• 제목/요약/키워드: Stress in Clinical Practice

검색결과 304건 처리시간 0.031초

자살의 신경생물학적 요인 (Neurobiological Factors of Suicide)

  • 송후림;우영섭;전태연
    • 우울조울병
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    • 제10권1호
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    • pp.13-21
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    • 2012
  • 자살은 다양한 신경생물학적, 심리사회적 요인들이 모두 관여하고 있는 복합적인 행동으로, 유전적 요인과 가족력, 신경생물학적인 특성, 발달 단계에서의 요인들과 성격적 특성 등의 취약한 체질적 소인을 가진 사람들에게서 환경적인 스트레스와 물질남용, 정신질환, 신체질환 등의 영향을 통해 최종적으로 발생하게 된다. 신경생물학의 발달로 인해 자살에는 정신질환과 무관하게 독립적으로 작용하는 유전적 소인이 있으며, 이와 관련된 신경전달물질, 신경호르몬, 신경영양인자, cytokine, 지질 대사의 이상 등이 신경회로의 신호 전달을 교란시켜 자살에 취약하도록 만든다는 사실이 밝혀졌다. 또한 그 중 가장 주된 역할을 하는 인자는 5-HT와 HPA 축의 기능부전인 것으로 생각할 수 있다. 이러한 소견들은 향후 자살의 생물학적 표지자를 설정하고, 임상적으로 자살 고위험군에 대한 조기 개입을 하는 한편 새로운 치료 방법을 개발하는데 많은 도움을 줄 수 있을 것이다.

Similarities and differences between alpha-tocopherol and gamma-tocopherol in amelioration of inflammation, oxidative stress and pre-fibrosis in hyperglycemia induced acute kidney inflammation

  • Shin, Hanna;Eo, Hyeyoon;Lim, Yunsook
    • Nutrition Research and Practice
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    • 제10권1호
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    • pp.33-41
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    • 2016
  • BACKGROUND/OBJECTIVES: Diabetes mellitus (DM) is a major chronic disease which increases global health problems. Diabetes-induced renal damage is associated with inflammation and fibrosis. Alpha (AT) and gamma-tocopherols (GT) have shown antioxidant and anti-inflammatory effects in inflammation-mediated injuries. The primary aim of this study was to investigate effects of AT and GT supplementations on hyperglycemia induced acute kidney inflammation in alloxan induced diabetic mice with different levels of fasting blood glucose (FBG). MATERIALS/METHODS: Diabetes was induced by injection of alloxan monohydrate (150 mg/kg, i.p) in ICR mice (5.5-week-old, male) and mice were subdivided according to their FBG levels and treated with different diets for 2 weeks; CON: non-diabetic mice, m-DMC: diabetic control mice with mild FBG levels (250 mg/dl ${\leq}$ FBG ${\leq}$ 450 mg/dl), m-AT: m-DM mice fed AT supplementation (35 mg/kg diet), m-GT: m-DM mice with GT supplementation (35 mg/kg diet), s-DMC: diabetic control mice with severe FBG levels (450 mg/dl < FBG), s-AT: s-DM mice with AT supplementation, s-GT: s-DM mice with GT supplementation. RESULTS: Both AT and GT supplementations showed similar beneficial effects on $NF{\kappa}B$ associated inflammatory response (phosphorylated inhibitory kappa B-${\alpha}$, interleukin-$1{\beta}$, C-reactive protein, monocyte chemotactic protein-1) and pre-fibrosis (tumor growth factor ${\beta}$-1 and protein kinase C-II) as well as an antioxidant emzyme, heme oxygenase-1 (HO-1) in diabetic mice. On the other hands, AT and GT showed different beneficial effects on kidney weight, FBG, and oxidative stress associated makers (malondialdehyde, glutathione peroxidase, and catalase) except HO-1. In particular, GT significantly preserved kidney weight in m-DM and improved FBG levels in s-DM and malondialdehyde and catalase in m- and s-DM, while AT significantly attenuated FBG levels in m-DM and improved glutathione peroxidase in m- and s-DM. CONCLUSIONS: the results suggest that AT and GT with similarities and differences would be considered as beneficial nutrients to modulate hyperglycemia induced acute renal inflammation. Further research with careful approach is needed to confirm beneficial effects of tocopherols in diabetes with different FBG levels for clinical applications.

