• 제목/요약/키워드: State-Anxiety

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간세포암 환자의 증상군 분류와 타당도 검증 (Identification and Validation of Symptom Clusters in Patients with Hepatocellular Carcinoma)

  • 조명숙;권인각;김희선;김경희;류은정
    • 대한간호학회지
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    • 제39권5호
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    • pp.683-692
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    • 2009
  • Purpose: The purpose of this study was to identify cancer-related symptom clusters and to validate the conceptual meanings of the revealed symptom clusters in patients with hepatocellular carcinoma. Methods: This study was a cross-sectional survey and methodological study. Patients with hepatocellular carcinoma (N=194) were recruited from a medical center in Seoul. The 20-item Symptom Checklist was used to assess patients' symptom severity. Selected symptoms were factored using principal-axis factoring with varimax rotation. To validate the revealed symptom clusters, the statistical differences were analyzed by status of patients' performance status, Child-Pugh classification, and mood state among symptom clusters. Results: Fatigue was the most prevalent symptom (97.4%), followed by lack of energy and stomach discomfort. Patients' symptom severity ratings fit a four-factor solution that explained 61.04% of the variance. These four factors were named pain-appetite cluster, fatigue cluster, itching-constipation cluster, and gastrointestinal cluster. The revealed symptom clusters were significantly different for patient performance status (ECOG-PSR), Child-Pugh class, anxiety, and depression. Conclusion: Knowing these symptom clusters may help nurses to understand reasonable mechanisms for the aggregation of symptoms. Efficient symptom management of disease-related and treatment-related symptoms is critical in promoting physical and emotional status in patients with hepatocellular carcinoma.

산후 우울감을 보이는 산모에서 나타나는 전두엽 뇌파 비대칭에 대한 음악의 영향 (The Effects of Music on the Frontal EEG Asymmetry of the Mothers with Postpartum Blues)

  • 임성진;신철진
    • 생물정신의학
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    • 제18권3호
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    • pp.134-140
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    • 2011
  • Objectives Postpartum blues is known to be a major risk factor for postpartum depression and can be associated with the problems of language skills, behaviors or learning skills of their children. Therefore, it is very important for clinicians to evaluate precisely and control postpartum blues. Recent studies have found that music has an effect on depressive mood and the frontal EEG asymmetry of the patients with depression. The purpose of this study was to find out the effects of music on the frontal EEG asymmetry of the mothers with postpartum blues. Method Among one hundred and seventy mothers assessed with Korean version of the Edinburg Postnatal Depression Scale (EPDS), nine mothers with postpartum blues (EPDS ${\geq}$ 10) as postpartum blues group and nine non-depressive mothers (EPDS < 10) as non-depressive mother group were included. Ten non-labored, non-depressive women were also included as a normal control group. The subjects were evaluated with the State Trait Anxiety Inventory (STAI)-X1, the Visual Analogue Scale (VAS) and the Depression Adjective Checklist-Korean version (K-DACL) and EEG twice before and after the music sesssion with the length of twenty minutes and thirty two seconds. The statistical analyses were done for A1 score (log R - log L) which were computed from the alpha powers at F3 and F4. Results No significant difference was noted in demographic data among all three groups. The postpartum blues group had higher scores in the STAI-X1, the VAS and the K-DACL compared to the other groups at baseline, and their A1 scores were lower than those of only normal controls. There was a statistically significant increase of A1 score only in the postpartum blues group after the music session. Conclusion This study suggests that the mothers with postpartum blues may have a frontal EEG asymmetry which is possibly associated with their depressive mood, and the music session can affect the frontal asymmetry positively.

