• 한국컴퓨터정보학회논문지
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• 제25권10호
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• pp.151-158
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• 2020

본 연구는 국민건강영양조사의 자료를 이차분석하여 시간적 추이에 따른 19세 이상 한국 성인 암환자의 자살생각 관련 요인을 파악하여 암환자 관리의 기초자료를 제공하기 위해 시도되었다. 자료는 IBM SPSS WIN 22.0 program을 이용하여 2009년, 2017년 2개년도 연구대상자의 인구사회학적 특성, 건강관련 특성, 정신관련 특성을 분석하기 위해 복합표본 빈도분석, 복합표본 교차분석, 복합표본 다중 로지스틱 회귀분석을 이용하여 분석하였다. 연구결과 암환자 자살생각 관련요인은 2009년 활동제한, 우울증상 경험으로 나타났고(Negelkerke R²=.384) 2017년 연령, 결혼상태, 활동제한, 우울증상 경험으로 나타났다(Negelkerke R²=.525). 본 연구는 시간적 추이에 따른 암환자 자살생각 관련요인을 파악하여 관련요인의 변화를 확인했다는 점에서 의의가 있으며, 암환자의 자살을 예방할 수 있는 중재 프로그램의 개발 및 적용이 필요하다.

• 한국보건간호학회지
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• 제30권2호
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• pp.326-336
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• 2016

Purpose: This study was conducted to help with the development of an intervention program in efforts to prevent suicidal ideation and suicide. The study also sought to generate strategies for improving health conditions by ascertaining and analyzing potential factors that may influence suicidal ideation according to age group in adults. Methods: Data on general characteristics and suicidal ideation from 447 adults aged between 20 and 59 years, living in Y city, Gyeonggi Province, South Korea, were collected based on a structured questionnaire, The data were analyzed using SPSS20.0 statistics program. Results: The results showed that 48.6% of young and older adults have experienced suicidal ideation while 44.5% of middle-aged adults have had suicidal thoughts. With regard to suicidal ideation, young and older adults revealed relevant differences in terms of gender, residential type, degree of stress and subjective physical and mental health, while middle-aged adults revealed relevant differences in terms of marital status and degree of stress. With regard to factors that influence suicidal ideation, it was found that the relevant variables of young and older adults included gender, residential type, depression, degree of stress, and subjective physical and mental health, while for middle-aged adults, relevant variables included marital status and degree of stress. Conclusion: These findings indicate that as stress and depression decreases, subjective physical and mental health improves. Therefore, this study proposes that developing and operating an intervention program can help prevent suicidal ideation in local residents.

• 한국보건간호학회지
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• 제27권1호
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• pp.113-128
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• 2013

Purpose: The purpose of this study was to investigate the degree of suicidal risk, meaning in life, and life respect in various ages of patients and identify factors influencing their life respect. Method: The participants were 229 patients in a public hospital who completed questionnaires. Data were analyzed using descriptive statistics, t-test, Fisher's exact test, ANOVA with Duncan post hoc test, and multiple regression. Results: There was a negative correlation between the meaning of life and life respect in the old age group (r=-.23, p=.02) and all subjects (r=-.14, p=.01) after controlling for age. Factors significantly influencing life respect were gender (${\beta}$=0.11, p=.050) and educational status (${\beta}$=-0.17, p=.022), and the multiple regression model explained 16.7% of the variance in all subjects (p<.001). In the early adulthood group, factors significantly influencing the life respect were gender (${\beta}$=0.18, p<.001) and suicidal thoughts (${\beta}$=0.21, p=.028), and the multiple regression model explained 6.8% of variance in all subjects (p=.001). Conclusion: The results of this study suggest that suicidal prevention and educational programs for increasing an appreciation of life should consider subject's characteristics, such as gender and educational status.