분노반응척도의 개발과 임상적 적용 (Development of the Anger Response Scale and its Application in Clinical Practice)

  • 고경봉;박중규;김찬형;김도훈
    • 정신신체의학
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    • 제12권2호
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    • pp.122-134
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    • 2004
  • 연구목적 : 본 연구의 목적은 분노반응 척도를 개발하고 임상에 적용하고자 하는 데 있다. 방법: 성인 정상인 123명을 대상으로 분노반응 척도 예비설문을 시행하여 16개 문항을 추출하였다. 그 다음에 이 문항들이 포함된 설문을 정상인 258명을 대상으로 실시하였다. 상기 척도의 임상적 적용은 환자군 189명(불안장애 59명, 우울장애 72명, 신체형장애 58명)을 대상으로 하였다. 결과: 이 자료들을 요인분석한 결과 4개의 하위요인 즉 공격성반응, 짜증반응, 도피반응, 분노억압반응이 추출되었다. 상기 척도의 신뢰도는 정상인 53명에게 2주 간격으로 검사-재검사를 시행, 분석한 결과 4개 하위척도 점수와 척도 전체 점수간의 상관계수가 .53-.71로 모두 유의한 상관성을 보였다. 한편 내적 일치도는 4개 하위척도의 Cronbach's ${\alpha}$가 .62-.72, 척도 전체의 Cronbach's ${\alpha}$가 .76로 유의한 수준을 보였다. 공존 타당도의 평가는 공격성질문지 (Aggression Questionnaire) 총점, 상태-특성분노표출척도(State-Trait Anger Expression Inventory), 스트레스반응척도(Stress Response Inventory)의 분노 및 공격성 하위척도, Symptom Checklist-90-Revised (SCL-90-R)의 적대감 하위척도를 사용하였다. 환자군과 정상군 간에 척도의 전체 점수와 하위척도 점수를 비교한 결과 도피반응과 분노억압반응 하위척도에서만 각각 유의한 차이를 보였고 공격성 및 짜증반응, 척도 전체 점수에서는 유의한 차이를 보이지 않았다. 도피반응 하위척도 점수에서 우울장애군과 신체형장애군은 각각 정상군보다 유의하게 더 높았다. 결론: 이상의 결과들은 분노반응 척도가 신뢰도 및 타당도가 모두 유의한 수준의 도구이고, 특히 도피반응은 우울장애군 및 신체형장애군의 특징적인 분노반응일 가능성을 시사해 준다.

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간호대학생의 대학생활적응 모형 (Construction of the structural equation model on college adaptation in nursing students)

  • 김영선;서지영
    • Journal of the Korean Data and Information Science Society
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    • 제26권6호
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    • pp.1439-1452
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    • 2015
  • 본 연구는 간호대학생의 대학생활적응에 영향을 미치는 변수를 확인하고 구체적인 경로와 그 영향력을 규명하여 간호대학생의 대학생활적응에 대한 모형을 개발하고자 시도되었다. 구조모형에 사용된 변수로는 모애착, 자아개념, 스트레스, 임상실습스트레스, 심리적 안녕감, 대처와 대학생활 적응이었다. 연구결과 수정모형의 적합도는 ${\chi}^2=231.1$ (p <.001), ${\chi}^2/df=2.36$로 적합한 것으로 나타났으며, GFI=.91, AGFI=.86, NFI=.91, PNFI=.73 RMSEA=.07, CFI=.95로 권장수준을 만족하였다. 변수들 중 애착, 자아개념, 스트레스, 대처방식과 심리적 안녕감은 직접으로 대학생활적응에 영향을 주었다. 자아개념은 대처방식과 심리적 안녕감을, 스트레스는 심리적 안녕감을 경유하여 대학생활적응에 영향을 주었다. 또한 이들 변수는 간호대학생의 대학생활적응을 71% 설명하는 것으로 확인되었다. 따라서 간호대학생의 대학생활적응을 증진시키기 위한 방안으로 스트레스감소와 함께, 심리적 안녕감과 대처능력을 증진시킬 수 있도록 자기관리능력 및 자아성장을 추구할 수 있는 학생관리 프로그램 개발 등을 모색하는 것이 중요할 것으로 사료된다.

