• 제목/요약/키워드: Severe anxiety

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초등학교 2학년 어린이의 치과치료장면 그림에 투사된 치과불안도 (DENTAL ANXIETY OF SECOND GRADE ELEMENTARY SCHOOL CHILDREN PROJECTED IN THE DRAWING OF DENTAL TREATMENT SITUATION)

  • 김윤희;이광희;라지영;이동진
    • 대한소아치과학회지
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    • 제34권3호
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    • pp.390-397
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    • 2007
  • 어린이의 치과불안도를 측정하고자 전주와 익산 3개 초등학교 2학년 어린이 213명을 대상으로 치과치료장면을 그리게 하였고, 보조적으로 설문조사를 시행하였다. 수정된 Sheskin 방법에 의하여 그림을 분석하고 치과불안도(Dental Anxiety Scale, DAS) 점수를 산출하였다. 치과불안도의 점수별 분포는 최저치 0점과 최고치 6점 사이에서 2점이 29.1%로서 가장 많았고, 평균치는 2.00이었다. 치과치료 경험이 없는 어린이들의 치과불안도 평균 점수는 2.82로서 경험이 있는 어린이들의 점수 1.92보다 유의성 있게 높게 나타났다(P<0.05). 남아의 치과불안도 평균 점수는 2.00점, 여아는 1.99로서 유의한 차이는 없었다. 치과치료시 심한 공포를 경험한 어린이들의 비율은 8.2%이었고, 심한 동통을 경험한 어린이들의 비율은 5.6%이었다. 치과치료에 대해 약간 혹은 매우 부정적인 태도를 나타낸 어린이들의 비율은 19.9%, 치과의사에 대해 약간 혹은 매우 부정적인 태도를 나타낸 어린이들의 비율은 4.6%로서 치과의사보다 치과치료에 대해 보다 부정적인 태도를 나타냈다.

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Quality of Life and Psychological Well-Being of Breast Cancer Survivors in Jordan

  • Abu-Helalah, Munir;Al-Hanaqta, Motasem;Alshraideh, Hussam;Abdulbaqi, Nada;Hijazeen, Jameel
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권14호
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    • pp.5927-5936
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    • 2014
  • Introduction: Breast cancer is the most common cancer among Jordanians. Breast cancer patients suffer from several negative consequences after treatment and these include pain, fatigue, sexual problems, appearance and body image concerns, with psychological dysfunction. This could affect the patient quality of life and psychological well-being. To the best of our knowledge, there is no published quantitative data on the quality of life and psychological well-being of breast cancer patients in Jordan. The objective of this study was to obtain such data and assess predictors with calculated scores. Methods: In this cross-sectional study conducted among breast cancer patients in Jordan diagnosed in 2009 and 2010, assessment was performed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Breast Module (QLQ-BR23) and the Hospital Anxiety and Depression Scale (HADS). Clinical, demographic and psychosocial indicators that could predict patient quality of life scores were collected. Results: The number of patients interviewed was 236 (mean age=$50.7{\pm}10.7$ years). The mean Global Health score for the QLQ-C30 was $63.7{\pm}20.2$ SD. Among functional scales, "social functioning" scored the highest ($mean=78.1{\pm}28.6$ SD), whereas "emotional functioning" scored the lowest ($mean=59.0{\pm}SD\;33.5$). For the QLQ-BR23, the worst scores within the functional scales were for "body image" ($mean=52.1{\pm}36.8$ SD) and "future perspective" ($mean=52.9{\pm}38.5$ SD). The worst symptom was "upset by hair loss" ($mean=69.8{\pm}43.0$). The mean HADS scores was $18.{\pm}9.0$ SD. Out of study participants, 53% scored abnormal on the anxiety scale and 45% on the depression scale. Severe depression and severe anxiety were detected among 8% and 14% of study participants, respectively. Statistically significant predictors for individual scores were similar to those reported in published studies, such as the presence of recurrence since baseline, family history of cancer, low educational status, current social problems, extent of the disease, presence of financial difficulties, and employment status. Conclusions and Recommendations: Breast cancer survivors in Jordan have overall good quality of life scores when compared with patients from Western countries. However, their psychological wellbeing is more impaired. There is an urgent need for psychosocial support programs and psychological screening and consultation for breast cancer patients at hospitals of the Ministry of Health in Jordan.

