depression in older people related to the experience of continued and long term powerlessness can lead even to death. The purpose of this study was to measure powerlessness and resources to increase power in older people, and to measure the effectiveness of a psychological rehabilitation program for reducing powerlessness. The research methodology used was a two step process. In the first step, a survey was done of perceived powerlessness and power resources comparing four groups of elderly people ; those living at home, those in hospital, those living in nursing homes and those attending educational programs for the elderly. The total sample size was 236. In the second step, a psychological rehabilitation program was carried out, pre and post measurements were taken related to this program. The sample consisted of 29 residents in a nursing home. The results of the study are as follows : 1. Powerlessness was classified as cognitive, emotional, activity and learning. The lowest score for powerlessness was in the area of activity, that is the people in the sample felt more power concerning their activities. The highest score was in the area of cognition where they felt they had less power. 2. When the different groups of elderly were compared, it was found that the residents of the nursing home had the highest score on perceived powerlessness and the group who were living at home had the lowest score. 3. Among the general characteristics, the factors influencing the powerlessness score were age, sex, level of education, financial resources and health status. In the interaction effects among these factors, it was found that level of education and health status were factors influencing perceived powerlessness. The elderly with lower education and poorer health status had the higher scores for perceived powerlessness. 4. The power resources could be classified into the following areas : physical strength, emotional strength, positive self-image, energy, knowledge, motivation and belief system. Belief system was given the highest score among the power resources and energy, knowledge and motivation were given low scores. 5. The group participating in an educational program for the elderly had the highest score for power resources while the group made up of residents of a nursing home had the lowest score as well as the highest score for perceived powerlessness. 6. The factors influencing the power resource scores were sex, level of education, financial resources and health status. In the analysis of the interaction effect among the factors, it was found that sex, level of education and financial resources were the factors that influenced the power resource score, that is, women, those with a low level of education and those with poor financial resources reported a lower level of power resources. 7. There was a negative correlation between perceived powerlessness and power resources in the elderly in this study. Since power resources explainded 49% of the variance for powerlessness, it can be concluded that the power resources can be used to reduce powerlessness. 8. The psychological rehabilitation program was carried out with the nursing home residents over a period of five weeks. No statistically significant difference was found in the scores on powerlessness between the pre and post tests, but there was a slight decrease in the raw scores on the post test for emotional, activity and learning powerlessness. There was a statistically significant increase in the power resource scores for emotional strength, positive self-image, energy, knowledge and motivation in the post test as compared to the pre test. In conclusion, the study indicates that a psychological rehabilitation program for the elderly could be effective in increasing power resources and this in turn could lead to a decrease in perceived powerlessness.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.2
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• pp.192-217
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• 2001

Object：This study was carried out to classify adolescents in runaway shelters by evaluating their psychopathology. And the ultimate purpose is to offer basic data for preventing adolescents‘ runaway and for diversifying runaway shelters suitable for the problem of individual adolescent. Method：128 adolescents who stay in the runaway shelters were asked to complete self-report qeustionnaires including basic sociodemographic data, Child Behavior Check List(CBCL), Minnesota Multiphasic Personality Inventory(MMPI), and Symptom Check List-90-Revised(SCL-90-R). Korean Wechsler Adult Intelligence Scale(K-WAIS)[or Korean Educational Developmental Institute-Wechsler Intelligence Scale for Children(KEDI-WISC)] and Bender-Gestalt test(BGT) were also done by clinical psychologists. Results：The most common age of the subjects were 15-year-old, and they dropped out their schools in the middle school most commonly. Mostly they were from middle class family and their parents' educational level were high school graduates. The first runaway episode was most common in the middleschool period, and their runaways were repeated. The most common frequency of runaways were more than 10 times. About 10% of them abused drugs and about 80% of them abused alcohol. One third of them had experiences of illegal problems and 10% of them engaged in sexual activity for money. 95 adolescents(83%) in CBCL, 42 adolescents(36%) in SCL-90-R, and 70 adolescents(69.3%) in MMPI showed clinical significance. In intelligence test, 22 adolescents(22%) were mentally retarded. In BGT, 35 adolescents(39.4%) manifested brain dysfunction signs. Conclusion：Runaway adolescents in the shelters have variable and severe psychopathology. Their psychopathology is classified as follows；The behavior disorder group, the mood disorder group with anxiety/depression, the somatic disorder group with somatic symptoms, and the psychosis group with possibility of severe psychopathology. Therefore it is very important to evaluate psychiatric problems of runaway adolescents, and specific therapeutic interventions according to their problems are required.

• Korean Journal of Health Education and Promotion
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• v.1 no.1
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• pp.21-36
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• 1983