수술 후 보조적 항암화학요법을 받는 대장암 환자의 일상영양관리 순응도에 대한 질적 연구 (Qualitative Study of Compliance with Nutritional Management in Colorectal Cancer Patient Undergoing Chemotherapy)

  • 박희정;길현선;조우균
    • 대한지역사회영양학회지
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    • 제25권4호
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    • pp.303-316
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    • 2020
  • Objectives: The nutritional status of cancer patients undergoing chemotherapy is closely related to the compliance of nutrition education. However, as chemotherapy is conducted repeatedly, compliance with nutrition management is lowered, leading to malnutrition. Malnutrition is related directly to the quality of life after surgery in cancer patients. Therefore, this study examined the factors related to compliance with nutrition management during chemotherapy. Methods: In this study, five subjects with colorectal cancer undergoing adjuvant chemotherapy were interviewed in-depth using the Giorgi study method. The contents of the nutrition education visits and in-depth interviews were transcribed in the language of the subject after recording, and the appropriateness of the data was improved by reflecting the subject's actions and facial expressions. Results: After conducting the in-depth interviews for each subject, the experience of the subject's diet and adjuvant chemotherapy was drawn into two domains, six elements, and 26 sub-elements. In the cognitive domain, the patients experienced physical and psychological changes, and the need for nutrition management was recognized by analyzing the dietary causes of the diseases. In the domain of practice, a knowing-doing gap was formed, unlike the patient's will. Factors that inhibited compliance with nutritional management included digestive problems, sensory changes, loss of appetite, and social interaction stress. Conclusions: Dietary management is very important for patients receiving periodic anticancer therapy, and step-by-step training and personal monitoring based on the chemotherapy order is necessary to maintain the patient's will and social and environmental support.

자기공명영상 검사에서 외국인 환자를 위한 자동음성 시스템 개발 (Development of Automatic Voice System for Foreign Patients in Testing of Magnetic Resonance Imaging)

  • 구은회
    • 한국방사선학회논문지
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    • 제10권1호
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    • pp.59-64
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    • 2016
  • 본 연구의 목적은 자기공명영상을 이용하여 외국인 환자를 검사할 때 언어의 소통을 위하여 자동음성시스템을 개발하고자 하였다. 자동음성을 위해 사용된 문장은 병원에서 자주 사용하고 있는 12개의 문장과 5개의 외국어를 선택하였다. 이러한 번역된 문장은 Oddcast's website로 부터 무료로 재공 되며 Wav 파일로서 각 언어 특징에 소리로 기록하게 된다. 기록된 오디오 파일은 Mobile phone 환경에서 적용되는 PHP 프로그램을 사용하여 MS-파워포인트(extension; ppsx) 와 Web-enabled system 형태로 재생하게 된다. 음성 시스템 개발은 방사선사에게 언어 소통의 어려움에 관하여 스트레스를 해소될 것이며, 다양한 언어로 설계된 자동음성시스템은 외국인 환자를 검사 할 때 환자에게 진단적 정보를 증가시킬 것이다. 본 연구를 위해 개발된 음성 시스템은 한국의 방사선사와 외국인 환자 사이에서 검사의 이해를 증가시킬 수 있기 때문에 임상실무에서 더욱더 유용하게 이용될 것이라고 기대된다.

