• Journal of East-West Nursing Research
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• v.27 no.1
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• pp.14-21
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• 2021

Purpose: This study aims to examine the levels of posttraumatic stress disorder (PTSD), depression and social stigma among nurses caring for Corona Virus Disease-19 (COVID-19) patients. Methods: 169 nurses caring for COVID-19 patients participated in this study. Data collection was conducted at university hospitals from March 1 to August 31, 2020. Data analysis was performed for descriptive statistics, t-test, ANOVA, and Pearson correlation coefficients using SPSS/WIN 24.0 program. Results: The mean scores of PTSD, depression and social stigma were 25.16±16.80, 17.26±8.63 and 5.83±2.84, respectively. The PTSD scores were significantly different between the department (F=2.89, p=.037). Depressive scores were significantly different between the marital status (t=2.27, p=.024) and the department (F=4.91, p=.003). Social stigma scores were significantly different between age (F=6.49, p=.002), marital status (t=-3.30, p=.008), having or not having children (t=3.82, p=.001), department (F=5.82, p=.001) and clinical experience (F=7.43, p=.001). Positive correlations were found between PTSD and depression (r=.70, p<.001) and social stigma (r=.22, p<.004). Conclusion: Integrated assessment and management are required to address the psychological and emotional problems faced by nurses caring for COVID-19 patients, and active follow-up measures should be considered.

• Anxiety and mood
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• v.15 no.1
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• pp.35-44
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• 2019

Objective : The aim of this study was to investigate the individual and job related factors as risk factors for mental health of firefighters. Methods : The data of 202 fire-fighters was analyzed by using a multinomial logistic regression analysis. All participants completed self-reported questionnaires including demographics (sex, age, work duration), the Childhood Trauma Questionnaire, the Ways of Coping Checklist, the Colleague related traumatic events, the Korean occupational stress scale, the Korean Perceived Stress Scale-10, and the Beck Depression Inventory. Participants were divided into three groups according to the level of stress and depressive symptom scores: Low Stress-Low Depression (LS-LD), High Stress-Low Depression (HS-LD), and High Stress-High Depression (HS-HD). Results : A job related factor-organizational injustice-was a significant factor related to HS-LD, while individual factors such as active coping level and childhood trauma experience and a job related factor-difficult physical environment-were significantly associated with HS-HD. Conclusion : These results imply the need to take both individual and environmental approaches into account when managing the stress and depression of firefighters. More specifically, psycho-education to facilitate active coping strategy and adaptive emotional regulation at the individual level and the improvement of physical work environment of firefighters should be supported.

• Journal of Trauma and Injury
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• v.32 no.1
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• pp.8-16
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• 2019

Purpose: The Essential Surgical Procedures in Trauma (ESPIT) course was developed as a model to teach necessary surgical procedures to trauma physicians. Its goals are to improve knowledge, self-confidence, and technical competence. Methods: The ESPIT course consisted of five lectures and a porcine lab operative experience. The ESPIT course has been run seven times between February 2014 and April 2016. ESPIT participants completed a questionnaire to assess self-efficacy regarding essential surgical procedures in trauma before and immediately after taking the ESPIT course. Sixty-three participants who completed both pre- and post-course questionnaires on self-efficacy were enrolled in this study. Results: The overall post-ESPIT mean self-efficacy score was higher than the pre-ESPIT mean self-efficacy score ($8.3{\pm}1.30$ and $4.5{\pm}2.13$, respectively) (p<0.001). Self-efficacy was significantly improved after the ESPIT course in general surgeons (p<0.001), thoracic and cardiovascular surgeons (p<0.001), emergency medicine doctors, and others (neurosurgeons, orthopedic surgeons) (p<0.001). The differences in self-efficacy score according to career stage (<1 year, 1-3 years, 3-5 years, and >5 years) were also statistically significant (p<0.001). Conclusions: The data of the ESPIT participants indicated that they felt that the ESPIT course improved their self-efficacy with regard to essential surgical procedures in trauma. The ESPIT course may be an effective strategy for teaching surgical procedures, thus promoting better management of traumatic injuries.

• Journal of the Korea Convergence Society
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• v.11 no.12
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• pp.261-274
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• 2020

Research on the development and effectiveness of internet-based cognitive-behavioral therapy with a trauma focus (iCBT-T) has been actively conducted in Western societies, but these studies have just begun in Korea. The purpose of this study was to suggest practical considerations to developing and managing the iCBT-T program. After reviewing previous studies on iCBT-T, this author suggested a model of convergence and collaboration between mental health knowledge and information and communication technologies (ICT) to develop the iCBT-T program. This article outlines practical considerations, including focus and target groups of iCBT-T, intervention types of iCBT-T (open access vs. guided), number of sessions, ethical issues, professional support, and degree of user involvement. Methods to complement the limitations of internet as a medium are also proposed in the iCBT-T program. The convergence model of CBT-T and ICT is expected to promote the development of programs that can contribute to improving the mental health of users who experience traumatic events.

