• 한국응급구조학회지
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• 제6권1호
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• pp.5-14
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• 2002

The purpose of the study was to compare on the cognition and attitudes toward the mentally ill person among EMT College Student before and after Psychiatric Nursing Course Work. The data was collected twice before and after Psychiatric Nursing course work during one semester 16-weeks from 71 EMT department Students. Used measurements were self-reported questionnaires about cognition and CAMI questionnaires about attitudes. Analysis of data was done by frequence, percentage and t-test with SAS program. The cognition was changed over positively after then before Psychiatric Nursing Course. Especially, It was answered that needed to learning, caring and curing for mental illness. The study of attitudes for mentally ill person was that authoritarianism, benevolence and social restrictiveness were changed over positively but community mental health ideology was not changed. In conclusion, follwing the results of this study, the psychiatric nursing course work was influenced very much to changing of attitudes and cognition toward mentally ill person. Accordingly, psychiatric nursing curriculum will be offered and psychiatric educators have to emphasize the understanding of attitudes and cognition toward mentally ill person.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제28권1호
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• pp.31-39
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• 2022

Purpose: The study aimed to extract the space mentioned in the criteria for evaluation and certification of psychiatric institutions in which the most specific standards for medical services of psychiatric institutions are prepared, and to organize and analyze the requirements. Method: The implied space is derived by analyzing the evaluation and certification criteria. The derived space is re-classified by departments of the hospital, and the requirements are organized and analyzed. Results: First, a total of 41 spaces were derived. The derived spaces can be considered as spaces to be treated as important in psychiatric institutions. Second, as a result of reclassifying the derived space by department, 10 spaced for the hospital as a whole, 10 for wards, 12 for central/outpatient departments, 5 for pharmaceutical departments, 2 for catering facilities, and 2 for facilities. Third, if organized by psychiatric institution, there is a total of 40 spaces for psychiatric hospitals according to certification criteria, and according to evaluation criteria, there is 38 spaces for psychiatric hospitals and departments and 19 spaces for the clinics. The difference between the certification and evaluation criteria of psychiatric hospitals is insignificant. In order to promote the qualitative improvement of psychiatric institutions, it is necessary to gradually strengthen from the certification criteria. Fourth, the requirements reflecting the characteristics of a psychiatric institution were very limited to emergency exits and treatment rooms. It is necessary to prepare the space requirements for other rooms in consideration of the behavior of the mentally ill. Implications: The derived spaces and requirements can serve as practical reference materials for practitioners preparing to receive certification and evaluation of psychiatric institutions. In addition, it has meaning as a basic data for estimating the level of space and requirements of psychiatric institutions that are currently required in Korea.

• 정신신체의학
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• 제29권2호
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• pp.176-183
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• 2021

연구목적 응급실 기반 자살시도자 사후관리사업에 등록된 자살시도자의 인구학적 요인, 자살시도 패턴 및 정신건강의학과 병력 및 관리가 사후관리 프로그램 완수에 어떠한 영향을 끼치는지 알아보고자 하였다. 방 법 2018년 6월 1일부터 2021년 5월 31일까지 중앙대학교병원 응급실을 방문한 자살시도 환자 중 사례관리에 동의한 661명을 연구대상으로 하였다. 대상자는 응급실 퇴원 후 8주간의 사후관리 서비스 프로그램에 등록하여 관리를 받았다. 인구학적 요인, 자살시도 패턴, 정신건강의학과 병력 및 관리에 해당하는 요인들을 독립변인으로, 사후관리사업 프로그램의 완수 여부를 종속변인으로 두고, 위계적 로지스틱 회귀 분석을 시행하였다. 결 과 자살시도 패턴이 사후관리 사업 완수에 가장 큰 영향을 미치고, 인구학적 요인, 정신건강의학과 병력 및 관리 순으로 사후관리 사업 완료 여부에 영향을 미치는 것으로 나타났다. 자살시도자 사후관리사업 프로그램 완수자는 미완수자에 비해, 향후 자살계획을 가진 경우가 유의하게 많았고, 자살시도의 진정성이 강했으며, 과거자살시도력 또한 유의하게 높았다. 결 론 대상자들이 사후관리사업 프로그램을 완수하고 지역사회 서비스로 연계되도록 하기 위하여, 자살시도 패턴, 인구학적 요인, 정신건강의학과 병력에 대한 고려를 바탕으로 한 개별화된 접근이 필요하다.

