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다요인적 프로그램이 농촌 지역 여성노인의 요실금, 자아존중감 및 자기효능감에 미치는 효과
최현경(Choi Hyun Kyoung),임은실(Yim Eunshil) 한국농촌간호학회 2019 한국농촌간호학회지 Vol.14 No.1
Purpose: The purpose of this study was to examine the effect of a multifactorial program for urinary incontinence, self-esteem and self-efficacy in older women. Methods: A one-group pretest-posttest with no control group was used. Nineteen women completed weekly 90-min group sessions for eight weeks. The group received a multi-factorial program comprised of Kegel exercise, education and psychosocial programs over 8 weeks. Data on urinary incontinence, self-esteem and self-efficacy were collected twice: before the intervention and 8 weeks after the intervention. Data were analyzed using paired t-test by non-parametric statistics. Results: Total scores for the International Consultation on Incontinence Questionnaire decreased significantly after the intervention (pretest 7.95±5.48, posttest 5.15±4.72, p<.05). The scores for self-esteem and self-efficacy improved significantly. Conclusion: These results indicate that a multifactorial program for older women is feasible to prevent urinary incontinence in women living in the community.
정신건강의학과 안정병동 내 병원학교교실 참여자의 학교복귀율과 만족도
이미경(Mi-Kyeong Lee),방수영(Soo-Young Bhang),안준호(Joon-Ho Ahn),박장호(Jang-Ho Park),최현경(Hyun-kyoung Choi) 대한소아청소년정신의학회 2013 소아청소년정신의학 Vol.24 No.3
Objectives:The objective of this report is to identify the utilization of hospital school service during hospitalization among patients in their childhood and adolescence with psychiatric disorders. Methods:We retrospectively reviewed the medical record of child and adolescent psychiatric who were hospitalized during March 2009 through October 2012. We compared the one-year successful schooling and outpatient follow up rate between users and nonusers of the inpatient hospital school service. The hospital schooling experiences of the users were investigated upon follow-up visits to the outpatient clinic. Results:Sixty-three students received hospital school service during hospitalization among total 122 child and adolescent inpatients. Hospital school participants showed a significantly higher school reentry rate (61.9%) than non-participants (40.7%). However, there was no difference on follow up rate between the two groups. More than 60% of the 22 interviewed participants expressed an above-average level of satisfaction about hospital school service. Conclusion:Many patients with mental illness experience difficulty in receiving school education during treatment. That induces deterioration in disease, academic failure, poor social skills, low self-esteem, economic difficulties, and future job opportunities. The results of this study emphasize the importance of hospital school service and offer useful guidance for hospital school operation.
최현경,김정기 대한신경정신의학회 2000 신경정신의학 Vol.39 No.2
저자들은 50대 여성에서 인슐린종에 의해 발생한 간질 발작에서 인슐린종의 제거 이후, 저혈당이 교정된 상태에서도 지속적인 이상 뇌파를 보인 예를 경험하였다. 환자는 간질 발작 이외에 저혈당의 일반적인 증상인 두통, 진전, 발한, 창백, 심계 항진 등을 거의 보이지 않아 오랫동안 측두엽 간질로 진단되어 항전간제를 사용하였다. 뇌파에서 좌측 측두엽에 이상을 보였고 인슐린종을 성공적으로 제거하고 저혈당이 교정되어 간질이 소실되었는데도 뇌파의 이상 소견이 지속되었다. 본 증례에서 혈당의 농도가 낮은데도 불구하고 환자가 전혀 저혈당의 증상을 느끼지 못하였다. 낮은 혈당에서도 glycosy Hb A1c의 농도가 정상에 가까워 뇌의 glucose uptake 가 유지되고 sympathoadrenal activation 과 counteregu-latory hormones으 반응이 감쇠되는 경우가 있다고 한다. 본 증례에서도 glycosy Hb A1c가 4.0%로 정상에 가까웠다. 저혈당에 의한 간질의 기전에 대하여서 간질의 역치를 감소시킨다는 설과 국소적인 뇌의 산소 소모를 감소시킨다는 설이 있어왔다. 최근에는 국소적인 뇌손상이 간질 유발의 원인이라는 설이 우세한데 excitotoxic mechanism으로 설명되고 있다. 증례에서 뇌파의 이상소견이 지속되었던 것은 국소적인 뇌 손상의 기전과 일치하는 결과로 생각되며 지속적인 뇌파의 추적 관찰이 필요할 것으로 여겨진다. Authors experienced a case of insulinoma which was initially misdiagnosed as idopathic tem-poral lobe epilepsy with automatism. This patients did not show other hypoglycemic symptoms except seizure. It has been reported that some of the patients with insulinoma are unaware of hypoglycemia and are at increased risk for seizures and coma. These patients would have normal glucose uptake in the brain and consequently no sympathoadrenal activation would begin, resulting in an awareness of hypoglycemia. It this case, abnomal EEG pattern consistent with a complex partial seizure remained after successful operation. Recent reports indicate that hypoglycemia is capable of killing neurons in the brain . An endogenous neurtoxin is produced and is released by the brain into tissue and cerebrospinal fluid. Endogenous excitotoxins produced during hypoglycemia may explain the tendency toward seizure activity often seen clinically. We suggest that persistent abnormalities of EEG in this case may be related to focal neuronal damage in hypoglycemia.