• 의료법학
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• 제24권3호
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• pp.155-206
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• 2023

의사결정능력이 저하된 자가 필요한 의료서비스를 거부하거나 적절히 의사를 표현하지 못하는 경우, 외부로부터의 후견주의적·예방적 개입이 언제 정당화될 수 있는지에 대한 규범적 판단이 쟁점이 된다. 이러한 어려움은 정신의료에서의 비자의 입원의 경우 더욱 명확하게 드러나며, 국내에서는 전통적으로 '정신질환의 존재'와 '자타해 위험'을 주된 요건으로 하는 정신건강복지법에 근거하여 비자의 입원을 시행해 왔다. 그러나 2011년 민법 개정으로 민법상 후견제도를 통한 비자의 입원의 방식이 새롭게 도입되며, 국내의 비자의 입원은 형식상 이원화된 체계를 갖추게 되었다. 이때, 후견제도를 통한 비자의 입원은 당사자에게 '의사결정능력의 저하'가 있고, 개입이 '당사자의 복리 증진'에 부합할 것을 실행의 요건으로 한다는 점에서 정신건강복지법에 근거한 비자의 입원과 그 목적과 성질을 달리한다. 정신적 능력이 저하된 당사자에 대한 비자의 입원이 이처럼 정신보건법을 통한 방식과 후견제도를 통한 방식으로 이원화되는 양상은 해외에서도 유사한 양상으로 전개되었다. 그러나 대상자가 고령화되어 정신질환과 신체질환의 치료가 동시에 이루어지는 경우가 많아지고 정신질환과 신체질환의 구분이 모호한 노인성 정신질환의 문제가 대두됨에 따라, 민법상 '최선의 이익-대리의사결정' 패러다임과 정신보건법상의 '사회방위-예방적 구금' 패러다임이 정신장애인에 대한 법적 규율 영역에서 중첩되고 서로 충돌하는 현상이 발생하기 시작했다. 해외에서는 이러한 이원화된 체계가 비효율적이고 형평성에도 어긋난다는 지적이 이어졌으며, 나아가 '정신질환'이 있을 것을 근거로 하여 후견주의적·예방적 개입을 정당화하는 정신보건 법제의 비자의 입원 요건은 정신장애인에 대한 부당한 차별에 해당한다는 비판도 꾸준히 이루어졌다. 이에 해외에서는 '의사능력'을 기초로 후견제도와 정신보건 법제를 융합(fusion)하여, 능력이 저하된 개인에 대한 후견적·예방적 개입을 일관되게 규율하고자 하는 시도가 이루어졌다. 이는 의사능력 저하자의 신체질환과 정신질환에 대한 의료서비스 제공을 동일한 체계 속에서 할 수 있을 뿐만 아니라, 단지 '정신장애'를 지니고 있다는 것만으로 차별적으로 대우하는 정신보건법의 한계를 극복하는 것이기도 했다. 본 연구에서는 의사능력을 기반으로 후견제도와 정신보건법을 융합(fusion)하여 정신의료 서비스 체계를 새롭게 재구성한 전 세계 최초의 사례인 영국 북아일랜드 정신능력법(Mental Capacity Act 2016)의 제정 과정과 구체적 작동방식을 분석하였다. 후견제도와 정신보건 간의 충돌의 문제를 1990년대부터 고민하여 최근 2016년 '의사능력' 이라는 단일하고 비차별적인 기준을 제시한 영국 북아일랜드의 사례를 분석함으로써, 국내 후견 및 정신보건 제도에의 함의와 앞으로 나아가야 할 방향에 대해 제언하고자 하였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제32권1호
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• pp.37-42
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• 2010

Purpose: The mental foramen (MF) is an important anatomical structure during local anesthesia and surgical procedures in terms of achieving effective mental nerve blocks and avoiding injuries to the neurovascular bundles. Thus, understanding the anatomic features of the mandibular canal and accessory mental foramen in Korean could contribute to the surgical anatomic assessment. This study was to elucidate frequency, position and course of AMF (accessory mental foramen) in Korean using 3D cone beam computed tomography. Materials and Methods: The CBCT (Conbeam computed tomography) DICOM data (Alphard, Asahi, Japan) from 540 patients in korean were analyzed. We investigated images of 3D CBCT using Ondemand (CyberMed, Korea) software program on the incidence and anatomical characteristics of accessory foramen. Results: The accessory mental foramina were found in 17 patients. Accessory mental foramina exist predominantly in the apical area of the second premolar and posteroinferior area of the mental foramen. The accessory branches of the mandibular canal showed common characteristics in the course of gently sloping posterosuperior direction in the buccal surface area. The size of most AMF was obviously smaller than that of MF. Conclusion: We could identify frequency, position and course of AMF (accessory mental foramen) by the anatomical study of the accessory mental foramen using 3D cone beam CT in Korean.

