• Title/Summary/Keyword: Psychiatric patient

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Clinical Applications of Quantitative EEG (정량화 뇌파(QEEG)의 임상적 이용)

  • Youn, Tak;Kwon, Jun-Soo
    • Sleep Medicine and Psychophysiology
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    • v.2 no.1
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    • pp.31-43
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    • 1995
  • Recently, the methods that measure and analyze brain electrical activity quantitatively have been available with the rapid development of computer technology. The quantitative electroencephalography(QEEG) is a method of computer-assisted analyzing brain electrical activity. The QEEG allows for a more sensitive, precise and reproducible examination of EEG data than that can be accomplished by conventional EEG. It is possible to compare various EEG parameters each other by using QEEG. Neurometrics, a kind of the quantitative EEG. is to compare EEG characteristics of the patient with normative data to determine in what way the patient's EEG deviates from normality and to discriminate among psychiatric disorders. Nowadays, QEEG is far superior to conventional EEG in its detection of abnormality and in its usefulness in psychiatric differential diagnosis. The abnormal findings of QEEG in various psychiatric disorders are also discussed.

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A Study of the Factor on Behavioral Change of the Psychiatric in-patient (정신과 입원환자의 행동변화에 영향을 주는 요소에 관한 연구)

  • 이소우;김태경
    • Journal of Korean Academy of Nursing
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    • v.14 no.2
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    • pp.84-92
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    • 1984
  • This article examined relationships between selected variables, such as demographic background, care, treatment variables, environmental characteristics, and patient's daily behavior and mood change. Relationship were determined between independent variabltherapeutic-rapeutie approach, demographic data, environmental management approach-,and dependent variable-patient's daily behavioral and mood change. 35 patients selected within some criteria in a psychiatric ward, were obserbed during 5 weeks by use of Wyatt's Behavior & Mood Rating Scale ac-cording to the object of the study. At the same time, the frequence of the care and treatment were collected. Criteria for sample selection and independent variables as an influential factor to the patient behavioral change, based on a literature revienw and clinical experiences. Pearson's correlation and multiple regression analysis were used to determine the influfntial factors to the patient behavioral change. Systematic reading (r=.8324), Psychiatrist's individual interview (r=.5764), tranquilizer (r=.3441) and hospitalization processing date (r=.4143) were related with patient's behavioral change. That is these 4 variables can be said to influence to the patient's behavior and mood. A stepwise multiple regression analysis of the effect of the independent varibles of systematic reading, psychintrists individual interview, tranquilizer and hospitalization processing date on the dependent variable, patient's behavioral change was carried out. Systematic reading with on R²of. 69 revealed to be the main influential factor to the patient's behavior and mood change, as the next factor psychiatrist individual interview. A total inclusion of these factors revealed a 73% prediction for the patient's behavior and mood change. But the most influential factor was the interaction of the systematic reading and psychiatrist's individual interview.

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A Study of Anxiety of Families of Psychiatric Patients at Discharge (정신과 환자 퇴원시 가족들이 느끼는 불안에 관한 연구)

  • 김기숙
    • Journal of Korean Academy of Nursing
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    • v.7 no.2
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    • pp.31-42
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    • 1977
  • This study investigated the anxiety of families of psychiatric patients at discharge. The purpose was to contribute to the improvement of psychiatric nursing care, rehabilitation and social adjustment of psychiatric patients and community mental health. The objectives of this study were to identify the acceptance of the psychiatric nurse by the families, their anxiety at the time of discharge, whether any help was wanted to reduce anxiety, the attitude toward the patient after discharge and feelings about the patients. The population studied consisted of 180 family members of patients from 10 mental hospitals (including local clinic) in Seoul and Kyung- Ki province, from March I to April 30, 1977. The date were collected by an interview schedule, and compared and analysed by Computer usings х$^2$- test. Results were as follows : 1. Many of the families(83.6%) expressed a acceptance of psychiatric nurse. 2. A little more than half of the families(51.1%) expressed happiness but a largo portion (38.9%) had "anxious" feelings at discharge. 3. Almost all families(92.6%) wanted a physician′s help to reduce discharge anxiety. Younger families tended to want the physician′s help more. 4. Many of the families(83.1%) wanted a nurse′s help. Families of parents patients admitted for the 1 st time wanted the nurse′s help more. 5. Comparing the feelings at a previous discharge with the present discharge, 49.1% of the family expressed greater happiness at tile latter than the former. 6. More than half the families responded positively toward the patient. Unmarried family members responded more positively than married Families of 1 st admission patients responded more positively than families of readmission patients. 7. Many families(78.8%)had positively feelings toward the patients. More negative responses came from women than from men, from lower education levels, lower incomes and readmission patients.

