• The Korean Journal of Pain
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• v.19 no.1
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• pp.91-95
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• 2006

Background: Opioid delivered by epidural patient-controlled analgesia (PCA) is effective in relieving pain after surgery, but it is associated with side effects, such as nausea, vomiting, pruritus, respiratory depression, and urinary retention. The purpose of this study was to compare hydromorphone related side effects and the quality of analgesia when naloxone was added to epidural PCA regimen. Methods: Fifty-two thoracotomy patients with PCA were allocated blindly into two groups. Patients in group H (n = 26) received continuous epidural hydromorphone ($16{\mu}g/ml$) in 0.1% bupivacaine; patients in group N (n = 26) received an epidural infusion containing naloxone ($2{\mu}g/ml$) and hydromorphone ($16{\mu}g/ml$) in 0.1% bupivacaine. The basal rate of PCA was 4 ml/hr and the demand dose was 1.5 ml with a lockout time of 15 min. Pain intensity, sedation, pruritus, nausea and vomiting, respiratory depression were checked at 6, 12, 24 hours postoperatively. Results: The Visual Analog Scale (VAS) scores were significantly lower in group H than in group N. There were no significant differences in the overall incidence of pruritus, nausea and sedation between the two groups. Conclusions: Continuous epidural infusion of naloxone combined with hydromorpho-ne is not effective in reducing the incidence and severity of pruritus induced by epidural hydromorphone.

• Korean Journal of Biological Psychiatry
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• v.15 no.1
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• pp.14-22
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• 2008

Objectives : The authors purposed to present data for explaining gene-environmental interaction causing depressive disorder by examining the effects of genetic factors related to the serotonin system and environmental factors such as stressful life events in early adulthood. Methods : The subjects were 150 young adults(mean age 25.0${\pm}$0.54), a part of 534 freshmen who had completed the previous study of genotyping of TPH1 gene. We assessed characteristics of life events, depression and anxiety scale and checked if they had a depressive disorder with DSM-IV SCID interview. Along with TPH1 A218C genotype confirmed in previous study, TPH2 -1463G/A and 5HTR2A -1438A/G genes were genotyped using the SNaPshot$^{TM}$ method. Results : In comparison with the group without C allele of TPH1 gene, the number of life events had a significant effect on the probability of depressive disorder in the group with C allele. Other alleles or genotypes did not have a significant effect on the causality of life events and depressive disorder. Conclusion : The results of this study suggest that TPH1 C allele is a significant predictor of onset of depressive disorder following environmental stress. It means that the TPH1 gene may affect the gene-environmental interaction of depressive disorder.

• Korean Journal of Hospice Care
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• v.2 no.1
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• pp.21-40
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• 2002

Cancer is the second leading cause of the death in Korea. Family caregivers of dying patients manifest many psychological and physical symptoms of stress, and they often seek for informational support from health care providers. Unfortunately, however, few systematic studies identify the actual effect of such support on family caregivers. This study, thus, intends to evaluate the effect of informational support for hospice care. One group pretest-posttest design was used, employing the stress-coping model by Cohen and Wills as a conceptual framework. This research was conducted from July 1 to November 15, 1998, initially with 32 subjects sampled from hemato-oncology department of two general hospitals in Seoul, but reduced to 18 at the end due to the untimely death of patients or caregiver's refusal during the course of study. Informational supports were programmed to provide the family caregivers with 8 times of education and counseling as well as 24-hour hot-line for 4 weeks. A booklet that explains the various problems of hospice care was also prepared and distributed to all subjects. Data were collected by using self-report questionnaires and reviewing medical records. The tools used in this study were based on the Weinert's PRQ-II(scale of perceived social support), Spielberger's state anxiety inventory, and CES-D. Also included in the data collection were the general characteristics of family caregivers and patients, and the pain intensity and the performance status of patients. The data were analyzed with descriptive statistics, Wilcoxon sign rank test and paired t-test using SPSSWIN program. The results of the study were as follows: 1.The perceived social support of family caregivers was not significantly increased with informational support for hospice care(t=1.64, one tailed p=.060). 2.The anxiety of family caregivers was significantly reduced following informational support for hospice care(t=3.48, one tailed p=.002). 3.The depression of family caregivers was significantly reduced following informational support for hospice care(t=-2.18, one tailed=.022). 4.The pain intensity of patients with terminal cancer was significantly reduced following informational support for hospice care(t=-2.41, two tailed p=.027). The results suggest that the informational support provided to family caregivers of patients with terminal cancer reduced not only their anxiety and depression but also the pain intensity of patients. Further study is necessary to consolidate the conceptual framework of this study with expanded number of subjects. Nevertheless, it was certain that the informational support program for hospice care was very helpful to both caregivers and patients. Thus, the informational support program is strongly recommended for the hospitals which have no hospice unit yet.

