의과대학 교육 과정에서 아동학대 교육의 요구도

양수진(Su-Jin Yang),김선영(Sun-Young Kim),김웅장(Woong-Jang Kim),김향화(Hyang-Wha Kim),김재민(Jae-Min Kim),김성완(Sung-Wan Kim),신일선(Il-Seon Shin),윤진상(Jin-Sang Yoon) 대한소아청소년정신의학회 2008 소아청소년정신의학 Vol.19 No.1

Objectives : This study aimed to examine current educational experiences, knowledge, intention to report, and requests for child abuse education in medical interns. Methods : A descriptive cross-sectional study was conducted in 2006 and 2007. The study sample consisted of 193 medical interns who served their internships at the university hospital. They answered 11 self-administered questionnaires related to child abuse. Results : Although respondents indicated a strong will to assist in eradicating abuse of children, about 90% had no educational experiences and knowledge of child abuse. Ignorance was a major factor for low reported cases of abused children. The preferred nominated reporting agency for child abuse was the National Child Protection Agency in 47.9% of female respondents, while 48.3% of males nominated Police Stations as their preferred option. In relation to sexual abuse, Police Stations were the preferred reporting agency by 49.2% of males and 37.0% of females. Medical school curricula were chosen by the majority of interns as the most appropriate stage where child abuse education should be introduced. Conclusion : This study found that medical graduates had limited experience and knowledge related to child abuse. The medical school curricula for child abuse needs to be further developed, implemented, and evaluated when appropriate.

가정환경이 인터넷 중동과 정신증상에 미치는 영향

양수진(Su-Jin Yang),김웅장(Woong-Jang Kim),노경선(Kyung-Sun Noh) 대한사회정신의학회 2003 사회정신의학 Vol.8 No.2

목적: 본 연구의 목적은 인터넷 중독과 정신증상 및 가정환경 간의 개별적인 연관성을 조사하고, 가정환경이 인터넷 중독과 정신증상 간의 연관성에 미치는 효과를 평가하는데 있다. 방법: 2001년도에 광주광역시의 747명 중고생을 대상으로 하였다. 인터넷 중독은 인터넷 중독 척도(Internet Addiction Scale, IAS) 를 이용하여 평가하였고, 정신증상 및 가정환경은 각각 간이정신진단검사(Symptom Checklist-90-Revised, SCL-90-R)와 가정환경척도(Family Environment Scale, FES)를 통해 측정하였다. 결과: IAS 점수는 SCL-90-R의 모든 증상척도 및 FES의 일부 소척도 점수와 유의한 상관이 있었다. IAS 점수와 SCL-90-R 점수 간의 연관성은 FES 점수의 효과에 따라 수정되었다. 결론: 가정환경의 조정 또는 개입을 통해, 인터넷 중독과 이와 연관된 정신증상을 조절할 수 있음이 시사된다.

고령화와 연관된 인지감퇴에 대한 혈관성 위험인자의 영향

신일선(Il-Seon Shin),김재민(Jae-Min Kim),김웅장(Woong-Jang Kim),최성구(Sung-Ku Choi),윤진상(Jin-Sang Yoon) 대한노인정신의학회 2002 노인정신의학 Vol.6 No.1

목 적: 본 연구에서는 인지감퇴와 고령화 간의 연관성, 그리고 그 연관성에 미치는 혈관성 위험인자(고혈압과 당뇨병) 의 영향을 조사하고자 하였다. 방 법: 65세 이상 노인 1134명이 1999년에 한국판 간이정신상태검사(Korean version of Mini-Mental State Examination;MMSE-K)로 평가를 받았고, 이들 중 686명(61%)이 2년 후에 MMSE-K로 재평가를 받았다. 연령과 혈관성 위험인자(고혈압과 당뇨병)에 대한 자료를 수집하였다. 결 과: 인지감퇴는 고령화와 유의한 연관성이 있었다. 층화분석에서, 인지감퇴와 고령화 간의 연관성은 혈관성 위험인자가 있는 경우 유의하였으나, 혈관성 위험인자가 없는 경우에는 유의하지 않았다. 결 론: 혈관성 위험인자에 대한 적절한 조절을 통해 고령화와 연관된 인지감퇴를 지연시킬 수 있음을 시사한다. Objective:This study aimed to investigate the association between cognitive decline and advancing age, and the potential effects of vascular risk factors on the associations. Method:1134 old persons aged 65 or over was assessed by the Korean version of Mini-Mental State Examination (MMSE-K) in 1999, and after two years 686 (61%) of the total subjects were reassessed with MMSE-K. Data on age and vascular risk factors (hypertension and diabetes) was obtained. Results:Cognitive decline was significantly associated with advancing age. The stratified analyses showed that the association of cognitive decline with advancing age was significant for those with vascular risk factors, but not significant for the subjects without vascular risk factors. Conclusion:We suggest that the cognitive decline with advancing age might be delayed by appropriate management for the vascular risk factors.

