Anxiety Symptoms and Associated Psychological and Job-Related Factors Among Hospital Nurses

Eun Hyun Seo,Jae-Hon Lee,Arlene MacDougall,Nancy Liu,Alexander Hofkirchner,Simran Sharma,Mohamad Elfakhani,Hyung-Jun Yoon 대한신경정신의학회 2024 PSYCHIATRY INVESTIGATION Vol.21 No.1

Objective Recently, burnout and mental health issues regarding nurses are reported increasingly. This study aimed to investigate the prevalence of anxiety symptoms among hospital nurses and determine their association with psychological and job-related factors.Methods Data on demographics, job-related characteristics, burnout, Type A behavior patterns, self-esteem, and happiness were collected from 515 nurses working at a university hospital in Korea. Anxiety symptoms were assessed using the anxiety subscale of the Hospital Anxiety and Depression Scale, with scores of 8 or higher indicating the presence of anxiety symptoms. Demographic, job-related, and psychological factors were compared according to the presence of anxiety. Logistic regression was conducted to identify factors associated with anxiety symptoms.Results Two hundred and four (39.6%) participants had anxiety symptoms. Self-esteem and happiness were associated with a lower risk of anxiety symptoms, whereas burnout was associated with a higher risk of anxiety symptoms. Furthermore, being female, having a career of less than five years, and requiring counseling due to stress were associated with a higher risk of anxiety symptoms. Being younger, female, or a basic nurse; having a career of less than five years; partaking in shift work; experiencing job dissatisfaction; requiring counseling due to stress; being exposed to higher levels of burnout; and having lower levels of self-esteem and happiness were all found to be significantly correlated with anxiety symptoms.Conclusion These findings suggest that promoting self-esteem and happiness while reducing burnout may be beneficial in preventing and managing anxiety symptoms among hospital nurses.

인간형성의 조건으로서의 불안

임병덕(Byung-Duk Lim) 한국도덕교육학회 2021 道德敎育硏究 Vol.33 No.4

불안은 인간의 존재 그 자체에서 비롯되는 정서이다. 그것은 자유 또는 정신의 정서적 대응물로서, 무구에서 죄책을 거쳐 신앙에 이르는 인간형성의 조건으로 간주될 수있다. 인간형성은 절망 또는 죄에서 신앙으로의 이행이며, 이 이행은 ‘질적 도약’을 필수적 요소로 하는 과정이다. 불안은 질적 도약에 가장 가까운 그것의 ‘심리학적 근사치’ 에 해당하는 만큼, 그것에 대한 고찰은 인간형성의 해명에 결정적인 도움이 될 수 있다. 불안은 부정적인 정서로서 심각한 질병으로 간주되기도 하고, 심지어 ‘악마적인’ 양상을띠기도 하지만, 그것은 ‘자유의 가능성’으로서 ‘시간성과 영원성의 종합’으로서의 자아가‘그것이 있게 한 힘’으로서의 신과 관계를 맺도록 이끄는 안내자가 되기도 한다. 인간형성 과정에서 불안은 ‘신앙의 도움으로 개인을 섭리에 귀의하도록 교육하는’ 역할을 한다. ‘불안에 의한 교육’은 개인에게서 유한하고 사소한 것들에 대한 미련과 집착을 제거함으로써 ‘그가 가기를 원하는 곳’으로 이끈다. 키에르케고르는 그의 저작 전체가 그 자신의 자기교육을 위한 것이었음을 분명하게 밝혔으며, 이 점에서 그 저작들은 그 자신이 몸소 경험한 ‘불안에 의한 교육’을 기술한 것이라는 해석이 가능하다. 불안에 의하여안내되는 그의 저작활동은 신에 의한 교육을 지향하는 자기교육의 기록이라고 말할 수있다. 불안이 무엇인지를 배우는 것은 지고의 존재로부터 지고의 것을 배우는 것이다. In his monumental study on anxiety, The Concept of Anxiety, Kierkegaard approaches to anxiety in relation to the dogmatic issue of hereditary sin. He denies any qualitative difference between Adam and subsequent individuals, in that both of them sin by a ‘qualitative leap’ as an individual’s free act. The psychological approach to anxiety can contribute to understanding the qualitative leap which does not permit any rational explanation, for anxiety is the psychological state that precedes and follows sin. Though it cannot explain sin, ‘which breaks forth only in the qualitative leap’, can serve as “the closest psychological approximation.” Anxiety is rooted in the very being of man as a ‘synthesis of the psychical and the physical’ sustained by spirit as the third term. Spirit posits this synthesis along with the synthesis of the temporal and the eternal. Human becoming can be construed as spirit’s movement constituted by the relation’s(synthesis’) relating itself to “the Power that posited it.” Spirit express itself as anxiety in the process of human becoming. Anxiety leads the individual to ‘rest in providence.’ Kierkegaard opened the possibility of understanding anxiety as ‘a serving spirit’ that help the individual relate himself to God. When he is educated by anxiety, it leads him to faith. It means that anxiety get rid of everything finite and petty out of him and make him free. Kierkegaard’s works can be seen as documents to describe his own self-education by anxiety. His authorship as the true autodidact is also a theodidact. An individual who has learned to be anxious in the right way has learned ‘the ultimate.’