Fluoxetine 투여 후 조증과 자살 사고를 보인 강박증 환자 1례 (A Case of Fluoxetine-induced Mania & Suicidal Ideation in Obsessive-Compulsive Disorder)

  • 이승환;이민수
    • 생물정신의학
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    • 제6권2호
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    • pp.253-258
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    • 1999
  • The fluoxetine is one of the most frequently prescribed drugs for the treatment of depression and obsessive-compulsive disorder(OCD). This has been known as one of the most safest medication. But since the advent of this drug, there have been several reports of side effects-the mania and suicidal ideation-encountered during coadministration of fluoxetine with or without other psychotropic drugs. We experienced a case of 20 years old male OCD patient who developed into abrupt manic state and also was preoccupied with intense suicidal ideation following fluoxetine use. He was a only child in his family and his father had a history of alcoholism about 15years ago. Our patient's obsessive-compulsive symptoms have been occured since puberty. His OCD symptoms and anxiety were aggravated since joining the army. Beside these facts, we could not find any other psychiatric history such as depressive disoder and bipolar disorder. We used the fluoxetine starting dosage of 20mg and increased to 40mg at second week. About 3 weeks after the treatment, he developed sudden manic symptom and more aggravated suicidal ideation without any OCD symptoms. He felt vitalized and energetic without having enough sleep and food. These symptoms were ceased over two weeks by stopping medication. Up to this point, the reason why fluoxetine induces mania and suicidal preoccupation is unclear. But somehow the fluoxetine has effects on serotonin receptor and serotonin-dopamine regulations, thus we could make an assumption that fluoxetine can induce mania, extrapyramidal symptoms(EPS) and suicidal ideation in some part of the serotonin unbalanced patients. We think this would be the first report to remark on fluoxetine's suicidal and manic side effects in Korea. So here we present the case with the summary of reviewed articles.

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외상 후 스트레스장애로 진단된 화상 환자의 기질 및 성격차원 특성 (Temperament and Charcater Dimensions of Posttraumatic Stress Disorder in Burn Patients)

  • 윤석찬;함병주;변정현;은헌정;손현균;서국희;최인근
    • 생물정신의학
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    • 제12권2호
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    • pp.159-164
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    • 2005
  • Objective:The aim of this study was to evaluate the temperament and character profiles of the patients with posttraumatic stress disorder(PTSD) after burn injury. Methods:The study subjects consisted of 23 PTSD patients after burn injury, 24 patients not being diagnosed as PTSD after burn injury(non-PTSD) and 53 healthy controls. The assessment of PTSD was performed using clinician administered PTSD scale. All participants were instructed to complete the Temperament and Character Inventory(TCI), the Beck Depression Inventory and the State and Trait Anxiety Inventory of Spielberger. Results:The PTSD group after burn injury, compared with the non-PTSD group and the normal controls, had the higher novelty seeking and harm avoidance scores. But there were no differences in other dimensions in the TCI among the three groups. Conclusion:The results of this study suggest that the PTSD group after burn injury showed the specific properties of temperament and character compared with the non-PTSD group and the normal group.

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심박변이도 및 SCL-90-R 측정을 통한 자율훈련법과 과일 명상의 효과 비교 분석 (An Analysis of Comparison between Autogenes Training and Imaginary Meditation by Heart Rate Variability and SCL-90-R)

  • 서진우;김종우;정선용;김지영;황은영
    • 동의신경정신과학회지
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    • 제19권3호
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    • pp.35-44
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    • 2008
  • Objective: There are many meditation methods used in clinical field. But the effect of meditation may be different to people's mind, and meditation itself. Now we investigate this subject with two different meditation methods which has been analyzed by heart rate variability. Method: We tried to check people's heart rate who educated meditation, before educated and during the meditation. The meditation was educated differently for each group. One is the auto genes traning, and the other is the imaginary meditation by thinking about eating and smelling favorite fruits. All of them are used to oriental psychiatry clinic patients. And we simultaneously conduct people's emotional state by SCL-90-R. Result: The result in Autogene traning group has significant difference in total power and HRV-index score between before and during the training but in imaginary meditation group has no significance: Autogene traning group has a significance in low frequency score and has increased tendency with increasing tendency of Heart rate index and Total power. Through the SCL-90-R score, the higher depression t-score, the anxiety t-score, and the hostility score is, the HRV scores such as total power, low frequency, and HRV-index much increase. and so on. Conclusion: We can guess that the Autogenes training has more significant effect than the imaginary meditation. And we can also guess that as the emotional problem is getting more severe, the effect of meditation would be much better. And we finally suggest that we should make a standard guideline of imaginary meditation, cause the imaginary meditation has so many variation.