• 한국학교보건학회지
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• 제15권1호
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• pp.63-72
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• 2002

The purpose of this study was to find out the relationship between self-esteem and mental health in Middle school students, and provided basic data to develop a nursing program for the prevention of mental disease and the promotion of mental health in adolescence. Subjects were 153 students in the third year of three middle schools located in K city. Instruments used in this study were the self-esteem questionnaire developed by Choi, B. K. & Jun, G. Y.(1993) and the simplified SCL-90 developed by Lee, H. K.(1986) for measuring mental health. Data were analyzed by Cronbach's alpha, descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient by using SPSS/PC+ program. It was found that the mean score of the self-esteem was 3.20. The score of self-esteem in family was high and the score of self-esteem in school was low. The mean score of mental health was 1.94. The scores of depression, obsessive-compulsive and interpersonal sensitivity were high, the scores of phobic anxiety and somatization were low. There were significant differences among religions (F=2.709, p= .032), and between personalities (t=-2.285, p= .024) with respect to self esteem. There were no significant differences between general characteristics variables and mental health. However there was significant negative correlation between the mean self-esteem score and the mean mental health score (r=-.431, p= .000). In conclusion, mental health is strongly related to self-esteem. If and adolescent who suffers from mental health is not received proper treatment, his or her mental health prohibits him from managing sound social life even after grown-up. Thus, nursing intervention in adolescence should be developed to enhance the self-esteem of adolescence and to help him raise sound mind.

• 지역사회간호학회지
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• 제8권2호
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• pp.289-303
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• 1997

This study analyzes the relations between perceived family characteristics, experienced abuse and mental health in childhood. For this, this study used row data by questionnaire, analysis, and frequency, ANOVA, t - Test, Pearson' correlation analysis. The sample was 118 children 10-12 years old in primary school. The findings are as follows. First, children perceived family cohesion and family adaptability highly, family adaptability showed a significant difference from the relations with a parent's job, a parent's academic level, and type of residence. Second, it appeared that some children experienced physical, emotional, and sexual abuse. Third, in general the mental health of children was good. Their mental health showed a significant relation to economic level of family, and type of residence, creating problems such as depression, anxiety, phobic anxiety, psychoticism. By family size, their mental health showed a significant relation to somatization, interpersonal sensitivity, depression, hostility, phobic anxiety, paranoid ideation, and psychoticism, Fourth, family cohesion and mental health perceived by children supported a linear relation to phobic anxiety, and family adaptability and mental health perceived by children supported the reverse -linear relation to somatization, anxiety, paranoid ideation, etc. Fifth, connections with perceived abuse and mental health as well as emotional abuse and mental health were also supported. Further more, on somatization, interpersonal sensitivity, depression, hostility, phobic anxiety, paranoid ideation, psychoticism, etc, a reverse-linear re lation existed. Physical abuse supported a reverse-linear relation with interpersonal sensitivity, depression, paranoid ideation, etc. and sexual abuse supported a reverse-linear relation with depression. These findings suggest that school and family have to concern themselves with the mental health of children because experienced abuse and family characteristics do indeed affect the mental health of children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권4호
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• pp.235-243
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• 2017

Objectives: This study aimed to evaluate the mental health status of the children of psychiatric patients in order to plan for the resources that may be necessary to help these children achieve their full potential. Methods: Forty-eight children (age 9-18) whose parents were registered in 5 community mental health centers located in Seoul were recruited. Tests assessing 3 psychological domains were conducted: 1) cognition: Korean version of Learning Disability Evaluation Scale, Comprehensive Attention Test, 2) parent reported emotion and behavior: Korean Child Behavior Checklist, Korean attention-deficit hyperactivity disorder Rating Scale, and 3) self-reported emotion and behavior: Korean Beck's Depression Inventory-II/Children's Depression Inventory-II, Korean Youth Self Report). We defined the children as having a high risk of developing mental health problems if their test scores were over the cut-off levels in 2 or more of the 3 domains assessed. Results: Twelve (25%) children were classified as having a high risk of developing mental health issues. 20 (41.6%) children scored above the cut-off in only one of the domains. Conclusion: Our results suggest that the children of psychiatric patients might be vulnerable to mental illness and need early prevention or interven-tions for the sake of their mental health.

