• 생물정신의학
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• 제24권1호
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• pp.10-18
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• 2017

Occupational hazards of firefighting and rescue works include frequent exposure to emergencies and life-threatening situations. These stressful work conditions of being constantly under pressure and exposed to potentially traumatic events put them at higher risk of developing posttraumatic stress disorder (PTSD), compared to the general population. PTSD is a potentially debilitating mental disorder, due to persistent intrusive thoughts, negative alterations of mood and cognition, hypervigilance, avoidance of similar situations and reminders, and re-experiences of the traumatic event. Previous studies have shown a relatively high prevalence of PTSD among firefighters, indicating the need for a systematic approach of early detection and prevention. Therefore, a critical review of the current literature on PTSD in firefighters would provide valuable insights into developing effective prevention and intervention programs. Literature indicated that there are risk factors of PTSD in firefighters, such as pre-existing depression, anxiety, sleep disorders, occupational stress, physical symptoms, and binge drinking, whereas social support and adequate rewards are protective factors. Although there are differences in the prevalence of PTSD across studies, partly due to various assessment tools utilized, different sample sizes, and sample characteristics, over one tenth of the firefighters were estimated to have PTSD. The current review warrants further investigations to precisely assess PTSD and co-morbid mental disorders, functional outcomes, and associated factors, and to develop evidence-based preventive and interventional programs to help firefighters with PTSD.

• 감성과학
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• 제4권2호
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• pp.33-38
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• 2001

본 연구는 가상현실을 이용하여 교통사고 후 경험하게 되는 불안감 및 공포감과 같은 심리적인 후유장애에 대한 치료 프로그램을 개발하기 위한 예비연구로 수행되었다. 가상현실을 통한 교통사고 후유장애 프로그램의 핵심내용이 되는 운전주행 시나리오의 효과를 검증하고, 이완훈련 등의 불안감소 훈련의 효과를 피험자를 통해 검증해 보았다. 총 8명의 피험자(정상인 7명, 교통사고 환자 1명)를 대상으로 세 가지 주행상황 시나리오를 제시하고, 이후 이완훈련을 실시하였다. 그 결과 이완훈련 후 유의미한 불안감소 효과가 나타났다. 하지만 각각의 주행상황에 따라서 불안이 증가되는 경향성은 나타났으나 통계적으로 유의미한 수준에 이르지는 못하였다. 이를 종합하여 볼 때, 주로 정상인을 대상으로 한 연구임에도 불안유발 경향성이 나타난 점은 고무적이나 교통사고자를 대상으로 한 경험적인 증명이 필요하며, 가상현실을 이용한 이완훈련은 효과적인 것으로 판명되었다.

• 대한정형도수물리치료학회지
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• 제21권1호
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• pp.37-42
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• 2015

Background: This study investigates the impact of the cervical musculoskeletal intervention on post-traumatic stress disorder patient's cervical pain levels and depression factor. Methods: Thrty neck pain patients diagnosed with post-traumatic stress disorder were enrolled. Neck exercise training using a sling system was applied to the experimental group and self-neck movement exercise, modification of the McKenzie exercise, was applied to the control group. Both groups were checked every week whether they performed or not. Both groups performed their exercise for 35 minutes for a time and 3 times per week. Total period of the intervention was 6 weeks. To compare the effects of interventions, threshold of cervical tenderness and depression level were measured before and after the each intervention and also measured at follow-up. Results: Painthreshold of left trapezius showed a significant difference between two groups at three points. It increased 19.71% in the experimental group after the intervention compared to before the intervention. At follow-up it also increased 20.06% in the experimental group. Pain threshold of right trapezius showed a significant difference at three points. It increased 18.35% in the experimental group after the intervention compared to before the intervention. At follow-up it also increased 15.93% in the experimental group. According to the result interaction between groups and measurement time in both side of trapezius was valid. Depression level showed significant difference in the experimental group between three points. It decreased 18.07% after the intervention compared to before the intervention and decreased 15.21% at follow-up. According to the result interaction between groups and measurement time in depression level was valid. Conclusions: This study has important implications as the therapeutic strategy, high potent of improving symptoms, shows effect to a subject who has psychological problem such as posttraumatic stress disorder (PTSD).

• 대한간호학회지
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• 제46권1호
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• pp.29-38
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• 2016

Purpose: The Perinatal Post-Traumatic Stress Disorder Questionnaire (PPQ) was designed to measure post-traumatic symptoms related to childbirth and symptoms during postnatal period. The purpose of this study was to develop a translated Korean version of the PPQ and to evaluate reliability and validity of the Korean PPQ. Methods: Participants were 196 mothers at one to 18 months after giving childbirth and data were collected through e-mails. The PPQ was translated into Korean using translation guideline from World Health Organization. For this study Cronbach's alpha and split-half reliability were used to evaluate the reliability of the PPQ. Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and known-group validity were conducted to examine construct validity. Correlations of the PPQ with Impact of Event Scale (IES), Beck Depression Inventory II (BDI-II), and Beck Anxiety Inventory (BAI) were used to test a criterion validity of the PPQ. Results: Cronbach's alpha and Spearman-Brown split-half correlation coefficient were 0.91 and 0.77, respectively. EFA identified a 3-factor solution including arousal, avoidance, and intrusion factors and CFA revealed the strongest support for the 3-factor model. The correlations of the PPQ with IES, BDI-II, and BAI were .99, .60, and .72, respectively, pointing to criterion validity of a high level. Conclusion: The Korean version PPQ is a useful tool for screening and assessing mothers' experiencing emotional distress related to child birth and during the postnatal period. The PPQ also reflects Post Traumatic Stress Disorder's diagnostic standards well.

