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바이오매스-암모니아 혼소 및 air-staging 적용을 통해 생성된 CO₂ 및 NO 배출 특성 연구
박성진(Sung-Jin Park),김성주(Seong-Ju Kim),조성호(Sung-Ho Jo),임호태(Ho-Tae Lim),박선영(Sun-Young Park),이후경(Hoo-Kyung Lee),윤상준(Sang-Jun Yoon),문지홍(Ji-Hong Moon),라호원(Ho-Won Ra),윤성민(Sung-Min Yoon),이재구(Jae-Goo Lee),문태영( 한국에너지기후변화학회 2023 한국에너지기후변화학회 학술대회 Vol.2023 No.11
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이규항,김한오,이후경,윤성철,성상경,함웅,윤배중 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5
목 적 : 본 연구는 전문병원 위탁형 정신보건센터에서 실시한 주간보호의 전체적인 체계, 운영, 프로그램에 관한 모델을 소개하고, 이 모델을 주간보호에서 시행한 후 그 결과와 시행과정에서 나타난 특징을 분석하여, 우리 실정에 맞는 주간보호 모델을 발전시켜 만성정신병환자의 생활유지와 재활을 촉진시키기 위한 목적으로 실시되었다. 방 법 : 본 주간보호 모델(이하 본 모델이라 함)을 1997년 3월부터 1998년 2월까지 의왕시 정신보건센터에서 총 23명의 환자를 대상으로 실시하였다. PANSS, Quality of Life, 삶의 만족 척도를 주간보호 전과 주간보호 실시 3개월 이후에 조사하였다. 프로그램 유익성 척도, 13가지 치료요인 척도를 주간보호 1개월째와 주간보호 실시 3개월 이후에 조사하였다. 결 과 : 1) 본 모델은 만성정신병환자의 증상을 감소시키고 삶의 질을 향상시켜, 환자의 생활유지 및 재활에 도움을 주었다. 2) 본 모델은 다양한 형태의 집단치료들을 사용하여 만성정신병환자에게 유익을 주었으며, 특히 예술치료와 활동치료가 환자의 신체적, 심리적, 사회적 기능회복을 위해 중요한 역할을 하였다. 3) 본 모델에 작용하는 치료요인의 특징을 보면 주간보호 초기와 후기에 모두 중시된 치료요인은 치료자와의 동일시, 치료자의 조언, 일차가족집단의 교정적 감정경험이었다. 주간보호 초기에 중시된 치료요인은 집단응집력, 이타심이었으며, 주간보호 후기에는 희망의 고취가 중시되었다. 4) 본 모델은 여러 분야의 치료자들과 다양한 치료방법들을 전체적으로 통합하여 사용하는데 유용하였다. 결 론 : 본 모델은 만성정신병환자의 생활유지와 재활을 위해 우리 나라에서 효과적이면서 효율적으로 적용될 수 있을 것으로 생각된다. Objectives : The purpose of this study was to present general system, operation, and program of a day care model managed by a psychiatrist, to evaluate the results of performing this model, and thus to develop a day care model applied to Korean situation appropriately for promoting maintenance and rehabilitation of chronic psychotic patients. Methods : We performed this day care model(hereinafter called as this model) from March 1997 to February 1998. The subjects were composed of 23 psychotic patients. PANSS, Quality of Life Scale, Life Satisfaction Self-Rating Scale were used before beginning this model and after three months of performing this model. Program Helpfulness Scale, 13 Therapeutic Factors Scale were used at one months of day care and after three months of day care. Results : 1) This model helped maintenance and rehabilitation of chronic psychotic patients through reducing their symptoms and increasing quality of life. 2) This model used the various group therapy, especially creative art therapy and activity therapy, played an important role for recovering physical, psychological, and social functions. 3) Important therapeutic factors at early and late period of this model were identification with therapists, guidance of therapists, and the corrective recapitulation of the primary family group. Important therapeutic factors at early period were group cohesiveness and altruism, and at late period instillation of hope. 4) This model was useful for integrating the multidisciplinary therapeutic team and the various therapeutic methods. Conclusion : This model would be applied to day care in this country effectively and efficiently for maintenance and rehabilitation of chronic psychotic patients.
