• Title/Summary/Keyword: old age anxiety

검색결과 112건 처리시간 0.029초

비배우자간 인공수정이 권유된 남성불임환자의 의식조사 (An attitude survey of male infertile patients with artificial insemination by donor)

  • 박현준;박남철
    • Clinical and Experimental Reproductive Medicine
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    • 제30권4호
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    • pp.281-291
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    • 2003
  • Objectives: In determining to perform non-spousal artificial insemination by donor (AID) to an infertile married couple, infertile couple requires not only the thorough understanding of the medical procedure but also scrutinizing the effect, which it will have on the relationship of the family including the baby to be born itself. Materials and methods: 148 cases with non-curable male infertility were enrolled in this inquiry survey. The donor insemination questionnaire consists of 18-items which are assessing subjects' clinical properties, the background for AID practice, psychological traits, and long term influence. Results: Of the survey, 49 cases were returned (33.1%) and 10 cases (20.4%) of these gave birth after AID practice. The mean age of husbands and wives of the 49 cases were $34.6{\pm}4.2$ and $32.1{\pm}3.0$ yers old, respectively and the duration of marriage was 5 years and 4 months. In about half of the cases, AID was first suggested by husband and the decision was made by only the couple. The major reason for the operation was to form a complete family. In the item of the psychological effects, two-third of the couples felt anxiety related to the procedure which are mostly about the possible congenital or acquired deformity of baby. The AID was positively suggested in overall by all of recipients. After giving birth to a child, most couples felt positive about their decision. As a child grows up, about half of the couples felt the child as their own and expected not to tell of the AID. In overall, about 50% of couples presented satisfaction with the procedure. Conclusions: As the above results, various psychological impacts including anxiety about a child-to-be-born were accompanied to those who were recommended of AID. To overcome these problems, sufficient medical information and consultation about the course of selecting the donor and the whole procedures of AID should be provided beforehand.

『상한론(傷寒論)』 태음병(太陰病)으로 진단된 신체증상장애 환자 7례 증례 보고 (Case Series Reporting 7 Somatic Symptom Disorder Cases Diagnosed as Greater Yin Disease by Shanghanlun Provisions)

  • 윤효중;하현이;두인선;이숭인;이성준
    • 대한상한금궤의학회지
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    • 제13권1호
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    • pp.45-59
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    • 2021
  • Objectives: This study was conducted to confirm the reproducibility of the diagnosis of greater yin disease (太陰病) and the efficacy of herbal treatment using Gyejigajakyak-tang or Gyejigadaehwang-tang in somatic symptom disorder (SSD). We also further refined the characteristics of greater yin disease in SSD. Methods: We analyzed the demographic and treatment data of seven patients with SSD from four Korean medical clinics. The reliability of diagnosis and the efficacy of the treatments were evaluated by the Beck Anxiety Inventory (BAI), a numerical rating scale (NRS), and the patients' statements. Finally, we analyzed patients according to the diagnostic points of Shanghanlun provision 273. Results: Seven SSD patients took Gyejigajakyak-tang or Gyejigadaehwang-tang. The mean age of the patients was 52.1±15.8 years old, and the herbal medication period was 82.2±38.2 days. At the first visit, the patients showed hypochondriasis, obvious stress, and a severe BAI score (40.4±10.9). The NRS significantly decreased from 8.9±1.6 to 0.7±0.7 after the treatments. There were no side effects reported. As a result of analyzing these 7 cases, hypochondriasis, obvious stress, and anxiety were identified, which had been previously suggested as 自痛, 因爾, and 結硬. Conclusions: We confirmed the reproducibility of greater yin disease in 7 SSD cases from 4 medical institutions. These results imply that there could be a considerable relation between SSD and greater yin disease as defined by the Shanghanlun provisions.

대퇴경부 골절 환자의 입원 생활 (The Hospital Life of the Patient with Femoral Neck Fracture)

  • 김경자;지성애
    • 간호행정학회지
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    • 제2권1호
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    • pp.35-56
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    • 1996
  • Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.

