• Title/Summary/Keyword: Medical psychotherapy

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Experiences of traumatic events, knowledge and attitudes concerning post-traumatic stress disorder, and resilience among nurses and paramedics working in emergency department (응급실 간호사와 응급구조사의 외상성 사건의 경험, 외상후 스트레스장애에 대한 지식, 태도 및 회복탄력성)

  • Hong, Sun-Woo;Bang, Kyung-Sook;Bang, Hwal Lan;Hyun, Hye Jin;Lee, Miyoung;Jung, Yu Na
    • The Journal of Korean Academic Society of Nursing Education
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    • v.29 no.1
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    • pp.86-97
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    • 2023
  • Purpose: This study aimed to assess exposure to traumatic events, knowledge and attitudes concerning post-traumatic stress disorder (PTSD) and the level of resilience among nurses and paramedics working in emergency departments. Methods: Data were collected from May 22 to June 12, 2022, using a self-administered survey questionnaire. The participants comprised 135 nurses and 80 paramedics working in emergency departments. The collected data were analyzed with descriptive statistics, a t-test, and an analysis of variance with Scheffé's test. Results: Compared with emergency room nurses, paramedics were more positive about the government's spending on job opportunities for people with PTSD. There were no significant differences in attitude regarding government strategies and people with PTSD between nurses and paramedics. Paramedics had higher scores on the effective treatment for PTSD, while emergency room nurses showed higher scores on effective psychotherapy. General knowledge of PTSD differed according to sex (t=-2.33, p=.021) and education level (F=3.21, p=.042). Resilience scores differed significantly according to sex (t=2.02, p=.045), education level (F=4.10, p=.018), self-reported economic state (F=10.34, p<.001), and self-reported health (F=11.57, p<.001). Conclusion: The findings support that emergency department nurses and paramedics are in need of self-care programs to support their mental health and indicate that intervention programs should be developed to enhance resilience in emergency department professionals.

Psychotherapy for Somatoform Disorder (신체형 장애의 정신치료)

  • Lee, Moo-Suk
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.2
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    • pp.269-276
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    • 1996
  • A theroretical study was made on the psychodynamism of somatoform disorder. Somatoform disorder is caused by a defense mechanism of somatization. Somatization is the tendency to react to stimuli(drives, defenses, and conflict between them) physically rather than psychically(Moore, 1990). Ford(1983) said it is a way of life, and Dunbar(1954) said it is the shift of psychic energy toward expression in somatic symptoms. As used by Max Shur(1955), somatization links symptom formation to the regression that may occur in response to acute and chronic conflict. In the neurotic individual psychic conflict often provokes regressive phenomena that may include somatic manifestations characteristic of an earlier developmental phase. Schur calls this resomatization. Pain is the most common example of a somatization reaction to conflict. The pain has an unconscious significance derived from childhood experiences. It is used to win love, to punish misdeeds, as well as a means to amend. Among all pains, chest pain has a special meaning. Generally speaking, 'I have pain in my chest' is about the same as 'I have pain in my mind'. The chest represent the mind, and the mind reminds us about the heart. So we have a high tendency to recognize mental pain as cardiac pain. Kellner(1990) said rage and hostility, especially repressed hostility, are important factors in somatization. In 'Psychoanalytic Observation on Cardiac Pain', psychoanalyst Bacon(1953) presented clinical cases of patients who complained of cardiac pain in a psychoanalytic session that spread from the left side of their chests down their left arms. The pain was from rage and fear which came after their desire to be loved was frustrated by the analyet. She said desires related to cardiac pain were dependency needs and aggressions. Empatic relationship and therapeutic alliances are indispensable to psychotherapy in somatoform disorder. The beginning of therapy is to discover a precipitating event from the time their symptoms have started and to help the patient understand a relation between the symptom and precipitating event. Its remedial process is to find and interpret a intrapsychic conflict shown through the symptoms of the patient. Three cases of somatoform disorder patients treated based on this therapeutic method were introduced. The firt patient, Mr. H, had been suffering from hysterical aphasia with repressed rage as ie psychodynamic cause. An interpretation related to the precipitating event was given by written communication, and he recovered from his aphasia after 3 days of the session. The second patient was a dentist in a cardiac neurosis with agitation and hypochondriasis, whose psychodynamism was caused by a fear that he might lose his father's love. His symptom was also interpreted in relation to the precipitating event. It showed the patient a child-within afraid of losing his father's love. His condition improved after getting a didactic interpretation which told him, to be master of himself, The third patient was a lady transferred from the deparment of internal medicine. She had a frequent and violent fit of chest pains, whose psychodynamic cause was separation anxiety and a rage due to the frustration of dependency needs. Her symptom vanished dramatically when she wore a holler EKG monitor and did not occur during monitoring. By this experience she found her symptom was a psychogenic one, and a therapeutic alliance was formed. later in reguar psychotherapy sessions, she was told the relaton between symptoms and precipitating events. Through this she understood that her separation anxiety was connected to the symptom and she became less terrifide when it occurred. Now she can travel abroad and take well part in social activities.