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함웅,김선재,윤성철,성상경,이규항,이후경 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.6
본 연구는 통합치료를 위한 낮병원 모델을 소개하고, 이 모델의 낮병원 치료를 시행하여 그 결과를 평가하고 시행과정 중에 나타난 특징을 분석하며, 우리 실정에 맞는 낮병원 모델을 발전시켜. 정신병환자를 효과적으로 돕고 사회 재적응을 촉진시키기 위한 목적으로 실시되었다. 본 모델의 낮병원 치료를 1996년 5월부터 12월까지 총 25명의 환자를 대상으로 실시하였다. BPRS. 삶의 만족 척도, 프로그램 유익성 척도, 13가지 치료요인 척도, 가장 중요한 사건 설문지를 낮병원 치료초기와 말기에 시행하여 그 결과를 중심으로 낮병원 모델에 대한 평가를 하였다. 본 연구결과는 다음과 같다. 1) 본 낮병원 모델은 나이, 입원횟수, 유병기간. 기능수준에 있어 다양한 환자들에게 광범위한 치료를 제공할 수 있었다. 2)본 낮병원 모델은 치료효과라는 측면에서 볼 때 주로 음상증상을 호전시키고 주관적인 삶의 만족도를 높여주는데 기여하였다. 3) 상위기능집단과 하위기능집단으로 나누었을 때 상위기능집단에서는 집단정신치료, 싸이코드라마등 비구조적이고 자신의 내면을 깊이 있게 탐구를 할 수 있는 치료를 높이 평가하였으나 하위기능집단에서는 그렇지 않았다. 그러므로 두 집단으로 나누어 낮병원 치료를 진행하는 것이 더 효과적일 수 있다. 4) 치료요인의 결과를 살펴보면 상위기능집단과 하위기능집단 모두 치료가 진행됨에 따라 작용하는 치료요인에 차이가 있었으며. 상위기능집단은 말기에 대인관계학습을 더 중요시하였고. 하위기능집단은 말기에 사회화 기술의 발달을 더 중요시하였다 그러므로 상위기능집단은 낮병원 종결 후 장기외래환자 집단정신치료에. 하위기능집단은 사회복귀시설에 참여하는 것이 타당할 것으로 생각된다. 5) 본 낮병원 모델은 전체적으로 운영하기가 편하였고, 치료인력을 최대한 효율적으로 사용 할 수 있게 하였다. Objects : The purpose of this study was to present a day hospital model(hereinafter called as "this model" ) for integrated therapy, to evaluate the result of performing this model, and thus to develop day hospital model for helping psychotic patients effectively and promoting social re-adaptation. Methods : The authors performed this day hospital model from 1996, May to December. A total of 25 psychotic patients participated in this study. BPRS, Life Satisfaction Se1f-Rating Scale, Program Helpfulness Scale, 13 Therapeutic Factors Scale, and Most Important Event Questionnaire were used at the start of day hospital treatment and at the end. Results : The results were as fo11ows : 1) In this model, It was possible to offer the wide treatment to heterogeneous patients who varied in age, number of admission, duration of illness, and functional level. 2) In the aspect of therapeutic effect, this model contributed for improving negative symptoms and increasing subjective life satisfaction 3) When the patients were divided into the higher functional level group and the lower functional level group, the higher functional level group set a high value on group psycho-therapy and psychodrama that were unstructured and could make patients explore their inner side deeply. But the lower functional level group did not so. Therefore dividing into two groups by functional level may be more effective for day hospital treatment. 4) Therapeutic factors were different between the periods of der hospital treatment. And in the higher functional level group, 'interpersonal learning' was important at the last period, but in the lower functional level group, 'socializing technique' was important at the last period. So long-term group psychotherapy may be more suitable for the artier-care of the higher functional level group, and day care or other psychosocial rehabilitation programs may be more suitable for the after-care of the lower functional level group. 5) This model was easy to apply to Korean day hospital setting, and made staffs treat patients efficiently. Conclusion: This day hospital model would be used effectively and efficiently in Korean day hospital setting.
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방양원,이규황,이후경,함웅,윤성철 大韓神經精神醫學會 1995 신경정신의학 Vol.34 No.4
Objects : This study was conducted to understand the essential group phenomena of Encounter group and Patient group through the global comparison of short-term group psychotherapy between two groups. Methods : The Encounter group consisted of 17 normal persons and Patient group consisted of 19 patients with schizophrenia. all the members of the two groups were unmarried females. The mean rank of therapeutic factors of two groups was compared by short-form of Yalom's Q-sort. The differences between each therapeutic factor of two groups was compared by Mann-Whitney test. Also the global differences between two groups were compared by analyzing both the individuals within the groups and the groups as a whole. Results : The results of the comparison of the therapeutic factors of the two groups are as follows : 1) Existential factor was set a high value by all the two groups. 2) Encounter group set a high value an interpersonal learning(Input), but Patient group set a high value on instillation of hope and group cohesiveness. 3) Identification was set a high value by Encounter group, but was set a low value by Patient group. The results of the global analysis of two groups are as follows : 1) It was more difficult for Encounter group to maintain the motivation of attendance and to recognize their own problems than Patient group. 2) All the leaders and the members of Encounter group showed more positive attitude than those of Patient group. On the contrary all the leaders and the members of Patient group showed more negative attitude than those of encounter group. 3) Patient group expressed more intense feelings and expressed the feelings more frankly and more simply than Encounter group. 4) Encounter group dealt with the matters pertaining to "self realization", that is, fundamental question of human beings more than Patient group. Patient group dealt with the matters pertaining to social adaptation, that is , "ego strengthening" more than Encounter group. 5) In Encounter group, the feeling of in feriority was the major cause of the dropout. But in patient group, the discharge from hospital was the major cause of th dropout. Conclusion : We have found out the various differences between encounter group and patient group by the comparison of therapeutic factors and analytic understanding of the two groups. These results are the basic data for understanding of Encounter group and Patient group. And these results can be applied to the development of the skills of group psychotherapy for the treatment of the patients.