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직장인의 직무수행능력, 노후준비도, 미래불안감이 창업의지에 미치는 영향연구: 퇴직후 삶에 대한 또 다른 성공기대감의 매개효과를 중심으로 (A Study on the Influence of Office Workers' Job Performance Ability, Retirement Readiness, and Future Anxiety on Entrepreneurship Will: Focusing on the Mediating Effect of Another Success Expectation on Life after Retirement)

  • 박국근;하규수
    • 벤처창업연구
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    • 제15권6호
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    • pp.167-187
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    • 2020
  • 현재 우리나라는 초고령화 사회로 변화되어 가고 직장인은 주된 일자리에서 평균 49.5세에 퇴직하며, 국민연금은 현재 62세에서 2034년까지 65세로 늦춰지는 상황에서 직장인의 퇴직 이후 고령화에 대비한 연구가 필요함. 전국 직장인들을 대상으로 퇴직이후 창업의도에 영향을 미치는 요인과 퇴직이후 삶에 대한 또 다른 성공기대감의 매개효과를 규명하고자 한다. 퇴직이후 100세까지 지속가능한 직업, 즉 직장생활 속 지혜와 경험을 살린 창업을 위한 준비를 할 수 있도록 개인의 태도변화와 체계적인 제도적 지원이 필요하다. 연구결과, 직무수행능력인 목표수행능력, 노후준비도인 경제적 준비, 외적관계준비 및 미래불안감은 창업의지에 정(+)의 영향을 미치고, 직무수행능력인 신기술활용능력, 노후준비도인 신체적준비, 내적관계준비는 영향을 미치지 않는 것으로 나타났다. 외적관계준비와 창업의지, 미래불안감과 창업의지 간의 영향관계에서 또 다른 성공기대감은 부분매개 효과가 확인되었다. 경제적준비와 창업의지 간의 영향관계에서는 완전매개 효과가 확인되었다. 퇴직이후의 창업의지를 높이기 위해서는 또 다른 성공기대감이 중요한 변수임을 확인하였다. 잠재적 창업자인 직장인이 재직하는 동안 초고령화에 따른 정부의 재정적 부담도 줄이고 직원교육을 통한 기업의 성장도 이룰 수 있도록 정부지원의 교육시스템을 회사 내에 도입, 직장인의 인생 3모작을 위한 기업가정신 및 목표수행능력 향상프로그램을 도입, 개인과 기업의 성장 및 정부의 재정 부담을 줄이는 해결책이 될 시사점을 얻을 수 있었다.

치과 구내촬영 장비 현황과 방사선 안전 관리 실태 연구 (Current status of dental intraoral imaging devices and radiographic safety management)

  • 강은주;형주희
    • 한국치위생학회지
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    • 제16권2호
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    • pp.205-214
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    • 2016
  • Objectives: The purpose of the study is to investigate the current status and radiographic safety management in Korea. Methods: A self-reported questionnaire was completed by 200 dental hygienists in Jeonbuk province from September 1, 2014 and October 31, 2014. The questionnaire consisted of general characteristics of the subjects, radiation knowledge, radiation safety management, and radiation exposure anxiety. Data were analyzed using SPSS 18.0 program. Results: Duration of clinical experience(r=0.142) and number of daily radiation shot(r=0.145) showed a positive correlation to radiation safety management, and a nrgative correlation to use of intraoral films and digital devices(r=-0.587). A logistic regression analysis was performed in order to evaluate the influence on radiography knowledge. The results showed that the factors had significant influences on the age group over 41 years old(OR 7.25; 95% CI 1.30-40.43) and those who took a position above team leader(OR 0.23; 95% CI 0.59-0.90). Conclusions: It is very important to have the safety management toward dental intraoral imaging and radiograpgic shot in the dental hygienists. Continuous efforts should be emphasized on radiographic safety management and behavior.

어지럼증의 감별진단 (Differential diagnosis of vertigo)

  • 강지훈;신지용;김민주;마효일
    • Journal of Medicine and Life Science
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    • 제16권3호
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    • pp.64-75
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    • 2019
  • Vertigo and dizziness are common symptoms with various etiologies and pathogeneses. Vertigo is an illusion of motion due to disease of the vestibular system, usually a sense of rotation. Dizziness, a term that represents a wide range of non-vertigo symptoms, is commonly associated with non-vestibular disorders including old age, cardiac syncope, orthostatic hypotension, metabolic disease, anxiety, and drugs. Vertigo should be determined whether the cause is central or peripheral. Peripheral vertigo is usually benign but central vertigo is serious and often require urgent treatment. The careful history and detailed physical examinations(pattern of nystagmus, ocular tilt reaction, head impulse test and positional tests such as Dix-Hallpike maneuver) provide important clues to the diagnosis of vertigo. Most of patients have benign peripheral vestibular disorders - vestibular neuritis, benign paroxysmal positional vertigo (BPPV), and Meniere's disease. BPPV is a leading cause of peripheral vertigo and can easily be cured with a canalith repositioning maneuver. In this review, a focus is on the differential diagnosis of common vestibular disorders with peripheral and central causes.

