• 제목/요약/키워드: long-term depression

검색결과 262건 처리시간 0.026초

노인의 거주유형별 건강증진 행위 영향요인 비교 (A Study of Factors That Influence the Promotion of Healthy Behavior in the Elderly According to Types of Residency)

  • 전은영;김귀분
    • 대한간호학회지
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    • 제36권3호
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    • pp.475-483
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    • 2006
  • Purpose: The goal of this study was to investigate the factors influencing health promoting behaviors in elderly individuals according to types of residency. Method: This was a descriptive study. The subjects were comprised of 243 elderly aged 65 years or over living in 3 large cities. The instruments used for this study were a health promoting lifestyle, perceived health status, geriatric depression short form scale-Korea, social support scale, and self-efficacy. The data was analyzed using SPSS Win 12.0. Result: Powerful predictors of a health promoting lifestyle were depression, self-efficacy, and perceived health status for the elderly living at home. In the cases of the elderly living in institutions, a powerful predictor of a health promoting lifestyle was identified as social support. Conclusion: For the operation of long-term care insurance, a service for home care programs is needed for the elderly living at home in order to reduce depression and to increase self-efficacy and perceived health status. In addition, social support provided by health-care professionals should be developed to promote a healthy lifestyle for the elderly living in institutional environments.

주요우울증에서 치료반응을 예측할 수 있는가? (Can We Predict Treatment Response in Major Depression?)

  • 고영훈;김용구
    • 생물정신의학
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    • 제11권2호
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    • pp.77-87
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    • 2004
  • Due to the high population prevalence of major depression and the strong emphasis on pharmacotherapy for this disorder, antidepressants are among the most frequently prescribed pharmacological agents. But the clinicians are still unable to predict accurately the response of their depressed patients to medication. This article reviews the biological predictors of treatment response including monoamine, neuroendocrine, pharmacogenetic, and psychophysiologic markers. The biological predictors of response, despite some interesting leads that may in the long term be of considerable importance, are not yet sufficiently established to be of routine clinical usefulness. Many of the predictive factors explored in this article are examples of mediators and moderators that affect outcomes. Each one alone may not provide definitive answers for predicting response to treatment, but each must be taken into account at the outset of treatment. It is clear that treatments must be individualized for each patient. It would be necessary to develop the algorithm in order to predict the responsiveness of antidepressant treatment with integration of the results from the previous studies.

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무료 양로${\cdot}$요양시설 노인의 건강보존정도 (Comparison of Health Conservation for Elders in Assisted Living Facilities and Nursing Homes)

  • 성기월
    • 대한간호학회지
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    • 제35권7호
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    • pp.1379-1389
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    • 2005
  • Purpose: This study was performed to evaluate and compare health conservation and its related factors of elders in assisted living facilities or nursing homes. Method: Data for health conservation was collected from 316 elders in 10 institutions in Daegu city and Kyungpook province from February 1st to February 22nd, 2005. Data was collected by a structured questionnaire that included general characteristics, general health status, health conservation, functional health status (ADL, IADL) and depression (GDS-K) scales. The collected data was analyzed by the SPSS (version 11.5) program including descriptive statistics, t-test, -test, Pearson's correlation and stepwise method regression analysis. Result: The elders in assisted living facilities revealed lower scores in health conservation, ADL and IADL than the elders in nursing homes. Predictable variables influencing health conservation of the elders in assisted living facilities were depression and MAC (Mid-Arm Circumference) that is equal to .270, and the the elders in nursing home were depression, IADL, degree of sleep, and TSF (Triceps Skin Fold) that is equal to .409. Conclusion: The development of a health conservation program and long-term health care service system for elders in assisted living facilities are needed than for the elders in nursing homes.

