• 제목/요약/키워드: Fear of death

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Effects of Forest Healing Program on Depression, Stress and Cortisol Changes of Cancer Patients

  • Lee, Mi-Mi;Park, Bong-Ju
    • 인간식물환경학회지
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    • 제23권2호
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    • pp.245-254
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    • 2020
  • Patients diagnosed with cancer face mental problems such as alienation, isolation, anxiety about death and fear, recovering from psychological difficulties. In this study, a forest healing program was provided for cancer patients to recover from psychological stress, depression, social isolation and self-esteem caused by cancer and changes in salivary cortisol through psychological and emotional recovery were measured. From September 19 to November 28, 2017, a forest healing program composed of a total of 10 sessions, two hours per session was provided for 12 cancer patients in the Forest of Taegyo located in Yongin. Psychological tests were performed with Social Adaptation Self-evaluation Scale (SASS), Korean-version Perceived Stress Scale (PSS) and Beck Depression Inventory (BDI) and the collected data were analyzed with the SPSS 18.0. The salivary cortisol level was measured along with the psychological tests and were analyzed by a specialized testing agency. The results of the analysis showed that the pre- and post-assessment score of SASS was 29.17 and 25.92, respectively, and that the pre- and post-assessment score of PSS was 30.50 and 23.92, respectively. The pre- and post-assessment score of BDI was 41.00 and 34.83, respectively, which showed significant differences. In addition, the pre- and post-assessment level of saliva cortisol was 3.13 and 1.68, respectively, showing a significant decrease. In short, the forest healing program was found to be effective in reducing physiological changes caused by social isolation and stress due to the emotional and psychological difficulties that the subjects who were diagnosed with cancer and were recovering from it have. In the future, it will be necessary to develop and implement a forest healing program by conducting a forest healing requirement survey on cancer patients.

정신건강의학과 환자의 우울과 자살사고의 관계에서 자살하지 않는 이유의 조절효과 (The Moderating Effect of Reasons for Living on the Relationship Between Depression and Suicidal Ideation Among Psychiatric Patients)

  • 방현지;김대호;김일빈;김은경
    • 정신신체의학
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    • 제30권2호
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    • pp.179-186
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    • 2022
  • 연구목적 본 연구에서는 정신건강의학과 환자의 우울과 자살사고의 관계에서 자살하지 않는 이유의 조절효과를 확인하고자 하였다. 방 법 본 연구는 한양대학교 구리병원 정신건강의학과에 진료를 위해 내원 및 입원한 환자 137명을 대상으로 자기보고식 질문지를 실시하였다. 결 과 자살하지 않는 이유의 4개의 하위 요인 중 생존과 대처 신념, 죽음 공포와 사회적 비난 그리고 미래 기대의 조절효과가 관찰되었다. 결 론 본 연구의 결과는 정신건강의학과 환자의 우울과 자살사고의 관계에서 자살하지 않는 이유가 보호 요인이 될 수 있음을 확인하였다.

북한이탈주민의 남한이주 과정의 외상적 체험에 대한 현상학적 연구 (A Phenomenological Approach to Traumatic Experiences Among North Korean Defectors)

  • 엄태완
    • 한국사회복지학
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    • 제61권2호
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    • pp.189-213
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    • 2009
  • 본 연구의 목적은 북한이탈주민들이 남한이주 과정에서 경험한 외상 사건의 의미와 본질이 무엇인지를 이해하는 것이었다. 이를 위하여 현상학적 연구방법으로 접근하였으며, 연구 참여자는 탈북과정에서 고문, 공포, 폭행, 기아, 질병 등의 외상을 경험한 7명의 북한이탈주민들이었다. 연구결과, 6개의 주제묶음(Theme clusters)을 '삶과 죽음의 경계에서의 몸부림', '살아남음과 살아가는 것의 차이'로 범주화 하는 과정에서 연구 참여자들의 남한이주 과정에서의 외상은 수년이 지난 현재와 연결되어 있음을 발견하였다. 연구 참여자들이 외상 사건을 경험하며 살아남은 과정에서 각인된 이미지와 기억은 수 년 동안 지속되어 남한에서의 일상생활과 관련을 맺고 있었다. 본 연구를 통하여 북한이탈주민들의 부정적 특성이라고 간주되었던 일부 요인들이 외상을 경험한 개인들에게는 피할 수 없는 개별적 특수성임을 알 수 있었다.