미병상태(未病狀態)의 학문적(學問的).임상적(臨床的) 중요성(重要性)과 의의(意義)에 대한 고찰(考察) (Study on the Siginificance and Importance of Preclinic Phase Theory(=mibyung) in Oriental Medicine)

  • 이선동;김명동
    • 대한예방한의학회지
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    • 제1권1호
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    • pp.105-117
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    • 1997
  • The result of this paper runs as follows: 1. The theory of preclinic phase (=mibyung) was scientifically completed as one basic philosophy in "NAEKYUNG(內經)" and on influenced in the coming generations. Two principles for mibyung is to grow good energy and to avoid etiological cause. 2. So far oriental medicine has responded to already diseases, while to recognize the importance of mibyung is to convert it into preventive medicine which study and improve health. In spite of the opinion that no disease is health and no health is disease, the contrite of medical approch by the relative importance is necessary by understanding the steps of mibyung between health and disease with subdividing the steps of the occurance therefore, the scope of oriental medicine may be recognized from every disease to mibyung, that is, health. 3. Diagnosing and treating in the step of mibyung has more important meaning than suffering step because the checkup of mibyung means early examination and treatment. Mibyung can make an opportunity that improve scientific contradiction and defect of oriental medicine. However, scince the theory and practice lack the arrangement and study, much exertion and discussion is necessary.4. The diagnosis and cure in mibyung doesn't have many methods for treating, its index and standard isn't nified, and related theory is of small quantity. But the most prominent means of solution. with combination with other sciences and through the convertion into modem clinical examination, is to accomplish moderization, objectivity and indexation, etc. 5. The representive mibyungs are a hereditary disease, immune lack, mutation, early tumor, incubation of hepatitis and each infectious diseases, stress, etc. Since every science is the product of the times, it has the historical limits. As the times develop, the desire for good health is growing. Therefore we should consider above request in this times.

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암 위험요인과 관련된 식이와 환경요인에 관한 간호학생의 인식 (Nursing Students식 Perceptions on Diet and as Environmental Factors Related to Cancer Risk Factors)

  • 이혜경;전성주;황미혜;서순림
    • 대한간호학회지
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    • 제28권1호
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    • pp.193-200
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    • 1998
  • The purpose of this study was to identify how students majoring in nursing perceive causes of cancers and the effects of diet for preventing cancers. Data for the study were collected by 651 nursing students, who were registered in the second and third year in three technical colleges and third and fourth year in two universities. The Research instruments included items on general characteristics of subjects, items about the degree of perception of the frequency of cancer onset and items on the perception of mortality. risk factors. preventive diets, knowledge, and high risk factor for cancer in specific body areas. The findings of this study are as follows : 1. Almost all subjects(92.8%) reported that the frequency of cancer onset increases and that it is 93.9% for people over 40. Degree of perception about cancer mortality was low at 33.0%. 2. As far as the perception of risk factors for cancer onset was concerned, smoking, stress, heredity, family history, and alcohol were rated high, over 80.0%. Risk factor in. eluding virus, hormones. pesticides were rated as low. 3. As to the perception of risk factor for body area as associated with diet salted and scorched food were rated at 44.5% for stomach cancer, alcohol, 50.4% for liver cancer, smoking. 72.8% for lung cancer. pregnancy times. 25.3%, and marriage age, 23.0% for uterine cancer, and no delivery experience, 40.1% for breast cancer. 4. The knowledge score for cancer was between 12 and 36, with a mean score of 26.75(SD=4.13). There was a statistically significant difference between experience in raring for cancer patients during clinical practice and knowledge score(t=3.09. p=.002).

