• Journal of Korean Academy of Nursing
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• v.12 no.2
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• pp.1-26
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• 1982

The main purpose of this study was to test the effect of the structured information on the sleep amount of the patients undergoing open heart surgery. This study has specifically addressed to the Following two basic research questions: (1) Would the structed in formation influence in the reduction of sleep disturbance related to anxiety and Physical stress before and after the operation? and (2) that would be the effects of the structured information on the level of preoperative state anxiety, the hormonal change, and the degree of behavioral change in the patients undergoing an open heart surgery? A Quasi-experimental research was designed to answer these questions with one experimental group and one control group. Subjects in both groups were matched as closely as possible to avoid the effect of the differences inherent to the group characteristics, Baseline data were also. collected on both groups for 7 days prior to the experiment and found that subjects in both groups had comparable sleep patterns, trait anxiety, hormonal levels and behavioral level. A structured information as an experimental input was given to the subjects in the experimental group only. Data were collected and compared between the experimental group and the control group on the sleep amount of the consecutive pre and post operative days, on preoperative state anxiety level, and on hormonal and behavioral changes. To test the effectiveness of the structured information, two main hypotheses and three sub-hypotheses were formulated as follows; Main hypothesis 1: Experimental group which received structured information will have more sleep amount than control group without structured information in the night before the open heart surgery. Main hypothesis 2: Experimental group with structured information will have more sleep, amount than control group without structured information during the week following the open heart surgery Sub-hypothesis 1: Experimental group with structured information will be lower in the level of State anxiety than control group without structured information in the night before the open heart surgery. Sub-hypothesis 2 : Experimental group with structured information will have lower hormonal level than control group without stuctured information on the 5th day after the open heart surgery Sub-hypothesis 3: Experimental group with structured information will be lower in the behavioral change level than control group without structured information during the week after the open heart surgery. The research was conducted in a national university hospital in Seoul, Korea. The 53 Subjects who participated in the study were systematically divided into experimental group and control group which was decided by random sampling method. Among 53 subjects, 26 were placed in the experimental group and 27 in the control group. Instruments; (1) Structed information: Structured information as an independent variable was constructed by the researcher on the basis of Roy's adaptation model consisting of physiologic needs, self-concept, role function and interdependence needs as related to the sleep and of operational procedures. (2) Sleep amount measure: Sleep amount as main dependent variable was measured by trained nurses through observation on the basis of the established criteria, such as closed or open eyes, regular or irregular respiration, body movement, posture, responses to the light and question, facial expressions and self report after sleep. (3) State anxiety measure: State Anxiety as a sub-dependent variable was measured by Spi-elberger's STAI Anxiety scale, (4) Hormornal change measure: Hormone as a sub-dependent variable was measured by the cortisol level in plasma. (5) Behavior change measure: Behavior as a sub-dependent variable was measured by the Behavior and Mood Rating Scale by Wyatt. The data were collected over a period of four months, from June to October 1981, after the pretest period of two months. For the analysis of the data and test for the hypotheses, the t-test with mean differences and analysis of covariance was used. The result of the test for instruments show as follows: (1) STAI measurement for trait and state anxiety as analyzed by Cronbachs alpha coefficient analysis for item analysis and reliability showed the reliability level at r= .90 r= .91 respectively. (2) Behavior and Mood Rating Scale measurement was analyzed by means of Principal Component Analysis technique. Seven factors retained were anger, anxiety, hyperactivity, depression, bizarre behavior, suspicious behavior and emotional withdrawal. Cumulative percentage of each factor was 71.3%. The result of the test for hypotheses show as follows; (1) Main hypothesis, was not supported. The experimental group has 282 minutes of sleep as compared to the 255 minutes of sleep by the control group. Thus the sleep amount was higher in experimental group than in control group, however, the difference was not statistically significant at .05 level. (2) Main hypothesis 2 was not supported. The mean sleep amount of the experimental group and control group were 297 minutes and 278 minutes respectively Therefore, the experimental group had more sleep amount as compared to the control group, however, the difference was not statistically significant at .05 level. Thus, the main hypothesis 2 was not supported. (3) Sub-hypothesis 1 was not supported. The mean state anxiety of the experimental group and control group were 42.3, 43.9 in scores. Thus, the experimental group had slightly lower state anxiety level than control group, howe-ver, the difference was not statistically significant at .05 level. (4) Sub-hypothesis 2 was not supported. . The mean hormonal level of the experimental group and control group were 338 ㎍ and 440 ㎍ respectively. Thus, the experimental group showed decreased hormonal level than the control group, however, the difference was not statistically significant at .05 level. (5) Sub-hypothesis 3 was supported. The mean behavioral level of the experimental group and control group were 29.60 and 32.00 respectively in score. Thus, the experimental group showed lower behavioral change level than the control group. The difference was statistically significant at .05 level. In summary, the structured information did not influence the sleep amount, state anxiety or hormonal level of the subjects undergoing an open heart surgery at a statistically significant level, however, it showed a definite trends in their relationships, not least to mention its significant effect shown on behavioral change level. It can further be speculated that a great degree of individual differences in the variables such as sleep amount, state anxiety and fluctuation in hormonal level may partly be responsible for the statistical insensitivity to the experimentation.