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Predictors of Posttraumatic Stress in Psychiatric Nurses (정신과 병동 간호사의 외상 후 스트레스 영향요인)

  • Yeo, Hyun Ju
    • Korean Journal of Occupational Health Nursing
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    • v.26 no.3
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    • pp.125-132
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    • 2017
  • Purpose: This study was performed to identify the impact of aggressiveness of patients and a sense of coherence on posttraumatic stress in psychiatric nurses. Methods: After collecting data from 162 psychiatric nurses, we carried out a t-test, ANOVA, Pearson's correlation coefficient, and multiple regression using IBM SPSS Statistics 19.0. Results: The mean score of posttraumatic stress was $20.75{\pm}16.59$ points. Verbal aggression, aggressiveness about property, aggression toward oneself, and aggression toward others had a positive correlation with posttraumatic stress, while a sense of coherence had a negative correlation with post-traumatic stress. It was concluded that the significant predictors of posttraumatic stress in psychiatric nurses were aggression toward oneself, a sense of coherence, and aggression toward others, all of which accounted for 38.9% of the variability. Conclusion: The results of this study indicate that the factors influencing posttraumatic stress in psychiatric nurses were aggression toward oneself, aggression toward others, and a sense of coherence. Therefore, education programs should be developed in consideration of the fact that aggressive behavior against the patient himself and against others intensify the posttraumatic stress of the psychiatric nurse, but the integration force mitigates it.

Effects of a Psychiatric Nursing Clinical Practice Program Using Situation-Oriented Case-Based Learning: A Qualitative Study

  • Lee, Sowon;Kim, Boyoung
    • International Journal of Advanced Culture Technology
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    • v.10 no.3
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    • pp.210-219
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    • 2022
  • Psychiatric nursing is a specialty where nursing students experience many difficulties in applying what they have learned in theory to clinical practice. Therefore, a situation-oriented case-based strategy is required to help them overcome the limitations of psychiatric nursing clinical practice and reduce their burden. This study aimed to measure the effectiveness of a psychiatric nursing clinical practice program using situation-oriented case-based learning. Participants comprised 63 nursing students in psychiatric nursing classes. The students were asked to create a scenario of interaction between a nurse and patient based on a case study. Empathy, therapeutic communication ability, and attitudes toward mental illnesses were measured. We analyzed the effectiveness of the program by comparing changes in the nursing students' empathy, therapeutic communication ability, and attitude toward mental illness after the program. The participants showed significant increases in empathy and therapeutic communication abilities. However, there were no significant changes in attitudes toward mental illnesses. Based on the results of this study, it is expected that situation-based learning will be effective for students who have difficulties in certain aspects, such as COVID-19, or where there are limited clinical practice opportunities, such as psychiatric nursing.

Psychosomatic Approach to Plastic Surgery (성형수술의 정신신체의학적 접근)

  • Hwang, Kun
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.3-9
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    • 1999
  • Abnormal external appearance may cause psychiatric trauma or problem in social adaption. The plastic surgeons should consider the patient's quality of life, and their roles are correcting psychiatric and emotional trauma as well as external appearance which help the patient adapting social life. Because the patients in plastic surgery have higher level of expectation for the result of their operation, it is necessary for the surgeons to explain precisely the procedure and possible complications precisely at preoperative meeting and to maintain the good doctor-patient relationship at postoperative follow-up period. In case if the patient dissatisfy the postoperative result, it is recommended to listen the second opinion from another plastic surgeon. If the patient still dissatisfy, then the patient should be consulted to psychiatrist.

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A Study on Nurses한 and Patients한 Perceptions of Psychotropic Medication (향정신성 약물치료에 대한 간호사와 환자의 지각 비교 연구)

  • 이평숙
    • Journal of Korean Academy of Nursing
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    • v.24 no.1
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    • pp.47-57
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    • 1994
  • The purpose of this study was to examine nurses’ perceptions of medication treatment for psychiatric patients and to compare these perceptions with the perceptions held by the patients. The methodology used in this study was a descriptive design with semi-structured and open-ended interviews. This study used a convenience sample of 112 nurses who worked in, and 209 patients who were under psychiatric treatment, in four hospitals attached to a university and one national mental hospital in the city of Seoul. The collected data were analyzed by SAS, using percentages for descriptive purposes, and t-test or x$^2$ for comparing the variables. The results were as follows : 1. There was no significant differences between nurses’ and patients’ perceptions on the extent to which patients complied with their medication treatment. Generally speaking, the mean compliance scores for both nurses and patients was high(nurse : (equation omitted)=3.70, Patient : (equation omitted)=3.76). 2. There was a significant difference in nurses’ and patients’ perceptions on the reasons why patients do not take medication. The nurse group indicated that the patients did not take medication because of the “worry about side effects or habituation(49.53%)”, “boredom from long-term use of medication(26.17%)” and “distrust toward medical staff(12.15% )”, but the patient group indicated that they “did not want to be dependent on medication (25%)”, “forgot to take medication(19.7%) and “worried about side effects or habituation(15.91%). 3. As for the necessity of medication, both groups showed some different responses. Even though both groups were aware of the necessity of taking medication, the patient group(21.53%) showed a more negative response. As (or the effects of medication, both groups (nurses and patients ) showed positive responses. However, the nurse group showed a higher positive response (91.07% ) than the patient group(74.16%), 5. Both the patient and nurse group indicated that the most helpful element for the patient’s life under psychiatric treatment was interviews and conversations with therapists and nurses. However, the nurse group showed a higher response(70.15%) than the patients group(47.15%). According to the patient group, family support for the patient was another important factor for psychiatric treatment and daily struggles. In conclusion, as there were differences between the perception of nurses and patients, the nurse must consider the patients’ subjective perceptions first. They should also revaluate their false belief and prejudice concerning the patients’ perceptions. Such information can provide a base to be applied by the nurses in devloping effective mutual relationships with patients which can in turn help in compliance with medication regimen. As it was confirmed that medication was the most important factor in the patients’ recovery, a thorough education program on the therapeutic effect of medication and the necessity of their continued use after discharge is also needed.