Factors Related to Anxiety in Predialysis Patients with Chronic Kidney Disease

Su-Jeong Han,Hye-Won Kim 보안공학연구지원센터 2015 International Journal of Bio-Science and Bio-Techn Vol.7 No.4

Anxiety is common emotions in predialysis patients with chronic kidney disease (CKD). The purpose of this study was to measure the anxiety in predialysis patients and to identify clinical variables that are associated with anxiety. The subjects for this study were 102 patients who visited the nephrology outpatient department of a tertiary hospital in Seoul between October 12th and October 26th, 2013 and consented to participate in the study. The collected data were analyzed by the SPSS WIN 12.0 program. The mean score of anxiety was 12.2 which means their experience of high level anxiety and moderate and severe symptoms of anxiety were identified in 59.8% of the patients. There were significantly negative correlations between anxiety and residual renal function (r=-.221, p=.026). There was a significant difference in the anxiety of the subjects at each stage (F=4.54, p=.013). The Scheffe post hoc test confirmed that patients at Stage 5 had highest levels of anxiety. There were significantly positive correlations between anxiety and uremic symptoms (r=.481, p<.001). There were significantly negative correlations between anxiety and age (r=-.201, p=.045) and comorbidities (r=-.218, p=.028). Also, Age, GFRs, comorbidities and uremic symptoms predicted value accounted for 57.2% of the variance on anxiety (F=11.77, p<.001). Hence, health care providers should be concerned about helping to slow the progression of renal failure and considered related variables when planning an approach towards managing the anxiety in predialysis patients with CKD.

Effects of shirodhara in generalized anxiety disorder

Rastogi, Sanjeev,Baiswar, Antriksha,Nischal, Anil,Srivastava, Prem Swarup,Nischal, Anuradha Cellmed Orthocellular Medicine and Pharmaceutical 2016 셀메드 (CellMed) Vol.6 No.4

Anxiety is a common clinical presentation. Primary anxiety poses a significant problem in its management. Many among the current treatment options of anxiety are habit forming causing significant withdrawal symptoms. There are dose dependent responses often associated with drug adversities. Day time sedation is an undesired effect of many drugs used for anxiety management limiting its usage. Ayurveda recommends a bio- physical procedure to manage anxiety. Shirodhara, a dripping procedure is utilized as a front line therapy for anxiety in Ayurveda. Seeing the limitations of conventional biomedical management of anxiety requiring an improvement upon the existing protocols of managements, and also seeing the use of shirodhara for anxiety management in ayurvedic clinics, a pragmatic study to evaluate the effect of shirodhara in generalized anxiety disorder was done. This was a pragmatic study consisting of shirodhara with ksheer bala oil as an intervention upon generalized anxiety disorder patients. The study was conducted upon 13 patients and observations were done for six weeks. The responses observed through the changes in Hamilton Anxiety Scale were evaluated using paired t test to observe the pre-post significance.