• Archives of Craniofacial Surgery
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• v.23 no.2
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• pp.89-92
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• 2022

Post-traumatic pseudoaneurysms of internal maxillary artery are rare, but may be life-threatening. When arterial damage leads to pseudoaneurysm formation, delayed intractable epistaxis can occur. We report our experience with the diagnosis and management of a ruptured internal maxillary arterial pseudoaneurysm that was discovered preoperatively in a patient with a zygomaticomaxillary complex (ZMC) fracture. He presented to the emergency room with epistaxis, which ceased shortly, and sinus hemorrhage was observed with a fracture of the posterior maxillary wall. The patient was scheduled for open reduction and internal fixation (ORIF) of the ZMC fracture. However, immediately before surgery, uncontrolled epistaxis of unknown origin was observed. Angiography indicated a pseudoaneurysm of the posterior superior alveolar artery. Selective endovascular embolization was performed, and hemostasis was achieved. After radiologic intervention, ORIF was successfully implemented without complications. Our case shows that in patients with a posterior maxillary wall fracture, there is a risk of uncontrolled bleeding in the perioperative period that could be caused by pseudoaneurysms, which should be considered even in the absence of typical symptoms.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.91-99
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• 2019

Most patients experience pain relief and functional improvement after arthroscopic rotator cuff repair. In some patients, however, symptoms still remain after surgery. Failed rotator cuff repair is a complex outcome of biological, technical, and traumatic factors. Moreover, re-tears might or might not be the main cause for patients with persistent pain after rotator cuff repair. Therefore, a thorough understanding of the patient's history, physical examination, and appropriate imaging studies will be needed to evaluate and manage these patients. The patient's age, functional requirement, quality of the rotator cuff, preoperative range of motion, quality of the deltoid, and glenohumeral arthritis are factors to consider before performing revisional rotator cuff repair. Preoperative patient education is as important as the surgical technique for successful revisional rotator cuff repair.

• Korean Journal of Schizophrenia Research
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• v.20 no.2
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• pp.37-43
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• 2017

Objectives : This study was aimed to investigate the associations of childhood trauma with psychopathology and clinical characteristics in patients with schizophrenia. Methods : This study enrolled 66 inpatients with schizophrenia. Korean Childhood Trauma Questionnaire (K-CTQ) and Life Event Questionnaire (LEQ) were administered to assess childhood trauma. Psychopatholgy and clinical characteristics were assessed with the Positive and Negative Syndrome Scale (PANSS), Beck Depression Inventory (BDI), Korean Version of Internalized Stigma of Mental Illness (K-ISMI), Perceived Stress Scale (PSS), and visual analogue scale of EuroQoL-5 Dimension Index (EQ-5D). Results : Total scores on K-CTQ were positively associated with scores on the BDI, K-ISMI, PSS, and PANSS and negatively associated with the score on the EQ-5D. Among subscales of K-CTQ, emotional abuse was significantly associated with all measures for psychopathology and clinical characteristics. Patients with physical abuse (36.5%), emotional abuse (30.2%), or bullying (30.6%) according to the LEQ showed sighificanlty higher the ISMI score and lower EQ-5D score. Emotional abuse and bullying were also significantly associated with higher scores on BDI and/or PSS. Conclusion : Our results suggest that childhood trauma negatively influences on internalized stigma, depression, perceived stress and quality of life in patients with schizophrenia. Clinicians should carefully evalute and manage childhood traumatic experience of patients with schizophrenia.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.376-384
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• 2023

Purpose: The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity. Methods: In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients' mode of transport. Results: This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder. Conclusions: This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.2
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• pp.190-198
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• 2022

Backgrounds/Aims: Traumatic pancreatic injury (TPI) is rare as an isolated injury. There is a trend to perform conservative treatment even in patients with complete duct dissection and successful treatment. This study reviewed our 20 years of experience in the management of TPI and assessed patient outcomes according to age group and treatment strategy. Methods: A retrospective analysis of patients diagnosed and treated with TPI at a level-I trauma center from 2000-2019. Patients were divided into two groups: adults and pediatrics. Conservative treatment cases were subjected to subgroup analysis. Level of evidence: IV. Results: Of a total of 77 patients, the mean age was 24.89 ± 15.88 years. Fifty-six (72.7%) patients had blunt trauma with motor vehicle accident. Blunt trauma was the predominant mechanism in 42 (54.5%) patients. Overall, 38 (49.4%) cases had grade I or II injury, 24 (31.2%) had grade III injury, and 15 (19.5%) had grade IV injury. A total of 30 cases had non-operative management (NOM). Successful NOM was observed in 16 (20.8%) cases, including eight (32.0%) pediatric cases and eight (15.4%) adult cases. Higher American association for the surgery of trauma (AAST) grade of injury was associated with NOM failure (16.7% for grade I/II, 100% for grade III, and 66.7% for grade IV injury; p = 0.001). An independent factor for NOM failure was female sex (69.2% in females vs. 29.4% in males; p = 0.03). Conclusions: High AAST grade TPI is associated with a high rate of NOM failure in both pediatric and adults.

• Korean journal of psychology:General
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• v.36 no.2
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• pp.241-270
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• 2017

In this study we investigated the structural relationship between the Big Five personality traits which is a pretrauma characteristic, posttraumatic cognition, rumination, posttraumatic growth(PTG), and posttraumatic stress disorder(PTSD) symptoms. The participants were 1,000 adults who experienced traumatic event. For statistical analysis we set the research model with the Big Five personality traits affecting deliberate rumination through posttraumatic cognition and intrusive rumination. Competing model was set without the path from intrusive rumination to deliberate rumination. The results indicated that rumination and posttraumatic cognition did not mediate the relationship between extraversion, agreeableness, conscientiousness and PTG, PTSD symptoms. Second, there was a mediating effect of intrusive rumination between openness to experience and PTSD symptoms. Moreover, the pathway to intrusive rumination, deliberate rumination, and PTG from openness to experience was also significant. Third, the pathway to posttraumatic cognition, event-related rumination, and both PTSD symptoms and PTG from neuroticism was significant. These results support the cognitive process of PTG model In the end we discussed the implication and limitations of the study.