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간호중재로서의 마사지 적용연구 분석 (An Analysis of Research Related to the Massage as the Nursing Intervention)

  • 지은선;조결자
    • 부모자녀건강학회지
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    • 제7권2호
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    • pp.168-181
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    • 2004
  • Purpose: The purpose of this study was to identified patterns of studies and to analyze the nursing research related to the massage intervention in Korea and to improve direction of nursing research in massage intervention in Korea. Methods: The research studies related to the massage were selected from the Korean Nurses Academic Society Journal and dissertation which were conducted experimental research design the last 7 years in Korea. The total numbers of the studies were 58. Result: The study subjects were post operational state in 34.5%, healthy adult in 17.2% studies. The others dealt with infant, cancer, dementia, hypertension, preterm neonates, elderly. Types of massage were whole body in 31.1%, foot in 22.6%, hand in 17.2%, back in 13.8% studies. And Meridian massage in 17.2%. Length of massage was below 5 minutes in 17.2%, 6~10 minutes in 29.4% and 11~20 minutes in 32.8% studies. Frequency of massage was only 1 time in 25.9%, 2~5 times in 31.1% studies. Massage produced psychological and physiological effects. Positive psychologic effects were anxiety relief, pain relief, mood enhancement and fatigue relief. Positive physiologic effects on body systems were blood pressure, heart rate, edema, skin temperature, immune system, blood glucose, excretion, PMS syndrome and growth and development. Conclusion: As a result, effects of massage were almost positive. Therefore massage is useful alternative nursing intervention. But more attention research is needed to identify the objectivity instrument to measure and repeat research.

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사업장 근로자의 고혈압 관리를 위한 자가발반사요법의 효과 (Effects of Self-foot Reflexology Shown in Hypertension Workers)

  • 차남현
    • 지역사회간호학회지
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    • 제13권1호
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    • pp.17-29
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    • 2002
  • This study was carried out to investigate the effect of Self-foot reflexology (SFR) on the hypertension of workers. The purpose of the research was to evaluate: levels of knowledge, physical and emotional condition, work stress and fatigue on the hypertension of employees in the workplace. Quasi-experimental study was designed in the setting of a nonequivalent control and experimental Group applied by the pre and post test. The total subjects undertaken in the study were total of 34 employees working in three companies in Seoul. The SFR program was consisted of 6 phases. There were 2 minutes for preparation, 4 minutes for slow down, 26 minutes for base reflex, symptoms of a disease reflex and excretion reflex stimulation. Finally, there was 20 minutes relaxation in a comfortable posture and drinking hot water after blood pressure was checked in the order. This program was running 55 minutes a day everyday three times a week during the entire 8 week course. The finding showed blood pressure was reduced significantly. Moreover, the level of total cholesterol. high and low density lipoprotein cholesterol, depression, work stress, and fatigue were decreased in the study. But, they were not statistically significant except as it related to Group comparisons in time. The level of state anxiety was statistically significant between 2 Groups, but not in the time comparison of both Groups. As a summary of the study results, the SFR program was regarded as contributing to the physical and emotional promotion of employees. It had partially increased body circulations of functional organ related to the SFR sites. And, it improved relaxation of physical and mental condition through energy movement 'Chi'. Therefore, the SFR technique should be considered as an effective skill of a nursing program. Furthermore, it can be newly adopted as a nursing curriculum as a part of alternative treatment. However, it still needed to testify its effects through the review study.

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심박동수 변이(Heart Rate Variability) 측정법의 개념과 임상적 활용 (The Concept and Clinical Application for the Measurement of Heart Rate Variability)

