• Journal of Korean Academy of Nursing
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• v.26 no.4
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• pp.808-819
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• 1996

The purpose of this study was to examine the stressors and coping strategies of school -age children and to explore the relationship between stressful life events and health symptoms and the effects of coping and trait anxiety which is theoretically considered to mediate the relationship between stress and health symptom. The study subjects consisted of 639 elementary school children in the fourth to sixth grade living in Seoul. Of the 639 subjects, 348 were boys and 291 were girls. The mean age was 11.35 (SD=.86). The Feel Bad Scale(FBS), Schoolager's Coping Strategy Inventory(SCSI), Spielberger's Trait Anxiety Scale for Children(STAIC), and Health Symptom Questionnaire (HSQ) were adapted for this study. A pilot study was undertaken to ascertain the reliability and validity of the instruments. The Cronbach alphas of FBS, SCSI, STAIC and HSQ were from .81 to .92. The Researcher and a research assistant visited the school and data were collected in the class using the questionnaire method after an explanation of the purpose and procedures was given to the children. Data collection was done during the period between Nov.25 to Dec.19, 1995. Using the SAS statistical program, percentages, t-test, ANOVA, correlation analysis, and multiple regression were used for data analysis. The result are as follows : 1. The mean score for the FBS was 204.79(range : 48-472) and there was a significant difference according to grade. The most severe stressors perceived by children were parental divorce and death or illness of family members. The most frequently experienced stressful life events were conflict with siblings and being home alone. 2. The mean score for the SCSI was 57.36(range : 9-118) and there was a significant difference according to grade. The most frequently used, and perceived as helpful, coping strategies were distraction and cognitive activities. 3. The mean score for the HSQ were 20.7(range : 0-81) and there were significant differences according to grade and sex. The percentage of the children answering that they perceived their health state as not good was 3.9%. 4. The mean score for the STAIC was 33.76 and there were significant differences according to grade and sex. 5. There was a significant relationship between stressful life events and health symptoms ( r=.53, p<.01). Also, Stressful life events were postively related with coping strategies(r=.39, p<.01). Trait anxiety was highly correlated with health symptoms(r=.72, p<.01). 6. To examine the multivariate effects of the variables to health symptoms, multiple regression was performed. Stressful life events, coping, trait anxiety, and health concerns were identified as significant variables. Explanation of the health symptoms by these variables was 56.78%. The study revealed that stressful life events correlated with health symptoms in school-age children and coping and trait anxiety had mediating effects on this relationship. The implication for nursing is that there is a need to develop supportive interventions for high risk population to decrease health problems due to stress. Also, it is recommended that a study be conducted to explore protective factors for the prevention of health problems in children.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.1
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• pp.53-61
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• 2006

Objectives: This study was designed to evaluate difference of the alexithymia between panic patients and normal controls by examination of the relationships between different components of the alexithymia construct and level of anxiety and depression in panic patients and normal controls. Methods The subjects were 167 patients who met DSM-IV criteria for panic disorder and 110 normal controls. They drew up symptom checklists and self-rating scales, and were measured by Anxiety Disorders Interview Schedule-Panic attack & Agoraphobia(ADIS-P & A), Korean version of Toronto Alexithymia Scale (TAS-20K), Spielberger State-Trait Anxiety Inventory-State & Trait (STAI-S & T), Beck Depression Inventory (BDI), and Revised Anxiety Sensitivity Index (ASI-R). For statistical analysis, we performed t-test to compare the sociodemographic characteristics and the scores of self reported scales between panic patients and normal controls. Pearson correlation was performed between TAS-20K and it's subfactors, STAI-S & T, ASI-R and BDI in panic patients and normal controls. And stepwise multiple regression analysis was preformed to explain results of correlation analysis for alexithymia. Results: The panic patients reported more significant alexithymic (p<0.001), more difficulty identifying feeling (p<0.001) and describing feeling (p=0.001) than normal controls. Futhermore, panic patients were more significant anxious, sensitive to anxious feeling and depressive than normal controls. Moreover, the alexithymia of panic patients was explained by trait-anxiety $({\Delta}R^2=0.255)$ and anxiety sensitivity $({\Delta}R^2=0.062)$, that of normal controls was predicted by depression $({\Delta}R^2=0.144)$ and anxiety sensitivity $({\Delta}R^2=0.033)$ Conclusion: The panic patients reported more anxious and sensitive to anxious feeling, and these symptoms predict alexithymia in panic patients. However, the alexithymia of normal controls was explained by depression more than anxiety sensitivity, and such a result isn't consistent with previous studies and this may be mainly due to difference of the homogeneity in object of the studies.

• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.17-22
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• 2017

Background and Objectives: Voice change after thyroidectomy may develop without injury of recurrent laryngeal nerve. Psychogenic or emotional factors related to voice change after thyroidectomy has been rarely studied. In this study, we sought to analyze the impact of anxiety on early state of post-thyroidectomy voice change. Materials and Methods: We made a retrospective chart review of 36 patients who underwent thyroidectomy for papillary thyroid carcinoma and voice exam before surgery, 2 weeks after and 1 month after surgery. All patients included in the study answered a questionnaire for State-Trait Anxiety Inventory ; STAI-KYZ (form Korean YZ). Clinico-pathologic factors and parameters of voice analysis were reviewed to analyze correlation to the anxiety index. Results: No differences were identified between clinicopathologic factors and preoperative parameters of voice analysis between patients with higher and lower level of anxiety. Noise to harmonic ratio (NHR) was higher in those patients with higher level of anxiety, 2 weeks after surgery (p=0.043). However, none of the parameters showed any difference 1 month later. Conclusion: With limited number of patients and short period of follow up, significant impact of preoperative anxiety on postoperative voice change after thyroidectomy could not be identified in this preliminary study.

• Journal of Korean Academy of Nursing
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• v.30 no.2
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• pp.476-487
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• 2000

The purpose of this study was to examine the effects of hand massage as a nursing intervention on the anxiety of the hysterectomy patients in immediately prior to surgery. The method of this study was Nonequivalent Control Group Non-Synchronized Design. The data were selected from at K university hospital in Pusan, and they consisted of Experimental group-25 patients, Control group -24 patients. The data were collected from Jan. 4 to Jan. 30 in 1999. The subjects′ self-reports of anxiety (measured by the Spielberger Trait-State anxiety Inventory and Visual Analogue Scale developed by Cline et al.) were recorded before and immediately after the intervention. The objective physiologic measures of blood pressure and pulse rate. The collected data were analysed by means of frequency, percentage, standard deviation, chi- square test, t-test, ANCOVA with SPSS program. The results of this study were as following; 1. Hypothesis 1: The 1st hypothesis that "There will be significant difference of the state anxiety level just before surgery in the experimental group and control group" was supported(P= .000). 2. Hypothesis 2: The 2nd hypothesis that "There will be significant difference of the visual analogue scale score just before surgery in the experimental group and control group"was supported(P= .000). 3. Hypothesis 3: The 3rd hypothesis that "There will be significant difference of the systolic and diastolic blood pressure level just before surgery in the experimental group and control group"was supported (P= .003, P= .041). 4. Hypothesis 4: The 4th hypothesis that "There will be significant difference of the pulse rate just before surgery in the experimental group and control group"was supported(P= .004). In conclusion, hand massage is a benefical nursing intervention that alleviates the psychological, physiological anxiety of the hysterectomy patients in immediately prior to surgery. therefore it is recomended to use the hand massage as a nursing intervention for patients undergoing anxiety. The results of this study appear promising, additional research is recomended to further the appropriate uses of hand massage in nursing practice for this and other patient population.

• Sleep Medicine and Psychophysiology
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• v.21 no.2
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• pp.69-73
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• 2014

Objectives: This study was designed to assess the change of heart rate variability (HRV) at resting, upright, and psychological stress in anxiety disorder patients. Methods: HRV was measured at resting, upright, and psychological stress states in 60 anxiety disorder patients. We used visual analogue scale (VAS) score to assess tension and stress severity. Beck depression inventory (BDI) and state trait anxiety inventories I and II (STAI-I and II) were used to assess depression and anxiety severity. Differences between HRV indices were evaluated using paired t-tests. Gender difference analysis was accomplished with ANCOVA. Results: SDNN (Standard deviation of normal RR intervals) and low frequency/high frequency (LF/HF) were significantly increased, while NN50, pNN50, and normalized HF (nHF) were significantly decreased in the upright position compared to resting state (p < 0.01). SDNN, root mean square of the differences of successive normal to normal intervals, and LF/HF were significantly increased, while nHF was significantly decreased in the psychological stress state compared to resting state (p < 0.01). SDNN, NN50, pNN50 were significantly lower in upright position compared to psychological stress and nVLF, nLF, nHF, and LF/HF showed no significant differences between them. Conclusion: The LF/HF ratio was significantly increased after both physical and psychological stress in anxiety disorder, but did not show a significant difference between these two stresses. Significant differences of SDNN, NN50, and pNN50 without any differences of nVLF, nLF, nHF, and LF/HF between two stresses might suggest that frequency domain analysis is more specific than time domain analysis.