간호사들에서 월경전불쾌기분장애와 삶의 질, 사회직업기능 및 장애 간의 연관성

김선영,김재민,김웅장,양수진,김성완,신일선,윤진상 大韓神經精神醫學會 2008 신경정신의학 Vol.47 No.1

Objectives : This study aimed to investigate the prospective associations of premenstrual dysphoric disorder (PMDD) with quality of life, socio-occupational function and disability. Methods : 170 nurses were recruited 6om two general hospitals. Interviews were made at baseline and at four follow-up points (two mid follicular phases and two late luteal phases ofthe two consecutive menstrual cycles). The baseline evaluation Consis-ted of sociodemographic characteristics and menstmal history. PMDD was diagnosed by DSM-IV criteria after observation of the two menstrual cycles. The follow-up evaluations were consisted ofthe World Health Organization Quality of Life-Brief form, the Social and Occupational Functioning Assessment Scale, and the World Health Organization Disability Assessment Scale-II. Results : PMDD was detected 15 (8.8%) of 170 participants. The PMDD group showed significantly worse quality of life and socio-occupational functioning than the none-PMDD group particularly at the late luteal phases. No significant differences were found in sociodemographic characteristics and menstrual history between those with and without PMDD. Conclusion : PMDD was prospectively associated with worse quality of life and socio-occupational functioning in this study group.

광주광역시 치매의 유병률과 위험인자의 도시-농촌 지역 비교

신일선,김재민,윤진상,김석재,양수진,김웅장,이승현,강순아,곽지영,이형영 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.6

연구목적 : 본 연구의 목적은 광주광역시의 도시 및 농촌 지역에 거주하는 노인에서 치매의 유병률과 위험인자를 조사하고자 하였다. 부가적으로 이 두 지역간에 치매의 유병률과 위험인자를 비교하고자 하였다. 방 법 : 광주광역시의 전형적인 도시와 농촌지역의 65세 이상의 노인(N=1,598)을 대상으로, 2단계의 역학연구를 수행하였다. 1차 선별 단계에서는 38명의 훈련된 연구보조원이 대상노인을 면담하여, 사회인구학적 특징을 조사하고 한국판 간이정신상태검사(Korean version of Mini-Mental State Examination ; MMSE-K)로 평가하였다. 2차 임상 진단 단계에서는 1차 단계에서 MMSE-K 점수가 24점 이하인 노인(N=431)을 대상으로, 전문연구팀의 임상적 평가를 통해 치매를 진단하고 원인질환별로 알쯔하이머병(Alzheimer's disease ; AD), 혈관성 치매(vascular dementia ; VaD) 및 기타 치매로 분류하였다. 대상노인에서 치매의 유병률을 측정한 후, 광주광역시 전체 노인의 연령보정 유병률을 산출하였다. 전체 대상에서 AD의 위험인자를 조사한 후, 도시와 농촌군으로 나누어 분석을 다시 시행하였다. 결 과 : 1차 및 2차 단계의 참가율은 각각 71.0%(N=1,134) 및 83.2%(N=410) 였다. 연구 참여 노인(N=1,134)에서 전체 치매, AD 및 VaD의 유병률은 최소 각각 9.7%, 5.2%, 1.8%였다. 광주광역시 전체 노인의 연령 보정 유병률은 각각 10.7%, 5.7%, 1.9%인 것으로 산출되었다. AD의 독립 위험인자는 고령, 여성, 무학이었다. 도시와 농촌에 따른 유병률의 차이는 파악되지 않았다. 그러나 AD의 위험인자는 지역에 따라 차이가 있었다. 도시 노인에게는 무학만이, 농촌 노인에게는 고령과 여성인 경우가 독립 위험인자였다. 결 론 : 광주광역시 노인에서 치매의 유병률은 높았고, 이는 국내 다른 지역에서 수행된 선행연구 결과와 유사하였다. 알쯔하이머형 치매의 위험인자는 도시와 농촌에 따라 다른 결과를 보였다. 본 연구 결과는 한국에서의 치매의 실태를 반영하며, 치매의 적절한 관리와 예방을 위해서는 지역성 특성이 고려되어야 함을 시사한다. Objectives : The purpose of this study was to investigate the prevalence rate and risk factors of dementia in an urban and a rural sample of older persons in the metropolitan Kwangju area, Republic of Korea. In addition, the prevalence rate and risk factors of dementia between the two samples were compared. Methods : A two-phase epidemiological study of residents aged 65 or over(N=1,598) was conducted in a highly developed, urban and a non-contiguous, poorly developed, rural area of metropolitan Kwangju. In the first(screening) phase, 38 trained research assistants collectively peformed in-home interviews for all participants. Detailed sociodemographic characteristics were gathered and the Korean version of Mini-Mental State Examination (MMSE-K) was administered. In the second (diagnosing) phase, diagnosis of dementia was established for those scoring 24 or less on the MMSE-K in the screening phase(N=431), and etiological types of dementia were classified to Alzheimer's disease(AD), vascular dementia(VaD) or miscellanous type by two teams of experts. Prevalence rate of dementia was determined in the participants, and age-standardized prevalence rate adjusted by age distribution in metropolitan Kwangju was estimated. For AD, the risk factors were investigated in all participants, and analyses were repeated for the urban and rural samples separately. Results : The participating rates in the first and second phases were 71.0%(N=1,134) and 83.2%(N=410), respectively. In the participants, the prevalence rates of dementia(all types), AD and VaD were 9.7%, 5.2% and 1.8%, respectively. The age-standardized prevalence rates were 10.7%, 5.7% and 1.9%, respectively. Aging, female gender and no education(complete lack of formal education) were identified as independent risk factors for AD. No difference between the urban and rural samples was observed in the prevalence rates of dementia(all types), AD and YaD. However, risk factors for AD differed between these areas. In the urban sample, no education was the only significant factor ; whereas, aging and female gender were identified as risk factors in the rural sample. Conclusion : A high prevalence rate of dementia was observed among old persons in metropolitan Kwangju, consistent with previous studies conducted in other Korean areas. The risk factor profi1es for AD differed between urban and rural settings. The results of this study reflect the current status of dementia in Korea and suggests that appropriate management and prevention strategies for dementia should be tailored toward the geographic settings.