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Intravenous Patient-controlled Analgesia Has a Positive Effect on the Prognosis of Delirium in Patients Undergoing Orthopedic Surgery

  • Heo, Dae Young;Hwang, Byeong Mun
    • The Korean Journal of Pain
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    • v.27 no.3
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    • pp.271-277
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    • 2014
  • Background: Postoperative delirium is relatively common. However, the relationship between intravenous patient-controlled analgesia (IV-PCA) and delirium has not been thoroughly investigated. The aim of this study was to evaluate the effects of IV-PCA on the prognosis of postoperative delirium in patients undergoing orthopedic surgery. Methods: Medical records of 129 patients with postoperative delirium were reviewed. Patients were divided into two groups according to whether they used IV-PCA with fentanyl and ketorolac. The IV-PCA group consisted of 73 patients who were managed with IV-PCA; the NO-PCA group consisted of 56 patients who were managed without PCA. Results: Incidences of multiple psychiatric consultations and prolonged delirium were significantly lower in patients using IV-PCA with fentanyl and ketorolac than in those without PCA. Conclusions: We recommend the use of IV-PCA for pain control and management of delirium in patients with postoperative delirium.

Significant Variables Affecting Follow-up after Psychiatric Consultation in General Medical Units (정신과 자문이 의뢰된 내과 환자들의 추적치료 결정요인)

  • Lee, Sang-Kyu;Kim, Do-Hoon;Son, Bong-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.2
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    • pp.176-187
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    • 1998
  • This study was performed to identify the significant variables affecting Follow-up after psychiatric consultation in General medical units and the trends of psychiatric consultation at the Hallym University hospital in Chunchon. Subjects of this study were 107 patients from April 1, 1998 to August 31, 1998, who were referred for psychiatric consultation during hospitalization. The results were as follows ; 1) Referral rate of General medical units was 7.5% and ordered Gastroenterology, Cardiology, nephrology, Other part. 2) The rate of total follow-up was 58% and the rate of No-follow-up was 42%. 3) In the cases of referral timing over admission 8th days, the days hospitalized after consultation performed were lengthened, significantly. 4) Common reasons for no follow-up of consultation were 'early- discharge' and 'patient's unwillingness to psychiatric reconsult. 5) Significant variables affecting follow-up were 'treatment recommendation', 'concordance with psychiatric drug recommendation', 'concordance with laboratory recommendation', 'total days hospitalized', 'Days hospitalization after consult was performed' and 'referral reason'.

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Late avulsion of a free flap in a patient with severe psychiatric illness: Establishing a successful salvage strategy

  • Schaffer, Clara;Hart, Andrew;Watfa, William;Raffoul, Wassim;Summa, Pietro Giovanni di
    • Archives of Plastic Surgery
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    • v.46 no.6
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    • pp.589-593
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    • 2019
  • Post-traumatic defects of the distal third of the leg often require skipping a few steps of the well-established reconstructive ladder, due to the limited local reliable reconstructive options. In rare cases, the reconstructive plan and flap choice may encounter challenges when the patient has psychiatric illness affecting compliance with postoperative care. We describe a case of a patient with severe intellectual disability and an open fracture of the distal lower limb. After fracture management and debridement of devitalized tissues, the resultant soft tissue defect was covered with a free gracilis flap. On postoperative day 7, the patient ripped out the newly transplanted flap. The flap was too traumatized for salvage, so a contralateral free gracilis muscle flap was used. The patient showed good aesthetic and functional outcomes at a 1-year follow-up. When planning the postoperative management of patients with psychiatric illness, less complex and more robust procedures may be preferred over a long and complex surgical reconstruction requiring good compliance with postoperative care. The medical team should be aware of the risk of postoperative collapse, focus on the prevention of pain, and be wary of drug interactions. Whenever necessary, free tissue transfer should be performed despite potential compliance issues.