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A Study on the Development of the Standard Manual for ETE (Emotion To Emotion) Therapy (오지상승위치료법의 표준매뉴얼 개발을 위한 타당화 연구)

  • Cheong, Moon Joo;Lee, Do-Eun;Kim, Jeesu;Kang, Sunghyun;Lyu, Yeoung Su;Jung, In Chul;Kang, Hyung Won
    • Journal of Oriental Neuropsychiatry
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    • v.33 no.3
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    • pp.227-239
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    • 2022
  • Objectives: The purpose of this study was to develop a standardization manual for Emotion To Emotion therapy. In this study, the processes and categories derived through literature search related to the Emotion To Emotion treatments, were revised and supplemented by the expert FGI (Focus Group Interview). Afterwards, the expert Delphi was conducted, to develop a standard manual for the disease types, purpose, and method of Emotion To Emotion therapy. Methods: In this study, literature analysis and expert Delphi, as a quantitative research method, were conducted, and the expert Focus Group Interview (FGI) was conducted as a qualitative study. The manual was completed by leading the consensus, on the standardization manual for Emotion To Emotion therapy. After that, a clinical expert Delphi was conducted to test the reliability as well as validity of the manual, through quantitative consensus on the manual of the Emotion To Emotion therapy. Results: First, as a result of literature studies, to date, studies related to Emotion To Emotion therapy have been qualitatively and quantitatively limited, as comparative literature related to clinical cases. Second, through expert FGI, the manual was structured with eight sub-factors for the indication diagnosis, six sub-factors for the implementation method, and 13 detailed factors. Third, through an expert Delphi, the consensus did the factor of indication, implementation methods, and implementation process, and developed a standardization manual for Emotion To Emotion therapy ver 1.0. Conclusions: Through literature analysis, expert FGI, and expert Delphi, the Emotion To Emotion therapy standardization manual ver 1.0 was completed, and will proceed with the revision and improvement report.

Differences in quality of sleep, job stress, fatigue, job satisfaction, and posttraumatic stress disorder according to the type of work in fire-fighting officers (소방공무원의 근무형태에 따른 수면의 질, 직무스트레스, 피로도, 직무만족 및 외상 후 스트레스장애 차이)

  • Choi, Jin;Song, Yeon-Joo
    • The Korean Journal of Emergency Medical Services
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    • v.22 no.3
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    • pp.149-162
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    • 2018
  • Purpose: The purpose of the study was to investigate the differences in quality of sleep, job stress, fatigue, job satisfaction, and posttraumatic stress disorder (PTSD) according to the type of work in fire-fighting officers. Methods: This study used an online questionnaire. The participants were 322 fire-fighting officers. The data were collected from May 2 to 20, 2018. Data were analyzed using SPSS 22.0. Results: According to the work styles of fire fighting officers, job stress, job satisfaction, and PTSD showed significant differences. However, There were no differences in sleep quality and fatigue. There were significant differences in job stress, job satisfaction, and PTSD in those in roles of fire suppression and rescue emergency medical technicians and this result suggests a way to improve the quality of sleep, job stress, job satisfaction and fatigue for fire-fighting officers who suffer from PTSD. Conclusion: Based on the results of this study, mental health of fire-fighting officers will be improved through basic data for psychotherapy which can overcome the quality of sleep, job stress, fatigue, job satisfaction and PTSD according to the work style of fire-fighting officers.

Feasibility of Emotional Freedom Techniques in Patients with Posttraumatic Stress Disorder: a pilot study