• Journal of Oriental Neuropsychiatry
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• v.27 no.3
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• pp.131-146
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• 2016

Objectives: This study was performed to determine the correlation between Instrument on Pattern Identification for Depression and Psychological tests by Pearson Correlation Coefficient and Regression analysis.Methods: Two assessors carried out the evaluation using the instrument on pattern identification for depression. They also performed the following psychological tests: Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), State-Trait Anger Expression Inventory (STAXI), the Temperament and Character Inventory (TCI), Insomnia Severity Index (ISI_Total), Self-disclosure Inventory, subjective well-being Inventory, Health perception Inventory, and Personality Assessment Inventory (PAI). A total of 167 participants who got HAM-D score over 12 were targeted for the evaluation. Our research team carried out Pearson correlation coefficient analyses and regression analysis between pattern identification for depression and Psychological tests. We listed the results by descending order and interpreted the results.Results: Pearson correlation analysis revealed the following results: 1) Stagnation of Liver Gi was associated with BDI (0.60) and STAI (0.55); 2) Dual Deficiency of the Heart and Spleen was associated with BDI (0.60), ISI_Total (0.52), and STAI (0.42); 3) Relieving stagnation of Phlegm-Gi was associated with BDI (0.65), STAI (0.54), and Subjective well-being inventory (−0.52); 4) Gi-deficiency Mingled with sputum was associated with BDI (0.50), ISI_Total (0.40), and STAI (0.395); 5) Stagnant Gi transforming into fire was associated with BDI (0.56), STAI_TR (0.51), and Health perception Inventory (−0.458); 6) Yin-Deficiency with Effulgent Fire was associated with BDI (0.55), ISI_total (0.54), and STAI (0.41).Conclusions: Through correlation analysis between Instrument on Pattern Identification for Depression and Psychological tests, we could suggest a System for Oriental Medical Diagnosis for Depression.

• Korean Journal of Adult Nursing
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• v.12 no.3
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• pp.407-417
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• 2000

The purpose of this study was to examine the effect of preoperative teaching as a nursing intervention on the emotional status of the patients prior to surgery. The method of this study was Nonequivalent Control Group Non-Synchronize Design. The data were selected from H universuty hospital in Seoul, and they consisted of an experimental group-30patients, and a control group-30 patients. The questionnaire consisted of 28 Preoperative Stress Inventory(Kang, 1998), and 16 State- Trait Anxiety Inventory(Spielberger, 1972). The collected data were analized by means of frequency, percentage, $X^2$ test, t-test and paired t-test with SPSS WIN. The results of this study were as follows : 1. The level of stress prior to surgery was significantly lower for the preoperative teaching group than for the control group(t=2.61, p< .01). 2. The level of anxiety prior to surgery was not significantly lower for the preoperative teaching group than for the control group. 3. The difference level of the anxiety level the prior to surgery was significantly higher for the preoperative teaching group than for the control group(t=2.82, p< .01). In conclusion, preoperative teaching is a beneficial nursing intervention that has a positive effect on the stress and anxiety of patients prior to surgery. Therefore it is recommended to use the preoperative teaching program as a nursing intervention for patients prior to surgery.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.2
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• pp.149-158
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• 2003