• 한방재활의학과학회지
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• 제20권3호
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• pp.37-60
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• 2010

Objectives : The purpose of this study was to investigate the relationship between masseter and cervical muscle activity and temporomandibular disorder in female office workers. Methods : Experimental group of 24 healthy subjects complained of temporomandibular joint related to computer use which lasted more than 3 months in the past year and was present in the past 7 days as well as on the day of test. Control group of 20 healthy subjects had no complaints of minimal discomfort on the day of test, and had no discomfort in the past 7 days. If they had reported discomfort in the past 12 months, it was of a short duration(<3 months) and resolved at least 3 months prior to participation. Outcomes were assessed by meridian-electromyography(MEMG), whole spin x-ray, mandibular function impairment questionnaire(MFIQ), neck disability index(NDI), visual analog scale(VAS), Beck depression inventory(BDI), stress reaction inventory(SRI) and Holmes & Rahe social readjustment rating scale(SRRS). Results : The contraction power of masseter muscle, upper trapezius, sternocleido-mastoid muscle and erector spinae by MEMG was significantly higher in the experimental group. The muscle fatigue of masseter muscle and sternodeido-mastoid muscle by MEMG was significantly higher in the experimental group. SRI was significantly higher in experimental group. There was no significant difference between two groups in the Jackson's angle, Cobb's method and cranio-cervical posture. Conclusions : The results suggest that temporomandibular disorder related mental stress but physical stress does not change cervical structure significantly.

• 한국노년학
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• 제37권2호
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• pp.293-308
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• 2017

돌봄 서비스를 수행하는 독거노인생활관리사는 사회안전망 서비스 구축에서 매우 중요한 역할을 감당하고 있다. 그러나 독거노인생활관리사들이 독거노인들을 관리하면서 나타나는 역할갈등이나 그들의 욕구와 불만들을 직접적으로 받아들이고 해결하는 상황에서 받고 있는 외상 후 스트레스나 압박감이 높다는 실천 현장의 목소리가 많다. 따라서 독거노인 돌봄 서비스의 성공적 정착을 위해서라도 독거노인생활관리사의 심리적 소진에 대한 개입 필요성 연구는 중요할 수밖에 없다. 이에 본 연구에서는 서울 지역 독거노인생활관리사를 대상으로 외상 경험 및 외상 후 스트레스에 대한 장애현황 실태를 파악하여 이를 바탕으로 개선 방안을 마련하는데 목적을 두고 있다. 연구방법은 서울 지역 독거노인생활관리사를 대상으로 외상경험 여부, 외상경험 유형, 외상 후 스트레스 진단, 외상경험에 대한 대처 실태 등을 자기기입식 설문조사 방식으로 진행하였다. 연구결과 응답자 중 186명 (37.57%)이 부분 혹은 완전 외상 후 스트레스 증상을 갖고 있는 것으로 조사되었다. 그럼에도 이에 대한 대처 실태는 매우 열악한 것으로 나타났다. 이에 다음과 같이 몇 가지 의미 있는 대안들을 제시하였다. 첫째, 외상 후 스트레스 장애를 갖고 있는 독거노인생활관리사를 발견하고 이들을 지속적으로 관리할 수 있는 시스템을 마련하여야 한다. 둘째, 외상 경험 및 외상 후 스트레스 관리에 대한 교육을 활성화해야 한다. 셋째, 외상 경험을 하였거나 외상 후 스트레스 장애군으로 진단을 받은 독거노인생활관리사를 위한 지원 체계 구축이 시급하다. 넷째, 전문적인 지식과 기술을 가진 전문가 양성 및 배치가 필요하다. 다섯째, 의료기관과의 네트워크를 구축하여 신속한 진단과 전문적인 치료를 받을 수 있도록 해야 한다.

• 동의신경정신과학회지
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• 제23권4호
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• pp.215-228
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• 2012

Objectives : This study aims to research the effect of oriental psychotherapy and treatments for reduction of Psychosomatic disorder symptoms caused by maladjustment of interpersonal relationship. Methods : We treat a patient with Oriental medical treatment (acupuncture, moxibustion, cupping and aroma therapy, oriental psychotherapy and Herb-medication) and follow up the changes of stress index for 3 times per 8 days. Results & Conclusions : After oriental psychotherapy and treatments, clinical symptoms of the patient were improved and the patient overcoming psychosomatic disorder can go back to the workplace. It is suggested that oriental psychotherapy and treatments are effective on psychosomatic disorder.