• Journal of Environmental Health Sciences
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• v.8 no.1
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• pp.67-80
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• 1982

In order to evaluate the psychosomatic health status of metal manufacturing industries workers and their working environments, the present study was conducted from March 1, 1981 to the end of September 1981. The data was obtained from the samples of metal manufacturing industries in Kyung-In Area and their 1, 162 employees. In addition, the 803 urban residents including students, office clerks, and general publics were sampled as control groups to compare with factory employees in psychosomatic analysis. The basic tool employed in the present study was the Todai Health Index (THI) which modified CMI and was developed by Tokyo University Research Team of Japan. The results of the present study were summarized as follows: 1. Working environments of the factories 1) The data shows that fabrication shop produced the highest noise level ranging from 91 to 96 dB (A) and iron and steel shop had the lowest noise level ranging from 81 to 86 dB (A). 2) Dust concentration was the highest in iron foundry shop ($3.8 mg/m^3$) and the lowest in fabrication shop ($1.2 mg/m^3$). 3) WBGT above threshold limit values (T.L.V.) was noted in steel shop (38$\circ$C) and iron foundry shop (34$\circ$C) 4) The concentration of Sulfur dioxide ($SO_2$)was 30.5ppm at steel shop and 12.0ppm at iron foundry shop. 5) The concentration of carbon monoxide (CO) was 140.0ppm at steel shop and 110.5ppm at iron foundry shop. 6) The atmospheric lead concentration was $0.49 mg/m^3$ at soldering shop. 2. The responses of psychosomatic complaints were much higher in steel shops group than in other manu-facturing group, except the response of aggressiveness. 3. The responses of psychosomatic complaints were much higher in industrial workers than in urban residents, except the responses of depression and aggressiveness (p < 0.01 ). 4. The psychosomatic symptoms which industrial workers and urban residents complained frequently were nervousness. agressiveness and lie scale in order. 5. The responses of psychosomatic complaints by sex were much higher in female group than in male group, except the response of aggressiveness. 6. The responses of psychosomatic complaints by age were that both the female and male group showed an increasing tendency in the all items, except the response of depression as age was increasing. 7. The responses of psychosomatic complaints by the length of services were that both the female and male group showed a tendency of increasing in physical symptoms as work years increased. 8. The responses of psychosomatic complaints were higher in unmarried group in the score of nervousness, aggressiveness, mental irritability and irregular life.

• Journal of Preventive Medicine and Public Health
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• v.50 no.1
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• pp.1-9
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• 2017

Objectives: By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands. Methods: From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men) from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6), that is, smoking habits, diet quality (MedDietScore), depression status (Geriatric Depression Scale) and physical activity. Results: Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p<0.05), irrespective of age, gender, several clinical characteristics, or socioeconomic status of the participants (an almost 50% adjusted increase in the lifestyle score from before 2009 to after 2009, p<0.001). Conclusions: A shift towards less healthy behaviours was noticeable after the economic crisis had commenced. Public health interventions should focus on older adults, particularly of lower socioeconomic levels, in order to effectively reduce the burden of cardiometabolic disease at the population level.

• Anxiety and mood
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• v.16 no.1
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• pp.9-17
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• 2020

Objective : The purpose of this study was to investigate the association of depressive/anxiety symptoms with psychosocial factors including ego resilience, social conflict, and social support as well as hemoglobin A1c in patients with diabetes mellitus (DM). Methods : The subjects were 144 patients with DM. Depressive/anxiety symptoms were evaluated by the Hospital Anxiety and Depression Scale. Sociodemographic factors, hemoglobin A1c, ego resilience, social conflict, and social support were measured. Multiple regression analyses were performed to examine the impact of hemoglobin A1c, ego resilience, social conflict, and social support on depressive/anxiety symptoms. Results : A total of 32.6% and 24.3% of participants were identified with depressive and anxiety symptoms, respectively. Depressive/anxiety symptoms positively correlated with the social conflict score. Conversely, ego resilience and social support negatively correlated with depressive/anxiety symptoms. In the final model of the multiple regression analyses, ego resilience was associated with a lower level of depressive (β=-0.083, p=0.019)/anxiety (β=-0.125, p=0.001) symptoms whereas social conflict was related to a higher level of depressive (β=0.353, p=0.011)/anxiety (β=0.460, p=0.003) symptoms. Also, hemoglobin A1c positively associated with anxiety symptoms (β=0.495, p=0.012) whereas social support negatively related to depressive symptoms (β=-0.464, p=0.004). Conclusion : We found possible risk and protective psychosocial factors of underlying depressive/anxiety symptoms among patients with DM. Our findings suggest that enhancing ego resilience and social support as well as decreasing social conflict would be crucial in the prevention and management of depressive/anxiety symptoms in patients with DM.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.29 no.4
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• pp.550-561
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• 2019