• Journal of Yeungnam Medical Science
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• 제41권1호
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• pp.30-38
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• 2024

Background: Although Korea ranks first in the suicide rate of elderly individuals, there is limited research on those who attempt suicide, with preventive measures largely based on population-based studies. We compared the demographic and clinical characteristics of elderly individuals who attempted suicide with those of younger adults who visited the emergency department after suicide attempts and identified the factors associated with lethality in the former group. Methods: Individuals who visited the emergency department after a suicide attempt from April 1, 2017, to January 31, 2020, were included. Participants were classified into two groups according to age (elderly, ≥65 years; adult, 18-64 years). Among the 779 adult patients, 123 were elderly. We conducted a chi-square test to compare the demographic and clinical features between these groups and a logistic regression analysis to identify the risk factors for lethality in the elderly group. Results: Most elderly participants were men, with no prior psychiatric history or suicide attempts, and had a higher prevalence of underlying medical conditions and attributed their attempts to physical illnesses. Being sober and planning suicide occurred more frequently in this group. In the elderly group, factors that increased the mortality rate were biological male sex (p<0.05), being accompanied by family members (p<0.05), and poisoning as a suicide method (p<0.01). Conclusion: Suicide attempts in elderly individuals have different characteristics from those in younger adults and are associated with physical illness. Suicides in the former group are unpredictable, deliberate, and fatal. Therefore, tailored prevention and intervention strategies addressing the characteristics of those who are elderly and attempt suicide are required.

• 대한간호학회지
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• 제39권1호
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• pp.124-135
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• 2009

Purpose: The purpose of this study was to evaluate the service satisfaction for families who have someone with mental illness, and are using community mental health centers in Gyeonggi Province. Methods: The participants in this study were 796 family members. Data were collected using Family satisfaction survey questionnaire developed by the author (23 items on family service and 15 items on client service). Results: The total satisfaction level for the service with family and client resulted in above average scores. Of the 23 service items, data showed the highest level of satisfaction was with professional skills and attitude, and day rehabilitation programs, and the lowest for professional activities for advocacy and social welfare benefits, emergency & crisis intervention, medical expense subsidies. Of the 15 service items, job and housing related service had the lowest level of satisfaction. Conclusion: It is recommended that psychiatric emergency & crisis intervention programs and system development be accelerated. Also, there is a need to develop medical expense subsidy programs for older family caregivers, job and housing focused rehabilitation programs and community facilities for the client, as well as more active and powerful professional advocate activities for persons who have mental disabilities and their families.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권1호
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• pp.4-14
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• 2023