• 대한간호학회지
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• 제11권1호
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• pp.7-17
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• 1981

The purpose of this study is to investigate the relationship between family attitude about mental illness and their general characteristics. The subjects for this study were a sample of 120 families selected from psychiatric ward of one university hospital, which is one national hospital in Seoul. Data was collected from July 1th to August 10th in 3980 used by Opinion about Mental Illness Scale (O.M.I.). The materials were analized by S.P.S.S. program. The findings of the study were as follows: A. Families' attitude toward mental illness shown ay this study was more negative compared to those of Korea1 nursing professorss, nurses and nursing students. B. Variables which influence families' attitude about mental illness: 1. There is no significant between general characteristics and authoritarianism. (p＞ 0.05) 2. Benevolence (Factor B) was found to be significantly related to such variables as religion, eucation levels, existence of mental patient in their an intimate friends. (P < 0.01) Families' attitude about benevolence was mere positive in families who have not relegion or having christion beliefs: haying the higher education levels; not having a mental patient in their an intimate friends. 3. Mental health ideology (Factor C) was found to be significantly related to variable experience of mental illness. (P < 0.01). families' attitude about mental health ideology was more positive in families who had experience of mental illness. 4. Social Restrictiveness (Factor D) was found to be significantly related to variable relationship between families and patients(P<0.01). An intimate friend's attitude about mental health Ideology was mon positive than that of parent and couple. 5. Interpersonal Etiology (Factor E) was found to be significantly related to variable religion (P < 0.05). Families' attitude about interpersonal etiology was more positive in families who have relegion.

• 대한불안의학회지
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• 제14권1호
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• pp.28-35
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• 2018

Objective : The purpose of this study was to assess the use of mental health services by North Korean defectors. The study sought to understand the determinants of use with socio-demographical characteristics and the barriers of using mental health service. Methods : Data were collected from a sample of the 300 North Korean defectors who have settled in South Korea within the last three years, aged 18 years and older. Face-to-face interviews and a survey using the North Korean version of the Composite International Diagnostic Interview were conducted. Results : 21.0% of respondents reported the use of mental health services. Among them, 16.0% reported the use of mental health specialty, 2.0% reported the use of general medical services, and 3.0% reported the use of others. Of the respondents who had one or more psychiatric disorders, 28.8% used mental health services. The highest rate of use of mental health services was by respondents who are aged over 50 years old, had less than 10 years of education, and were unemployed. Of those who suffered from a psychiatric disorder but did not seek for consultation, 74.4% said that they could handle the problem by themselves, and 74.6% asserted that they had no psychiatric disorder. Conclusion : North Korean defectors in South Korea used mental health services more than the general South Korean population. It would be crucial to provide appropriate mental health services based on the needs of North Korean.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제22권2호
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• pp.25-33
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• 2016

Purpose : The information of mental health facilities in Korean law is so unclear that people hardly enable to understand what sort of proper mental health service is prepared for them. Futhermore, there is not enough regulation and standard to classify each type of facilities in the law. Therefore the purpose of this study is to provide data on the basis for classification and facility standards by analysing Korean law and policies. Methods : This study was conducted by a research on law and regulation of mental health facility. Results : The result of this study can be summarized into three points. The first one, current law and policy do not reflect a change in community mental health services paradigm. The second one, the classified facility should be designed to fit the community mental health services. The third one, overall, it requires more detailed guidelines to enhance the quality of mental health services. Besides, the treatment as well as the function of the prevention and rehabilitation are necessary criteria that can also be enhanced. Implications : This study looked at the classification and facility standard of mental health facility by the change in community mental health services paradigm. Forward according to these changes, there is a need for specific guidelines for mental health facility.

