불안정 애착관계를 형성한 남아의 개별놀이치료 사례: 애착지향치료(Attachment-Oriented Therapy)의 관점에서

윤혜경 ( Hae-kyung Youn ),심혜원 ( Hae-won Shim ) 한국영유아아동정신건강학회 2016 영유아아동정신건강연구 Vol.9 No.1

본 연구는 불안과 우울감을 드러내며, 적응에 어려움을 보이고 있는 7세 남아의 개별 놀이치료 사례이다. 연구자는 아동의 현재 어려움의 원인을 불안정 애착관계 형성에 의한 것으로 보고, 이에 내담아동을 애착지향 치료의 이론적 배경을 바탕으로 총 57회의 놀이치료를 진행하였다. 연구자는 내담아동이 상담자와의 관계를 통해 안전기지를 경험하고, 외부세계는 안전하지 않으며 자신의 기대에 반응하지 않을 것이라는 과거의 내적작동모델을 해체하고 안정적 애착관계를 재형성할 수 있도록 돕고자 하였다. 본 연구에서 놀이치료의 목표는 첫째, 아동이 안전지대를 확보하여 외부세계에 대한 불안과 두려움으로부터 벗어나서 일상생활에서 안정적 정서를 유지할 수 있도록 돕기, 둘째, 아동이 과거의 내적작동모델에서 벗어나, 새로운 내적작동모델을 획득할 수 있도록 돕는 것이다. 본 놀이치료의 결과 첫째, 아동은 돌발행동과 긴 울음이 소거되었다. 둘째, 아동은 일상생활에서 지연행동이 감소되기 시작하였다. 셋째, 아동은 유능감을 경험하고 자기에 대한 긍정적 경험이 확산되기 시작하였다. 넷째, 아동은 자기 욕구를 허용하고 욕구의 충족을 경험하기 시작하였다. 다섯째, 아동은 욕구를 조절하려는 태도가 드러나기 시작하였다. 여섯째, 아동은 두려움을 넘어서 도전하고 성공하는 경험이 확산되고 있다. 일곱째, 아동은 다양한 정서를 경험되며 자기 정서를 구체적으로 표현하는 일들이 많아졌다. 이에 본 연구는 불안정 애착을 형성한 아동에 대한 애착지향 치료(AOT)의 관점에서의 놀이치료의 효과를 확인하였다는 점에서 의의를 갖는다. This paper is based on a case study of a seven-year-old boy who showed anxiety and depression and had difficulty adapting to his environment. His problems were attributed to insecure attachment and play therapy was conducted for 57 sessions based on the theory of attachment-oriented therapy (AOT). The researchers worked with the boy to help him experience secure base, deconstruct his previous internal working model, and rebuild secure attachment relationship. The play therapy aimed to: (1) help him to obtain secure base to escape from the fear and anxiety about the outside world and maintain stable emotional state in everyday life and (2) help him to abandon his previous internal working model and acquire a new one. After the sessions: (1) he stopped unpredictable behaviors and crying for long hours; (2) his procrastination in everyday life decreased; (3) he experienced competence and his self-confidence began to expand; (4) he allowed himself to pursue his desires and began to experience fulfillment of desires; (5) he began to control his desires; (6) he overcame his fear and tried new things more frequently and successfully; and (7) he began to experience diverse emotions and express his emotions more specifically. These findings are meaningful in that they verified the effectiveness of the role playing counseling from the perspective of attachment-oriented therapy for children who had developed insecure attachment.

대상관계 관점에서 애착장애를 보이는 아동의 놀이치료 사례

윤혜경 ( Hae-kyung Youn ),심혜원 ( Hae-won Shim ) 한국영유아아동정신건강학회 2013 영유아아동정신건강연구 Vol.6 No.2