만성폐색성 폐질환 환자에서의 내장신경차단중 발생한 급성호흡부전 (Acute Respiratory Failure during Splanchnic Nerve Block in COPD Patient)

  • 장원영;최근춘
    • The Korean Journal of Pain
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    • 제4권2호
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    • pp.200-204
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    • 1991
  • Neurolytic splanchnic nerve block is a relatively safe and effective method for the relief of intractable pain caused by upper abdominal cancer. We have experienced a case of severe acute respiratory failure during splanchnic nerve block under control of X-ray fluoroscopy. We think that the most likely cause of the acute respiratory failure was an asthmatic attack due to anxiety and dyspnea from the injury or stimulation of the diaphragm and pleura in this case.

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지역사회 거주 기혼 여성의 요실금 중증도에 따른 불안, 우울 및 삶의 질 (Anxiety, Depression and Quality of Life of Married Women with Urinary Incontinence Living in the Community)

  • 송영신;홍성경;송주은;조혜경;손연정
    • 기본간호학회지
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    • 제14권4호
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    • pp.483-492
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    • 2007
  • Purpose: The purpose of this study was to compare anxiety, depression and quality of life according to the severity of urinary incontinence in married women. Method: The participants were 168 married women aged 30-65 years who experienced urinary incontinence. The data were collected from May to July, 2006 using a structured questionnaire. Frequencies, percent, means and standard deviation, t-test, ANOVA, $X^2-test$ and Scheffe test with SPSS win 14.0 program were used to analyze the data. Results: The distribution of urinary incontinence severity was mild 87.5%, or moderate 12.5%. Significant differences in the severity of urinary incontinence were found for the general characteristics of age, education level, having a job and having a spouse and for the obstetric characteristics of type of delivery, and menopause. Differences in the score for anxiety(t=-2.41, p=0.001) and quality of life(t=5.50, p<0.001) according to the severity of urinary incontinence were statistically significant. Conclusion: Women with moderate to severe urinary incontinence should be screened for psychosocial factors. Severity of urinary incontinence in married women negatively affects their quality of life. Further research is needed to determine factors predicting the quality of life for incontinent women.

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6.25 전쟁 당시 외상을 경험한 노인의 후유증상에 관한 예비연구 (Impacts of Trauma during the Korean War on Physical and Psychological Symptoms of Elderly ; Pilot Study)

  • 김대현;류성곤;김호찬;연병길;한창환
    • 대한불안의학회지
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    • 제5권2호
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    • pp.120-124
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    • 2009
  • Objectives : This pilot study examined the physical and psychological sequela of Korean War victims. Methods : Of 255 elderly who completed the Mini International Neuropsychiatric Interview (MINI), we selected 16 subjects who suffered severe traumatic experiences during the Korean War and met more than 2 specified symptoms of PTSD in DSM-IV-TR and 16 controls. Demographic characteristics, medical history including hypertension, diabetes mellitus, hypercholesterolemia and brain infarction, Geriatric Depression Scale, State-Trait Anxiety Inventory, suicide scale in MINI, and a scale for the assessment of somatic symptoms were compared between subjects with trauma experience and controls. Results : Subjects with trauma experience were more likely to have brain infarction and diabetes mellitus compared to control group. Depressive symptoms and suicidal risk were significantly higher in subjects with trauma experience than controls. Subjects with trauma experience showed significantly higher scores in Trait Anxiety scale and more complained of pain than controls. Conclusion : This study suggests that traumatic experience probably induce physical and psychological problem even 60 years later. Further studies are needed to confirm the results of this pilot study.