  • Yujin Choi;Yunna Kim;Do-Hyung Kwon;Sunyoung Choi;Young-Eun Choi;Eun Kyoung Ahn;Seung-Hun Cho;Hyungjun Kim
    • Journal of Pharmacopuncture
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    • v.27 no.1
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    • pp.27-37
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    • 2024
  • Objectives: Posttraumatic stress disorder (PTSD) is a prevalent mental health condition, and techniques using sensory stimulation in processing traumatic memories have gained attention. The Emotional Freedom Techniques (EFT) is a psychotherapy that combines tapping on acupoints with exposure to cognitive reframing. This pilot study aimed to assess the feasibility of EFT as a treatment for PTSD by answering the following research questions: 1) What is the compliance and completion rate of patients with PTSD with regard to EFT protocol? Is the dropout rate reasonable? 2) Is the effect size of EFT protocol for PTSD sufficient to justify a future trial? Methods: Thirty participants diagnosed with PTSD were recruited. They received weekly EFT sessions for five weeks, in which they repeated a statement acknowledging the problem and accepting themselves while tapping the SI3 acupoint on the side of their hand. PTSD symptoms were evaluated using the PTSD Checklist for DSM-5 (PCL-5) before and after the intervention. Results: Of the 30 PTSD patients (mean age: 34.1 ± 9.1, 80% female), 96.7% showed over 80% compliance to the EFT sessions, and 86.7% completed the entire study process. The mean PCL-5 total score decreased significantly after the intervention, with a large effect size (change from baseline: -14.33 [95% CI: -19.79, -8.86], p < 0.0001, d = 1.06). Conclusion: The study suggests that EFT is a feasible treatment for PTSD, with high session compliance and low dropout rates. The effect size observed in this study supports the need for a larger trial in the future to further investigate EFT as a treatment for PTSD. However, the lack of a control group and the use of a self-rated questionnaire for PTSD symptoms are limitations of this study. The findings of this pilot study can be used to plan a future trial.

Mother's Marital Conflict and Satisfaction Mediate the Relationship Between Father's Child-Rearing Involvement and the Mother's Warmth of Parenting Style: The Moderating Role of Mother's Depression and Self-Esteem (부의 양육참여가 모의 온정적 양육에 미치는 영향에서 모가 지각한 부부갈등 및 결혼만족도의 매개효과: 모의 우울과 자아존중감 조절효과를 중심으로)

  • Eom, Sung Hye;Jeon, Hyo Jeong;Goh, Eun Kyoung
    • Korean Journal of Child Studies
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    • v.38 no.1
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    • pp.153-167
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    • 2017
  • Objective: This study was aimed to examine the mediating effects of mother's marital conflict and satisfaction between father's child-rearing involvement and mother's warmth of parenting style, and the moderating effect of mother's depression and self-esteem. Methods: The analyses involved using cross-sectional weights from the 1,703 samples of the 5th Panel Study on Korean Children to classify them into high and low depression groups, and high and low self-esteem groups. Path analysis and multiple group comparison analysis were conducted, controlled by child sex, mother's age and highest education level, and household financial assets. Results: The results were as follows: First, mother's marital conflict and satisfaction had a mediating effect on the relationship between father's child-rearing involvement and mother's warmth of parenting style. Second, mother's depression and self-esteem levels had a moderating effect the relationship between father's child-rearing involvement and mother's warmth of parenting style. In particular, mother's depression level affected the path between marital conflict and warmth of parenting style, and mother's self-esteem level affected the path between marital satisfaction and warmth of parenting style. Conclusion: Father's child-rearing involvement and mother's psychological level affect mother's marital relations and parenting style. Also, father's parenting involvement and psychological support is needed for a mother to regulate mood disorders, including depression and any self-serving bias.

Stimulation-Oriented Interventions for Behavioral Problems among People with Dementia: A Systematic Review and Meta-Analysis (치매 환자의 문제행동을 위한 자극지향적 중재의 효과 연구: 체계적 고찰과 메타분석)

  • Kim, Eun Young;Hwang, Sung-Dong;Kim, Eun Joo
    • Journal of Korean Academy of Nursing
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    • v.46 no.4
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    • pp.475-489
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    • 2016
  • Purpose: This study was a systematic review and meta-analysis designed to investigate the effects of stimulation-oriented interventions for behavioral problems among people with dementia. Methods: Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a literature search was conducted using seven electronic databases, gray literature, and other sources. Methodological quality was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) for randomized controlled trials (RCTs). Data were analyzed using R with the 'meta' package and the Comprehensive Meta-Analysis (CMA 2.0) program. Results: Sixteen studies were included for meta-analysis to investigate the effect of stimulation-oriented interventions. The quality of individual studies was rated as '++' for eight studies and '+' for the rest. The effect sizes were analyzed according to three subgroups of interventions (light, music, and others); Hedges' g=0.04 (95% CI: -0.38~0.46), -0.23 (95% CI: -0.56~0.10), -0.34 (95% CI: -0.34~0.00), respectively. To explore the possible causes of heterogeneity ($I^2=62.8%$), meta-regression was conducted with covariates of sample size, number of sessions, and length of session (time). No moderating effects were found for sample size or number of sessions, but session time showed a significant effect (Z=1.96, 95% CI: 0.00~0.01). Finally, a funnel plot along with Egger's regression test was performed to check for publication bias, but no significant bias was detected. Conclusion: Based on these findings, stimulation-oriented interventions seem to have a small effect for behavioral problems among people with dementia. Further research is needed to identify optimum time of the interventions for behavioral problems among dementia pateints.

