• 제목/요약/키워드: Exposure therapy

검색결과 437건 처리시간 0.023초

외상후 스트레스 장애에 대한 심리치료 효과 개관 : 재난 생존자를 중심으로 (Review of Psychological Treatment for Post-Traumatic Stress Disorder : Focus on Survivors of Disaster)

  • 장은영;이현지;김대호
    • 대한불안의학회지
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    • 제12권2호
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    • pp.69-78
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    • 2016
  • Objective : Disaster causes psychological distress to a large number of people in a short period of time, by both direct and indirect exposure to traumatic events embedded in various realms of disaster experience. Optimal, well-planned treatment interventions should follow from the early acute period to recovery phase, extending up to several months later. In this context, there is an increasing need for systemic review to gain comprehensive insights for disaster interventions. These need to be added to public policy, and for the prevention and treatment of disaster-related psychopathology. Here, we review the published studies on psychological interventions for disaster-related posttraumatic stress disorder. Methods : Specific psychological interventions regarded as effective treatments for have been selected for this review, such as CBT (Cognitive-Behavior Therapy), Exposure Therapy, EMDR (Eye Movement Desensitization & Reprocessing), SIT (Stress Inoculation Therapy) and Psychoeducation. In addition, natural disasters, industrial disasters, and accidents involving aircraft and ships were also categorized as disasters, along with war and combat trauma. Results : Cognitive behavior therapy and exposure therapy had the strongest research support for effectiveness, and could be considered as the first-choice treatment for disaster-related PTSD. The second line of treatment is EMDR, although this treatment modality has the advantage of reaching certain treatment improvements in fewer sessions. However, the effects of SIT and psychoeducation to the survivors of disasters, remains unclear at this point. Additionally, we propose the possibilities of using virtual reality component and imagery rescripting as modified forms of traditional cognitive behavior therapy and exposure therapy. Conclusion : Cognitive behavior therapy and exposure therapy, deemed effective treatments for various trauma, are considered to be effective for survivors from disasters. However, the efficacy of other interventions has not yet been examined methodologically in well-designed studies, such as randomized controlled trials. In particular, future empirical studies are needed, since it is difficult to conclude that psychological interventions have similar effects on different types of disasters.

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갑상선 암의 방사성요오드 치료 시 의료진은 방사선 피폭으로부터 안전한가? (Are Medical Personnel Safe from Radiation Exposure from Patient Receiving Radioiodine Ablation Therapy?)

  • 김창근;김대응
    • Nuclear Medicine and Molecular Imaging
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    • 제43권4호
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    • pp.259-279
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    • 2009
  • Radioiodine ablation therapy has been considered to be a standard treatment for patient with differentiated thyroid cancer after total thyroidectomy. Patients may need to be hospitalized to reduce radiation exposure of other people and relatives from radioactive patients receiving radioiodine therapy. Medical staffs, nursing staffs and technologists sometimes hesitate to contact patients in radioiodine therapy ward. The purpose of this paper is to introduce radiation dosimetry, estimate radiation dose from patients and emphasize the safety of radiation exposure from patients treated with high dose radioiodine in therapy ward. The major component of radiation dose from patient is external exposure. However external radiation dose from these patients treated with typical therapeutic dose of 4 to 8 GBq have a very low risk of cancer induction compared with other various risks occurring in daily life. The typical annual radiation dose without shielding received by patient is estimated to be 5 to 10 mSv, which is comparable with 100 to 200 times effective dose received by chest PA examination. Therefore, when we should keep in mind the general principle of radiation protection, the risks of radiation exposure from patients are low and the medical personnel are considered to be safe from radiation exposure.