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폐경 전 전업주부의 대사증후군 관련 요인: 2010~2015년 국민건강영양조사자료분석 (The Prevalence and Associated Factors of the Metabolic Syndrome in Pre-menopausal Housewives: An Analysis of the 2010~2015 Korean National Health and Nutrition Examination Survey)

  • 김철규;김영지
    • 지역사회간호학회지
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    • 제29권1호
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    • pp.108-119
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    • 2018
  • Purpose: The purpose of this study is to estimate the prevalence of the metabolic syndrome in pre-menopausal housewives and to explore controllable and uncontrollable factors regarding metabolic syndrome. Methods: The study population of this cross-sectional survey was from the Korean Health and Nutrition Examination Survey (KHANES) 2010 through 2015, including the fifth and sixth population-based studies. The criteria for metabolic syndrome include waist circumference, blood pressure, fasting plasma glucose, triglyceride, high-density lipoprotein (HDL) based on Korean Clinical Practice Guideline for Metabolic Syndrome by the Korean Academy of Family Medicine 2015. Results: Among the 2,498 subjects, 247 subjects had metabolic syndrome and the prevalence was estimated to be 9.9%. The number of subjects who met the criterion of HDL was 936 (36.2%), which was the most prevalent among the criteria for metabolic syndrome. Statistically significant (p<.05) factors include age, livinghood benefit group, perceived health status, obesity, family history of DM, sleeping time, awareness of stress,leukocyte, and erythrocyte count. The odds ratio of obesity in the BMI ${\geq}25$ group was 12.59 times as high as that of the BMI <25 group (p<.001) for metabolic syndrome. Conclusion: The prevalence of metabolic syndrome in pre-menopausal housewives in the survey was not low, and it is necessary to develop and apply comprehensive health habit management programs to improve controllable factors including exercise and food intake.

임상물리치료에 있어서 아로마테라피의 활용 (The Utilization of Aromatherapy in Clinical Physical Therapy)

  • 장정훈;정동혁;박래준
    • The Journal of Korean Physical Therapy
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    • 제15권1호
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    • pp.82-95
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    • 2003
  • Our health is intimately connected to the health of our environment. The contemporary world view which sees a radical distinction between humans as subjects and world as object can obscure our recognition of how much we rely on nature for health and survival. Indigenous traditions and contemporary scholars remind us that we live in a universe in which all things are connected, and in which nature continues to offer its gifts in co-creative partnership for the health and wellbeing of all. Living in awareness of our relationship with nature enables us to open more to the experience of nature's nurturing. Many complementary therapies derive from ancient practices that involve nature in healing partnership. Essential oils have been used for thousands of years. Hippocrates claimed that the way to health was through aromatic baths and massages. Much anecdotal evidence exists regarding aromatherapeutic positive effects on recipients. Aromatherapy is a branch of complementary or alternative therapy which is increasing in popularity, yet has scant scientific credibility. Aromatherapy should be defined as treatment using odors and practised as such. However, essential oils are usually used in conjunction with therapeutic massage and often combined with counselling of some kind. Aromatherapy complements and enhances the therapeutic powers of massage. Massage is one of the most wonderful ways to relax and is throughly beneficial to health. Massage can help unknot tense and aching muscles and other minor symptoms of stress, leaving patients fresh and energized. As the use of aromatherapy within a health care setting has grown so rapidly in recent years, and will continue to do so, the need for suitable training has become apparent. No health service can afford the risk of having staff who are inadequately trained in the practice of aromatherapy using essential oils incorrectly on those in a state of ill-health, especially if the essential oils used are not to a standard suitable for therapeutic use. Training to an acceptable level in aromatic therapy is essential for safety and effectiveness. Knowledge of the nature and make-up of essential oils, their effect on the body and the emotions, and how, when, and where to apply them is imperative in order for them to be beneficial to a patient's health. In order to achieve best practice, further research is necessary to explore the use of aromatherapy in the management of multiple disorder.

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