It is assumed that menarche is affected not only by the biological factors such as nutrition and genetic heritage, but also it is affected by other socio-cultural environmental factors including weather, geographic location, education and level of modernization. Also recent trend of menarche in Korea indicates that a lot of discussion are being generated to the need of sex education as a part of formal school education. The purpose of this study is to develop the school health education program by determine the age of menarche, the factors relavant to time of menarche and psycho-mental state of students at the time in menarche and investigate the present state of school health education relate to menarche of adolescents. The total number of 732 girls was drown from first, second and third grades of 4 middle schools in Seoul. For the data collection the survey was conducted during the period from May 1 to May 20, 1982 by using prepared questionair. The major results are summarized as follow; 1. Mean age at menarche and the percent distribution of menarche experienced. It was observed that about 68.7% of sampled students have been experienced menarche at the time interviewed. For the each group, age at menarche is revealed that among the students about 37.8% are experienced menarche for under 12 years old group, 62.1% for 13 year-old group, 80.6％ for 14 year-old group and 95.5% for over 15 years old. In sum it was found that the mean age at menarche was 12.3 years old, ranged from age at 10 as earlist the age at 15 as latest. 2. Variables associated with age at menarche. 1) There was tendency those student who belong to upper class economic status have had menarche earlier than those student who belong to lower class. Therefore, economic status is closely related to age at menarche. 2) In time of mother's education level, it is also found that those students whose mother's education levels from high school and college are experienced menarche earlier than those students whose mother's education levels from primary school and no-education. 3) However, in connection with home discipline, there was no significant relationship between age at menarche and home disciplines which are being treated "Rigid", "Moderated ", "Indifferent". 4) Degree of communication between parents and daughter about sex matters was found to be associated each others in determination of age at menarche. 5) It was found that high association between mother's menarche age and their daughter's menarche age was observed. Mother's age at menarche earlier trend to be shown also as earlier of their daughters. 6) Those students belong to "D & E" of physical substantiality index are trend to be earlier in menarche than those students in the index "A & B". 3. Psycho-mental state at the time of menarche. Out of the total students 68.2% had at least one or more than one of subjective symptoms. Shyness was shown as most higher prevalent symptom and others are fear, emotional instability, unpleasant feeling, depression, radical behavior, inferior complex and satisfaction appeared. Very few cases are appeared be guilty and stealing feeling. 4. The present status of school health education program related to menarche. As to the source of information about menarche, teacher was a main source with average index 5.88 and the other informants were mother & family member, friends, books and magagines, movies, television, and radio. For the problem solving at menarche, mother & family members were subject to discussion with an average index 6.02 as high. The others for discuss and knowledge about menarche were books, magagine, friends, teachers, and self-learning based on own experienced. The time of learning about menarche, it was learned as highest percentage with 43.2% at a 6 grades of primary school, middle school with 34.4%, 5 grade of primary school with 18.2%, and 4 grade of primary school with 4.0% respectively.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.2
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• pp.126-134
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• 2020

Objectives : The purpose of this study was to investigate the needs for return-to-work support of cancer survivors and related factors in patients with cancer and their caregivers. Methods : 182 patients and 114 caregivers were recruited. Distress Thermometer and Problem List and scale ranging 0~10 measuring the degree of needs for return-to-work support were utilized. The needs for return-to-work support between the patient group and caregiver group (patient's needs evaluated by the caregiver) were compared, and related factors were investigated using logistic regression analysis. Results : 34.6% and 28.1% of patients and caregivers reported return-to-work support of cancer survivors is "very necessary". The degree of needs was 6.60±3.365 points in the patient group and 6.17±3.454 points in the caregiver group, with no significant difference (p=0.282). The needs for return-to-work support evaluated by patients was high when they underwent surgery (OR=2.592, p=0.007), has fertility problems (OR=6.137, p=0.025), has appearance problems (OR=2.081, p=0.041), or has fatigue (OR=2.330, p=0.020). The needs for return-to-work support of patients evaluated by caregivers was high when patients treated with breast cancer (vs respiratory cancer, OR=13.038, p=0.022 ; vs leukemia/lymphoma, OR=4.517, p=0.025 ; vs other cancer, OR=13.102, p=0.019), has work/school problems (OR=4.578, p=0.005), or has depression (OR=3.213, p=0.022). Conclusions : The degree of needs for return-to-work support of cancer survivors was high, and factors related to the needs were different between the two groups. This suggests that return-to-work support of cancer survivors is required, and clinical characteristics, the distress of patients, and differences between patients and their caregivers should be considered in establishing a support plan.

• Korea Journal of Hospital Management
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• v.27 no.2
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• pp.53-66
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• 2022

Aim : The purpose of this study is to investigate the influence of the awareness level of the mandatory employment system for the disabled and the help of the employment increase on the health status of the disabled. Based on this, the purpose of this study is to raise awareness of the compulsory employment system for the disabled and to suggest a way to improve the health of the disabled. Methods : In this study, the first data of the second wave of the 2016-2018 Employment Panel Survey for the Disabled was used to analyze the participation of the disabled in economic activities. a total of 1,648 subjects were analyzed using the chi-square test and generalized estimating equation (GEE). Results : Compared to the group knowing about the compulsory employment system for the disabled, in the group who did not know about the compulsory employment system, the cognitive level was significantly higher for subjective health status (Odds Ratio [OR]: 1.573, 95% Confidence Interval [CI]: 1.252-1.977) and chronic diseases (OR: 1.407, 95% CI: 1.091-1.816), Compared to the group that the compulsory employment system for the disabled is helpful in increasing employment, the group that said it was not helpful at all had depression feel (OR: 2.330, 95% CI: 1.219-4.452) and subjective health status (OR: 2.052, 95% CI: 1.232. -3.416) significantly affected. Conclusion : It was found that the lower the level of awareness and help of the compulsory employment system for the disabled, the negative impact on their health status. Therefore, it is necessary to promote employment growth by raising awareness of the employment system for the disabled. Furthermore, in order to improve the health of the disabled, public relations plans to increase the understanding of the disabled on the system and policies to protect the disabled people who lose their will to work due to difficulties in accessing employment were enacted, and Changes to a disability-friendly working environment should be activated so that participants can participate.