Influence of the Vibration Exposure on Shoulder and Back Extensor Muscles Activity During Forward-head and Over-head Task

  • Cheon-jun Park;Duk-hyun An;Jae-seop Oh;Won-gyu Yoo
    • 한국전문물리치료학회지
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    • 제30권1호
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    • pp.23-31
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    • 2023
  • Background: Several factors contribute to shoulder pain, including abnormal neck posture, repeated use of the upper limbs, work involving raising the upper limbs above the head, and the effects of vibration. However, previous study has reported that constant vibration exposure could impact improvement of the stability on joints related with muscle recruitment and activation. For this difference reason, we need to verify for the complex study of relationship with repetitive upper limb movements, poor head posture, and constant vibration exposure. Objects: Our study was made to investigate the influence of vibration exposure on the shoulder muscle activity during forward-head and over-head tasks with isometric shoulder flexion. Methods: In a total of 22 healthy subjects, surface electromyography (EMG) data were collected from shoulder muscles (upper/lower trapezius, serratus anterior, and lumbar erector spinae) on tasks (neutral-head task [NHT], forward-head task [FHT], and over-head task [OHT]) with and without vibration exposure. Results: In all tasks, the EMG data of the upper trapezius and serratus anterior significantly increased with vibration exposure (p < 0.05). Furthermore, the EMG data of the lumbar erector spinae significantly increased with vibration exposure in the NHT and FHT (p < 0.05). Conclusion: We suggest that continuous vibration exposure during the use of hand-held tools in the tasks could be associated with harmful effects in the workplace. Lastly, we clinically need to examine the guidelines regarding the optimal posture and vibration exposure.

양성자 치료 시 방사선 작업 종사자에게 미치는 방사선 피폭에 대한 평가 (Evaluation on the Radiation Exposure of Radiation Workers in Proton Therapy)

  • 이승현;장요종;김태윤;정도형;최계숙
    • 대한방사선치료학회지
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    • 제24권2호
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    • pp.107-114
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    • 2012
  • 목 적: 기존의 광자선을 이용한 선형가속기와는 달리, 양성자 치료의 경우 물질과의 상호작용으로 발생되는 중성자를 비롯한 여러 핵종 등으로 인해 다량의 이차방사선이 생성되기 때문에 방사선 작업 종사자의 피폭은 더욱 주의 깊은 관심이 필요하다. 이에 방사선 측정 시에 널리 이용되고 있는 열형광선량계를 이용하여 방사선 작업 종사자의 피폭정도를 평가하고 이를 토대로 양성자 치료 시 방사선 피폭선량에 관한 기초 자료를 제시하고자 한다. 대상 및 방법: 본원의 양성자 치료실에서 근무한 방사선 작업 종사자를 대상으로 열형광선량계 뱃지를 이용해 피폭현황을 측정한 데이터를 비교했다. 양성자의 빔 라인 주변에서 발생하는 이차방사선의 신체부위별 피폭선량 분포를 알아보고자 신체부위(외안각, 목, 유두점, 배꼽, 등, 손목)에 가로, 세로가 각각 3 mm인 정사각형 모양의 열형광선량계를 부착하여 일일 8시간의 근무시간동안 유지하도록 하였고 총 80시간 측정하여 평균 데이터를 얻었다. 그리고 치료실 내 공간적인 방사선량의 분포를 보기 위하여 빔 사출구, PPS (Patient Positioning System), Pendant, 차폐체보관장, DIPS (Digital Image Positioning System) Console, 출입통로에 각각 열형광선랑계를 부착하고 일일 근무시간 동안의 평균 방사선량을 측정하였다. 결 과: 방사선 작업 종사자의 열형광선량계 뱃지로 측정된 피폭량을 조사한 결과 분기별 평균 0.174 mSv, 연평균 0.543 mSv로 나타났고 신체부위별로 측정한 결과에서 가장 많은 피폭량을 보인 곳은 목이였으며 가장 적은 피폭량을 보인 곳은 등(양견갑골 상각을 이은 선의 중간 지점)으로 나타났다. 작업 동선에 따른 공간적 방사선량을 알아본 결과에서는 빔 사출구 근처에서 상대적으로 높게 나타났고 거리가 멀어짐에 따라 줄어들었다. 결 론: 적은 양의 피폭일지라도 동일 장소에서 장기 근무하게 되면 피폭 누적량은 증가할 수밖에 없고 특정 부위의 누적량은 건강상의 위험을 가져다 줄 수도 있다. 그러므로 국제 방사선 방어 위원회가 권고하는 ALARA의 원칙에 따라 가능한 합리적으로 감소시킬 수 있도록 스스로 개인별 피폭관리에 철저를 기하고 피폭을 최소화시키는데 최선의 노력을 다해야 할 것이다.