대처 개념의 국내 간호연구 분석 (Analysis of Nursing Studies of Coping Conducted in Korea from 1978 to 1995)

  • 소향숙;조복희;홍미순
    • 대한간호학회지
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    • 제26권3호
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    • pp.709-729
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    • 1996
  • This study was done to analyze the trends of research on coping in Korea, to suggest future direction, for research on coping, and ultimately to contribute to an increase in explanation of adaptation. This article reviewed 79 nursing research papers on coping done since 1978 by examining them according to the period of publication or presentation, research design, type of subjects, measurement instruments, research for a degree or not, range of reliability, and association of coping and related variables. The results are as follows : The number of studies on coping increased rapidly from the mid-1980's and decreased slowly from the mid-1990's. The maority of the studies were surveys, comparative studies, or correlational studies. The subects of the 46 studies were healthy people, while those in the remaining studies were patients with a variety of illnesses. Thirth-eight studies on coping were done for master's thesis, three for dissertion, and 38 were not degrees. The Bell and Jalowiec coping scales have not been used since the early 1990's. In contrast, Lazarus and Folkman's W.C.C.L. has been used increasingly since that time. The reliabilities of the coping scale were reported in 37 cases and the Cronbach's alpha coefficients were .71 to .86. All subjects reported using more problem-oriented coping than emotion-oriented coping in short-term or emotion-oriented coping and healthy groups did more long-term coping. It was difficult to describe consistently the relationship between stress and coping according to the type of coping scale or research subjects, but generally moderate relationships were found. This was due to instrumental problems and no consideration of situational context. The subject group who used more short-term coping and less long-term coping reported poorer mental status, and higher scores in burnout and state anxiey than others. That is, the relationship between stress and adaptation increased the power of explanation with intervening the mediating effect of coping. The association of locus of control, mastery, social support, and self-concept with coping showed positive relationships : those of uncertainty and severity in illness with coping showed negativerelationships ; those of state anxiety and depression with short-term coping were positive, and those of self-esteem with long-term coping or problem-oriented coping were negative. There were significant differences in the scores of types of coping according to religion, level of education, and socio-economic status. That is, Presbyterians and Catholics, those with higher education levels and higher socio-economic status used more long-term or problem-oriented coping. On the basis of the above findings the following recommendations are made : 1. There is a need to test the mediating effect of coping variable in order to clarify the concept. 2. Longitudinal studies are needed to determine the patterns of change in coping strategies when stressful events are encountered. 3. It's necessary to develop a reliable and variable measurement tool for coping. 4. There is a need to identify subscales of coping to increase explanation of variance 5. It's necessary to consider personal, situational, and antecedent variables : the characteristics of subject populations, the natures of illness and treatment situations. 6. The power of explanation of studies designed to identify the stress-adaptation process should be increased using the combination model of process-oriented coping and cognitive-structural model.

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아우토겐 트레이닝이 스트레스반응에 미치는 효과: 체계적 문헌고찰 및 메타분석 (Effect of Autogenic Training for Stress Response: A Systematic Review and Meta-Analysis)

  • 서은주;김숙영
    • 대한간호학회지
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    • 제49권4호
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    • pp.361-374
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    • 2019
  • Purpose: This study was conducted to evaluate the effectiveness of autogenic training on stress responses through a systematic review and meta-analysis. Methods: A systematic search was conducted using eight core electronic databases (Embase, CENTRAL, Medline, CINAHL, PsycInfo, DBpia, KISS, and RISS). To estimate the effect size, a meta-analysis of the studies was performed using RevMan 5.3.5 program. Results: A total 21 studies out of 950 studies were included in the review, and 11 were included for meta-analysis. These studies showed that autogenic training decreased anxiety and depression, and increased the high frequency of heart rate variability. Calculations to understand the effect of autogenic training on anxiety, through a meta-analysis, observed a reduction effect of anxiety score by 1.37 points (n=85, SMD=-1.37: 95% CI -2.07 to -0.67), in the studies on short-term intervention targeting healthy adults. On the other hand, similar calculations to understand the effect of autogenic training on depression observed, a reduction effect on the depression score by 0.29 point (n=327, SMD=-0.29: 95% CI -0.50 to -0.07), in the studies on long term intervention targeting the patient group. Conclusion: Autogenic training is effective for adults' stress management, and nurses will be able to effectively perform autogenic training programs for workers' stress relief at the workplace.