• Safety and Health at Work
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• 제8권1호
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• pp.77-83
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• 2017

Background: In contemporary China, most parents are dual-earner couples and there is only one child in the family. We aimed to examine the associations of parents' work stress with suicidal ideation among the corresponding adolescent. We further hypothesized that low parental support experienced by adolescents may mediate the associations. Methods: Cross-sectional data from school students and their working parents were used, with 907 families from Kunming City, China. Stress at work was measured by the effort-reward imbalance questionnaire. Perceived parental support was assessed by an item on parental empathy and their willingness to communicate with the adolescent. Suicidal ideation was considered positive if students reported thoughts about suicide every month or more frequently during the previous 6 months. Logistic regression was used to examine the associations. Results: We observed that parents' work stress was positively associated with low parental support, which was in turn associated with adolescent suicidal ideation. The odds ratio for parents' work stress and adolescent suicidal ideation was 2.91 (95% confidence interval: 1.53-5.53), and this association was markedly attenuated to 2.24 (95% confidence interval: 1.15-4.36) after additional adjustment for parental support. Notably, mothers' work stress levels exerted stronger effects on children's suicidal ideation than those of fathers. Conclusion: Parents' work stress (particularly mother's work stress) was strongly associated with adolescent's suicidal ideation, and the association was partially mediated by low parental support. These results need to be replicated and extended in prospective investigations within and beyond China, in order to explore potential causal pathways as a basis of preventive action.

• 응용통계연구
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• 제20권3호
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• pp.449-458
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• 2007

양극성 장애 (bipolar disorder)는 조증 삽화 (manic episode)와 우울증 삽화 (depression episode)를 반복적으로 경험하는 기분장애이다. 양극성 장애환자에게 우울증은 조증보다 심각한 결과를 가져오며, 치료의 효과를 측정하기도 어렵다고 알려져 있다. 본 연구의 목적은 우울증(depression) 상태에 있는 환자들을 대상으로 항우울제를 사용하여 정상 (normal) 상태로 전환했을 때, 약물의 장기 사용으로 일어날 수 있는 조증 (mania)과 같은 부작용을 통제하고자 한다. 이를 위해 정상 상태에서 조증으로 전환하는데 소요되는 시간의 분포를 추정한다. 본 연구에서는 세 가지 방법, 모수적, 비모수적 그리고 준모수적 방법을 차례대로 적용하였다. 특히 기분 전환의 흐름을 파악하기 위해 3단계 모형을 사용하였다. 예를 들어, Illness-Death 모형하에서 기분 전환의 발생시점에 대한 분포를 추정하기 위해 계수 과정에 의해 기분 전환에 대한 과정을 모형화하였다.

• 우울조울병
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• 제16권3호
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• pp.152-157
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• 2018

Objectives : The purpose of this study was to examine psychosocial factors influencing suicidal ideation of community dwelling elderly, using the senior community center in Jeonnam Province. Methods : A total of 2,202 subjects (369 males, 1,833 females) were recruited. We evaluated sociodemographic factors, using a self-reporting questionnaire. Subjects completed the Geriatric Depression Scale-Short Form Korean Version (SGDS), Multi-dimensional Scale of Perceived Social Support (MSPSS), Korean version of the General Health Questionale-12 (GHQ-12) and Satisfaction with Life scale (SWLS), to assess psychosocial factors affecting suicidal ideation. Results : Among 2,202 subjects, 179 (8.1%) reported recent suicidal ideation. Self-perceptive health status (p<0.001) and physical disease (p=0.002) revealed differences between two groups. The scores of four scales in the suicidal group were significantly different from the control group: SGDS (p<0.001) and GHQ-12 (p<0.001) were higher, while MSPSS (p<0.001) and SWLS (p<0.001) were lower, in the suicidal ideation group than the control group. Multivariate logistic regression analysis revealed that physical disease (OR 2.575, 95%CI 1.022-6.492), SGDS (OR 1.181, 95%CI 1.120-1.246) and GHQ-12 (OR 1.192, 95%CI 1.108-1.283), were significantly associated with suicidal ideation. Conclusion : Findings support that physical disease, depression, and general mental health may correlate to suicidal ideation in the elderly.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제33권3호
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• pp.73-81
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• 2022