  • 우종민
    • 정신신체의학
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    • 제12권1호
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    • pp.3-14
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    • 2004
  • 신경심장학의 발전으로 중추신경 활성이 심장의 전기적 활동도에 미치는 영향이 밝혀지고 있고, 심박동수변이(Heart rate variability, HRV)가 정신적 스트레스와 심혈관질환의 기계적 연관성을 나타내는 중요한 지표로 제기되고 있다. HRV란 자율신경계의 정상적 상호작용에 의해 나타나는 생리적인 심박수 변동을 타나내며, 자율신경 기능을 정량화하여 측정할 수 있는 방법론이다. 분석 방법은 시간 영역 분석과 주파수 영역 분석으로 나눌 수 있으며, 측정 시간대에 따라 단기간 측정과 24시간 측정 등의 방법이 확립되어 있다. 임상적으로는 변이 정도, 교감신경과 부교감신경의 활성과 균형도를 파악하여 다양한 질환과 스트레스 등의 진단과 치료 및 예후 판정에 활용되고 있다. HRV를 이용한 바이오피드백도 최근 자율신경 관련 질환의 치료에 활용되고 있다. 향후 다양한 프로토콜의 개발과 임상적 적용이 필요할 것으로 보인다.

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방임 및 학대경험이 청소년의 정서문제에 미치는 영향에 대한 자아존중감 조절효과 (Self-respect Moderating Effects on Adolescents with Emotional Problems due to Neglect and Abusive Experiences)

  • 김숙향;김형모
    • 한국콘텐츠학회논문지
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    • 제18권2호
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    • pp.26-36
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    • 2018
  • 본 연구의 목적은 방임 및 학대경험이 청소년의 정서문제에 미치는 영향에 대한 자아존중감의 조절효과를 검증하는 것이며, 연구결과는 다음과 같다. 첫째, 청소년의 방임수준보다 학대경험 수준이 높았으며, 일반적 특성인 성별, 주관적 가정형편이 청소년의 정서문제에 영향을 미치는 것으로 나타났다. 둘째, 방임과 학대경험 수준이 높은 청소년은 정서문제인 우울수준, 사회적 위축, 공격성, 신체증상 수준이 높은 것으로 나타났다. 셋째, 방임 및 학대경험이 청소년의 정서문제에 미치는 영향에 대한 자아존중중감의 강력한 조절 효과를 가지지는 못하지만, 학대경험과 정서문제 간에 응답자의 자아존중감 평균을 중심으로 높은 집단과 낮은 집단은 기울기 검정 결과 차이가 있는 것으로 나타났다. 본 연구결과 방임 및 학대경험 청소년이 정서 문제에 미치는 영향 간에 부정적 정서 상태를 감소시킬 수 있는 강력한 변인에 대한 연구의 필요성에 대해 후속연구로 제언하고자 한다.

노인성치매 발생요인과 돌보는 가족원의 스트레스에 관한 조사 연구 (A Study on risk factors for senile dementia)

  • 홍여신;이선자;박현애;조남옥;오진주
    • 대한간호학회지
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    • 제24권3호
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    • pp.448-460
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    • 1994
  • This study was conducted to investigate risk factors for senile dementia as well as care givers' stresses and thier needs for nursing care. It was done using a retrospective survey. A convenience sample or In senile dementia patients and l20 nor-mal elders in a rural area was used. The tools used in the study were the MMSE-K(Mini-Mental State Examination-Korea) for dementia screening test and a questionaire developed by the research team. Data were collected through home visits by Com-munity Health Practitioners. Data were analyzed using descriptive statistics, T-test, and Chi-square test. The findings are as follows : 1. There were significant differences in age, marital status, and religions between the two groups. 2. There was a significant difference in smoling behavior between the two groups. 3. There was a significant difference in past his-tory of cancer between groups. 4. There was a significant difference in past and present elderftmily relationship between the two groups. 5. There were significant differences in intellectual activities, assuming major role in family and seeking other's help in daily life troubles between the two groups. 6. There were significant differences in stress factors such as child problem, family conflict, health problem and illegal behavior between the two groups. 7. The major problems out by families in caring for dementia patient were catastrophic reactions, dirtiness, mood change, devouring and tremor. The most serious problems faced by families was dirtiness. with catastrophic reactions, sleep distrubance, changeableness, and a suspcio-usness following. The care givers expressed chronic fatigue, anxiety, tension, depression, disorder in daily life, shamefulness, blame from neighbours and guiltiness. 8. There is need for geriatric hospitals, nursing homes, burden sharing, and counselling or education for family care givers. A replicate study in the urban area is recommended to validate the findings of this study. To explore the impact of stress in life and ‘han’ on senile dementia, a qualitative study is recommended.

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