1993~2002년 일본불황에 대한 연구 (An Analysis on Japanese Recession Between 1993 and 2002)

  • 윤형모
    • 국제지역연구
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    • 제13권2호
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    • pp.168-188
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    • 2009
  • 일본은 과거 10년(1993-2002) 동안 버블붕괴로 극심한 경기침체기를 경험하였다. 최근 미국에서도 유사한 현상이 발생하였고, 그 여파로 세계 각국이 불경기를 겪고 있다. 본 연구의 목적은 과거 일본 경기침체기를 분석하여 현재 미국 등 여러 나라의 경제 불황을 탈출할 수 있는 방법을 모색하는데 있다. 과거 문헌자료에 의하여 나타난 시사점은 정부부채에는 최적 상태가 존재하고, 경기회복을 위한 정책은 실시 시점이 중요하다는 것이다. VAR 모형과 State Space Model에 의한 통계적 분석으로부터는 다음과 같은 결과가 도출되었다. 정부 재정지출의 경기부양에 대한 영향은 단기적이며 미약했다. 조세는 생산에 장기적이며 부정적 영향을 준다. 그러므로 정부부채 감소를 위한 증세(增稅)는 신중히 실시되어야 한다. 재정지출의 효과는 정책이 발표된 후 반년의 시차를 두고 효과가 나타나는 반면, 조세증가는 공시와 동시에 민간소비와 투자를 감소시키고 그 영향도 길며 크다.

집단 따돌림 피해학생을 대상으로 한 인지행동적 집단치료 개발을 위한 예비 연구 (THE PRELIMINARY STUDY ON THE DEVELOPMENT OF COGNITIVE-BEHAVIORAL GROUP THERAPY FOR SCHOOL BULLIED)

  • 이주현;신지용;연병길;한창환
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제11권2호
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    • pp.221-230
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    • 2000
  • 본 연구는 집단 따돌림 피해학생을 대상으로 시행한 인지행동적 집단치료의 개발을 위한 예비 연구이다. 정상적인 중학교 1학년 학생 202명에게 도덕발달수준척도, 오퍼 자아상척도, 우울 및 상태 ${\cdot}$ 특성불안척도의 분포와 상관관계를 조사하였다. 자아상과 우울, 불안은 서로 강한 상관관계를 보였으나, 도덕발달과는 상관관계를 보이지 않았다. 이는 도덕발달이 정서에 크게 영향받지 않고 인지 발달적 과정에 의존하는 것을 시사한다. 그리고 교사의 관찰에 의해 집단 따돌림 피해를 받으면서 학교 적응에 어려움을 보이는 중학교 1학년 학생 5명의 도덕발달수준척도, 오퍼 자아상척도, 우울 및 상태 ${\cdot}$ 특성불안척도는 전체 집단과 유의한 차이를 보이지 않았다. 이 피해학생들을 대상으로 12회에 걸쳐 인지적 집단 정신치료를 시행하고, 치료 전후에 상기 4가지 척도의 변화를 평가하여 효용성을 검정하였으나 통계학적으로 유의한 변화는 없었다. 그러나 참가 학생들이 치료 기간 중에 기재한 일기에서 확인되는 심리적 마음자세(psychological mindedness)의 향상과 담임 교사의 긍정적인 평가보고는 의미있는 것으로 생각되었다.

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Major Depressive Disorder 질환성 노인 환자들의 치료제 평가 (Drug Use Evaluation of the Elderly Patient with Major Depressive Disorder)