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강봉선,이만홍,이후경,이호영,김경희,노경선 中央醫學社 1987 中央醫學 Vol.52 No.12
This study was done for the purpose of identifying symptoms with discriminating power in the diagnosis of childhood depression by DSM-III criteria. The data were obtained from 155 primary school age children and their parents through interviews with the depres-sion section of the Diagnostic Interview Schedule for Children (DISC) and the Diagnostic Interview Schedule for Parents (DISP), which were developed by A. Costello (1984) with the collaboration of NIMH. The author analyzed the data by discriminant analysis and discussed the results that revealed as follows; 1. The most powerful discriminant variable was loss of interest in all cases regardless to the differences of information source (DISC or DISP) and school age group (lower or higher grade). 2. As other depressive symptoms that have discriminate power between normal and depressive disorder, irritability, decreased attention, and social withdrawal in lower grade DISC group; psychomotor agitation, loss of energy, and worthlessness in higher grade-DISC group; psychomotor agitation, conduct problem, aggressive behavior, loss of energy, decreas-ed attention, loss of appetite, somatic symptom, no pleasure to reward in lower grade-DISP group; and finally change in school work, separation, suicide, social withdrawal, under-achievement, irritability, crying, and phobia in higher grade - DISP group, were identified.
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정신병 환자의 통합치료를 위한 낮병원 모델의 효과성 연구 : 1년 반 동안의 전향적 추적 연구
김선재,윤성철,이후경,성상경,함 웅,이규항 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.6
연구목적:, 낮병원은 환자의 위축된 심리적, 사회적 기능을 회복시키고 장기입원으로 인한 퇴행과 지역사회와의 단절을 피할 수 있는 장점이 있다. 저자들은 이전 연구에서 한국 실정에 맞는 정신병환자의 통합치료를 위한 낮병원 모델을 개발하였다 그러므로 본 연 구는 이전의 낮병원 모델에 대한 연구를 기초로 하여, 1) 입원치료만 받은 환자 및 보호자를 대조군으로,하고, 2) 전향적으로 추적조사를 하여. 3) 저자들이 개발한 통합치료를 위한 낮병원 모텔의 효과성을 연구할 목적으로 실시되었다. 연구방법: 1996년 5월부터 1997년 l1월까지 계요병원 낮병원에 참여하여 치료를 받았던 17명의 환자 및 보호자를 대상군으로(이하 낮병원군 및 낮병원보호자군이라 함) 하였으며 대조군은 동기간 동안 입원병동에서 퇴원한 후 외래치료만 받고 있는 환자 증 진단, 나이, 성별, 기능에 대한 평가가 일치하는 환자 및 보호자 (이하 입원군 및 입원보호자군이라 함)를 일대일로 짝지어 선발하였다. 두 군을 대상으로 삶의 질 척도 (quality of life scale)를 시행하였고 저자들이 제작한 병식, 약물에 대한 자세, 치료에 대한 만족도 설문지를 두 군 환자 및 가족들을 대상으로 시행하였다. 낮병원군 및 낮병원보호자군은 낮병원 치료를 받기 시작한 시점부터 입원군및 입원보호자군은 퇴원한 시점부터 2주,3개월,6개월,12개월,18개월 간격으로 위의 척도들을 전향적으로 시행하였다. 결과: 1) 삶의 질 평균점수에 있어서 낮병원군이 입원군에 비해 의미 있게 높았다. 낮병원군은 3개월에 의미있는 상승을 보인 후 큰 변화 없이 유지되다가 18개월에 의미 있는 하강이 나타났으나 입원군은 3개월에 의미있는 상승을 보였고 낮병원군에 비해 6개월이 빠른 12개월부터 의미 있는 하강을 보이기 시작했다. 2) 병식 평균점수에 있어서 낮병원군, 낮병원보호자군의 점수가 입원군,입원보호군에 비해 의미 있게 높았다. 낮병원군 및 낮병원 및 낮병원보호자군의 점수는 3개월,6개월에 의미 있게 상승하여 18개월까지 큰 변화없이 유지되었고 입원군 및 임원보호자군의 점수는 기준시점인 퇴원 당시와 변화없이 18개월까지 유지 되었다. 3) 약물에 대한 자세 평균점수에 있어서 낮병원군이 입원군에 비해 의미 있게 높았으나 낮병원보호자군의 경우에는 입원보호자군에 비해 의미있게 높게 나타나지 않았다. 낮병원군이 3개월,6새월에 의미 있게 사응하여 입원군에 비해 6개월부터 18개월까지 의미 있게 나타 났다. 4) 치료에 대한 마녹도 평균점수에 있어서 낮병원군, 낮병원보호자군의 점수가 입원군, 입원보호자군에 비해 의미 있게 높았다. 낮병원군의 경우에 3개월,6개월에 의미 있게 상승하여 6개월부터 18개월까지 입원군에 비해 높게 나타났다. 낮병원보호자군의 경우에 3개월,6개월에 의미 있게 상승하여 6개월부터 18개월까지 입원보호자군에 비해 의미 있게 나타났다. 5) 연구 기간 동안 낮병원군의 입원횟수. 입원기간이 입원군에 비해 의미 있게 더 낮았다. 결론: 저자들이 개발한 낮병원 모델이 정신병환자의 삶의 질을 높여주고 환자 및 보호자의 병식 수준을 높여주며 약물에 대해 올바른 자세를 갖게 하고 치료에 대한 만족도를 높여 주었다. 