• Title/Summary/Keyword: Family dysfunction

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CHARACTERISTICS OF UNRULY & DELINQUENT ADOLESCENTS ADMITTED TO A PSYCHIATRIC INPATIENT UNIT (청소년 병동에 입원한 비행 청소년의 특성에 관한 연구)

  • Lee, Young-Sik;Kim, Wun-Jung;Carey, Michael
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.70-82
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    • 1997
  • Objective:This study was performed to identify and understand the characteristics of adolescents who had a history of police arrest and/or were adjudicated unruly/delinquent by the juvenile court. Method:The study employed a retrospective reivew of coumputer-recorded data set on 210 consecutive admissions to an adolescent psychiatric inpatient unit. Three groups(No Police Contact, N=115;Police Contact Only, N=60;Adjudicated, N=35) were compared on the areas of a) cognitive and educational performance b) emotion:anxiety, depression, suicidality c) personality d) family and life experiences. Standardized assessments were administered to all subjects using WISC-Ⅲ, Kaufman Test of Educational Achievement, Millon Adolescent Personality Inventory, Reynolds Adolescent Depression Scale, Revised-Chilren’s Manifest Anxiety Scale, Suicide Ideation Questionnarie, Suicide Behavior Interive, Life Events Checklist, and Family Environmental Scale. A subgroup of the subjects, 60 cases also received a standardized interview by Child Assessment Schedule. Results:The characteristic findings of the delinquent group(the police contact only and adjudicated subjects combined) included (1) a high rate of adoption, sexual promiscuity, out of home placement, and repeated psychiatric hospitalization, (2) low verbal IQ scores and educational achievements, (3) high impulsivity, low social conformity, and high forcefulness in personality inventory, (4) low activityrecreation orientation and low moral religious emphasis in family environment, (5)a high frequency of adverse life experiences, (6) among 3 groups, the Police Contact Only group showed the lowest depression, anxiety and suicidal ideation scores, (7) a high diagnostic frequency of conduct disorder, ODD, and ADHD. Conclusions:The adolescent psychiatric inpatients with a delinquent history presented with a certain clinical, family, psychometric characteristics that warrant specific clinical intervention strategies for their cognitive deficits, an impulsive personality style, family dysfunction with adverse life experiences and disruptive behavioral disorders, different from the rest of adolescent psychiatric inpatients.

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Factors Associated with Care Burden among Family Caregivers of Terminally Ill Cancer Patients (말기암환자 가족 간병인의 간병 부담과 관련된 요인)

  • Lee, Jee Hye;Park, Hyun Kyung;Hwang, In Cheol;Kim, Hyo Min;Koh, Su-Jin;Kim, Young Sung;Lee, Yong Joo;Choi, Youn Seon;Hwang, Sun Wook;Ahn, Hong Yup
    • Journal of Hospice and Palliative Care
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    • v.19 no.1
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    • pp.61-69
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    • 2016
  • Purpose: It is important to alleviate care burden for terminal cancer patients and their families. This study investigated the factors associated with care burden among family caregivers (FCs) of terminally ill cancer patients. Methods: We analyzed data from 289 FCs of terminal cancer patients who were admitted to palliative care units of seven medical centers in Korea. Care burden was assessed using the Korean version of Caregiver Reaction Assessment (CRA) scale which comprises five domains. A multivariate logistic regression model with stepwise variable selection was used to identify factors associated with care burden. Results: Diverse associating factors were identified in each CRA domain. Emotional factors had broad influence on care burden. FCs with emotional distress were more likely to experience changes to their daily routine (adjusted odds ratio (aOR), 2.54; 95% confidence interval (CI), 1.29~5.02), lack of family support (aOR, 2.27; 95% CI, 1.04~4.97) and health issues (aOR, 5.44; 2.50~11.88). Family functionality clearly reflected a lack of support, and severe family dysfunction was linked to financial issues as well. FCs without religion or comorbid conditions felt more burdened. The caregiving duration and daily caregiving hours significantly predicted FCs' lifestyle changes and physical burden. FCs who were employed, had weak social support or could not visit frequently, had a low self-esteem. Conclusion: This study indicates that it is helpful to understand FCs' emotional status and family functions to assess their care burden. Thus, efforts are needed to lessen their financial burden through social support systems.