키르케고르의 자유의 가능성으로서의 불안과 사이코드라마의 우주적 불안 - 철학적‧사이코드라마적 재조명을 통한 불안의 역설 -

손창선 동국대학교 동서사상연구소 2016 철학·사상·문화 Vol.0 No.22

This paper aims paradoxically the necessity of anxiety through the reilluminations of the philosophical(Kierkegaard) and psychodramatical(Moreno) meanings of anxiety. Kierkegaard asserts that only the spiritual being i.e., a human can experience anxiety. He sees anxiety as a psychological state that human as a free being experiences when he leaps qualitatively from one state to another state. The person who seeks stability without the true human spirit, that is, the person who is bound by unfreedom cannot experience anxiety. Only, through the infinite free spirit, a finite human can experience anxiety. That is, for Kierkegaard, anxiety is a person's psychological state facing the possibility of freedom. In psychotherapy area, anxiety is not always treated as something that needs to be removed. As a synthesis of psychotherapy, psychodrama relates anxiety to trying to return to a cosmic being. Human as a cosmic being is eager forr free transformation to the whole universe, and anxiety occurs in cosmic hunger to maintain cosmic identity. It is related with trying to reach a role reversal with the whole universe, attempting to have creative encounters with other beings. Anxiety is the state of hunger for this encounter. As indicated above, for Kierkegaard and psychodrama, anxiety is understood in the prospect freedom and encounter, and by fully suggesting the different view of value and necessity of anxiety, it provides the new power of starting a life from anxiety. 이 논문은 ‘불안’의 의미에 대한 임상철학적인 재조명을 통해 인간 삶에서의 불안의 가치, 불안의 필요성을 역설적으로 주장하려는 데에 목적이 있다. 키르케고르는 정신적인 존재인 인간만이 불안을 경험한다고 하였다. 그는 자유로운 존재인 인간이 어떤 한 상태에서 다른 상태로 질적비약을 할 때 경험하는 심리 상태를 불안으로 보고 있다. 진정한 인간 정신을 지니지 못한 채 안정을 추구하는 사람, 부자유에 얽매인 사람은 이런 불안을 경험하지 못한다. 오직 무한히 자유롭고자 하는 정신을 통해서만 유한한 인간이 불안을 경험할 수 있다. 즉, 키르케고르에게 불안은 곧 자유의 가능성 앞에 놓인 개인이 경험하는 심리 상태이다. 정신치료 영역에서도 불안이 제거해야 할 요소로만 취급되는 것은 아니다. 다양한 정신치료 방법들을 종합하며 등장한 사이코드라마는, 불안을 인간이 우주적인 존재로 돌아가려는 것과 연관 짓는다. 우주적 존재인 인간은 온 우주로의 자유로운 변환을 갈망하며, 온 우주와의 이 동일성을 유지하려는 우주적 갈증에 의해 야기되는 것이 바로 불안이다. 그것은 온 우주와 역할교대하려는 것, 다른 존재와 창조적 만남을 가지려는 갈망과 관련된다. 따라서 불안은 이런 만남을 갈망하는 상태에 다름 아니다. 이처럼 키르케고르와 사이코드라마의 불안은 자유와 만남이라는 지평에서 이해되는 것으로서, 불안한 인간에게 불안의 가치와 필요성에 관해 완전히 다른 관점을 제시하여 불안으로부터 삶을 시작하는 새로운 힘을 제공할 수 있을 것으로 보인다.

리더의 불안, 리더십 연구에서 어떻게 다룰 것인가? 문헌 검토와 연구 제언

김성준,이중학,임창현 리더십학회 2021 리더십연구 Vol.12 No.4

Main purpose of this study is to review studies on the anxiety of the leaders, to explore its application in leadership research, and to suggest future research directions. Under the rapidly changing environment, leaders are likely to feel anxiety especially after COVID-19 pandemic. Even if the anxiety is an important emotion these days, studies have yet to pay attention to it, especially about leader’s anxiety. It might be because there is a conceptual overlap of fear, neuroticism, and job stress, and at the same time, may studies have not been conducted due to the difficulty to observe leader’s emotion. Therefore, this study first looked at the history of anxiety research and clarified differences from other related concepts before reviewing researches at home and abroad. Then, we propose six research suggestions based on leader’s anxiety. In particular, it is suggested that studies about the sources of leader’s anxiety, the comparison between groups of leaders and employees, the negative and positive effects of anxiety, and the relevance of decision-making ability with leader’s anxiety need to be further investigated. This study presents a new emphasis on leadership research based on anxiety and has a theoretical contribution to making specific research suggestions. In addition, there is a practical contribution in terms of enhancing the understanding of anxiety of the leaders.