This study aimed to discuss mental health services for children and adolescents that are being implemented as initiatives of the Korean government and to review the functions and roles of these projects during the COVID-19 pandemic. Three government departments are in charge of providing mental health services for children and adolescents: Ministry of Education, Ministry of Gender Equality and Family, and Ministry of Health and Welfare. The Ministry of Education has implemented several policies to facilitate the early detection of mental health issues among school students (from preventive interventions to selective interventions for high-risk students). The Ministry of Gender Equality and Family additionally serves out-of-school children and adolescents by facilitating early identification of adolescents in crises and providing temporary protection or emergency assistance (as required) through the Community Youth Safety-Net Project. Furthermore, the Ministry of Health and Welfare operates relevant mental health agencies for individuals of all ages including children and adolescents. Any high-risk students who have been screened through the projects of the Ministry of Education are supported through referrals to the following institutions for appropriate treatment of their symptoms: specialized hospitals, the Youth Counseling and Welfare Center operated by the Ministry of Gender Equality and Family, the National Youth Healing Center, the Mental Health Welfare Center operated by the Ministry of Health and Welfare, the Suicide Prevention Center, and the Child Welfare Center. To assist students who are facing any psychological difficulties because of the COVID-19 pandemic, the Ministry of Education has established a psychiatric support group for providing emergency mental health care; furthermore, schools are promoting psychological surveillance (e.g., provision of non-face-to-face counseling services that are centered around the Wee Center). The Ministry of Education, Ministry of Gender Equality and Family, and Ministry of Health and Welfare have provided varied mental health support services in order to address the challenges faced by children and adolescents during the pandemic. Nevertheless, the mental health services operated by each ministry do show some limitations because their service provision system is insufficiently collaborative. The present study discussed the positive effects of each initiative as well as its limitations; furthermore, it suggested improvements for facilitating the healthy development of children and adolescents' mental health.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.376-384
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• 2023

Purpose: The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity. Methods: In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients' mode of transport. Results: This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder. Conclusions: This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.

• 정신신체의학
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• 제27권2호
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• pp.130-137
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• 2019

연구목적 자살시도로 음독을 시도한 환자가 응급실에 내원했을 때, 응급의학과, 내과, 정신건강의학과가 서로 의사소통을 하고 우선순위에 따른 처치를 하는 것은 중요하다. 본 연구는 약물중독 환자에 대한 다학제 응급협진체계(이하 약물중독 응급협진체계)의 효용성을 검증하고자 시행되었다. 방 법 약물중독 응급협진체계 구축을 위해 정신건강의학과, 응급의학과, 내과의 전문의가 협의체를 구성하여, 응급실 내원 당시 복용 약물의 종류와 의식 수준에 따른 담당 진료과 및 협진의뢰과 배정, 각 과별 약물중독 환자 전담 교수 배정, 정기회의, 협진 응답 소요시간 제한, 원내 생명사랑위기대응센터 및 지역사회 자원 연계 등을 모두 프로토콜화하였다. 본 연구에서는 약물중독 응급협진체계가 시행되기 전인 2017년 7월부터 2018년 5월까지의 기간과, 시행 이후인 2018년 7월부터 2019년 5월까지의 의무기록 데이터를 후향적으로 통계분석하여, 약물 중독 응급협진체계의 효과를 검증하고자 하였다. 결 과 약물중독 응급협진체계 시행 후, 시행 전에 비해 중환자실보다 개방병동으로의 입원이 유의하게 증가하였다(χ²=8.567, p=0.014). 또한 타과로 입원한 환자 중 정신건강의학과로의 협진 비율이 증가하는 경향을 보였고χ²=4.202, p=0.053), 협진 응답 소요시간은 감소하였다(Z=-2.031, p=0.042). 한편, 협진 결과 전과된 환자의 비율이 증가였하고(χ²=4.692, p=0.043), 전과까지 소요된 시간은 감소하는 경향을 보였다(Z=-1.941, p=0.052). 결 론 약물중독 응급협진체계 시행 후 불필요한 중환자실 입원, 협진 응답 소요시간, 전과 소요시간이 감소하였으며, 협진 의뢰 비율 및 전과 비율은 증가하였다. 이는 다학제 협진체계가 환자에게 필수적인 의료서비스를 보다 적은 의료비용으로 신속하게 제공하였음을 의미한다. 향후 약물중독 이외의 자살시도에 대해서도 응급협진체계를 구축하여, 각 과 간 명확하고 책임있는 의학적 권고를 신속하게 공유한다면, 환자의 치료 및 의료비용 측면에서 긍정적인 효과를 보일 수 있을 것으로 기대된다.