Since dissociative identity disorder (DID) has symptoms similar to schizophrenia, such as auditory hallucinations and delusional thoughts of being controlled, there are difficulties in its differential diagnosis. A 16-year-old adolescent male patient who was previously diagnosed with schizophrenia from a different hospital was admitted to our inpatient psychiatric unit for the evaluation of auditory hallucinations and suicide attempts. Through psychiatric evaluations, it was determined that the patient suffered from identity alternation, dissociation, and amnesia. As for the diagnostic evaluations, the following measures were implemented: a psychiatric interview regarding the diagnostic criteria, mental status examination, laboratory tests, brain imaging studies, electroencephalography, and full psychological test for adolescents, and the self-reported measure of the Adolescent Dissociative Experiences Scale. The patient was diagnosed with DID, and the following treatments were administered: pharmacotherapy, ego state therapy, psychoeducation regarding emotions, trauma-focused psychotherapy including stabilization, and family therapy. Following treatment, in the internal dimensions, the patient was able to recognize the nine alternate identities in charge of his emotions, which established a basis for the potential integration of identities. In the external dimensions, he showed improvements in the aspects of family conflicts and issue of school refusal. This is the first reported case of DID in an adolescent in Korea; it emphasizes the consideration of DID in the differential diagnosis of other mental illnesses such as schizophrenia, bipolar disorder, and posttraumatic stress disorder and expands the treatment opportunities for DID by sharing the procedures of ego state therapy.

• 대한간호학회지
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• 제4권1호
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• pp.162-178
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• 1974

The present study is purported to provide a basic information to be utilized by nurses to care and attend effectively for patients nearing the moment of death. Therefore, the primary purpose of the study has been placed upon grasping an understanding of the trends of death in general. For this purpose: 1. By utilizing the schneidman questionnaire, the trend of death has been categorized by 6 parts and analyzed. 2. A search has been conducted to find out dying patient's needs, nurse's attitudes viewed by the patient, and nurse attitudes to dying patient. The followings are itemized results of analysis: 1. Analysis by the schneidman questionnaire. (1) In general concepts of death. the first sighting of the occurrence of death was experienced upon strangers, grandfather and great grandfather. The death is openly discussed among people of all ages and sex. Ages in which the death is mostly feared were from 12 to well over 70 yews old that are evenly distributed regardless of difference in age. (2) As to the attitudes toward death the occurrence of death to most closely associated person influenced most upon the attitude of their own termination of lives. Among the reading materials, the maximum influence was effected by the Bible. In terms of religion, the thoughts of death were Influenced by religions education in case of the believers of the western religions (36%), and by their own health and physical conditions in case of the believers in the oriental religions (35%). In case of non-believer, their attitude toward death were largely determined through their own thinking meditation (45%). People aged 20 or thereunder revealed that they wished to know the day of their own death to be occurred (58%). However, the older the less thor wanted to know. (3) As to the choosing the time of death, 57% preferred senility, and 30% preferred the time in mediately following the prime period of their lives in general. In terms of religion, 85% of the believer in the oriental religion preferred senility, and 67% in the western religion, 58% in others, Therefore. the desiring of their lives to be terminated in earlier stage, not by the natural senility. sequenced as follows : Others, western religions and oriental religions. (4) Referring to the disposal of the corpse under the assumption that it had already occurred, majority desired the burial system. There has been seen a slight tendency to consider the importance of holding funeral services for the sake of survivors. Concerning the life insurance policy, it showed that the nurse had less belief in it than the patient (5) Upon the subject of life-after-death. religion wise, 72% of western religion believers preferred to have an existence of life-after-death: Among the believers of oriental regions, 35% desired this category, 30% did not mind either way. and 35% did not desire the existence of such a life-after-death. In others, 53% did not mind whether or not such a life existed. (6) In general, serious thoughts were not being attended to the commitment of suicide. 37% emphasized that such an act should be prevented. However, 30% insisted that such commitment should not be bothered, and that society possesses no right to prevented it. More male wished to commit suicide (13%) than females (9%). 2. Nurse's attitudes toward terminal patients and patient's needs. In the instance where the patient realized that their death is imminent, most of them showed desire to discuses mainly on the problems of life. When faced a situation of this nature, it is revealed that 40% of nurses could not furnish appropriate care for them.