• Annals of Clinical Neurophysiology
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• v.2 no.2
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• pp.70-80
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• 2000

Purpose : This study was performed to evaluate the antistress effects of two aromatic blends being composed of synergic essential oils and also to differentiate its effectiveness between two. Methods : The subject were 20(10 for men, 10 for women) for vital factors and another 20(10 for mem, 10 for women) for serum catecholamine. Vital factors(blood pressure, pulse), electroencephalograpy, psychological tests(SACL, STAI) and serum catecholamine were applied to the subjects. Results : 1. All two aromatic synergic blends revealed no significant differnce of vital factors after inhalation but stable conditions generally by lowering pulse and blood pressure after inhalation. 2. Both blends were significantly valuable in antianxiety and antistress effects statistically. There were no statistically difference between two blends. 3. There were no significant difference in all brain waves after inhalation of two blends but generally stable brain waves were seen in all areas. 4. There were antistress effects of both blends in accordance of decreased serum catecholamines after inhalation of both blends. There were no significantly difference between two blends statistically. Conclusion : Both two aromatic synergic blends reached effective antistress and antianxiety states after inhalation of each blends. There were no significant difference between two blends. Further studies about the effectiveness between the amount of aromatic essential oils and the duration of inhalation should be considered. Also clinical applications of these two aromatic synergic blending oils to develop the aromatic products would be affordable in the future.

• Anxiety and mood
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• v.7 no.2
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• pp.92-100
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• 2011

Objectives : The aim of this study was to investigate Post Traumatic Stress Disorder (PTSD)-related symptom severity, level of functional impairment and personality profiles between full-blown PTSD, partial PTSD and non-PTSD groups among 59 adolescent survivals from the Incheon fire disaster. Method : Using Short Screening Scale for DSM-IV PTSD, victims of the disaster were assigned to a full-blown PTSD group (n=18), a partial PTSD (n=22), or a non-PTSD group (n=19). Assessments included the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Impact of Event Scales (IES), the McBride's Degree of General Labor Loss, and the Korean Version of Temperament and Character Inventory (K-TCI). Results : Significantly severe PTSD symptoms (F=4.832, df=2, p<.05) and functional impairment (F=12.144, df=2, p<.01) were demonstrated by PTSD groups as compared to the non-PTSD group. Interestingly, full and partial PTSD did not differ in these comparisons. Similarly, the subtypes of PTSD did not differ with respect to personality profiles using the K-TCI ; however, personality profiles were sharply differentiated between the PTSD and non-PTSD group. Conclusion : Although high subject homogeneity and small sample size may limit the results of this study, the present results highlight the possibility of the underestimation as well as the insufficient, treatment and compensation of partial vs full PTSD.