The Influence of Biomedical Ethics and Brain-Death Organ Donation Education on Biomedical Ethics Awareness and Brain-Death Organ Donation Knowledge of Nursing students (생명의료윤리와 뇌사자 장기기증 교육이 간호대학생의 생명의료윤리 의식과 장기기증 지식에 미치는 영향)

  • Ju, Se-Jin;Kang, Gyun-Young;Park, Jung-hee
    • Journal of the Korea Convergence Society
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    • v.11 no.10
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    • pp.401-407
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    • 2020
  • This study is the quasi-experimental research of nonequivalent groups and is designed to measure and compare the awareness and knowledge of 2 groups of undergraduate nursing students - one group who received the education of biomedical ethics and brain-death organ donation and the other group who did not receive the education - regarding biomedical ethics and brain-death organ donation. We conducted this research for the 76 undergraduate nursing students of a certain university located in "C" city. Collected data were analyzed by Fischer's exact test and t-test, ANCOVA using SPSS 23.0 program. As result of the research, it was found that there was significant difference in the knowledge of brain-death organ donation between the above 2 groups (t=35.21, p=.000). In this regard, the education of biomedical ethics should be included in the curriculum of undergraduate nursing students in consideration of factors influencing the awareness of biomedical ethics.

Human Sexuality and Sexual Dysfunction (성(性)생활과 성기능장애)

  • Cho, Doo-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.10-25
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    • 1999
  • Children above age of two are able to have sexual excitement, and they actively seek the pleasure actively or passively through touch and masturbation. In late $60_s$ and early $70_s$, Masters, obstetrician, and Johnson, social worker, illustrated four phases of human sexual responses, namely excitement, plateau, orgasmic and resolution phases in both sexes, and multiple orgasms in the female. Their treatment principles of sexual dysfunctions were largely based on behavioral model, introducing the concepts of sensate focus, dual therapy and sex education. Following Masters and Johnson, Kaplan, psychiatrist and psychoanalyst, in the early and mid-$70_s$ introduced new sex therapy which was based on the combination of analytically-oriented psychotherapy and behavior therapy, and classified sexual dysfunctions into three categories such as desire excitement and orgasmic phase disorders. Since $1980_s$ other medical fields joined the stream, putting the concentrated effort on the treatment of the impotence in the male. They have developed penile prosthesis, local injection therapy, and the administration of oral medications. Nowadays Sildenafil(Viagra) seems the best choice for the treatment of the impotence in the male.

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Clinical Guidelines for Hwabyung IV. (Medications & Acupuncture and Moxibustion) (화병 임상진료지침 IV. (약물치료와 침구치료))

  • Kang, Hyung-Won;Lee, Seung-Gi;Lee, Jae-Hyuk;Park, Bo-Ra;Lyu, Yeoung-Su
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.spc1
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    • pp.37-46
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    • 2013
  • Objectives : The Hwabyung Research Center of The Korean Society Of Oriental Neuropsychiatry has attempted to develop the 'Clinical Guidelines for Hwabyung'. Methods : The Hwabyung Research Center constructed a committee of experts and advisory group. Relevant literature was collected and evaluated in order to find out effective Pharmacotherapy (Herbal medicine), acupuncture and moxibustion, and cupping of Hwabyung. Results : We found some evidences that proved the effectiveness of Pharmacotherapy (Herbal medicine), acupuncture and moxibustion, and cupping in the treatment of Hwabyung. 1) We recommend Pharmacotherapy (Herbal medicine), acupuncture and moxibustion, cupping, psychotherapy and management, other therapeutic approaches and education for Hwabyung. 2) Pharmacotherapy (Herbal medicine) should be determined according to the pattern identification of Korean medicine. Further, the prescription should be cost-effective, safe and have no side effects. Also, the interaction between Herbal and Western drugs should be considered carefully. 3) There are general acupuncture, scalp acupuncture, Pharmacopuncture, Sa-am acupuncture as well as acupuncture treatments for Hwabyung. 4) Moxibustion and cupping are useful, relieving various somatic symptoms of Hwabyung. Conclusions : Pharmacotherapy (Herbal medicine), Acupuncture and Moxibustion, Cupping for Hwabyung were studied. We hope that the 'Clinical Guidelines for the Treatment of Hwabyung' are helpful for oriental medical doctors and patients.