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암 환아 부모의 경험에 대한 질적 연구 (The Experience of Parents Whose Child is Dying with Cancer)

  • 조영숙;김수지
    • 대한간호학회지
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    • 제22권4호
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    • pp.491-505
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    • 1992
  • The purpose of this research was to understand the structure of the lived experience of parents of a child terminally ill with cancer The research question was “What is the structure of the experience of parents of a child terminally ill with cancer\ulcorner” The sample consisted of 17 parents of children admitted to the cancer units of two university hospitals in Seoul. The unstructured interviews were carried out from October 10, 1991 through January 10, 1992. They were audio-recorded and analysed using Van Kaam's method. Parents ascribed the cause of the cancer to the mother's emotional imbalance during pregnancy, the mother's stress, failure to observe religious rites, food, the parent's sin, misfortune and pollution. The theme clusters were tension, fear and depression experienced during pregnancy, stress that children suffer from abusive parents, failure to observe religious activites, bad luck, and sins committed during a previous life. When the child suffered a recurrence of cancer, the parents experienced negative emotions, nervousness, sorrow. depression and death. The theme clusters were feelings of despair, helplessness, regret, guilt, insecurity, emptyness and apathy. The long struggle with cancer resulted in the loss of economic security, loss of psychological and physical well being, and social withdrawal. The theme clusters were the economic burden of medical cost, giving up treatment, debt, limited medical insurance coverage and blood transfusion. The loss of psychological well being included stress, lack of support systems, inability to carry out responsibilities, lack of trust of the medical ten family breakdown, inappropriate expression of emotion and not disclosing the diagnosis to the child. Physically the parents suffered fatigue, insomnia, loss of appetite, loss of weight, dizzness, headache, psychosomatic symptoms, and increased consumption of liquor and cigarettes. Social withdrawal was manifested by taking time off from work to look after the child, decrease of outside social activities and feelings of isolation. Influences on family life were spousal conflicts, negative response of siblings, separation of the family members and economic hardship. The theme clusters were blaming a spouse for the cause of the illness and disagreements, maladjustment, lonliness, hostility and depression of siblings. The high price of medical care over the long period was a major factor influencing the life of the family. Positive experiences during the child's long illness were the strengthening of support systems and religious beliefs and financial help from social organizations. The support of one's spouse primarily helped to overcome the stress of the long illness. In addition, support was received from parents of other children with cancer and from nurses and religious leaders. The nurse, by providing empathetic support, should be a person with whom parents can express their feelings and share their experiences.

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개심술 환자의 퇴원후 간호요구에 대한 조사연구 (Post Discharge Nursing Needs of Patients with Open Heart Surgery)

  • 김명희
    • 대한간호학회지
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    • 제23권4호
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    • pp.664-677
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    • 1993
  • The purpose of this study was to provide basic data for the development of educational material in Korean for patient3 being discharge after open heart surgery. The subjects were 45 adult patients who were seen in the out -patient department of the thoracic surgery unit of P University hospital between February 1993 and May 1993. The data were collected through a chart review and interview. Nursing needs, and the patients status related to diet, activity, medication, physical and psychoemotional limitations were analyzed. The results are summarized as follows ; 1. Mitral valve replacement was the most frequent type of surgery(91.2%). In most cases, a mechanical valve was used (91.0%) . The duration of admission after the operation was two to four weeks for most of the patients(48.9%). The follow-up period was between one and two years for 28.9% of the patients and below 6 years for all of the patients. 2. Many Patients didn’t know the importance of a low salt diet(57.8%), and did not get any education on low salt diet (66.7%). Gimchi was included as one of the most commonly ingested foods (77.8%). All of the patients indicated nursing needs related to education about low salt diets and further they indicated a major interest in foods that are harmful (57.7%) or foods that are safe(51.1% ). 3. Most patients did not recognize the need for limitations on physical activity(84.4%). Further, 31.1% of them could not return to work at the time of the study. All patients had nursing needs related to physical activity, with the most frequent questions being about the permissble degree of activity and special cautions dictated by their illness (60.0%). 4. Many patients were ignorant of the necessity of medication(55.6%) . Forty percent of the patients were taking additional drugs, usually herb drugs. The time and duration of medication and the side effects of drugs were common concerns (57.7%) related to nursing. needs about medication and were mentioned by all of the patients. 5. All of the patients complained of physical discomfort including the following : memory disturbance(62.2%), weight gain(60.0%), chest tightness (55.6%), hair loss(51.1%), sleep disturbance(46.7%) and other symptoms in that order of frequency. Nursing needs related to physical condition were a concern for all of them. The viability and function of the replaced valve(53.3%) and weight gain(60.0%) were mal or concerns. 6. Looking at their psychoemotional condition it was found that 36 patients(80.0%) were emotionally unstable. The causes were physical discomfort(17 patients), insufficient knowlege of open heart surgery(6 patients), fear of death(6 patients), familial over protection(2 patients ) and lack of support (5 patients).