본 연구는 까다롭고 욕구수준이 높으며, 초기 영유아기에 안정적인 환경이 제공되지 않고 주 양육자가 변경되며, 우울하고 심리적으로 매우 지쳐있는 모로 인해 소아 불안장애와 애착장애를 보인 남아의 개별 놀이치료 사례이다. 본 연구는 총 52회의 개별놀이치료를 실시하였으며, 치료자는 아동이 새롭게 심리적 탄생을 이루어가는 과정을 대상관계 관점에서 이해, 해석, 평가를 하였다는 점에서 의의를 갖는다. 치료자는 아동에게 심리적 정서적 신체적 접촉을 통해 아동이 심리발달을 이룰 수 있도록 촉진하였다. 치료결과 아동은 외부세계에 대한 두려 움으로 인한 공격성이 감소되었고, 욕구의 지연과 대체 및 전환 그리고 정서조절이 가능하게 되었다. 또한 아동은 안정적이고 긍정적인 상호작용의 증진으로 가족에 대한 신뢰감을 형성 하게 되었으며, 자기에 대한 긍정적 이미지를 형성하고, 사회적 상황 및 유치원 생활에 비교 적 잘 적응하게 되었다. 그러나 아동의 긍정적 변화가 안정적으로 지속되는 과정을 충분히 훈습되지 못한 점, 그리고 모의 심리적 에너지 수준이 충분히 향상되지 못한 점 등으로 향후 스트레스 상황에서 어려움이 재연 될 가능성이다. This is a case study of a child who was fussy and hard to please. He spent his infancy or early childhood in an unstable environment. His primary care giver changed and he has suffered from anxiety disorder and attachment disorder caused by a depressed mood and psychological fatigue. Individual play therapy was conducted 52 times, and the therapist evaluated his psychological changes from the perspective of object relations. The therapist helped him improve his mental health through psychological, emotional, and physical interaction. As a result, his aggression associated with fear toward the external world decreased, and he was able to hold, sublimate, and transform his desires, showing emotional regulation. He was also psychologically stabilized and built trust with family members, improving his self-esteem and being adapted better to his kindergarten and social activities. However, there is still a possibility for the child to relapse into his previous conditions when facing stressful situations given that his positive changes were not firmly stabilized and that his mother's psychological energy standards were not sufficiently improved.

TV 프로그램을 활용한 중학교 과학 진로교육 자료 개발 및 적용

윤혜경 ( Hye Gyoung Yoon ),김형석 ( Hyoung Seok Kim ),정형식 ( Hyung Sik Jung ),김정연 ( Joung Youn Kim ),김명순 ( Myoung Soon Kim ) 한국과학교육학회 2006 한국과학교육학회지 Vol.26 No.4

손소독제 사용 실태 조사 및 성분 분석

윤혜경(Hye-Kyung Yoon),이은지(Eun-Ji Lee),허예림(Ye Lim Hur),박나연(Na-Youn Park),고영림(Younglim Kho) 한국환경보건학회 2020 한국환경보건학회지 Vol.46 No.6

Objectives: Hand sanitizer is made with ethyl alcohol as the main ingredient. Problems related to the use of hand sanitizers and cases of harm caused by the use of hand sanitizers are occurring. This study investigated the usage behavior and recognition level of people using hand sanitizer and identified the chemical components listed in the component label of hand sanitizer. In addition, the methanol and isopropanol contained in hand sanitizer were quantified using HS-GC-MSD. Methods: The investigation of the behavior and recognition of hand sanitizer usage was conducted through a survey of 143 college students and adults. The components marked on 34 types of hand sanitizers were investigated, and methanol and isopropanol concentrations were analyzed using the HS-GC-MSD method. Results: According to the survey, 57% of respondents use hand sanitizers two to three times per day, 92.3% of them do so when in public places and 41.3% of them do so at home. Ethanol, purified water, carbomer, glycerin, and triethanolamine were the ingredients listed in the hand sanitizer. Among the 34 samples, methanol and isopropyl alcohol were detected in 33 samples, the concentration range for methanol was ND-567 ppm, and the concentration range of isopropyl alcohol was ND-2121 ppm. Conclusion: The results of this study have shown that hand sanitizers are being used constantly every day, and methanol, which is not included in the marked content, was detected in a significant concentration compared to wet tissue. It has been found that maintenance of hand sanitizer manufacturing standards and training on how to use them are needed.

글로벌 마켓을 위한 한국적 이미지의 제품 디자인 개발 방안

문명옥(Moon Myeng-Ok),함연자(Ham Youn-Ja),문광희(Moon Kwang-Hee),윤혜경(Yoon Hae-Gyung) 한복문화학회 2007 韓服文化 Vol.10 No.3

This study aimed to suggest the direction of the product design development using Korean image for global market through investigating preference of Asian image and Korean traditional patterns by westerner. The subjects consisted of 65 American and 47 British aged 10 to 60. The experimental material used in this study was a questionnaire, composed of 17 question multiple choice. The data were analyzed by SPSS(14.0K). The results were as follows: The preference of Asian images were 'unique', 'mysterious', 'elaborate' and the preference of Asian cultural elements were 'food', 'architecture' and 'clothing'. The most influential element on choosing Asian goods was pattern and the most influential element on hesitating Asian goods was also pattern. Regarding Korean traditional patterns, the American prefer 'Sam-jok-o', 'dragon', 'bamboo' and the British prefer 'chrysanthemum', 'Japanese apricot tree', 'peony'. The suitable patterns for clothing were all botanical motifs and the suitable patterns for interior goods were geometrical motifs as well as botanical motifs. In case using Korean patterns for clothing and interior goods, using modified patterns in modern type was preferred.