Objectives: The authors studied the anxiety, depression and psychological characteristics of medical out-patients, which are diagnosed as peptic ulcer disorder and essential hypertension. We also examined the state of psychiatric consultation. Methods: The subjects were composed of 56 patients with peptic ulcer disorder, 44 patients with essential hypertension and 116 controls. STAI, BDI and SCL-90R was administered to all subjects. Chart review, telephone interview and Self report questionnaire of etiology and severity of illness, drug compliance and so forth were performed in disease groups. Results: Considerable depression was noticed in 39.3% among the patients with peptic ulcer disorder, 27.7% in hypertension and 12.1% in control group by BDI. State anxiety was noticed in 44.6% among the patients with peptic ulcer disorder, 54.5% in hypertension and 18.1% in control group by State anxiety. Trait anxiety was noticed in 42.9% among the patients with peptic ulcer disorder, 34.1% in hypertension and 25.8% in control group by Trait anxiety. The higher SOM, BDI, STAI, the lower drug compliance and rapport. Psychological problems are considered of the most important etiology in 48.2% of peptic ulcer group and 45.7% of hypertensive group. But psychiatric consultation is made only in 1.8% of peptic ulcer group and 2.3% of hypertensive group. Conclusions: Anxiety and depression are common phenomena in medical outpatients. In comparison with the normal control group, peptic ulcer group showed significantly higher trait anxiety and depression and hypertensive group higher state anxiety. These characteristics are related to the drug compliance and doctor-patient relationship. These results suggested the needs of active psychiatric consultation.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.9 no.1
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• pp.27-44
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• 2002

The main purpose of this study was to identify the effect of hand massage on pain and anxiety related to chest tube removal in patients with a lobectomy. The research design of this study was a nonequivalent control group non-synchronized design. Of the twenty nine adult subjects, fourteen were assigned to the experimental group and fifteen to the control group. The data were obtained over 3 months from a medical center in Seoul. The instruments used to assess trait state anxiety was the Spielberger Trait-State anxiety Inventory. For pain and psychological anxiety. The Visual Analogue Scale was used. Hiko analogue sphygmo-manometer(2001) was used to check blood pressure and pulse rate as indicators of physiological anxiety Subjects in the experimental group received hand massage for 5 minutes just before chest tube was removed, and subjects assigned to the control group did not receive hand massage. Data were analysed with $x^2$-test and Mann-Whitney U test using the SPSSWIN 10.0 program. The results of the study are as follows : 1. Hypothesis 1: 'there will be a significant difference between two groups in the level of pain after chest tube removal' was supported (u = 23.00, p < 0.001). 2. Hypothesis 2: 'there will be a significant difference between the two groups in the level of psychological anxiety after chest tube removal' was supported (u = 3.00, p < 0.001). 3. Hypothesis 3: 'there will be a significant difference between the two groups in physiological anxiety(systolic, diastolic blood pressure and pulse rate) after chest tube removal' was supported(u =55.50, p = 0.01 ; u = 41.50, p = 0.01 ; u = 20.50, p < 0.001, relatively). The findings of this study indicate that hand massage is effective for pain and anxiety related to chest tube removal in patients with lobectomy. Therefore, hand massage is recommended as an effective nursing intervention for relieving pain and anxiety in patients undergoing chest tube removal. Further research is needed to identify the proper duration and timing to achieve the optimal effect of hand massage. A larger subject population is required to apply the current findings to the general population. Further research is also needed to assess the effects of hand massage in other patient subsets. Finally, it would be interesting to see if the effects of hand massaging would be attenuated when performed by a non-medical specialist.

• Korean Journal of Adult Nursing
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• v.25 no.1
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• pp.13-23
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• 2013

Purpose: The purpose of this study was to investigate the factors that influence health-related quality of life in patients with atrial fibrillation. Methods: The subjects were 150 outpatients with atrial fibrillation who visited the cardiology clinic of a university hospital in U city. The instruments used for this study were Mhel Uncertainty in Illness Scale (MUIS), Center for Epidemiologic Studies-Depression Scale (CES-D), State Trait Anxiety Inventory (STAI), and the Short-Form-36 Health Survey (SF-36) Korean version II. The date were analyzed by ANOVA, Pearson-correlation coefficient, and hierachial multiple regression using SPSS/WIN 18.0. Results: The mean score of physical health-related quality of life (PCS) was $38.92{\pm}6.22$ and mental health-related quality of life (MCS) was $41.49{\pm}5.71$. Physical and Mental health-related quality of life had the significant correlations with uncertainty, anxiety and depression. In multiple regression analysis, physical health-related quality of life was significantly influenced by duration of disease, NYHA class, uncertainty. Mental health-related quality of life was significantly influenced by family income, NYHA class, anxiety and depression. Conclusion: These results suggest that these influencing factors should be consider in developing the nursing interventions to improve the healthrelated quality of life in patients with atrial fibrillation.