• Journal of Oriental Neuropsychiatry
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• v.26 no.2
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• pp.103-116
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• 2015

Objectives: Medical students suffer from mental health and academic problems due to academic stress. We investigated academic stress and exhaustion along with psychological issues caused by medical education during the years in the School of Korean Medicine. Methods: Two hundred fifty-one university students from the School of Korean Medicine, Pusan National University, were asked to complete the Medical Stress Scale (MSS), Maslach Burnout Inventory-Student Survey (MBI-SS), Positive Affect and Negative Affect Schedule (PANAS), and State-Trait Anxiety Inventory (STAI) three times during each semester for two years from 2013 onwards. We analyzed the influence of school term and vacation on educational stress and negative affect with the T-test. The Pearson's correlation analysis and regression analysis were used to predict changes during the first semester or first years of study in the School of Korean Medicine. Results: Academic stress and burnout increased steadily until the first semester of third grade, which was measured with MSS and MBI-SS. The anxiety level was highest when the students started the first grade and it decreased significantly after the first semester. Negative affect repeatedly increased significantly after each school term; however, it reduced after each vacation. In the first grade, 19.5% of the last measure of MSS can be explained with the first measure of MSS. Discussion: This study extensively reviewed the trends and characteristics of four years of academic stress and its related psychological influence, and discussed its importance for developing a more efficient academic curriculum for traditional Korean Medicine.

• Journal of Oriental Neuropsychiatry
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• v.29 no.1
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• pp.35-46
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• 2018

Objectives: The aim of this trial is to evaluate the efficacy and safety of Yukwool-tang (Liuyu-tang) for the treatment of major depression in women by comparing the Yukwool-tang (Liuyu-tang)-treated group with the placebo-treated group and assessing the association of various biological factors related to depression through various outcome measures. Methods: This study is a single-center, randomized, double-blind, placebo-controlled, parallel-design clinical trial. The subjects to be selected are women between the ages of 19 and 65, and the registered subjects are to be randomly assigned to treatment with Yukwool-tang or the placebo control. The Yukwool-tang group will take 1 bottle of Yukwool-tang (30 mg) for 8 weeks, 3 times a day, before meals. The control group will take the placebo in the same way. The primary outcome to be examined will be the change between the total score after 8 weeks and the total score before the start of the study of the K-HDRS score. Secondary outcomes are assessed by the change in total score after 12 weeks of K-HDRS, K-HDRS remission rate, K-HDRS improvement rate, BDI-K, PITD, KSCL-95, ISI, STAI-K, EQ-5D, VAS, Emotional Stimulation Test, BDNF test, inflammatory cytokine and tumor necrosis factor test, intestinal microbiome test, dietary report and Beck's hopelessness scale. Results: This protocol has been approved by the IRB of Dunsan Korean Medicine Hospital of Daejeon University and is registered in the CRIS, and it is made public in advance to ensure transparency of the research process and conduct ethical clinical trials. Conclusions: Based on this protocol, when the trial is completed, its data can be used to access the validity and safety of Yukwool-tang for major depression in women, and it is also expected to be helpful in the study of the correlation between future treatment of Korean medicine for depression and related biological factors, and quality of life.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.9 no.2
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• pp.288-299
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• 2002

The patients with abdominal surgery usually have acute pain. It is important for a patient's qualify of life and for good recovery after surgery to control the postoperative pain. The purpose of this study is to identify the relationship between emotional state of preoperative patients and postoperative pain. The participants in this study were the 100 patients receiving abdominal surgery who received Intravenous Patient Controlled Analgesia (IV-PCA) at the end of the operation. The data were collected using questionnaires and the period of the data collection was from March to August, 2001. The instruments used for this study were The State-Trait Anxiety Inventory (STAI) Developed by Spielberger (1972), The Center for Epidemeologic Studies-Depression (CESD) scale and Visual Analog scale (VAS). The data were analyzed using descriptive statistics. t-test, ANOVA and Pearson Correlation coefficient with the SPSS program. The results are as follows. 1. For general characteristics there were significant differences in the degree of trait anxiety according to gender (p= 0.0010), marital status (p=0.0122), religion (p=0.0040), education (p=0.0001), occupation (p=0.0002). monthly income (p=0.0001), diagnosis (p=0.0001), and operation title (p = 0.0001). 2. For general characteristics there were significant differences in the degree of state anxiety according to gender (p= 0.0023), education (P=0.0073), monthly income (p=0.0001), diagnosis (p=0.0005), and operation title (P =0.0063). 3. For general characteristics there were significant differences in the degree of depression according to gender (p= 0.0073), occupation (p=0.0469), monthly income (p=0.0001), diagnosis (p=0.012). and operation title (p =0.0033). 4. For general characteristics there were significant differences in the degree of postoperative pain according to gender (p=0.0213), marital status (p=0.0082), education (p=0.0016), occupation (p =0.0128). monthly income (p=0.0008), diagnosis (p =0.0007), and operation title (p =0.0008). 5. The relationship between trait anxiety and postoperative pain revealed a significant positive correlation (r =0.51, p =0.0001), and the relationship between state anxiety and postoperative pain revealed a significant positive correlation (r=0.50. p=0.0001) and the relationship between Depression and pain revealed a significant positive correlation (r =0.49. p =0.0001).