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광치료의 기본원리와 임상 실제 (Light Therapy : Basic Principle and Clinical Practice)

  • 조숙행
    • 수면정신생리
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    • 제5권2호
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    • pp.170-176
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    • 1998
  • Nowadays light therapy is accepted practice in the treatment for Seasonal Affective Disorder. The author reviewed the practical aspects of light therapy, latest treatment research on optimal parameters of light therapy and the mechanisms of action of light therapy. Therapeutic efficacy of light therapy using light visors & dawn simulators has been suggested but further studies are needed to clarify the efficacy. The treatment most strongly supported by research studies is light therapy using a light box to administer bright white light (2500 lux for 2 hours or 10000 lux for 30 minutes). Although some patients may be selective responders to morning light exposure, the optimal timing of light exposure still remains controversial. In practice, generally the duration of exposure can be increased or decreased as necessary and also the timing of exposure can be splitted (e.g. AM/PM usage) if optimal response is obtained. For most, a positive response of light therapy is usually noted within $4{\sim}5\;days$ and optimal response is obtained within 2 weeks. Generally the relapse of symptom occurs within days of discontinuation of light therapy, so to prevent relapse, light therapy should be continued throughout the winter season for typical seasonal affective disorder. Side effects of light therapy appear to be mild and well tolerated. Several theories for the mechanisms of action of light therapy at the basis of seasonal affective disorder had been suggested but remain still controversial. Further studies on the optimal parameters and the mechanisms of light therapy help us to better understand and treat not only seasonal affective disorders but also chronobiological disorders and nonseasonal affective disorders.

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스마트폰을 이용한 사진 기반 가상 현실 노출 치료 시스템 개발 및 시험적 적용 (Development of a Smartphone based Photo-realistic Virtual Reality Exposure Therapy System)

  • 박종현;박진영;김광욱
    • 한국컴퓨터그래픽스학회논문지
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    • 제22권3호
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    • pp.75-87
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    • 2016
  • 사진 기반의 가상 현실 노출 치료 요법(Virtual Reality Exposure Therapy)은 다양한 정신 질환의 평가 및 치료 연구에 사용되어 왔다. 그러나 최근에 보급되기 시작한 스마트폰 기반의 헤드 마운트 디스플레이(Head-mounted display, HMD)를 활용한 가상 현실 노출 치료 연구는 거의 없었다. 본 연구에서는 스마트폰 기반의 가상현실 기기를 활용하여 환경 촬영부터 노출까지 누구나 쉽게 사용할 수 있는 실제 사진 기반의 가상 현실(Photo-realistic VR) 노출 시스템을 제안하고, 32명의 정상군을 대상으로 시험적으로 적용하고자 한다. 본 연구 결과에 따르면 개발된 스마트폰 기반의 시스템은 실내/실외, 친숙한/친숙하지 않은 환경들에서 피험자의 감정 변화를 이끌어내었다. 이에 대한 의의와 모바일 기반의 가상현실 노출 치료 시스템의 장점에 대하여 본 연구에서 논의하였다.

사회불안장애의 인지행동치료 (Cognitive-Behavioral Therapy for Social Anxiety Disorder)

  • 이재헌
    • 대한불안의학회지
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    • 제12권1호
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    • pp.42-46
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    • 2016
  • The therapeutic effect of cognitive behavioral therapy (CBT) for patients with Social Anxiety Disorder (SAD) is supported by evidence from numerous studies. This article provides an overview of cognitive models and major techniques (i.e., cognitive restructuring and exposure) of CBT for SAD, developed by the study group of SAD in the Korean Academy of Anxiety Disorder. Korean-culture specific factors and new trends such as a third wave of CBT are also described.