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근디스트로피 자녀를 가진 어머니의 경험 (The Lived Experience of Mothers of Children with Muscular Dystrophy)

  • 오상은
    • Child Health Nursing Research
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    • 제7권4호
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    • pp.421-433
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    • 2001
  • The purpose of this phenomenological study was to understand the lived experience of mothers of children with muscular dystrophy. The participants were 11 mothers recruited by snowball sampling, who agreed with the objectives of the research and could verbally communicate with the researcher and who lived with their sons who had muscular dystrophy. Data collection was done through in-depth interviews with participants in their own homes. Each interview took 50 to 120 minutes. All of the interviews were audiotaped and then transcribed. Data were analyzed using Colaizzi's (1978) method of phenomenology. From the transcripts 109 significant sentences and phrases were selected and 13 clusters of themes were categorized from 67 significant statements. These results were integrated into the essential structure of the lived experience of mothers of children with muscular dystrophy. 1. Anxious and relying on chance due to indefinite diagnosis. 2. Only able to cry with shock because of son's fatal disease. 3. Seeing the future as dismal and feeling resentment that this disease in transmitted through the mother. 4. Feeling caught between a husband who is distancing himself from his family and the family which is disintegrating. 5. Feeling like a sinner for transmission of genetic disease(Feeling guilt for conceiving a son with a genetically transmitted fatal disease). 6. Empathizing with other suffers of muscular dystropy and their parents in their grief and helping to dissipate their heavy feelings. 7. Deciding to sacrifice self as a way of taking responsibility for giving birth to a handi-capped son. 8. Losing hope (feeling despair) as son's condition deteriorates in spite of all attempts to help him. 9. Wishing to die with son who becomes progressively immobile. 10. Accumulating Han*(한, 恨), because of rising Hwa(화, anger), and becoming sick both mentally and physically. 11. Seeing events as destiny and finding self-control through faith. 12. Finally, giving up sacrificing self for son and becoming concerned(involved) with other children in the family. 13. Feeling fear at son's impending death. This is the first research on the experience of Korean mothers of children with muscular dystrophy. In applying the phenomenology research method, this study not only helps health professionals understand the experience of these mothers in the Korean patriarchal social system, but the researcher, as a nurse, can share their agony and grief through identification of their inner world through in-depth personal interviews. The results obtained in this study will not only help in the development of family nursing practice for families with genetically transmitted diseases but also prepare basic data for family nursing practice in the Korean sociocultural context.

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지지적 간호중재가 두경부암 수술환자의 불안, 우울에 미치는 효과

  • 석정희;강은실
    • 호스피스학술지
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    • 제3권2호
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    • pp.19-33
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    • 2003
  • Cancer causes many crises to cancer patients imcluding physical dysfunction and emotional changes such as anxiety, depression as well as a threat of life, fear of death. As it develops, cancer makes people feel powerlessness due to the losses of their own positions, roles and independence. Although occupying a little proportion among all types of cancer, head and neck cancer may cause a wide range of physical transformation by surgical operation, damage to active functions such as eating and speaking, provoke anxiety and depression after its operation, influencing the quality life of head and neck cancer patients. Thus nursing intervention should be developed to provide supportive nursing for head and neck cancer patients and play roles as competent supporters. This study is a nonequivalent, control group, pretest-posttest, non-synchronized quasi-experimental research design to determine, how nursing intervention has effects on anxiety, depressing of head and neck cancer and operated. They were divided into experimental and comparison groups, each consisting of 20 members. The data were collected during the period from December 1, 1999 to April 11, 2000. Tools of the study included the protocol of supportive nursing intervention which was developed by researcher with reference to a literal review and esperts' advice. The measurement tool of anxiety was consisting of totaled 20 question items which was prepared by Spielberger and translated by Kim et al., the device of depression measurement consisting of total 20 question items which was the output of Song's translation the device of depression self-evaluation from Zung. Data were analyzed using the SPSS/PC 9.0 program. The homogeneity of the subjects were tested using x2-test and t-test. 5 hypoteses were tested using t-test. The results of the study can be summarized as follows. 1.The first hypothesis that the experimental group receiving supportive nursing intervention shows a little anxiety than the control group not receiving supportive nursing intervention was supported(t=3.817, P=.000). 2.The second hypothesis that the experimental group receiving supportive nursing intervention shows a little depression than the control group not receiving supportive nursing intervention was supported(t=8.089, P=.000). Consequently, supportive nursing intervention was found an effective nursing intervention strategy to reduce anxiety and depression of head and neck cancer patients. Providing supportive nursing intervention in nursing practice can enhance the quality of life of those cancer patients.