• 농촌의학ㆍ지역보건
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• 제38권2호
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• pp.116-129
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• 2013

이 연구는 건강플러스 행복플러스 사업의 기초자료를 활용하여 우리나라 지역사회에서 자살생각 및 자살시도의 수준을 알아보고, 이들과 사회적 참여와 신뢰의 사회적 자본과의 연관성을 규명하고자 수행되었다. 자료는 경상남도에서 표준화사망비가 상대적으로 가장 높은 40개 읍, 면, 동에서 체계적 표본 추출로 선정된 220 가구의 구성원 중 가장 생월일이 빠른 19세 이상 성인을 대상으로 직접 면접 방법으로 수집하였다. 자료 수집 기간은 2010년, 2011년, 그리고 2012년의 8-10월이었으며, 최종 자료 분석 대상자는 8,800명이었다. 사회적 참여는 공식 집단 또는 비공식 집단에 참여하는 여부로, 신뢰수준은 영국의 국립 사회조사센터의 신뢰 설문 3 항목을 번역한 질문에 대한 긍정적 답변의 수로 구하였다. 자살생각은 '최근 1년 동안 죽고 싶다는 생각을 해본 적이 있습니까?' 자살시도는 '최근 1년 동안 실제로 자살시도를 해 본 적이 있습니까?' 라는 질문에 대한 '예', '아니오'의 대답으로 구하였다. 인구사회학적 변수(성, 연령, 결혼상태, 직업, 식생활안정성), 주관적 건강수준, 그리고 건강행태 변수(흡연, 음주, 운동)를 모두 통제한 로지스틱 회귀분석에서 사회적 참여와 신뢰수준은 자살생각 및 자살시도와 유의한 연관성이 있었다. 사회적 참여와 신뢰 변수는 모형의 적합도를 유의하게 개선하였다. 신뢰수준은 0인 경우를 기준으로 할 때 신뢰수준이 1인 경우 자살생각에 대한 교차비는 0.77(95%신뢰구간,0.63-0.94), 신뢰수준 3인 경우 자살생각에 대한 교차비는 0.69(95% 신뢰구간, 0.56-0.85)로 유의하였다. 사회적 참여는 둘 다 미참여하는 경우를 기준으로 할 때 비공식집단만 참여하는 경우 자살시도에 대한 교차비는 0.41(95% 신뢰구간, 0.21-0.80)로 유의하였다. 결론적으로 다른 변수와는 독립적으로 사회적 참여와 신뢰의 사회적 자본은 자살생각 또는 자살시도와 유의하게 연관되어 있었다. 사회적 자본이 자살행동을 예방할 수 있는지에 대해서는 더 많은 연구가 필요하다.

• 한국산학기술학회논문지
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• 제17권11호
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• pp.584-594
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• 2016

본 연구는 생태학적 관점에서 노인이 생활하고 있는 지역의 경제 사회적 요인이 노인의 자살생각에 실제 영향을 미치는지 실증적으로 분석한 것이다. 분석 자료는 미시와 거시 데이터로 구분하여 미시 데이터는 "2014년도 노인실태조사" 10,248사례가 분석에 사용되었다. 거시데이터는 국가통계포털(KOSIS)에서 제공되는 각 지역별 사회적, 경제적 상황을 나타내는 지표들을 선별, 16개 시도의 2014년도 지역별 경제수준과 자연재해 및 보건과 노인의 여가, 복지 수준을 나타내는 6개 지표가 활용되었다. 분석방법은 분석단위가 개인차원과 지역차원의 2수준 이상의 위계적 특성과 이질성을 고려하여 위계적(다층) 분석 모형(Hierarchical or multi-level analysis model)을 적용하였다. 분석 결과, 노인의 자살생각 여부에는 지역의 생활물가지수와 국가기초수급률, 자연재해피해규모, 그리고 노인인구 대비 노인 대상의 여가 및 복지시설 수가 통계적으로 유의미한 영향을 미치는 것으로 분석되었다. 이상의 분석 결과들을 기반으로 지역사회에서는 자살생각을 증가시키는 주요 요인들을 주목하여 지역차원의 예방과 관리할 수 있는 시스템을 갖추고 노력이 강구 되어야 한다.