간호사의 신체화 증상과 정신건강의 관계

주정민,구애진,김성완,Joo, Jungmin,Goo, Ae Jin,Kim, Sung-Wan 한국정신신체의학회 2020 정신신체의학 Vol.28 No.2

연구목적 간호사의 신체화 증상과 스트레스, 우울 및 불안, 정신 증상 위험의 관계를 확인하여 정신신체의학 연구의 임상 근거를 창출하고, 신체화 증상의 의미에 대해 제고하는 것을 목적으로 한다. 방 법 서울시 내 1개 상급종합병원 외과계 중환자실 간호사 70명에게 자가기입형 도구(Perceived Stress scale, Fatigue Severity Scale, Patient Health questionnaire-15, Korean Beck Depression Inventory, Korean Beck Anxiety Inventory, Symptom Checklist-90-Revision)를 사용하여 수집한 데이터를 분석하였다. 결 과 대상자 중 12.9%가 신체화 증상을 경험하였고 피로, 낮은 에너지, 생리통, 허리 통증이 나타났다. 신체화 증상과 정신적 스트레스 인지의 통계적 관련성은 없었으나 불안한 느낌이나, 자신감의 감소는 신체화 증상의 수준과 관련이 있었다. 신체화 증상이 심한 집단은 우울, 불안을 더 많이 경험하였다. 신체적 피로가 높은 집단은 정신적 스트레스 인지의 통계적 관련성은 없었으나 긴장이나 스트레스를 느끼거나 통제력이 감소되는 경험에 영향을 미쳤다. 신체적 피로 수준의 증가는 불안과는 관련이 없었고 우울을 더 많이 경험하는 것으로 확인되었다. 신체화 수준이 높을수록 정신 증상 중 강박과 적대감이 증가하였다. 선형회귀모형에서 스트레스, 우울, 불안은 신체화 증상을 39.3%, 신체적 피로 증상을 16.1% 설명하였다. 결 론 이 연구의 결과를 바탕으로 우리는 한국 문화에서 신체화 증상의 특징으로 스트레스 인지 증상의 감소, 우울과 불안 경험, 강박 및 적대감의 동반 가능성을 추정할 수 있다. 이 연구에서 신체화와 정신 증상은 인과관계를 확인할 수 없었으나 상호관련성이 관찰되어 향후 중재 전략 마련에 참조할 수 있을 것이다. Objectives : To identify the relationship between somatization, stress, depression, anxiety, and psychological symptoms risk for nurses working in the intensive care unit. Create clinical evidence of psychosomatic medicine research and complement the meaning of somatization. Methods : Seventy of the mental health checkups conducted by the National Mental Health Center among the nurses using tools including Perceived Stress scale, Fatigue Severity Scale, Patient Health questionnaire-15, Korean Beck Depression Inventory, Korean Beck Anxiety Inventory, and Symptom Checklist-90-Revision. Results : 12.9% of the patients experienced more than moderate somatization. There was no statistical relationship between somatization and psychological stress perception, but feeling of anxiety and decreased self-confidence were related to the level of somatization. The group with severe somatization experienced more depression and anxiety. The group with high physical fatigue also had no statistical relationship with psychological stress perception, but had an effect on the feeling of tension, stress, or decreased control. Physical fatigue level was increased by experience of depression, not by anxiety. For psychological symptoms the higher the level of somatization, the higher the obsession and hostility was explored. In the linear regression model, stress, depression, and anxiety accounted for 39.3% of somatization and 16.1% of physical fatigue symptoms. Conclusions : We can estimate the decrease in stress cognitive symptoms, accompanying depression and anxiety, compulsion and hostility as characteristics of somatization. The causal relationship between somatization and psychological symptoms cannot be confirmed in this study, but the interrelationships are observed, can be referred to mediation strategies.

스리랑카 응급의료 기능강화 ODA 사업의 성과 평가

주정민(Jungmin Joo),김정연(Jeongyun Kim),권민지(Minji Kwon),손애리(Aeree Sohn),조병희(Byong-Hee Cho) 서울대학교 보건환경연구소 2016 보건학논집 Vol.53 No.1

Objectives: The aim of this study was to evaluate the performances of Preliminary Care Unit (PCU) in Avissawella Base Hospital in Sri Lanka, which has been constructed and operated since 2014 as an emergency care facility with the financial and personnel training supports by the Korean Foundation of International Health Care (KOFIH). Methods: Five evaluation criteria (relevance, efficiency, effectiveness, impact, and sustainability) of OECD/DAC were applied in order to assess the four steps of inputs, outputs, outcome, and impact. The evaluation data were collected by utilizing diverse methods such as literature review, field visit and observation, questionnaire survey, and in-depth interviews. Results: Since the war wounded, cardiovascular diseases, and accidents & injuries have increased in Sri Lanka recently, the supports to the introduction of emergency care system such as PCU were considered as adequate and relevant (relevance). It was found that the PCU has contributed to decreasing unnecessary admissions to and to lowering the mortality rate of major diseases (effectiveness). The benefits of the lowering mortality were estimated to be larger than the total amounts of inputs (efficiency). The social reputation of the PCU was high among community people who were mostly satisfied with the PCU services (impact). The PCU also has attained the sustainable future since the Sri Lanka government will firmly provide the PCU with medical personnel and operating expenses as much as now (sustainability). Conclusion: The PCU project has been found to be successful in attaining the goal of official development assistance (ODA) supports. However, the high quality of PCU services made patients flood into the PCU, which was likely to lower the capacity of decent emergency care services. Therefore, there are needs to cooperate with medical institutions to distribute properly the concentrating patients for lowering such risk.