  • 임옥정;이옥상;윤혜설;최경식;임성실
    • 약학회지
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    • 제57권2호
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    • pp.101-109
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    • 2013
  • Depressive disorders are the most common psychiatric problem in the elderly. Most depression treatment guidelines emphasize treatment with antidepressant medication and recommend that benzodiazepine use be minimized for limited period, particularly to elderly patients. In order to evaluate appropriate use of antidepressants and benzodiazepine, retrospective review of prescriptions was performed. The study population are older than 65 years who had been newly diagnosed with major depressive disorder in specialty mental health at a community general hospital from January $1^{st}$, 2007 to October $31^{th}$, 2012 (N=373). Initial antidepressant accounted for 89.5% with SSRI, and escitalopram accounted for 60.9% of SSRI group. 79% or more of the patients were prescribed the recommended dosage. The maintenance rate for 4 weeks of initial antidepressant was 48% and 6 weeks was 39%. Treatment-discontinuation rate was 68% at 3 month. Alprazolam (short acting benzodiazepine) was prescribed the most, followed by clonazepam (long acting benzodiazepine) and then diazepam. 55% of patients received a duplicated prescription for short acting plus long acting benzodiazepine. 61% of patients used long acting benzodiazepines. Prescribed dosages of benzodiazepines were commonly within a recommended range, while no one was prescribed a appropriate period (up to 2 weeks) except for the early discontinued patients. Appropriate use of zolpidem was only 16.2%. The depressed elderly treated in specialty mental health mostly received long-term treatment with benzodiazepines in combination with antidepressants, guideline recommendations was not followed. Multidisciplinary interventions like audit and feedback of benzodiazepine use are needed and education for the elderly is needed to properly maintain antidepressant treatment.

뇌자기자극을 이용한 운동신경계의 신경생리학적 평가 (Neurophysiological Evaluation of the Motor System Using Transcranial Magnetic Stimulation)

  • 신혜원;손영호
    • Annals of Clinical Neurophysiology
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    • 제13권1호
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    • pp.1-12
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    • 2011
  • Transcranial magnetic stimulation (TMS) is a non-invasive tool used to study aspects of human brain physiology, including motor function and the pathophysiology of various brain disorders. A brief electric current passed through a magnetic coil produces a high-intensity magnetic field, which can excite or inhibit the cerebral cortex. Although various brain regions can be evaluated by TMS, most studies have focused on the motor cortex where motor evoked potentials (MEPs) are produced. Single-pulse and paired-pulse TMS can be used to measure the excitability of the motor cortex via various parameters, while repetitive TMS induces cortical plasticity via long-term potentiation or long-term depression-like mechanisms. Therefore, TMS is useful in the evaluation of physiological mechanisms of various neurological diseases, including movement disorders and epilepsy. In addition, it has diagnostic utility in spinal cord diseases, amyotrophic lateral sclerosis and demyelinating diseases. The therapeutic effects of repetitive TMS on stroke, Parkinson disease and focal hand dystonia are limited since the duration and clinical benefits seem to be temporary. New TMS techniques, which may improve clinical utility, are being developed to enhance clinical utilities in various neurological diseases.

PCR을 이용한 개의 아나플라즈마병 진단과 장기간 치료 (Diagnosis of Anaplasmosis by PCR and Long Term Medication in a Dog)

  • 이숙진;이미진;채준석;나기정
    • 한국임상수의학회지
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    • 제22권2호
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    • pp.170-173
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    • 2005
  • A 4-year-old female Shunauzer dog was referred to the Veterinary Teaching Hospital of Chungbuk National University due to anorexia and depression. The dog had a history of regular walking on grass fields, weight loss, and hyperthermia $(40.6^{\circ}C)$. In the physical examination, lymph node enlargement was confirmed. Complete blood count result revealed leukocytosis and thrombocytopenia but there was no decreasing of red blood cells. On blood chemistry, serum ALP, GGT, CPK, and LDH were elevated. Abdominal radiograph showed splenomegaly. Anaplasma platys infection was suspected with inclusion body-like substances in platelets on blood smear. Anaplasma platys was confirmed by PCR. On the basis of laboratory examination, final diagnosis was anaplasmosis. Treatment was followed for 3 months with tetracycline and doxycycline. The patient was monitored every week during the treatment. The patient has recovered to normal condition without any clinical signs. We are going to emphasize the need of PCR technique in diagnosis and to report the possibility of long term treatment more than two months in rickettial disease.