• 한국전문물리치료학회지
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• 제5권1호
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• pp.51-62
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• 1998

Conversion disorder is defined as a specific and enduring sensorimotor dysfunction that contradicts known neurological or musculoskeletal pathology or physical findings. The patient with conversion symptoms unconsciously adopts these symptoms to convert their psychological stress to a physical phenomenon. Conversion disorder often involves the mimicry of organic symptoms similar to those experienced by a relative or an acquaintance. Because conversion symptoms are produced by psychological stress, specific treatment strategy and reinforcement program are needed for treatment. Treatment comprises avoiding unnecessary medical tests and removing symptoms by using graded exercises given by physical therapists. Clinical therapists must maintain a continuous and detailed follow-up to completely recover from conversion symptoms. The goal of treatment is to emphasize health rather than disease, to resolve physical symptoms, and to prevent recurrence. This study looks into the case reports of 4 patients diagnosed with conversion disorder.

• 성인간호학회지
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• 제16권4호
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• pp.556-565
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• 2004

Purpose: According to Lazarus & Folkman (1984), appraising a stressor as a threat is associated with negative psychological and physical adjustment, whereas appraising a stressor as a challenge is positive psychological and physical adjustment. This study examined how cognitive appraisal of PTCA(heart disease threat and treatment appraisal) related to the cardiac risk reduction behaviors(smoking cessation, low salt and low cholesterol diet, regular exercise and stress management) 6 weeks following discharge. Method: Data were collected from 50 subjects with successful primary PTCA. Result: Heart disease threat was negative related to treatment appraisal (r=-0.240, p=0.046). Psychological well-being was negative related to heart disease threat (r=-0.317, p=0.012) and positive related to treatment appraisal(r=0.402, p=0.002). The cardiac risk reduction behaviors score was negative related to heart disease threat(r= -0.296, p=0.018) and positive related to treatment appraisal(r=-0.291, p=0.020). Conclusion: More negative appraisal was related to lower the cardiac risk reduction behaviors score. But more positive appraisal was related to higher the cardiac risk reduction behaviors score. So, there is a need to develop the cognitive-behavioral intevention that increase the coping strategy to replace with positive appraisal.

• 대한불안의학회지
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• 제20권2호
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• pp.65-71
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• 2024

Objective : This study aimed to establish a consensus on treatment strategies for psychological therapy in generalized anxiety disorder (GAD) as outlined in the 2024 Korean guidelines for treating GAD. Methods : The executive committee developed questionnaires on treatment strategies for patients with GAD based on previous treatment guidelines and academic articles published internationally and in Korea. Sixty-two experts responded to questionnaires developed. The consensus of expert opinions was classified into three categories (first-line, second-line, and third-line choices) using chi-square test and 95% confidence intervals. Results : Findings of this study suggest that individual cognitive behavioral therapy (CBT), group CBT, mindfulness-based cognitive therapy (MBCT), acceptance and commitment therapy (ACT), and applied relaxation are appropriate psychotherapies for GAD. Additionally, it is recommended to initiate CBT early when treating GAD, with eight treatment sessions being the most preferred for both individual and group CBT. Conclusion : This expert consensus survey reflected clinical experiences of Korean practitioners. Results of this study provide valuable insights for Korean clinicians when implementing psychotherapy for GAD.

• 디지털융복합연구
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• 제15권12호
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• pp.591-604
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• 2017

본 연구는 청소년 여자테니스 선수의 부적응적 사고 변화를 위한 합리적 인지재구성 프로그램의 개발, 적용 및 효과검증을 목적으로 하였다. 효과검증을 위한 질적분석으로 피험자의 심리적 문제를 파악하여 REBT 상담절차를 진행하였고, 양적분석으로 청소년용 부적응적 사고척도, 스포츠 심리기술 질문지, 한국판 스포츠 수행전략 검사지를 사용하여 사전-사후 검사를 실시하였다. 그 결과 REBT 상담기법을 적용하여 개인의 심리적 문제를 파악하고 부적응적 사고와 비합리적 신념을 합리적 신념으로 전환되었으며, 경기력 향상은 물론 전인적인 성장에 긍정적 영향을 미치는 것으로 나타났다. 또한 청소년용 부적응적 사고척도, 스포츠 심리기술 질문지, 한국판 수행전략 검사지에서 긍정적으로 변화된 것으로 나타났다. 이러한 연구 결과를 통해 청소년기 선수들의 다양한 심리적 문제들을 심층적으로 다루어 주는 상담이 진행된다면 선수들의 경기력 향상은 물론 인격 성장과 발달에 있어 자아실현에 도움이 될 수 있을 것으로 기대한다.