불안장애 집단에 있어서 불안민감성의 차이

안준범,김지혜,강은호,유범희 대한신경정신의학회 2009 신경정신의학 Vol.48 No.4

Objectives The present study aimed to compare anxiety sensitivity among anxiety disorder groups, and to examine the relationships between lower-order factors of anxiety sensitivity and each anxiety disorder. Methods Three hundred and twenty four normal control subjects and 212 patients with anxiety disorders were enrolled in this study. All subjects completed a psychometric assessment package including the Korean Anxiety Sensitivity Index-Revised (ASI-R) test. Statistical analysis of the two groups was performed using the Mann-Whitney U test, and comparison of anxiety sensitivity among the anxiety-disorder groups (panic disorder-PD, general anxiety disorder-GAD, social phobia- SP, obsessive-compulsive disorder-OCD) was investigated using Kruskal-Wallis test. Results All anxiety disorder groups showed higher total scores of the ASI-R than did the normal control group (Z=-13.724, p<.001), and the mean total score of the ASI-R in the panic disorder group was the highest among the anxiety disorder groups. The mean score of each lower-order factor of the ASI-R in each anxiety disorder group was higher than that of the normal control group and there were statistically significant differences in fear of cardiovascular symptoms (PD,GAD>SP,OCD), fear of respiratory symptoms (PD>GAD, SP,OCD), and fear of publicly observable anxiety reactions (SP>PD,OCD) among the anxiety disorder groups. ConclusionZZThese results suggest that anxiety sensitivity reflects vulnerability to anxiety disorders, and that lower-order factors of the ASI-R may help in the differential diagnosis of anxiety disorders. 본 연구는 정상 집단과 불안장애 집단을 대상으로 KASIR의 총점을 비교한 첫 번째 연구로, 불안민감성이 정상 집 단에 비해 불안장애 집단에서 모두 높게 나타난다는 사실 을 확인하였다. 또한 불안민감성이 불안장애 집단 내에서는 통계적으로 유의미한 차이가 나타나지 않는다는 사실을 확 인함으로써, 불안민감성이 넓은 의미에서 다양한 불안장애 에 대한 취약성을 반영한다는 가설을 지지하고 있다. 마지 막으로, 불안민감성의 하위 요인들과 각각의 불안장애 사이 의 관련성을 확인하였으며, 임상에서 KASI-R의 하위 요인 이 불안장애를 변별하는 데 도움을 줄 수 있다는 가능성을 확인하였다. 이를 명확하게 하기 위해, 추후 연구에서는 임 상환자 집단을 대상으로 장기적, 종단적 연구가 필요할 것 으로 사료된다.

불확실성의 시대, 불안한 한국인

김문조,박형준 한국이론사회학회 2012 사회와 이론 Vol.21 No.-

Anxiety prevails when the faith in life is absent. Therefore, it is uncertainty that causes anxiety. Uncertainty as a source of anxiety consists of several conceptual elements. Existential uncertainty, cognitive uncertainty, moral uncertainty and aesthetic uncertainty to name a few. This study seeks to examine the social anxiety as a source of collective anxiety with emphasis on flexibilization and aging thesis, describe the unique characteristics embedded in South Korean society where collective anxiety is being aggravated, and explore the directions and strategies for possible countermeasures. Recently, it can be said that a flexible life attitude and strategies being required in all aspects of daily life including the world of work. The flexible society is demanding individual creativity and innovation more than ever. Thus, flexible society aims at network communication systems that have completely different properties than the centralized communication ones that used to operate in a perfect and orderly manner under vertical chain of command structure. However, in the age of flexibilization, where a high degree of freedom is appreciated and applauded, “corrosion of character” and “class disparity” have emerged as critical factors that exacerbate social anxiety. Social unrest caused by flexibilization gave way to social unrest in Korean society. Such tendency is further aggravated by the process of aging. In what ways such social unrest in Korea progressing? Unlike cognitive and normative uncertainty, the uncertainty of the modern society that is mainly derived from institutional flexibility has a high probability of being internalized into a social anxiety in situations where the social transparency is lacking. However, the consequences of social unrest can vary depending on whether or not the social anxiety is shifted to oneself or to the outside. The most decisive factor determining where the anxiety head toward is trust. In Korean society where the level of social trust is still low, there exists a high probability of anxiety turning into discontent rather than frustration. Also, discontent is more likely to be expressed in the form of outward anger instead of introverted resignation in Korean society where negative perceptions on social justice prevail. Thus, it can be said that it is not the anxiety itself, but the high degree of social distrust and unfairness determining the course of anxiety that characterizes the current social unrest in Korea. 경제성장에 몰두하던 60~70년대 산업화 시대에는 생계를 위협하던 경제적 빈곤이 지대한 국민적 관심사였고, 권위주의 체제에 저항하던 80~90년대 민주화 시기에는 정치적 억압이 척결해야 할 절박한 시대적 과제였다. 그러나 세계화‧개방화가 촉진되는 금세기의 각축적 생활 현실에서는 사회 불안이 새로운 쟁점으로 부각되고 있다. 불안의 인식적 토대로 간주할 수 있는 불확실성은 개인적 수준과 사회적 수준으로 구분할 수 있는데, 본 논문에서는 1) 사회적 불확실성을 유연화 및 고령화 논제를 중심으로 개관하고, 2) 사회 불안을 가중시키는 한국 사회 특유의 현황을 “인간성 파괴” 및 “계급적 단절”이라는 명제하에서 고찰한 후, 3) 불안의 진전 경로와 예상 효과를 주요 매개 조건들을 중심으로 탐지하면서, 4) 고도 불안사회의 대처 방향과 실천 전략을 논의해보고자 한다.