또한 재입원을, 재원기간을 낮춤으로써 정신병 환자 치료에 효과적인 것으로 생각된다. 0bjectives : A day hospital has been remodeled artier a vision to help psychotic patients quickly recover their psychologica1 and social functions and lessen their induced recessions caused by long-term hospitalization, thereby enhancing their social abilities. The authors concerned once developed a day hospital model of an integrated therapy for psychotic patients suitable for Korean situation in their previous paper. Based on it the present study was to determine how effective a day hospital would be, in comparison of the fo11owing two paired groups day hospital group with experience of hospitalization(hereinafter abbreviated as DH group) & day hospital parents group with experience of hospitalization(hereinafter abbreviated as DH parents group) and OPD group with experience of hospitalization(hereinafter abbreviated as OPD group) & OPD parents group with experience of hospitalization(hereinafter abbreviated as OPD parents group) . Methods : During the 18-month long research period(from May to 1996 October 1997), 17day hospital patients with experience of hospitalization & their parents and the same number of OPD patients with experience of hospitalization & their parents were corespondingly paired with at random, who identified themselves closest in the fo11owing categories : diagnosis, age, sex and function. All of them were asked to check questionnaires on their respective quality of life, insight, and their attitude about drug. Day hospital patients with experience of hospitalization and their parents were checked from the first day they were treated while OPD patients with experience of hospitalization and their parents were examined after discharge from hospital, commonly at the interval of 2 weeks,3 months,6 months,12 months, and 18 months. Results : 1) The quality of life scored higher in DH group than in 0PD group. It turned increased significantly at the 3rd month and continued the same until the 12th month. At the 18th month, it showed a significant downturn. Meanwhile, DH group showed a significant upturn at the 3rd month and it turned down at 12 month. 2) The insight of DH group and DH parents group scored higher compared with OPD group and OPD parents group between the 3rd and 18th month, with the 3rd and 6th month showing a particular strength as well. Meanwhile, it continued unchanging for day DH group and DH parents group from the date on, of their discharge from hospital. 3) Attitude towards drugs scored higher in DH group than in OPD group at the 3rd and 6th month. It continued unchanging between the 6th and 18th month. It didn't score significantly higher in DH parents group than in their counterparts. 4) Satisfaction on the therapy started upward in DH group at the 3rd and 6th month, and scored higher in them than in their counterparts during the period form the 6th and 18th month. It started upward as well in DH parents group at the 3rd and 6th month, and scored higher in them than in their counterparts during the period form the 6th to the 18 month. 5) Number, and duration of DH group totalled lower than those by OPD group during the research period. Conclusion : The day hospital model, developed by the authors concerned, has proved a highly effective treatment far psychotic patients, as the data scored higher in the day hospital patients and their parents than in the OPD patients with experience of hospital and their parents in terms of "Quality of life" by patients, insight, attitude toward drugs and satisfaction on its therapy.
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