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Etifoxine for Pain Patients with Anxiety

  • Choi, Yun Mi;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • 제28권1호
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    • pp.4-10
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    • 2015
  • Etifoxine (etafenoxine, $Stresam^{(R)}$) is a non-benzodiazepine anxiolytic with an anticonvulsant effect. It was developed in the 1960s for anxiety disorders and is currently being studied for its ability to promote peripheral nerve healing and to treat chemotherapy-induced pain. In addition to being mediated by $GABA_A{\alpha}2$ receptors like benzodiazepines, etifoxine appears to produce anxiolytic effects directly by binding to ${\beta}2$ or ${\beta}3$ subunits of the $GABA_A$ receptor complex. It also modulates $GABA_A$ receptors indirectly via stimulation of neurosteroid production after etifoxine binds to the 18 kDa translocator protein (TSPO) of the outer mitochondrial membrane in the central and peripheral nervous systems, previously known as the peripheral benzodiazepine receptor (PBR). Therefore, the effects of etifoxine are not completely reversed by the benzodiazepine antagonist flumazenil. Etifoxine is used for various emotional and bodily reactions followed by anxiety. It is contraindicated in situations such as shock, severely impaired liver or kidney function, and severe respiratory failure. The average dosage is 150 mg per day for no more than 12 weeks. The most common adverse effect is drowsiness at the initial stage. It does not usually cause any withdrawal syndromes. In conclusion, etifoxine shows less adverse effects of anterograde amnesia, sedation, impaired psychomotor performance, and withdrawal syndromes than those of benzodiazepines. It potentiates $GABA_A$ receptor-function by a direct allosteric effect and by an indirect mechanism involving the activation of TSPO. It seems promising that non-benzodiazepine anxiolytics including etifoxine will replenish shortcomings of benzodiazepines and selective serotonin reuptake inhibitors according to animated studies related to TSPO.

자살생각을 해 본 청소년의 자살계획 관련요인 (Factors related to Suicidal Planning among Adolescents who had Suicidal Ideation)

  • 이지선;박창승
    • 한국학교보건학회지
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    • 제35권2호
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    • pp.57-64
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    • 2022
  • Purpose: Adolescent suicide is an important issue worldwide. Although literature on preventing suicide among adolescents tends to focus on suicidal ideation, suicidal planning is also an important issue as a stage leading to suicidal behavior. This study aims to identify suicidal planning-related factors, including generalized anxiety disorder, among adolescents who had suicidal ideation. Methods: This secondary study used data generated from the 16th(2020) Korea Youth Risk Behavior Web-based Survey, which included 5,979 students who had suicidal ideation. Factors related to suicidal planning were identified by performing a logistic regression analysis of the participants. All analyses were performed using SPSS 27.0. Results: Among adolescents who had suicidal ideation, 23.8% had suicide plans. The suicidal plans were significantly related to school level (middle, OR=1.38, 95% CI=1.22~1.55), whether they were living with family (no, OR=1.36, 95% CI=1.06~1.75), perceived body image (normal, OR=1.23, 95% CI=1.05~1.44; Obese, OR=1.33, 95% CI=1.14~1.54), depression (yes, OR=1.47, 95% CI=1.25~1.72), tobacco use (yes, OR=1.31, 95% CI=1.12~1.54), alcohol use (yes, OR=1.21, 95% CI=1.06~1.38), drug use (yes, OR=1.96, 95% CI=1.44~2.66), and/or generalized anxiety disorder (severe, OR=1.76, 95% CI=1.44~2.14). Conclusion: The findings of the study suggest that in addition to the commonly recognized factors for adolescent suicide, generalized anxiety disorder should also be considered when establishing strategies to prevent suicide planning in adolescents who had suicidal ideation.

부부갈등이 청소년의 불안 및 학교적응에 미치는 영향 (The influence of parents conflict on youth's anxiety and school adaptation)