Objectives: The purpose of this study is to provide basic data for the improvement of the working environment for health prevention and related countermeasures for shift workers. This study was conducted based on the Fifth Korean Working Conditions Survey (KWCS), which analyzed the health effects of shift work forces and compared them with preceding studies. Methods: By analyzing secondary rates using raw data from the 5th KWCS, 4,870 (9.7%) of the 50,184 total study subjects were divided into shift work and 45,314 (90.3%) non-shift work groups based on the response to shift status. Variables that could affect work health issues were identified and corrected. A cross-analysis was conducted to examine demographic characteristics (gender, age, and education level) of the workers and occupation characteristics (monthly net earnings, employment type, occupation, working period up to now, workplace scale, type of work system, and weekly working hours). In order to find the work health issue ratio between the shift and non-shift work groups, logistic regression was analyzed and the association with health problems according to shift type by gender was looked at through cross-analysis. Results: According to the surveys conducted from the 1st KWCS (2006) to the 5th KWCS (2017), the proportion of shift workers continued to increase. Also, muscular pains in the lower limbs (hips, legs, knees, feet, etc.) (OR=1.135, 95%CI 1.031-1.251), headaches, eyestrain (OR=1.580, 95% CI 1.428-1.748), anxiety (OR=1.715, 95% CI 1.402-2.099), difficulty falling asleep (OR=1.391), and other problems (OR=7.392) were reported. In addition, back pain, muscular pains in shoulders, neck and/or upper limbs, muscular pains in lower limbs (hips, legs, knees, feet, etc.), headaches, eyestrain, depression, anxiety, overall fatigue resulted in significant results for both male and female shift workers. Depression and anxiety were higher in female shift/circulation compared to males. Conclusions: The social nets for the health and safety of shift workers should be explored in a variety of ways, including management and supervision of shift sites, attempts to reorganize and improve the shift system, development of workers' health recovery programs, promotion, systematic treatment, and compensation systems.

• Journal of the Korean Regional Science Association
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• v.11 no.1
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• pp.79-91
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• 1995

As an exit to solve the economic depression of the development countries in the early twentieth century, the 'old international division of labor' developed. The economic crisis(i.e., under-consumption crisis) was due to the absence of the mode of regulation compatible with the extensive regime of accumulation(i.e., "Fordist" regime). The crisis was solved by the state intervention through the creation on institutions in order to increase the level of consumption. Until the late 1960s when "high Fordism" reached(i.e., a harmonious relation between the monopoly mode of regulation and the intensive accumulation of capital), the developed core countries enjoyed a remarkable economic growth. The external market was not a necessity for the economic growth because there were increases in labor productivity and proportional increases in real wages and thus increases in consumption level. In the 1970s, however, the core faced with economic crisis again. Due to the breakdown of the postwar "Fordist" regime of capital accumulation and the post 1973 world depression, the core needed the Third World as a solution for their internal and international economic crisis. Thus the 'new international division of labor'(NIDL) arose. The "Fordist" method of production(i.e., the divisions of production process) led to the territorial division of labor and to the detailed division of labor. The aim of the NIDL is to exploit reserve armies of labor on a world scale and thus to reduce production costs. According to the NIDL model, the Third World countries have been developing by the core countries' investment on mainly labor-intensive industries and thus have been playing an important role in the global economy. And the NIDL theorists argue that multinational corporations have increasingly invested in the Third World nations and contributed to the economic growth in those regions. Tables presented in the paper show that the global trend since the 1970s does not follow the argument exactly as the NIDL theorists predicted. On the contrary, the core countries focus on developing technology, adopting the automation of production process, and trading within the core countries rather than on investing in the periopheral countries. The continuing investment of multinational corporations into the periphery is not because of cheap labor force but because of the market potentials in the regions. Majority of corporations of the core tries to reduce production costs by investing in technological development more intensively and also by changing regional strategies (i.E., investment from metropolitan areas to medium - or small - size cities, focusing on agglomeration economy, boosting regional diversification, etc.) within their own countries. The main purpose of the paper is to review and to criticize the NIDL theory based on some empirical data.IDL theory based on some empirical data.