• Korean Journal of Psychosomatic Medicine
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• v.18 no.1
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• pp.30-39
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• 2010

Objectives：Assessment of sleep disturbance is an essential part of the diagnostic criteria used for several psychiatric disorders. Change in sleep patterns over time may indicate response to treatment. In clinical practice, sleep is usually evaluated subjectively by patient self-report. This study was aimed to compare subjective sleep assessment with objective sleep measurement by actigraphy in psychiatric inpatients. Methods：A total of 32 psychiatric inpatients were studied. Patients were asked to wear a wrist actigraphy for three consecutive days and nights and to fill out a sleep log each morning. The severity of depression and anxiety was evaluated according to Beck Depression Inventory and State-Trait Anxiety Inventory on the first day of the study. The subjective level of satisfaction with quality of sleep was also evaluated according to visual analog scale. Nurses assessed sleep at one hour interval between 10:00 PM and 6:00 AM for three consecutive nights. Results：There was statistically significant difference of sleep latency between patient's sleep log and acti-graphic measurement. Nursing reports were more consistent with actigraphic measurement than sleep log. Interestingly, subjectively poor sleepers show no significant difference in sleep parameters compared with those of good sleepers. Subjectively poor sleepers report longer sleep latency than that of actigraphic assessment. The discrepancy between subjective and objective assessment of sleep latency was significantly correlated with scores of Beck Depression Inventory and State-Trait Anxiety Inventory. Conclusion：These results show that there are discrepancies between subjective and objective assessment of sleep. The discrepancy of sleep assessment could be influenced by severe depression and anxiety. Especially objective sleep measurement is needed to assess sleep in psychiatric inpatients with severe depression or anxiety and the subjectively poor sleepers for more reliable measurements.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.1
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• pp.83-93
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• 2016

Objectives : The Center for Epidemiologic Studies Depression scale-Revised is a recently revised scale which has been reported as a valid tool for the assessment of depressive symptoms. It encompasses cardinal symptoms of depression described in the Diagnostic and Statistical Manual of Mental disorders, fourth edition. In this study, we assessed the reliability, validity and psychometric properties of the Korean version of the CESD-R(K-CESD-R). Methods : Forty-eight patients diagnosed as major depressive disorder, dysthymia, depressive disorder NOS according to the DSM-IV criteria using Mini International Neuropsychiatric Interview and 48 healthy controls were enrolled in this study. They were assessed with K-CESD-R, K-MADRS, PHQ-9, KQIDS-SR, STAI to check cross-validation. Statistical analyses were performed using calculation of Cronbach's alpha, Pearson correlation coefficient, Principal Component Analysis, ROC curve and optimal cut-off value. Results : The Cronbach's alpha of K-CESD-R was 0.98. The total score of K-CESD-R revealed significantly high correlations with those of K-MADRS, PHQ-9, KQIDS-SR(r=0.910, 0.966 and 0.920, p<0.001, respectively). Factor analysis showed two factors account for 76.29% of total variance. We suggested the optimal cut-off value of K-CESD-R as 13 according to analysis of the ROC curve which value sensitivity and specificity both equally. Conclusions : These Results showed that the K-CESD-R could be a reliable and valid scale to assess depressive symptoms. The K-CESD-R is expected as a useful and effective tool for screening and measuring depressive symptoms not only in outpatient clinic but also epidemiologic studies.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.2
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• pp.145-156
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• 2004