  • 민대기;최미경
    • Journal of the Korean Data and Information Science Society
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    • 제25권6호
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    • pp.1407-1418
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    • 2014
  • 우리나라 청소년들은 하루 중 대부분 시간을 학교에서 입시 위주의 교육으로 지낸다. 많은 시간을 학교에서 보내기 때문에 학교생활의 적응 여부는 청소년의 학업성취도 및 생활만족도와 관계가 있고 길게는 사회생활에까지 영향을 미치므로 그 중요성이 크다고 할 수 있다. 학교적응에 많은 영향을 미치는 요인 중의 하나로 청소년기의 심리적 불안을 고려해 볼 수 있다. 청소년의 가정환경은 불안에 영향을 미치는 주요 요인으로 알려졌으며, 그중 부부갈등이 가정환경에 미치는 영향력은 아주 크다고 할 수 있다. 가정에서 부부가 심하게 싸울수록 자녀는 분노, 슬픔, 걱정 등 부정적인 감정을 더 많이 느꼈으며, 부부갈등의 문제가 자녀 자신에 관한 내용일수록 그 정도는 더욱 심하게 나타났다. 본 연구는 이러한 이론적 배경을 근거로 부부갈등이 청소년의 불안과 학교적응에 어떻게 영향을 미치는가를 구조방정식 모형을 통하여 분석하였다. 분석결과 부부갈등 강도와 부부갈등 내용은 청소년의 불안감에 영향을 주었으며, 불안감은 학교 교우들과의 적응에 부정적인 영향을 미쳤다. 그러나 부부갈등 해결은 불안감에 영향을 미치진 않았지만, 학교 교우적응과 수업적응에 직접적으로 부정적인 영향을 미쳤다.

진행성 치성 감염병소에서 부적절한 진정요법과 국소마취 시행하 절개 배농술에 따른 과환기증 (Hyperventilation due to Incision & Drainage under Inadequate Psychosedation & Local Anesthesia in Advanced Odontogenic Infectious Lesion)

  • 오지현;손정석;유재하;김종배
    • 대한치과마취과학회지
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    • 제14권1호
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    • pp.63-71
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    • 2014
  • Extension of advanced odontogenic infection from deep neck fascial spaces into the mediastinum is heralded by chest pain, dyspnea, fever, and radiographic demonstration of mediastinal widening. The critical care should be done in a team approach by multiple medical and dental departments, such as, oral & maxillofacial surgery, otolaryngology, anesthesiology, chest surgery, and infection medicine. Especially, fluid & drug therapy, adequate incision & drainage and systemic supportive psychosedation care are important. But, acute hyperventilation can be produced by several distinct causes: severe anxiety, respiratory alkalosis, increased blood catecholamine levels, and a decrease in the level of the ionized calcium in the blood. The orofacial fears about acute pain, trismus, dysphagia, swelling and oral surgical treatment lead to the severe anxiety and increased blood catecholamine level by stress. Therefore, the most dental patient should be cared gently as the stress reduction protocol. In spite of the care, hyperventilation was occurred during psychosedation and local anesthesia for incision and drainage of the masticatory fascial space abscess with deep neck infection & mediastinitis. We suggest that the dental patient with advanced odontogenic infection must be attention for the manifestation of hyperventilation, especially in the medically compromised conditions.

입시병의 아형과 대처방안 (CLINICAL SUBTYPING AND TREATMENT STRATEGY OF COLLEGE ENTERANCE EXAMINATION STRESS SYNDROME)

  • 이영식;구영진;이길홍
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제2권1호
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    • pp.43-48
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    • 1991
  • 입시병이란 진로선택의 갈등이나 시험불안, 입시실패에 대한 예기불안이 복합적으로 작용하여 생긴 일종의 불안장애인데 입시 자체가 정신장애를 일으키기 보다는 입시라는 정신사회적 스트레스로 인해 내재해 있던 문제가 표면화되고 악화되는 것이다. 흔한 ${\cdot}$ 증상으로는 두통 피로 현기증 식용부진 시력장애 기억력장애 불면증등의 정신생리적 신체증상, 우울절망감, 불안등의 정서장애가 동반되며 심할 경우 잠재해 있던 정신병리가 활성화되어 정신증을 유발하는 등 다양한 형태의 복합적 증상을 나타낸다. 이외에 넓게 원인적 측면에서 볼 때 학업포기, 등교거부, 가출, 비행, 약물남용, 자살등의 청소년 문제를 야기시킨다. 임상에서 이러한 환자를 치료하는데 있어 수험생이라는 특수상황을 고려하여 되도록 단기간에 치료에 대한 저항을 줄이며 환자의 핵심문제를 파악하는 것이 치료의 관건이라 하겠다. 따라서 이러한 목적의 일환으로 임상양상에 따라 입시병을 1) 불안초조형, 2) 공허형, 3) 절망형, 4) 탈진형, 5) 권태형으로 분류하였으며 각 아형의 대표적 증례를 통하여 구체적 치료방안을 제시하였다.

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