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투석 환자에서 연령에 따른 우울, 불안 및 긍정사고의 차이 (The Differences of Depression, Anxiety and Positive Thinking between Adult and Elderly Hemodialysis Patients)

  • 노기원;하주원;임세원;이재은;이규백;김향;오강섭
    • 대한불안의학회지
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    • 제9권1호
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    • pp.38-44
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    • 2013
  • 본 연구는 혈액 투석 중인 성인 환자 집단과 노인 환자 집단 간의 우울, 불안 및 자율신경기능의 차이를 비교해 보고자 하였다. 정신의학적 특징들과 자율신경기능을 비교해보았을 때 만성질환에 견디어 내는 능력에 있어서 노인 환자 집단이 성인 환자 집단에 비해 취약하지 않은 결과를 보였다. 이는 만성질환을 앓고 있는 동일한 상황에서 노인들이 보다 긍정적 사고 경향을 가지고 있는 것과 관련되어 있을 것으로 생각된다.

동해안풍어제의 원형미학적 연구 (The Study on Aesthetic Characteristics of the East Coast Poong-O-Je Festival)

  • 심상교
    • 공연문화연구
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    • 제41호
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    • pp.321-352
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    • 2020
  • 동해안풍어제의 원형미학에 대해 연구하였다. 풍어제를 하나의 예술작품으로 바라본 결과이다. 풍어제에는 마을의 서사가 있고, 굿이 있으며, 마을 사람들의 협력과 소통이 있다. 그 속에는 악가무희가 관통하며 그 주변으로 마을의 과거 설화와 현재의 스토리 등이 어우러지며 마을 사람들은 소통하고 추억하고 전망하는 축제의 본질을 나눈다. 동해안별신굿 자체가 바닷가 생활인들의 이상과 꿈이 반영되어 있다. 바닷가 마을에 사는 생활인으로서의 상상력과 물에 대한 관심이 온전히 동해안별신굿에 반영되어 있다. 바닷가 사람들에게 물은 생활의 터전이며 두려움의 대상이다. 생명의 물이면서 죽음의 물이기도 한다. 바다가 포괄하는 세계가 만드는 상상력에 삶의 전 과정을 투영시킨다. 바닷가의 상상력은 삶의 전 과정에 대한 실존적 통찰이자 존재적 고뇌의 반영이다. 풍어제에서 마을 사람들은 신의 구체적인 복덕이 내리기를 희망한다. 신의 응보가 내려야 사람들은 자유로워진다. 무당이 복을 주겠다는 덕담 정도에 마을 사람들은 자유를 느낀다. 정신적으로 자유로움을 얻는 것으로 어느 정도 개인의 트라우마는 극복되는 상태를 체험한다. 예술작품을 직접 창작함으로써 체험하는 미적 쾌감의 상태와 풍어제와 별신굿을 통해 체험하는 미적 쾌감의 본질이 다르지 않다고 볼 수 있다. 풍어제의 원형은 자유정신이고 자유정신을 더 공고히 하기 위한 신앙적 미의식이 원형미학의 핵심인 것이다.

공황장애 환자의 질환행동에 관한 연구 (A Study on Illness Behavior of Panic Disorder Patients)

  • 김상수;제영묘;김상엽;이대수;이승호;최은영
    • 정신신체의학
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    • 제6권2호
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    • pp.104-119
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    • 1998
  • This study was conducted to determine the important factors in the illness behavior of panic disorder patients. And then, find the best ways to lead the patients who have recurrent panic attacks to the adequate therapeutic situations. We studied 53 patients diagnosed as panic disorder according to DSM-IV among the outpatients who had been followed up at Bong Seng Memorial Hospital for 6 Ms, from May 1997 to October 1997. To evaluate the illness behaviors, we designed a checklist including socio-demographic data, degree of subjective distress from medical and psychiatric treatment, panic symptoms, life events, places of help-seeking, Anxiety Sensitivity Index. Using the checklist, we had semistructured interviews with the panic disorder patients to elucidate their help-seeking behaviors from first panic attack to diagnosing as panic disorder. The results were as follows ; 1) After first panic attack, the patients initially sought help at 1) Emergency room 40%, 2) Rest &/or Personal emergency care 35%, 3) Pharmacy 10%, 4) Outpatient care at hospital 10%, 5) Oriental medicine 5%. 2) Considering the panic symptoms, derealization, paresthesia and the severity of panic symptoms were the most important factors affecting the patient's help-seeking behaviors who had experienced the first panic attack. 3) Most of all the patients (80%) were apt to visit the hospitals within 15 days after experiencing about 3 panic attacks. 4) Before diagnosed as panic disorder, the patients had visited 3-5 health care centers during about 1 year. 5) Primary care physicaians(for example, emergency care physicians, family doctors and internists) had the most important roles in treating or guiding the patients to the adequate therapeutic situations. From the above results, the authors propose that non-psychiatric physicians have to know the panic disorder or attacks exactly. When patients complaint sudden onset physical symptoms e.g. palpitation, dyspnea, dizziness or the cognitive symptoms like the fear of death or insanity, physicians should consider the possibility of panic attack and encourage the patients to be evaluated for psychiatric illness.

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