• Child Health Nursing Research
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• 제12권3호
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• pp.417-425
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• 2006

Purpose: This study was done to investigate stress, coping and social support of mothers of children with seizure disorders, and to identify the relationship between these variables. Method: The participants were 105 mothers of children with seizure disorders. Data were collected through self-report questionnaires which were constructed to include stress, coping and social support. The data were analyzed using the SAS program. Result: Stress of mothers was significantly different according to number of times the child had been hospitalized and the mothers perception of the state of the child's health. Coping by mothers was significantly different according to religion, general health state and if mother knew the child's diagnosis. Social support for mothers was significantly different according to education level, monthly medical expenses and number of times the child had been hospitalized. Social support for mothers was correlated with stress and coping. Conclusion: The above findings indicate that coping in mothers of children with seizure disorder is related to social support. Therefore nursing interventions to reduce stress and improve coping should be provided for mothers of children with seizure disorder.

• 한국학교ㆍ지역보건교육학회지
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• 제18권3호
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• pp.17-28
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• 2017

Ojectives: This study performed to analyze health promotion factors related to subjective stress level among first-year students of university. Methods: To examine the association with subjective stress level and health promotion factors, health survey was conducted with 3,892 students who were first-year students in an university by self-reported questionnaire from February 26 to March 10, 2015 in an university. Multiple regression analysis performed to identify the difference of health promotion factors by subjective stress level. Results: 1,015 students (26.1%) were on high stress level and 2,110 students (54.2%) were in healthy status. The 10.8% of them was obesity group and the 40% was alcohol use disorder group. The 8.2% had experienced depression in the last 1 year. In multiple regression models, it remained significantly the difference of subjective stress level by sex, subjective health status, sleep hours in a day, eating frequency of fruit and vegetable in a day, depression experience and suicidal thought in the last 1 year(p<0.05, p<0.01). On the other hand, it was not significant the difference by age, BMI, alcohol use disorder, eating breakfast, regular exercise and current smoking. Conclusions: To improve health promotion of first-year students of university, it should provide the intensive mental health program to women on campuses.

• 수면정신생리
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• 제12권1호
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• pp.50-57
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• 2005

목 적：본 연구에서는 주요우울장애를 동반한 공황장애 환자들과 동반하지 않은 공황장애 환자들을 대상으로, 환자들이 경험하는 공황장애의 임상 양상 및 증상의 심각도의 차이를 확인하고, 주관적인 증상 평가 이외에 불안을 나타내는 생리적 지표인 자율신경계 기능의 차이도 함께 알아보고자 하였다. 방 법：DSM-IV 진단 기준으로 공황장애 환자들에서 주요우울장애가 공존하는 것으로 진단된 19명과 주요우울장애가 공존하지 않는 것으로 진단된 60명을 대상으로 첫 외래 방문시 공황 증상으로 인한 고통 정도와 회피 정도를 측정하는 기본 기록지와 기타 자기 보고식 설문지를 실시하였으며, 자율 신경계 기능을 평가하기 위해서 객관적, 생리적 지표로 Heart Rate Variability(HRV)를 측정하고 환자들이 경험하는 공황장애의 심각성을 평가하기 위해 임상가들에 의해 Clinical Global Impression(CGI)과 Panic Disorder Severity Scale(PDSS)을 시행하여 객관적으로 평정하였다. 자료 분석을 위해 환자들이 보고한 각 임상 척도 점수 및 임상가 평정 점수를 주요우울장애가 공존하는 공황장애 환자군과 그렇지 않은 공황장애 환자군에 따라 t-test를 통해 비교하고, 두 집단간 HRV 양상을 비교하기 위해서 연령을 공변인으로 설정하고 ANCOVA를 실시하였다. 결 과：주요우울장애가 동반된 공황장애 환자들은 공황장애로만 진단된 환자들에 비해 주관적으로 호소하는 우울이나 불안 수준이 더 높았으며, 불안 민감도나 신체 증상에 대한 예민성도 더 많이 호소하는 경향이 있었다. 또한 부정적인 일상생활에서 자신을 비하하고 낙담하게 하는 부정적인 자동적 사고 경향이 더 높았으며, 자기 자신을 고양하고 미래를 희망적으로 지각하는 긍정적인 자동적 사고 경향은 더 낮은 것으로 나타났다. CGI와 PDSS와 같은 객관적 평정 척도에서도 우울증이 동반된 공황장애 환자들의 증상 심각도가 더 높은 것으로 나타났다. 반면, 주요우울장애를 동반한 환자들의 심박 변이도가 보다 낮은 경향이 있었지만 두 군사이에 통계적으로 유의한 차이는 없었다. 결 론：본 연구 결과로 주요우울장애를 동반한 공황장애 환자들이 공황장애만을 지닌 환자들에 비해 임상 양상이 심하고 더 많은 고통을 겪는다는 것을 알수 있었다. 그러나 HRV 지표에서는 두 집단간 유의한 차이가 관찰되지 않았다. 향후 더 많은 대상자를 포함한 연구가 시행된다면 주요우울장애의 동반 여부에 따른 자율신경계 기능의 차이에 대해 더 많은 이해가 가능하리라고 기대된다.