• Journal of Korean Academy of Nursing
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• v.23 no.3
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• pp.431-452
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• 1993

This study was done to determine the effect of music therapy on stress and quality of life in patients undergoing hemodialysis. The research design was a nonequivalent control group pre -post test design. The subjects consisted of 21 patients who received hemodialysis in two hospitals located in Kwang Ju. The fourteen receiving treatment in one hospital were assigned to the experimental group and the seven in the other hospital to the control group. Data were gathered from December 14, 1992 to January 16, 1993 through questionnaires and physiological measurement. Data were analyzed by the SAS package using frequency, t-test, paired t-test and Pearson Prod uct - Moment Correlation Coefficient. The results of this study are summarized as follows ; 1. There were no significant differences between the two groups on stress scores and quality of life scores before the treatment. 2. The mean score on the psychological stress scale for the patients undergoing hemodialysis was 2.48 out of a maximum mean score of four, the items with high stress scores were “feeling of weakness and annoyed by everything”, “limitation of food”, “limitation of fluid”, “change in skin color” in that order. The psychological category showed the highest stress score followed by developmental, scoioeconomic and physiological stress categories in that order. 3. In the experimental group, post - test diastolic blood pressure decerased significantly(t=3.24, p=0.0064), but in the control group pre and post - test diastolic blood pressure were not different. 4. There was no difference between the two groups on the pre and post -test psychological stress scores or the depression scores. 5. The mean score of quality of life for patients undergoing hemodialysis was 2.75 out of a maxi-mum mean score of five. The category of ‘emtional state’ showed the highest score followed by ‘self - esteem’, ‘physical state and function’, ‘economic life’, ‘relationship with neighbors’ and ‘family relationship’ categories in that order. There was no significant difference in the pre and post - test quality of life scores between the two groups. 6. Hypothesis 1 that patients undergoing hemodialysis who received music therapy would have less stress than patients undergoing hemodialysis who did not receive music therapy is divided into two sub - hypotheses. 1) The first sub-hypothesis that patients undergoing hemodialysis who received music therapy would have less physiological stress than patients undergoing hemodialysis who did not receive music therapy was partly supported. Among three physiological stress indices (pulse, systolic blood pressure, diastolic blood pressure), only diastolic blood pressure decreased significantly after the treatment in the experimental group. 2) The second sub-hypothesis that patients undergoing hemodialysis who received music therapy would have less psychological stress than patients undergoing hemodialysis who did not receive music therapy was not supported. Psychological stress score and depression score were not significantly different before and after the treatment. 7. Hypothesis 2 that patients undergoing hemodialysis who received music therapy would have a higher quality of life score than patients undergoing. hemodialysis who did not received music therapy was not supported. There were no significant changes in the quality of life scores before and after the treatment.

• Sleep Medicine and Psychophysiology
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• v.6 no.1
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• pp.46-51
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• 1999

Objectives: Patients with premenstrual dysphoric disorder(or PMDD) have impairments of the social, occupational or academic function due to psychological or somatic symptoms, which have the characteristic pattern of symptom exacerbation in the week before menses begin and remission shortly after the onset of menses. In the chronobiological view, many researchers have assumed that the etiology of PMDD is the advanced circadian rhythm. It has been suggested that light has a therapeutic effect on PMDD, because evening light results in phase delay of circadian rhythm through the biochemical changes including melatonin. Methods: The authors investigated the therapeutic effect of light therapy on four patients with prospectively diagnosed PMDD by DSM-IV criteria using clinical psychiatric interview, Premenstrual Assessment Form(PAF) and Daily Rating Form(or DRF). In the evening(6:30pm-8:00pm), the 2,500 lux light administered for seven consecutive days during the symptomatic late luteal phase of menstrual cycle. Beck Depression Inventory(or BDI), Hamilton Rating Scale for Depression(or HAM-D), Spielberg State Anxiety Inventory(or SA), and DRF were evaluated before and after seven days of light therapy. Results: Premenstrual symptoms of PMDD could be effectively treated with the evening bright light therapy, especially in PMDD patients with atypical symptoms. In addition, the light therapy seemed to more effective on the psychologic symptoms than the somatic symptoms of PMDD. There was no significant side-effect of light therapy, except the transient and mild eye-strain in one case. Conclusions: In spite of the results of limited data from our clinical trial, the authors suggest that the potential use of light therapy as an alternative to the pharmacological management of patients with PMDD.