경련 질환 환아의 정신병리와 신경학적 요인과의 관계에 대한 연구 (THE STUDY ON RELATIONSHIP BETWEEN PSYCHOPATHOLOGY AND NEUROLOGICAL FACTORS IN CHRONIC EPILEPTIC CHILDREN)

  • 김붕년;조수철;황용승
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제7권1호
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    • pp.92-109
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    • 1996
  • 본 연구에서는 정상 지능 범위의 만성 특발성 경련 질환으로 치료중인 40명의 환아군과, 나이, 성별, 학업 성적, 지능 지수를 일치시킨 30명의 대조군을 대상으로, 국내외를 통해 신뢰도 및 타당도가 확인된 평가 도구들인, 부모용 아동 행동 조사표(Child Behavior Checklist)의 한국판, DSM-III-R에 따른 파탄적 행동 장애 척도(Disruptive behavior disorders scale according to DBM-III-R)의 한국판, 예일 아동 평가표(Yale children's inventory)의 한국판, 소아 우울 척도(Children's Depression Inventory)의 한국촌, 소아용 상태 및 특성불안 척도(State-Trait Anxiety Inventory for children)의 한국판, 피어스-해리스 자기 개념 척도(Piers-Harris self-concept questionnaire)의 한국판. 가정 환경 척도(Family environment Scale)의 한국판, 간이 정신진단 검사(Symptom check-list-90)의 한국판, 경련질환에 대한 부모태도 척도(Parent's attitude to epilepsy questionnaire)의 한국판, 아동 의존척도(self-administered dependency questionnaire)의 한국판을 사용하였고, 이들 결과로 부터 얻은 자료의 일부인 환아의 정신병리 부분과 경련 질환의 신경과적인 변수들인 환아의 성별 및 나이, 경련 질환 발병시 나이와 유병기간, 경련질환의 임상적 유형, 뇌파의 유형 최근 6개월간의 경련 빈도, 항경련 약물 치료력과 그 반응등과의 관련성을 평가하였다. 위에서 얻은 자료들을 토대로 분석하여 다음과 같은 연구 결과를 얻었다. 환아의 우울과 관계된 위험 요인은, 조기 발병(early onset), 복합성 부분 간질(complex partial seizure), 뇌파상 편측성 측두엽 이상(lateralized temporal focal abnormality in EEG), 약물 병합 투여(drug polypharmacy), 고 빈도 경련(high seizure frequency)임을 알 수 있었고, 이들 위험요인들은 상호 연관되어 있었다. 불안에 영향을 미치는 요인은 높은 연령. 뇌파상 편측성 측두엽 이상, 고 빈도 경련이었고, 학습 및 언어적 문제와 관련이 있는 위험 요인은 환아의 어린나이, 조기 발병, 복합성 부분 간질, 고빈도 경련 등이었다. 주의력 결핍 과잉행동 장애와 반항 및 품행장애에 영향을 미치는 위험 요인은 남성, 어린 나이, 조기 발병, 뇌파상 편측성 측두엽 이상, 고 빈도 경련등이었다. 위의 결과를 종합하면, 우울, 불안, 품행장애 및 주의력 결핍 과잉 행동장애에 공통적으로 관계되는 위험요인은, 뇌파상 편측성 측두엽 이상, 고 빈도 경련이라는 겻을 알 수 있었다. 향후 연구를 통해서는 신경학적 요인이외에 가족 및 사회-인구학적 위험 요인을 찾는 연구가 지속되어야 하며, 이를 통해 종합적 위험 요인 평가 작업과 치료적 대안을 제시하는 후속 작업이 지속 되어야 할 것 이다.

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생애진로분기점별 진로정체성 혼돈에 따른 진로전략 분석 (Analysis of Career Strategy according to Career Identity Confusion at the Each Life Career Branching Point)