농촌지역에 거주하는 다빈도의료이용자의 복합만성질환 경험 특성

주정민(Jungmin Joo),유명순(Myongsoon You) 서울대학교 보건환경연구소 2018 보건학논집 Vol.55 No.2

Objectives: Multiple chronic diseases are known to affect the amount of medical service use such as the number of visiting medical institutions and outpatient medical expenses. The purpose of this study was to investigate the characteristics of multiple chronic diseases experience of frequent medical service user living in the rural area which can provide basic data on the chronic disease policy Methods: The participants of the study were multiple chronic patients with more than 4 chronic diseases among the highest 1% of all medical service users based on the National Health Insurance claims data of 2013. Patient and their doctors randomly selected, qualified researchers performed semi-structured in-depth interviews. 10 cases as ‘residents’ of the rural area and 3 cases of doctors were analyzed using the consensual qualitative research method. Results: The subject areas of the individual cases were extracted from thematic domain: the perception of cause of the disease, the local primary medical institution, and the disease management behavior, five key concepts were extracted to explain the disease experience characteristics of the chronic disease patients in the rural area. For cross cases it has been shown that the experience of multiple chronic illnesses is a trail of a tough life, being fixed through repetitive controlling body to work. In addition, the lack of medical goals and the visit to medical institutions as a leisure activity shows that there was a need to understand the nature of the disease experience in the organizational context of the healthcare infrastructure. Conclusion: Chronic diseases can’t be cured, and the improvement and deterioration of the condition are repeated throughout life, so a supportive primary health care is essential as well as self-management in rural area

자폐스펙트럼장애 대처의 사회적 맥락 이해하기 : 사회관계망과 치료 체계를 중심으로

임은정(Lim, Eun-Chung),주정민(Joo, Jungmin) 한국자폐학회 2021 자폐성 장애연구 Vol.21 No.1

이 연구는 자폐스페트럼장애에 대처하는 행동을 사회적 산물로 보고, 증상 인지, 서비스이용 진입, 지속 여부 결정의 주요 시점에 사회관계망 및 치료 체계와의 상호작용이라는 맥락에 놓인 양육자의 선택 경험을 탐색하고자 하였다. 자폐스펙트럼장애 진단이나 관련 소견을 받은 적이 있는 2005~2010년생 자녀를 둔 주 양육자 19명이 연구에 참여하였으며, 타임라인을 시각 자료로 활용한 반구조화된 심층 면접을 실시하였고, 주제 분석 방법으로 분석하였다. 증상 인지에서 이용 진입 시기에는 부인에 힘을 싣는 가족과 의심에 무게를 두게하는 보육 기관 교사가 주요 관계망이었고, 치료 체계의 전문가는 진입 후 지속 여부에 중요한 역할을 하였다. 이용 지속 이후 현재까지는 다양한 지지를 제공하는 부모 모임이 의미있었으며, 교사가 주로 약물치료를 촉진하는 역할을 하였다. 또한, 장애를 분리하고 타자화하는 한국사회의 믿음과 태도는 전 시기에 걸쳐 선택에 영향을 주었다. 자폐스펙트럼장애아동이 지역사회에서 자립하여 생활하면서 수용될 수 있도록 장애의 증상이 아니라 개인의활동과 참여에 초점을 맞춘 사회적 홍보 및 옹호, 그리고 정책적 지원이 병행되어야 하고, 장애 당사자와 가족뿐만 아니라 그들과 함께 살아가는 사회관계망의 당사자로서 그들을 사회구성원으로 수용하고 옹호하는 각자 개인의 역할이 중요함을 발견할 수 있었다. This study considers the coping behaviors of autism spectrum disorder as social constructs, and explores the experiences of caregivers choices in the context of interaction with social networks and treatment systems at key points in symptom recognition, service use entry, and compliance. Nineteen caregivers with children born between 2005 and 2010 who had been diagnosed with r/o autism spectrum disorder participated in semi-structured in-depth interviews using the timeline as a visual data. Themes were extracted by thematic analysis. From symptom recognition to service entry, teachers in childcare institutions weighed on suspicion and families on denial. The treatment system expert played an important role in compliance. Since compliance, self-help parents groups that provide various supports have been meaningful, and teachers have played a primary role in promoting drug therapy. Also, the beliefs and attitudes of Korean society to separate and otherize disabilities have influenced the choices throughout the period. For children with autism spectrum disorders to live independently and to be accepted in the community, social publicity and advocacy and policy support focused on individual activities and participation, not symptoms of disability, should be combined. Also, the role of each individual as members of social network is important in accepting and advocating for them.

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L5 대역 ARNS 보호를 위한 KPS 신호 송신전력에 대한 연구

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