Objectives : Internet addiction is a newly appeared addictive phenomenon that is defined as 'difficulty in real life due to internet over-use', 'excessive time spent on the internet or replacement of genuine real relationships with superficial virtual ones' or 'weakness in self-control about internet use and if discontinued, fallen in psychological confusion and anergic state'. This study was aimed to compare the internet addiction rate, demographic factors, computer using patterns, anxiety, depression, and internet self-efficacy and outcome expectancy between Korean middle and high school students in three areas - Seoul, Cheonan, and Rural areas - that were different in economic, cultural, and geographic state. Methods : Subjects are consisted of middle and high school students in Seoul, Chunan, and Rural areas(N=1718). Self-rating questionnaire included demographic data, Korean Spielberger State-Trait Anxiety Inventory, Korean Self-Rating Depression Scale(SDS), questions for internet-using pattern, Korean version of Internet Addiction Scale invented by K. S. Young, Internet Self-efficacy and Out-come Expectancy Scale. Results: In this study, prevalence of internet addiction was 2.9%. There was no significant difference found in prevalence of internet addiction among three areas. In all subjects, there were significant differences in anxiety, depression, internet self-efficacy and outcome expectancy, leisure style, places of internet use, internet connecting method, and insight on internee addiction. But, in addicted group, there was no significant difference among three areas. Conclusion: This study suggested that the difference in economic, cultural, and geographic state was not related to prevalence of internet addiction. Although there were significant differences in anxiety, depression, self-efficacy associated with internee use, leisure style, places of internet use, internet connecting method, insight on internet addiction among three areas, there were no significant difference in addicted group among three areas. So, we concluded that the difference in economic, cultural, and geographic state did not influence the prevalence of internet addiction, and despite the difference in economic, cultural, and geographic state, people in three areas were equally influenced by internet addiction.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.2
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• pp.182-195
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• 2003

Background: Marriage is one of the major life events and the primary source of individual happiness and meaning of life. It is not possible to predict who will marry whom and which marriage will be successful. Marital adjustment has significant influences on an individual and relationship functioning and is associated with mental health. Good marital quality may imply good general relationship. There are several factors that correlate with or predict good marital quality. Especially individual personality factors may be a major factor in achieving and maintaining marital stability, satisfaction and happiness. The aim of the present study was to investigate the possible relationship between dyadic adjustment and personality dimensions in urban married women. Methods: Dyadic Adjustment Scale, Eysenck's Personality Questionnaire, Beck Depression Inventory and State-Trait Anxiety Inventory were administered to 215 married women. Data analysis was based on 170 women who provided reliable informations. The descriptive statistics of demographic data and 4 scales were obtained. Then the possible relationships between each data were tested by calculating Pearson's product moment correlations. To test the effects of depression and anxiety on dyadic adjustment, stepwise multiple regression analysis was done. Results: Age and length of marriage were negatively correlated with affectional expression and dyadic cohesion. Educational level was positively correlated with total dyadic adjustment score and dyadic satisfaction. Family income was positively correlated with total dyadic adjustment score, dyadic consensus, dyadic satisfaction and dyadic cohesion. Different family type showed different total dyadic adjustment score, dyadic satisfaction and dyadic cohesion. Psychoticism was negatively correlated with total dyadic adjustment score, dyadic consensus, dyadic satisfaction, affectional expression and dyadic cohesion. Neuroticism was negatively correlated with total dyadic adjustment score, dyadic consensus, dyadic satisfaction and affectional expression. Extraversion and lie were not correlated with any factors. Beck Depression Inventory and State-Trait Anxiety Inventory scores were negatively correlated with total dyadic adjustment score, dyadic consensus, dyadic satisfaction, affectional expression and dyadic cohesion. The result of multiple regression analysis indicated that psychoticism was correlated with dyadic adjustment. Conclusion: These results showed that the demographic factors such as age, length of marriage, educational level, family income and family type were significantly correlated with dyadic adjustment. Psychoticism and neuroticism measured by Eysenck Personality Inventory were significantly correlated with dyadic adjustment. But the correlations with extraversion and lie were not significant. Especially correlation between neuroticism and dyadic adjustment seemed to be mediated by emotional state such as depression and anxiety. These findings suggest that personality factors may be involved in marital relationship and that clinician must consider personality aspect in dealing with marital problems. Future study about differences between control group and psychiatric patient group will be needed.