• 대한간호학회지
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• 제3권2호
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• pp.31-43
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• 1973

The trend in modern nursing is toward the performance of comprehensive nursing care. Psychiatric nursing emphasizes education which enables the nurse to understand the underlying difficulties being expressed through a wide range of emotions and through practice to be more adept in her selection of a manner of approach which best meets the needs of a given situation. Presently, in Korea, there is nothing in the literature regarding evaluation of the effect of psychiatric nursing education on the attitudes of nurses towards mental illness and mentally ill patients. This stud!1 was attempted in order to understand 1) some of the problems in psychiatric nursing education 2) some of tile factors which affect the attitudes of nurses towards mental illness and mental patients. A questionnaire, a Korean translation of the "Opinions about Mental illness Scale" by Cohen and Stranding, 1962, was administered to 188 nonpsychiatric registered nurses employed in Yonsei University Hospital (Y. Hospital) and Seoul National University Hospital (S. Hospital) located in the city of Seoul. All of the nurses were directly involved with adult patient care. They graduated from various nursing schools. The data was collected during the period of October 2 to October 16,1972. The age, educational background , marital status, type of previous psychiatric experience, experience as a graduate nurse and close personal relationship with someone who was a psychiatric patient were compared with the O.M.I. scores. The mean and standard errors for each of the comparison groups were computed and tile relationships calculated by a t-test. The results of the study are summarized as follow: 1. There is no significant difference between the age of the nurses and their attitudes toward mental illness and mental patients. 2. There is no significant difference between the. educational backgrounds of the nurses and their attitudes toward mental illness and mental patients. 3. There is a significant difference in the nurses ′student psychiatric nursing experience and their attitudes towards mental illness and mental patients for the nurses in 5. Hospital only. The nurses who had 3-4 week of student psychiatric nursing experience had a significantly higher mean score for Benevolence (factor B) than nurses whose student psychiatric experience had been less than 1 Ivcek (P<0.05). The nurses who had 1-2 weeks, 3-4 weeks and more than 4 weeks of student psychiatric nursing experience had significantly higher mean scores for Interpersonal Ethology (factor E) than nurses whose student psychiatric had been less than 1 week (p<0.05), 4. There is a significant difference in the nurses′student psychiatric nursing experience by types of institution and their attitudes towards mental illness and mental patients for S. Hospital nurses only. The nurses who had their student psychiatric nursing experience in the government psychiatric hospitals recorded significantly higher mean score for Authoritarianism (factor A) than nurses who had their. experience in private psychiatric hospitals (p<0.05). 5. There is no significant difference in the nurses′psychiatric nursing experience as a graduate nurse and their attitudes toward mental illness and mental patients. 6. There is no significant difference in the nature and variety of the nurses′experience as a graduate nurse and their attitude toward mental illness and mental patients. 7. There is no significant difference in the presence or absence of a close personal relationship with a mentally ill person and the nurses′attitude toward mental illness and mental patients. 8. There is no significant difference in the nurses′ marital status and their attitude toward mental illness and mental patients. 9. There is no significant difference between the nurses who were employed ill S. and Y. hospitals and their attitudes towards mental illness and mental patients. Major suggestion for further study was to have more larger and wider scale research for establishing of the reliability and validity of the Korean translation of the O.H.I. Scale.

• 정신신체의학
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• 제31권1호
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• pp.33-41
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• 2023

연구목적 정신건강 지식에 영향을 미치는 요인을 알아보고자 이 연구를 수행하였다. 방 법 2021년 만 15세 이상 69세 이하 일반인구 2016명으로 대상으로 연구를 수행하였다. 연구는 보건복지부에서 시행한 2021년 '대국민 정신건강 지식 및 태도 조사'의 데이터를 이용하였으며, 인구사회학적 특성, 거주지별 특성, 정신건강 상태, 정신건강 문제 수준, 자원 인지를 조사하였으며, 32문항의 정신건강 지식 설문을 이용하여 정신건강 지식을 측정하였다. 결 과 다중회귀분석 결과 여성(p<0.001), 높은 연령(p=0.005), 높은 소득 수준(p<0.001)이 통계학적으로 유의하게 정신건강 지식과 상관관계가 있었으며, 지역사회정신보건기관 인지(p=0.002), 정신건강상담전화 인지(p<0.001)도 통계학적으로 유의하게 정신건강 지식과 상관관계가 있었다. 결 론 지역사회 진료나 정신건강 사업에 있어 정신건강 지식에 영향을 미치는 요인들을 고려한 접근이 필요하다.