학교기반 또래지도자 중심의 흡연예방교육 프로그램의 효과

신성례(Shin, Sung Rae),오복자(Oh, Pok Ja),윤혜경(Youn, Hye Kyung),신선화(Shin, Sun Hwa) 한국간호과학회 2014 Journal of Korean Academy of Nursing Vol.44 No.6

Purpose: The purpose of this study was to develop and evaluate a school-based peer leader centered smoking prevention program. Methods: Non-equivalent control group with a pre/post-test design was used. Students (n=174) in two boys" junior high schools located in D city, Korea participated with 85 being selected for the experimental group and 89 for the control group. Five sessions were given to the experimental group and a 50 minute lecture to the control group. Knowledge, attitude, non-smoking intention, and non-smoking efficacy were measured for the both experimental and control group at two weeks before the program and one month after the program was completed. Data were analyzed using χ2-test, Fisher’s exact test, independent t-test and paired t-test with the SPSS 21.0 program. Results: The experimental group showed higher overall knowledge, negative attitude toward smoking, and higher non-smoking intention and efficacy. After receiving the school based peer leader centered smoking prevention program scores for attitude toward smoking and nonsmoking efficacy increased in the experimental group were higher than in the control group. Conclusion: The school-based peer leader centered smoking prevention program needs longitudinal evaluation, but from this study, there is an indication that this program can be used with junior high school students and effectively change students’ attitude toward smoking and promote non-smoking efficacy.

배위자 1 , 2 - diaminopropane 을 함유하는 백금 (2) 착체의 항암효과 및 신독성

노영수(Young Soo Rho),정지창(Jee Chang Jung),최연웅(Youn Woong Choi),최승기(Seung Ki Choi),윤혜경(Hae Kyung Yoon) 경희대학교 동서약학연구소 2000 경희약대 논문집 Vol.28 No.-

N/A

H . pylori 감염과 관련된 다발성 위 용종증에 대한 제균요법의 임상적 고찰

하정수(Jung Su Ha),김성목(Sung Mok Kim),장윤식(Yun Sick Chang),이연재(Youn Jae Lee),이상혁(Sang Hyuk Lee),김영주(Young Ju Kim),윤혜경(Hye Kyoung Yoon),설상영(Sang Yong Seol),정정명(Jung Myung Chung) 대한내과학회 2001 대한내과학회지 Vol.61 No.1

N/A Background: Little has been known about the incidence, the relationship with H. pylori infection and the prognosis of the multiple gastric polyposis. Recently, it was suggested that the eradication of H. pylori infection led the disappearance of the gastric polyps associated with H. pylori. We carried out a prospective study to determine the effect of H. pylori eradication on multiple gastric polyposis associated with H, pylori. Methods-From July 1997 through August 2000, 13 patients who had multiple gastric polyposis on upper gastrointestinal endoscopy were recruited for this study. After eradication of H. pylori, we performed follow-up endoscopy at 2-3 months and 5-6 months later. Results : The topographical distributions of gastric polyps were as following : antrum only in 7 cases, antrum and lower body in 4 cases, antrum and fundus area in 1 case, and entire stomach in 1 cases, respectively. The histopathological findings were as following : 13 cases showed chronic active gastritis, 2 cases with hyperplastic polyps, and 1 case with adenomatous polyps. After eradication of H. pylori infection, regression of multiple gastric polyps occurred in 7 cases (53.8%). In 7 cases with regression, regression was observed in 5 cases with chronic active gastritis alone, 1 case with hyperplastic polyps, and 1 case with adenomatous polyps. The re-biopsy specimens in 7 cases with regression revealed that the grade of inflammation decreased from 2.2 to 1.5 by the histological index of the updated Sydney system. Conclusion : With these results, we may conclude that the development of multiple gastric polyposis might be closely related with chronic H. pylori infection, and the eradication of H. pylori could lead to the regression of polyposis. (Korean J Med 61:24-32, 2001)