• 대한의생명과학회지
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• 제27권1호
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• pp.28-34
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• 2021

The main cause of cervical cancer is a persistent infection with high-risk human papillomavirus (HR-HPV). Cervical cancer is reported as a preventable cancer in more than 80% of cases with early diagnosis and appropriate treatment. Papanicolaou test (Pap test) has been a global strategy to prevent cervical cancer, and recently, HPV test has been reported to be effective against cervical cancer and precancerous lesions. However, pelvic examinations give patients anxiety, discomfort, pain, distress, and psychological stress. HPV test via a urine sample caused less physical and psychological stress and more advantage than the Pap test. Therefore, it is necessary to study the usefulness of the HPV test for easy-to-collect urine samples. A total of 220 samples were collected from a pair of cervical and urine samples from 110 women and only 108 pairs of samples out of 110 were used because 2 cases were not amplified by β-globin. Among 108 pairs of cervical and urine samples, the prevalence of HPV was 37.0% (40/108) in cervical samples, 34.3% (37/108) in urine samples and HR-HPV was 22.2% (24/108) in cervical samples, 18.5% (20/108) in urine samples. In this study, urine samples showed a lower positive rate of HPV than cervical samples. There were many variables that could affect the condition of the urine sample. However, the HR-HPV agreement rate of the cervix and urine samples was 94.44% and the Kappa value was 0.823, which was "almost perfect". Through these results showed the significance of cervical cancer screening using a urine sample. Cervical screening is crucial, as cervical cancer can be prevented in more than 90% of cases. Urine samples collected by non-invasive methods may have the potential advantage of increasing acceptance of cervical cancer screening. Therefore, it is necessary to develop a new cervical cancer screening strategy using urine samples through further study based on the results of this study.

• The Korean Journal of Pain
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• 제31권3호
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• pp.155-173
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• 2018

Chronic postsurgical pain (CPSP) is an unwanted adverse event in any operation. It leads to functional limitations and psychological trauma for patients, and leaves the operative team with feelings of failure and humiliation. Therefore, it is crucial that preventive strategies for CPSP are considered in high-risk operations. Various techniques have been implemented to reduce the risk with variable success. Identifying the risk factors for each patient and applying a timely preventive strategy may help patients avoid the distress of chronic pain. The preventive strategies include modification of the surgical technique, good pain control throughout the perioperative period, and preoperative psychological intervention focusing on the psychosocial and cognitive risk factors. Appropriate management of CPSP patients is also necessary to reduce their suffering. CPSP usually has a neuropathic pain component; therefore, the current recommendations are based on data on chronic neuropathic pain. Hence, voltage-dependent calcium channel antagonists, antidepressants, topical lidocaine and topical capsaicin are the main pharmacological treatments. Paracetamol, NSAIDs and weak opioids can be used according to symptom severity, but strong opioids should be used with great caution and are not recommended. Other drugs that may be helpful are ketamine, clonidine, and intravenous lidocaine infusion. For patients with failed pharmacological treatment, consideration should be given to pain interventions; examples include transcutaneous electrical nerve stimulation, botulinum toxin injections, pulsed radiofrequency, nerve blocks, nerve ablation, neuromodulation and surgical management. Physical therapy, cognitive behavioral therapy and lifestyle modifications are also useful for relieving the pain and distress experienced by CPSP patients.

• 근관절건강학회지
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• 제8권2호
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• pp.250-261
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• 2001

Alternative therapy for rheumatoid arthritis has become worldwide phenomenon this decade without scientific validation. This study was undertaken to explore the prevalence, patterns of use, and perceived efficacy of alternative therapies by patients attending a rheumatology clinic. We conducted a crossectional survey of 142 RA patients with structured questionnaire at outpatient rheumatic clinic from July to August in 2001. Results of this study were summarized as follows : 1. 85.9% of subjects were woman. Mean age was 49.97years, duration of rheumatoid arthritis was 5.6years. Mean pain score was 5.29cm. 2. 74.6% of subjects perceived rheumatoid arthritis as a controllable disease. 31% of patients combined medical treatments with alternative therapies. 58.5% of patients perceived that combining medical treatments with alternative therapies is the most effective strategy in controlling disease. 3. 77.5% had used more than one alternative therapy since the diagnosis was made. The major reason of discontinuation of use was no effect for the treatment of their disease. 4. 34.5% were currently using an alternative therapies and 50.9% were going to use alternative therapies in future. 5. 42.7% reported that alternative therapies was effective and only 3.6% reported side effects. 6. The perceived effect score was 3.14cm in general expecially the physiological score 2.91cm, psychological score 4.16cm. In conclusion, our results demonstrate a high use of alternative therapies by rheumatoid arthritis patients. And the perceived effect score of physiological aspect was not higher than one of psychological aspect. Therefore it should be considered in education program for the use of alternative therapies.