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전립선암의 방사선 치료 시 주변 정상장기 피폭선량을 이용한 암발생확률 평가 (Evaluation of Cancer Incidence Rate using Exposure Dose to Surrounding Normal Organs during Radiation Therapy for Prostate Cancer)

  • 이주아
    • 한국방사선학회논문지
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    • 제16권3호
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    • pp.351-356
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    • 2022
  • 전립선암의 방사선치료 시 사용되는 세기조절방사선치료와 부피적회전방사선치료시 발생하는 광중성자선량을 측정하여, 암 발생률을 평가하며 기초자료를 제공하고자 하였다. Rando phantom에 중성자 측정용 광자극발광선량계를 복부와 갑상선에 위치시킨 상태에서 발생하는 광중성자선량을 측정하였다. 연구결과 세기조절방사선치료(7 portal)가 부피적회전방사선치료보다 복부와 갑상선 위치에서 모두 높게 측정되었다. ICRP 103의 명목위험계수를 이용하여 암 발생확률을 평가하였을 때, 세기조절방사선치료시 대장과 갑상선의 피폭으로 인한 암발생확률은 1,000명 당 9.9명 이었으며, 부피적회전방사선치료시는 1,000명 당 3.5명이었다. ALARA(As low as reasonably archievable)원칙에 의거하여 방사선치료계획 수립에 있어서 정상장기들의 피폭선량의 최소화를 위한 가이드라인이 되리라 사료된다.

2인용 치료병실 안전성 평가 (Evaluation on Safety of Two-bed Therapy Rooms)

  • 이경재;조현덕;오창범;고길만;박영재;이인원;안희용
    • 핵의학기술
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    • 제15권1호
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    • pp.75-80
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    • 2011
  • 유럽 및 미국에서는 다인용 치료병실을 사용하고 있는 실정이다. 이에 서울대학교병원에서 현재 1인용 치료병실로 사용하고 있는 병실을 2인용 치료병실로 운영할 때 안전성에 대해 알아보고자 한다. 서울대학교병원 기존 치료병실에 침대와 침대 사이 차폐벽을 설치하여 2인용 치료병실로 운영할 경우, 상대방 환자로부터 방출되는 감마선의 산란에 의한 외부피폭과 상대방 환자에 의해 발생되는 오염으로 인한 외부 및 내부피폭을 평가하였다. 2인용 치료병실의 안전성 평가를 위해 외부 및 내부피폭을 평가하였을 때 원자력법에서 고시하는 '진료환자의 격리 수량, 5 mSv'이하의 피폭을 받게 됨을 알 수 있었다. 그리고 환자들의 피폭관리방안을 수립하여 교육 및 관리함으로써 환자 상호 간의 불필요한 피폭을 방지할 수 있다는 것을 알 수 있었다. 갑상선암 환자의 증가에 따라 치료병실 이용하는 환자가 적체되고 있는 추세이다. 이에 국제적 추세에 발맞춰 현행 1인용 치료병실을 2인용 치료병실로 개선함으로써 비용절감 및 관리의 효율성을 증대할 수 있으며 환자의 소외감과 고립감을 해소하여 치료효과를 높일 수 있다.

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외부활동에 따른 자외선 노출이 피부에 미치는 영향 연구 -피부물리치료를 위한 기초 연구- (A study on the effect of UV exposure on the skin due to external activities)

  • 이광재;최영인
    • 대한물리치료과학회지
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    • 제21권1호
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    • pp.37-43
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    • 2014
  • Background : The purpose of this study is to verify the type of influence on the skin color according to the photoaging symptoms depending on the degree of external activities among the factors that influence the skin due to UV exposure and to obtain the basic study data on the physical therapy of the skin. Methods : In this study, in order to investigate the type of influence on the skin color according to the photoaging symptoms when the body is exposed to the UV rays having various effects on our body, a study was conducted using questionnaires and skin color measurement tool targeting 20 male college soccer students with many external activities and the senior high school students who has relatively less external activities due to the preparation for college entrance. The skin color was measured and the results were compared. Result : In the test group having relatively higher external activities, while they had less use of the sunscreen, they had more degree of UV exposure, and for the recognition of ultraviolet hazard, more were aware that it was harmful. In addition, in the skin color measurement test conducted targeting the son and the father in order to investigate the association between the skin color and the genetic factors, the experimental group showed a significant difference(p<.05) but the control group did not show any significant difference(p>.05). Conclusion : Based on such study results, the UV exposure time and the use of sunscreen are thought to be an important factor in the skin care.

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