Genetic classification and confirmation of inherited platelet disorders: current status in Korea

  • Shim, Ye Jee
    • Clinical and Experimental Pediatrics
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    • v.63 no.3
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    • pp.79-87
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    • 2020
  • Inherited platelet disorders (IPDs), which manifest as primary hemostasis defects, often underlie abnormal bleeding and a family history of thrombocytopenia, bone marrow failure, hematologic malignancies, undefined mucocutaneous bleeding disorder, or congenital bony defects. Wide heterogeneity in IPD types with regard to the presence or absence of thrombocytopenia, platelet dysfunction, bone marrow failure, and dysmegakaryopoiesis is observed in patients. The individual processes involved in platelet production and hemostasis are genetically controlled; to date, mutations of more than 50 genes involved in various platelet biogenesis steps have been implicated in IPDs. Representative IPDs resulting from defects in specific pathways, such as thrombopoietin/MPL signaling; transcriptional regulation; granule formation, trafficking, and secretion; proplatelet formation; cytoskeleton regulation; and transmembrane glycoprotein signaling are reviewed, and the underlying gene mutations are discussed based on the National Center for Biotechnology Information database and Online Mendelian Inheritance in Man accession number. Further, the status and prevalence of genetically confirmed IPDs in Korea are explored based on searches of the PubMed and KoreaMed databases. IPDs are congenital bleeding disorders that can be dangerous due to unexpected bleeding and require genetic counseling for family members and descendants. Therefore, the pediatrician should be suspicious and aware of IPDs and perform the appropriate tests if the patient has unexpected bleeding. However, all IPDs are extremely rare; thus, the domestic incidences of IPDs are unclear and their diagnosis is difficult. Diagnostic confirmation or differential diagnoses of IPDs are challenging, time-consuming, and expensive, and patients are frequently misdiagnosed. Comprehensive molecular characterization and classification of these disorders should enable accurate and precise diagnosis and facilitate improved patient management.

Model Construction of Sexual Adjustment of Patients with Spinal Cord Injury (척수장애인의 성적적응과 관련요인에 관한 모형구축)

  • Kang, Hyun-Sook;Koh, Jung-Eun;Shu, Yeon-Ok
    • Journal of Korean Academy of Nursing
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    • v.30 no.4
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    • pp.1018-1034
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    • 2000
  • The purpose of this study was to construct model of sexual adjustment in people with spinal cord injury and to determine factors that relate to sexual adjustment using methodological triangulation. A total of 134 persons who were registered members of spinal cord injury organization and admitted rehabilitation unit in the hospital were included in the study. Participants answered questionnaire concerning importance of life events, sexual concern, sexual adjustment. Qualitative data were collected through semi-structured indepth interviews from 10 individuals with spinal cord injury who were previously included in the quantitative study. Constant compatative method was used to analyze the data. The results were as follows : 1) With respect to eleven other areas of life, sex life ranked the sixth and economic status ranked the highest in terms of importance. However social life ranked the lowest among the 11areas. 2) Among seven topics related to sexuality were methods and techniques to achieve sexual satisfaction, and helping a partner cope emotionally with limitation on sexual dysfunction was the second greastest. 3) The mean score for sexual adjustment was 19.47 which can be considered. 4) A process on how individuals with spinal cord injury adjust to their changed sexual life immerged from the qualitative data. It includs 4 stages: 'stage of loss' 'stage of endeavoring' 'stage of effort' and 'stage of adjustment'. Categories showing context for the action/interaction strategies were 'steadiness' and 'rediscovery as a sexual being'. There were three factors which may stimulate the adjustment process while the others may interrupt it. Those factors included personal matters, family matters and social matters. The individuals may follow each stage step by step but may go back to the previous step depending on the outcomes of their adjustment. 5) There were three factors which may stimulate the adjustment process while the others may interrupt it. Those factors included personal matters, family matters and social matters.

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Factors Influencing Functional Status in Patients with Heart Failure (심부전 환자의 기능상태에 영향을 미치는 요인)