내시경적 용종 절제술을 시행받은 145례의 위용종에 대한 임상 및 병리학적 연구

이연재,이상혁,설상명,정정명,윤혜경 인제대학교 1996 仁濟醫學 Vol.17 No.2

내시경 시술의 발달로 위에서 발생되는 여러 종류의 용종 중 크기가 악성일 경우는 외과적 절제술이 시행되고 있고 그 외 대부분의 병변은 내시경적 치료가 가능해졌다. 이런 점에서 저자는 위에서 발생되는 용종의 임상적, 병리학적 특징과 각종 내시경적 용종 절제술의 치료 효과와 안정성을 관찰하고자 하였으며, 내시경적 용종 절제술 후 추적 관찰하여 용종의 재발이나 위암의 발생을 확인하고자 한다. Gastric polyps are narrowly defined as macroscopically localized mucosal elevations composed of epithelial elements. They can be divided into two types : hyperplastic polyp and adenoma. Hyperplastic polyps usually occur in a chronically inflamed mucosa with a mild degree of atrophy and composed of normal-appearing epithelial cells, so hyperplastic polyps rarely become malignant. When dysplasia occurs to the polyps, malignant potential increases. Adenoma is composed of immature cells with varing degrees of dysplasia and its malignant potential is very high. So according to the size and pathologic findings, the therapeutic modalities are variable. And they should be removed for prevention of gastric cancer. We have performed endoscopic polypectomy such as snare polypectomy, strip biopsy or "O"ring ligation in 145 patients from July 1988 to June 1995 and evaluated the clinical characteristics, histopathology of the polyps. Twenty three patients who had had adenoma and had been undergone mucosectomy were followed up endoscopically for 6 to 24 months. The results were as follows : 1.One hundred and forty five patients were enrolled in this study. The ratio of male to female was 0.7:1(59 men, 86 females) and mean age was 50.4 (range: 31-79). The polyps were most frequent in the 6th decades of age. 2.The common clinical symptoms were epigastric discomfortness(41.3%), epigastric pain(29.7%), indigestion(17.9%) and abdominal discomfortness(6.9%). 3.The location of polyps were antrum(47.3%), body(45.0%) and fundus(7.7%). The number of patients with multiple polyps were 16(11.0%) and 139 patients had single polyp. The most frequent size of polyps was 0.5-1.0 cm and the next was 1-2 cm. 4.The gross findings of polyps by Yamada's classification were type II (35.5%), type III (29.6%), type I (21.3%) and type IV(13.6%). On histologic examination, hyperplastic polyps were 68.6% and adenomatous polyps were 23.7%. 5.The methods of polypectomy were mucosectomy in 23 cases(strip biopsy : 18, "O"ring ligation : 5) and snare polypectomy in 122 patients. If adenomatous polyps were reseated incompletely, we applied the laser therapy. When snare polypectomy could not be performed, strip biopsy was done. The effectiveness and rate of complications of mucosectomy was not different from that of snare polypectomy. 6.The most frequent complication of polypectomy was epigastric pain(23.4%) and the next was bleeding(14.5%). We could manage epigastric pain with medical therapy. The bleeding was controlled with Nd : Yac laser in five cases, with hypertonic saline-epinephrine injection therapy in five cases and with conventional medical therapy in 11 cases. 7.Among the patients with adenomatous polyps or dysplasia, we followed up 23 cases for 6 to 24 months (mean: 16 mon). There was no recurrence, but in one case gastric carcinoma was detected on other site. In the patients wish gastric polyp, polypectomy should be performed for precise diagnosis and treatment and the methods of polypectomy are taken according to their size and morphologies. Polypectomy is an effective preventive therapy for gastric cancer with low procedural complications.

상부위장관의 각종 점막병변에 대한 내시경적 점막절제술의 응용

이상혁,정정명,설상영,이연재,윤혜경 대한소화기내시경학회 1996 Clinical Endoscopy Vol.16 No.3

In case of submucosal tumor, adenoma and atypism, we can't frequently use the snare polypectomy for treatment of them. Adenoma and atypism are premalignant, so other therapeutic modalities are necessary for resection of them. We have perfortned endoscopic mueosectomy such as strip biopsy, and $quot;O$quot;ring ligation on various mucosal lesions of upper GI tract in 23 patients(11 men, l2 women) from June 1993 to December l994 . Fourteen patients wbo had adenoma were followed up endoscopically for 6 months to 24 months(mean: 14 months). The results were as follows: 23 patients(27 lesions) were enrolled in this study. Mean age was 50.3(range 32-74 years). The method of mucosectomy was strip biopsy in 19 cases(21 lesions), and $quot;O$quot;ring ligation in 4 cases(6 lesions). The rate of complete resection was 88.9%. If adenomas were resected incompletely, we added a laser therapy. There was no recurrence except a case in which carcinoma was detected on the other site during follow-up. No serious compication occurred such as massive bleeding or perforation. Based on the above results, the endoscopic mucosectomy is considered to be a safe and effective modality in the treatment of the flat polyps of upper GI tract and could be used for prevention of gastric cancer.