불안장애 및 우울장애에 따른 불안민감성(Anxiety Sensitivity)의 차별성

김예원,이정애,오강섭,임세원 한국임상심리학회 2011 Korean Journal of Clinical Psychology Vol.30 No.1

Anxiety sensitivity is the fear of anxiety-related symptoms, arising from beliefs that the sensation has harmful physical, social, or psychological consequences. To measure anxiety sensitivity, the Anxiety Sensitivity Index(ASI) is commonly used. Several studies have show the relationship between depression and anxiety disorder assuming multidimensional structure. In this study, ASI, BDI, and BAI were administered to 611 adult males and females, who had been -diagnosed with depression and anxiety disorder, upon visiting the psychiatric clinic. Exploratory factor and Confirmatory factor analyses were employed to test competing models, and the results suggested that the hierarchical model(comprising three first-order factors corresponding to physical concern, social concern and cognition concern) provided the best fit to the data. This finding was consistent with the results of previous studies. The current study also investigated(using an ANCOVA) differences with respect to the three factors of anxiety sensitivity in four clinical groups of patients who had been diagnosed either with social anxiety disorder(n=101), panic disorder(n=145), generalized anxiety disorder(n=33) or depressive disorder(n=135) and had been free of comorbidity. Results indicated that physical concern was significantly higher in panic disorder patients compared with the other three groups, and that social concern was significantly higher in social anxiety disorder patients. Further, generalized anxiety disorder patients and depressive disorder patients had more cognitive concern than social anxiety disorder patients. The implications and limitations of this study were also discussed.

State and Trait Anxiety of Adolescents with Autism Spectrum Disorders

Kim So Yoon,Kim Young Ah,Song Da-Yea,Bong Guiyoung,Kim Jong-myeong,Kim Joo Hyun,Yoo Hee Jeong 대한신경정신의학회 2021 PSYCHIATRY INVESTIGATION Vol.18 No.3

Objective This study examined how state and trait anxiety of adolescents with autism spectrum disorders (ASD) are associated with their demographic characteristics, repetitive and restricted behaviors (RRBs), and internalizing and externalizing problem behaviors.Methods A total of 96 participants with ASD (mean age=14.30 years; 91 males) completed a battery of tests including the State/Trait Anxiety Inventory (STAI), the Autism Diagnostic Interview-Revised, the Social Responsiveness Scale (SRS), and a cognitive test measuring intelligence quotient (IQ). Participants’ parents completed the Child Behavior Checklist (CBCL). Pearson’s correlations among age, IQ, two subscales of the STAI (i.e., STAIS and STAIT, measuring self-reported state and trait anxiety, respectively), and the Anxiety subscale of CBCL (i.e., CBCL-Anxiety, measuring parent-reported trait anxiety) were computed. Subsequently, Pearson’s correlations were computed among the three anxiety measures, RRBs, and problem behaviors, while controlling for participants’ age and IQ.Results The STAIS and CBCL-Anxiety were both significantly correlated with higher age, sensory sensitivity, depressive symptoms, somatic complaints, and aggressive behaviors. All three anxiety variables were significantly and positively correlated with total SRS RRB scores. Additionally, the STAIS and STAIT were significantly associated with more severe Compulsion/Adherence behaviors, and the CBCL-Anxiety was also significantly associated with more severe Rule-breaking Behaviors.Conclusion Self-reported state anxiety showed association patterns similar to those of parent-reported trait anxiety. Future studies investigating the precise operationalization of different anxiety instruments are needed to accurately measure the anxiety of adolescents with ASD.