  • Song Eun-Kyeung;Kim Cho-Ja;Yoo Il-Young;Kim Gi-Yon;Kim Ju-Hyeung;Ha Jong-Won
    • Journal of Korean Academy of Nursing
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    • v.36 no.5
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    • pp.853-862
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    • 2006
  • Purpose: The purpose of this study was to identify the factors that influence the functional status of patients with heart failure. Method: A descriptive, correlational study design was used. The participants in this study were 260 patients with heart failure who were admitted at Y University and U University in Seoul, Korea. Between September 2005 and December 2005 data was collected by an interview using a questionnaire and from medical records. The Functional status was measured with KASI. Physical factors (dyspnea, ankle edema, chest pain, fatigue, and sleep dysfunction), psychological factors (anxiety and depression), and situational factors (self-management compliance and family support) were examined. Result: In general, the functional status, anxiety, depression, self-management compliance, and family support was relatively not good. The level of fatigue was highest and the level of ankle edema was lowest for physical symptom experiences. In regression analysis, functional status was significantly influenced by dyspnea(23%), age(13%), monthly income(7%), fatigue(3%), ankle edema(2%), depression(1%), and length of stay in the hospital(1%). These factors explained 50% of the variables in the functional status. Conclusion: These results suggest that psycho-physiological symptoms management should be a focus to improve the functional status in patients with heart failure.

Study on the Development of Home Care Nursing Intervention Protocol for Stroke Patients (뇌졸중 환자의 가정간호중재 프로토콜 개발)

  • Yoo Ji-Soo
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.1
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    • pp.122-136
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    • 2000
  • Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=.80 were chosen. 4. Nursing intervention protocols which showed above ICV=.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation/impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.

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Biological Mechanism of Suicide (자살의 생물학적 기전)

  • Cheon, Eun-Jin
    • Journal of the Korean society of biological therapies in psychiatry
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    • v.24 no.3
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    • pp.129-141
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    • 2018
  • Suicide is a behavior that is intended to cause death by itself and requires medical treatment, resulting in suicidal attempt or completion. Suicide causes loss of life, damages the body, costs a lot of medical expenses, and causes families to fall into sorrow and suffering therefore this suicide is a huge loss to family and society. There have been attempts to reduce and prevent suicide by understanding the mechanism of suicide. The mechanism of suicide can be thought of as psychological mechanism and biological mechanism. In the past, if we considered the psychological and biological mechanisms separately, the development of neuroscience now connects and integrates these two. Psychological factors affect biological factors and biological temperaments also affect perception or thinking about the situation and increase psychological vulnerability. Distant factors in suicidal behavior-such as childhood adversity and family and genetic predisposition-increase the lifetime risk of suicide. They alter the response to stress and other processes through changes in gene expression and regulation of emotional and behavioral characteristics. Distant factors affect the biological system and consequently changes in these systems can increase the risk of suicide. In other words, the distal factor does not directly induce suicidal behavior but rather acts indirectly through developmental or mediating factors. These mediating factors are impulsive aggressive and anxious trait, and chronic use of substances. The mechanism of this disorder is the abnormality of the serotonin system and the abnormality of the lipid level. Proximal factors are associated with the onset of suicide events and include changes in the major neurotransmitter systems, inflammatory changes, and dysfunction of glial cells in the brain. A series of studies, including a variety of research methods and postmortem and in-vivo imaging studies, show the impairment of the serotonergic neurotransmitter system and hypothalamic-pituitary-adrenal axis stress response system for suicidal behavior. These disorders lead to suicidal behavior due to difficulty in cognitive control of mood, pessimism, reactive aggression, abnormality in problem solving abilities, excessive response to negative social signals, severe emotional distress, and cognitive dysregulation of suicidal ideation.

Korean Red Ginseng protects endothelial cells from serum-deprived apoptosis by regulating Bcl-2 family protein dynamics and caspase S-nitrosylation

  • Kim, Young-Mi;Kim, Jung Hwan;Kwon, Hyuk Min;Lee, Dong Heon;Won, Moo-Ho;Kwon, Young-Guen;Kim, Young-Myeong
    • Journal of Ginseng Research
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    • v.37 no.4
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    • pp.413-424
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    • 2013
  • Korean Red Ginseng extract (KRGE) is a traditional herbal medicine utilized to prevent endothelium dysfunction in the cardiovascular system; however, its underlying mechanism has not been clearly elucidated. We here examined the pharmacological effect and molecular mechanism of KRGE on apoptosis of human umbilical vein endothelial cells (HUVECs) in a serum-deprived apoptosis model. KRGE protected HUVECs from serum-deprived apoptosis by inhibiting mitochondrial cytochrome c release and caspase-9/-3 activation. This protective effect was significantly higher than that of American ginseng extract. KRGE treatment increased antiapoptotic Bcl-2 and Bcl-$X_L$ protein expression and Akt-dependent Bad phosphorylation. Moreover, KRGE prevented serum deprivation-induced subcellular redistribution of these proteins between the mitochondrion and the cytosol, resulting in suppression of mitochondrial cytochrome c release. In addition, KRGE increased nitric oxide (NO) production via Akt-dependent activation of endothelial NO synthase (eNOS), as well as inhibited caspase-9/-3 activities. These increases were reversed by co-treatment of cells with inhibitors of eNOS and phosphoinositide 3-kinase (PI3K) and pre-incubation of cell lysates in dithiothreitol, indicating KRGE induces NO-mediated caspase modification. Indeed, KRGE inhibited caspase-3 activity via S-nitrosylation. These findings suggest that KRGE prevents serum deprivation-induced HUVEC apoptosis via increased Bcl-2 and Bcl-$X_L$ protein expression, PI3K/Akt-dependent Bad phosphorylation, and eNOS/NO-mediated S-nitrosylation of caspases. The cytoprotective property of KRGE may be valuable for developing new pharmaceutical means that limit endothelial cell death induced during the pathogenesis of vascular diseases.