  • 손민정;조인수;최정은
    • 한국산학기술학회논문지
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    • 제19권6호
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    • pp.299-323
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    • 2018
  • 이 연구는 진로전환의 기점을 분기점별로 확인하고, 진로정체성 혼돈에 따른 진로전략을 질적 연구를 통해 분석하였다. 이 연구의 참여자는 학령기 교육의 수직적 전환단계에 해당하는 중학교 3학년, 고등학교 3학년, 대학 졸업 전후의 시기별로 각 3명씩을 선정하였으며, 조직규모별 종사경험자가 포함될 수 있도록 30세 전후, 40세 전후, 60세 전후 참여자를 각각 3명씩 선정하였다. 총 18명의 면담내용을 주제 분석한 결과, 첫째, 중학교 3학년, 고등학교 3학년, 대학 졸업 후 취업하기 전까지, 직장생활 3년 차 이내, 40대 초중반, 60세, 80세를 생애진로분기점으로 나타났다. 둘째, 생애진로분기점별 외부적 상황은 부모, 교사, 상사, 동료, 또래 등 의미 있는 타인의 영향을 받거나 그 외에 교육 및 훈련, 일 관련 경험, 취업 실업, 직무전환 등 환경적 요인, 진로사건에 관한 내용이었다. 셋째, 생애진로분기점에서의 정서적 상황에서는 분기점별 차이가 거의 없었으나, 생애진로분기점을 경험할 때마다 부정적 정서가 반복되는 양상을 보였다. 넷째, 연구 참여자들은 생애진로분기점마다 진로정체성에 대한 혼돈을 보였다. 다섯째, 생애진로분기점에서의 진로 전략은 접근 전략으로 진로 범위의 확대, 멘토링의 활용, 직무 충실과 몰입, 관련 교육 및 훈련 등과 같이 진로 목표에 다다르기 위한 전략이 있었고, 회피와 관련한 전략은 진로 제한에 따른 타협, 당면과제 회피 및 현실도피, 사회 규범적 가치에 편승, 진로와 관련 없는 성과에 주력하는 등과 같이 궁극적으로 진로목표 달성과는 연관성 없는 행동을 지향하는 내용 전략으로 범주화되었다.

혈액투석 환자의 수면의 질에 영향을 주는 신체적, 심리적, 생리적 요인 (Physical, Physiological, and Psychological Factors Determing Sleep Quality in Patients on Maintenance Hemodialysis)

  • 신동순;임봉주;강영선;이지혜;정은경;오정희;민경애;송라윤;나기량
    • 임상간호연구
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    • 제23권2호
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    • pp.258-266
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    • 2017
  • Purpose: The study aimed to examine quality of sleep in hemodialysis patients and explore physical, physiological, and psychological factors determining sleep quality. Methods: The survey was conducted among 165 patients on maintenance hemodialysis at a university hospital. Data were collected from July to October in 2015. The sleep quality and its related factors were assessed by standardized questionnaires, anthropometric measures, and lab tests after obtaining a written consent from the participant. Results: The mean age of the participants was 62.58 years old, and 67.9% of the participants experienced sleep disorders such as 'not falling asleep within 30 minutes' or 'frequently waking up at night'. Pain (t=-3.29, p=.007) and depression (t=-6.028, p<.001) were significantly different between the group with sleep disorder and the other without. The demographic factors (age, shared room, sleep during the day), physical factors (pain and symptom), and psychological factors (depression and trait and status anxiety) together explained 20.0% of variance in sleep quality. Conclusion: Sleep disorder was frequently experienced among the patients on maintenance hemodialysis. The effective nursing strategies should focus on sleep environment, pain and depression management. Further study is warranted to explore the effect of physiological factors related to the disease on sleep disorder in this population.

불안, 기분장애로 치료 중 보행장애 외에 서동과 강직을 동반한 정상뇌압수두증 증례 (Bradykinesia, Rigidity and Gait Disturbance Due to "Possible" Normal Pressure Hydrocephalus in a Patient with Anxiety and Bipolar Disorder : A Case Report)

  • 장세헌;제영묘;최진혁;배정훈;성상윤;조세훈;김영훈
    • 정신신체의학
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    • 제23권1호
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    • pp.66-69
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    • 2015
  • 정상뇌압수두증은 보행장애, 요실금 및 치매 등의 전형적인 세 가지 증상 외에도 추체외로 증상과 다양한 신경심리 증상이 동반될 수 있다. 이 사례는 불안과 정동증상으로 치료 중 보행장애와 요실금 증상을 보였던 46세 여자 환자에서 항파킨슨 약물의 사용과 기존 정신과 치료 약물의 중단에도 불구하고 증상의 호전이 없었으나, 뇌 컴퓨터 단층 촬영상 뇌실의 확장 소견이 보였고 시험적 뇌척수액 배액에 의해서 수일 내에 증상들이 극적으로 호전되어 정상뇌압수두증을 감별해야 했던 경우이다. 뚜렷한 대뇌 실질의 위축 소견이 없으나 뇌실이 확장되어 있을 경우 추체외로 증상과 신경심리 증상이 있을 경우 정상뇌압수두증의 전형적 세 가지 증상을 보이지 않는다 하더라도 정상뇌압수두증의 가능성을 고려해서 시험적 뇌척수액 배액 등의 시술이 진단과 치료에 도움이 될 수 있음을 보여주는 사례라고 생각된다.