• 사상체질면역의학회지
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• 제26권2호
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• pp.156-164
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• 2014

Objectives The purpose of this study was to analyze the Sasang constitution and psychological traits of amyotrophic lateral sclerosis (ALS) patients and to utilize the results in treatment and management. Methods The differences of Sasang Constitution distribution, psychological characteristics, comorbid disorders between ALS group of 26 patients and general group of 1132 persons were investigated and analyzed. Results There was no significant different distribution of Sasang Constitution between ALS group and general group but there was Yang-like personality tendency in ALS group than general group. In overall constitution, ALS group had the high prevalence rate of musculoskeletal disorders and diabetes than general group. In Soyangin constitution, ALS group had a high prevalence rate of musculoskeletal disorders than genral group. In Taeeumin constitution, ALS group had a high prevalence rate of diabetes and hypertension than general group. Conclusion ALS patients have the Yang-like personality. It is due to the adaptation of personality on the environmental change or coping strategy on diseases rather than the characteristics of congenital Sasang Constitution.

• 보건교육건강증진학회지
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• 제23권4호
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• pp.47-65
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• 2006

Objectives: This research is to provide the basic data for the improvement on oral health by examining the relationship between the dental fear and the dental service utilization, and to discuss a strategy for dental health in order to lower the level of dental fear. Methods: Data were collected by conducting a structured survey of 1,607 people between the age of 13 and 70 who have experiences in visiting a dental institution. Both univariate and multivariate analyses were employed to analyze the relationship between the number of times dental service and dental fears. Results: The average level of dental fear the respondents reported was $52.16{\pm}15.71$ and 31.5% of the response was at the level of high dental fear. A strong physiologic response during the dental treatment was muscle tension and the stimulations that strongly arouse the dental fear were the anaesthetic needle and the sound of drill. A result of analysis on the relationship between the dental fear and the dental service utilization shows that as the level of dental fear became higher, the number of times for the dental service utilization for the last year had reduced. Also when a patient has an experience of putting off or canceling an appointment due to dental fear and as a physiologic response during the dental treatment became stronger, the result shows a tendency that the number of times for the dental service utilization for the last year had reduced. Conclusions: It has been observed that dental fear is one of the main barrier to use dental service. Therefore, a physio-psychological factor like the dental fear should be included in the task of promotion of dental health, and in analyzing the dental service utilization behavior. A discussion about how to lower dental fear was made with respect to oral health promotion. At individual level, improvement of communication skill by dental service providers should be made with rearrangement of clinic environment into more cozy one.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제11권2호
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• pp.252-261
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• 2000

목 적：만성 신체 질환 아동의 우울, 자기 개념 및 스트레스에 대한 지각과 대처 양상에 대해 알아보고자 하였다. 방 법：연구 대상자는 서울대학교 병원 어린이 병원에 입원해 있거나 외래에 다니는 환아 13명과 정상아동 13명으로 구성되었다. 만성 질환 아동군은 Schiffer 등(1963)이 만성 환자군으로 정의한 조작적 정의에 근거하여 최소한 3개월 이상 질환을 앓고 있거나 앓았던 적이 있으며, 현재도 그 질환으로 인해 지속적인 치료를 받고 있는 정형외과, 소아과 아동을 대상으로 하였다. 정상 아동군은 그러한 병력이 없는 아동 13명을 대상으로 하였다. 검사 도구는 피어스-해리스 자기 개념 척도, 소아 우울 척도, 투사적 검사(나의 기분을 색으로 표현하기, 다른 사람으로 인한 나의 기분을 색으로 표현하기, 비속의 아이)를 실시하였다. 결 과：만성 질환 아동군과 정상 아동군을 비교한 결과, 만성 질환 아동군이 소아 우울 척도에서 유의미하게 높은 점수를 보였으며, 자기 개념 척도에서는 보다 유의미하게 낮은 점수를 보였다. 또한 자기 개념 척도의 하위 항목인'인기도' 및 '학습 상태'에서 유의미하게 점수가 낮았다. 투사 과제의 경우,'색으로 표현하기' 과제에서는 집단간의 유의한 차이를 보이지 않았으나, 스트레스에 대한 지각 및 대처를 평가하는 '비속의 아이' 과제에서는 하위 항목(비의 양, 기간, 도구, 효율성) 모두에서 집단간의 차이를 보였다. 비속의 아이 과제와 우울 점수, 자기 개념 점수와의 상관 계수를 구한 결과, '비가 오는 기간' 항목이 우울 점수와는 정적 상관을, 자기 개념 점수와는 높은 부적 상관을 보였다. 결 론：만성 질환 아동군이 정상 아동군 보다 더 우울하며, 자기 개념이 더 부정적이었다. 또한, 이들이 지각하는 스트레스는 상당히 지속적이고 장기적이며, 이에 대해 대처할 수 있는 스스로의 능력이나 전략을 사용하는 데 있어서는 매우 무기력한 것으로 나타났다. 이러한 결과는 만성적인 신체 질환이 아동의 정신 건강 및 심리적 적응에 있어서 위험 요인이 될 수 있음을 시사해 준다.