Review of potential spermatogenic and aphrodisiac effects of the Ferula genus

  • Seyyed Majid Bagheri;Amir Shieh;Jalil Alizadeh Ghalenoei;Maryam Yadegari;Nasrin Alborzi
    • Clinical and Experimental Reproductive Medicine
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    • v.50 no.3
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    • pp.143-153
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    • 2023
  • Objective: Men's sexual health plays an important role in male fertility and childbearing, as it is associated with factors such as sexual desire, healthy spermatogenesis, and erectile function. In various cultures, medicinal plants have been utilized to address male sexual issues, including infertility and erectile dysfunction. Despite recent advancements in medical science for treating male impotence, some men opt for herbal supplements as an alternative, given that numerous herbs have the potential to enhance male sexual performance. The Apiaceae family is one of the oldest plant families used for medicinal purposes. Ferula, a genus within this family, comprises approximately 170 different species worldwide. Members of this genus possess numerous therapeutic properties due to the presence of various compounds. This article aims to explore the potential impacts of Ferula plants on the male reproductive system. Methods: This review article was prepared by searching for terms including Ferula and "aphrodisiac," Ferula and "spermatogenesis," and Ferula and "male reproductive system." Relevant information was gathered through electronic databases, including ISI Web of Knowledge, PubMed, and Google Scholar. Results: The findings indicated that relatively comprehensive studies have been conducted in this area, revealing that certain Ferula species have been employed in folk medicine to boost fertility and libido. Recent research has corroborated these effects. Conclusion: It is hoped that new aphrodisiac compounds with fewer side effects can be isolated from Ferula plants in the future.

Induction of Apoptosis by Ethanol Extract of Lythrum anceps (Koehne) Mak ino in Human Leuk emia U937 Cells (인체백혈병 U937 세포에서 부처꽃 에탄올추출물에 의한 apoptosis 유도)

  • Eun Jung Ahn;Chul Hwan Kim;Jin-Woo Jeong;Buyng Su Hwang;Min-Jeong Seo;Kyung-Min Choi;Su Young Shin
    • Proceedings of the Plant Resources Society of Korea Conference
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    • 2020.08a
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    • pp.77-77
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    • 2020
  • Purple loosestrife-Lythrum anceps (Koehne) Makino is a herbaceous perennial plant belonging to the Lythraceae family. It has been used for centuries in Korea and other Asian traditional medicine. It has been showed pharmacological effects, including anti-oxidant and anti-microbial effects. However, the mechanisms underlying its anti-cancer mechanisms are not yet understood. In this study, we investigated the mechanism of apoptosis signaling pathways by ethanol extract of Lythrum anceps (Koehne) Makino (ELM) in human leukemia U937 cells. Treatment with ELM significantly inhibited cell growth in a dose-dependent manner by inducing apoptosis, as evidenced by the formation of apoptotic bodies (ApoBDs), DNA fragmentation and increased populations of sub-G1 ratio. Induction of apoptosis by ELM was connected with up-regulation of death receptor (DR) 4 and DR5, pro-apoptotic Bax protein expression and down-regulation of anti-apoptotic Bcl-2 protein, and inhibitor of apoptosis protein (IAP) family proteins (XIAP, cIAP-1, survivin), depending on dosage. This induction was associated with Bid truncation, mitochondrial dysfunction, proteolytic activation of caspases (-3, -8 and -9) and cleavage of poly(ADP-ribose) polymerase protein. Therefore, our data indicate that ELM suppresses U937 cell growth by activating the intrinsic and extrinsic apoptosis pathways, and thus may have applications as a potential source for an anti-leukemic chemotherapeutic agent.

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