한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

婦人科領域에서 應用된 鍼灸治療에 關한 文獻的 考察

金哲源,柳深根,朴炳烈 圓光大學校 韓醫學硏究所 1991 원광한의학 Vol.1 No.1

Bibliographic study on the acupuncture and moxibustion treatment applied to gynecological diseases divided into 9 Parts. And the results are as follows. 1. Total numbers of meridian-point used in the JO-KYUNG Part(調經門) were 54. Kidney-Meridian, Liver-Meridian, Conception Vessel-Meridian were used with high frequency and Joong-Kuk (CV_3), Sam-Um-Kyo(SP_6), Ki-Hai(CV_6) were frequently used. Also Yin-Meridian was chiefly used. 2. Total numbers of meridian-point used in the BUNG-ROO Part(崩漏門) were 36. Liver-Meridian, Kidney-Meridian, Bladder-Meridian were used with high frequency and Tai-choong(LIV_3), Hyul Hae(SP_10) Um-Gok(K_10) were frequently used. Also Yin-Meridian was chiefly used. 3. Total numbers of meridian-point used in the DE-HA Part(帶下門) were 46. Bladder-Meridian, Conception Vessel-Meridian, Kidney-Meridian were used with high frequency and God-Gol(CV_2), Jook-Kuk(CV_3), Di-Hai(CV_6) were frequently used. Also Yin and Yang-Meridian showed same frequency. 4. Total numbers of meridian-point used in the JING-HA Part(징하문) were 51. Spleen-Meridian, Kidney-Meridian, Conception Vessel-Meridian were used with high frequency and Sa-Man(K_14), Suk-Kwan(K_18), Kok-Chun(LIV_8) were frequently used. Also Yin-Meridian was chiefly used. 5. Total number of meridian-point used in the KOO-SA Part(求嗣門) were 38. Kidney-Meridian, Conception Vessel-Meridian, Bladder-Meridian were used with high frequency and Kwan-Won(CV_4), Joong-Kuk(CV_3), Yeun-Gok(K_2) were used with high frequently used. Also Yin-Meridian was chiefly used. 6. Total numbers of meridian-point used in the IM-SIN Part(姙娠門) were 58. Conception Vessel-Meridian, Spleen-Meridian, Kidney-Meridian were used with high frequency and Sam-Um-Kyo(SP_6), Kwan-Won(CV_4), Kyum Jung(G_21) were frequently used. Also Yin-Meridian was chiefly used. 7. Total numbers of meridian-point used in the SAN-HOO Part(産後門) were 43. Conception Vessel-Meridian, Spleen-Meridian, Liver-Meridian were used with high frequency and Ki-Hai(CV_6), Sam-Um-Kyo(SP_6), Kwan-Won(CV_4) were frequently used. Also Yin-Meridian was chiefly used. 8. Total numbers of meridian-point used in the YOU-BYONG Part(乳病門) were 47. Kidney-Meridian, Stomach-Meridian, Conception Vssel-Meridian were used with high frequency and Jok-Sam-Lee(S_36), Ha-Lyum(S_39), Jun-Jung(CV_17) were frequently used. Also Yin and Yang-Meridian showed same frequency. 9. Total numbers of meridian-point used in the JUN-UM Part(前陰門) were 35. Liver-Meridian, Heart-Meridian, Kidney-Meridian were used with high frequency and Kok-Chun(LIV_8), Sho-Boo(H_8), Dai-Don(LIV_1) were frequently used. Also Yin-Meridian was chiefly used.

국가 대표급과 제주도 고교 대표급 수영선수들의 그랩 스타트의 운동학적 분석

김철원,김승곤,오만원,임상용,김성찬,이창준,남사웅,이세형,류재청,신석종,김세민 濟州大學敎 體育科學硏究所 1998 체육과학연구 Vol.4 No.-

The purpose of the study was to undertaken to analysis the Grab starting technique between national representive team(3) and Cheju's representive team(3) with 3D cinematography. The conclusions obtained were as follows: Cheju's showed more elapsed time than national representive team on starting block. and more vertical than horizontal direction of COG position, more concentrated vertical velocity & acceleration than forward direction. Therefore It is necessory for cheju's to train balanced trust force in horizontal and vertical direction in grab starting technique.

정상인에서 베타3-아드레날린 수용체 유전자의 변이가 복부 비만도 및 지질대사에 미치는 영향

김영선,윤석기,김철희,서교일,김학선,김극배,변동원,유명희 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

The β₃-adrenergic receptor is expressed in visceral adipose tissue in humans and is thought to contribute to the regulation of the resting metabolic rate and lipolysis. We studied the influence of a mutation in the β₃ -adrenergic receptor gene(Trp64Arg) on body fat distribution, central obesity, lipid metabolism in 65 healthy young male adults. One out of 65 subjects were homozygous (Arg/Arg) for the trp64Arg mutation, 17 subjects were heterozygous (Trp/Arg), and 47 lacked the mutation(Trp/Trp). The body weight, height, body mass index, waist-to-hip ratio were similar between the subjects with- and without the mutation. Total body fat, abdominal fat amount, body fat distribution, serum total- and HDL-cholesterol, triglyceride, glucose, and insulin concentrations were also not different according to the presence or absence of the mutation. These results suggested that Trp64Arg mutation in β₃-adrenergic receptor gene is not a major contributing factor for central obesity or change in lipid metabolism in Korean young adults.

현훈 환자 Neuron Specific Enolase의 임상적 의의

김원주,김선곤,유철형,김원찬,김용덕,최영철,이명식 대한신경과학회 1998 대한신경과학회지 Vol.16 No.4

정신과 입원환자의 서비스 만족척도의 개발

김철권,이지연,송영선,김규호,김경률,김제원,이동기,최병무 大韓神經精神醫學會 2006 신경정신의학 Vol.45 No.3

목적 본 연구의 목적은 국내 정신의료기관(정신병원, 종합병원 정신과)에서 간편하게 사용할 수 있는 신뢰도와 타당도가 검증된 입원환자의 서비스 만족척도를 개발하기 위한 것이다. 방법 여러 단계를 거쳐 국내 실정에 맞는 문항을 개발하였고,정신병원, 종합병원, 대학병원 정신과 병동에서 퇴원하는 348명의 환자들을 대상으로 신뢰도와 타당도를 조사하였다. 요인분석 결과 5개의 요인이 추출되었으며 전체 변량의 63.04%를 설명하였다. 내적 일관성에 대한 신뢰도 계수 (Crohnbach's α)는 0.95로 상당히 높은 수준이었고, 수정된 개별문항-총점 상관계수는 0.50부터 0.72까지의 범위에 속하였다. 요인분석을 통해 추출된 서비스 만족척도의 각 하위척도 점수와 서비스 만족척도에 첨부된 각 영역에 대해 전반적인 만족도를 묻는 세 개의 문항 점수 간의 상관성 역시 유의하게 높았다. 결과 진단명에 따른 서비스 만족척도의 전체 점수에서는 불안/신체형/강박장애 환자군과 기분장애 환자군이 각각 정신분열병 및 기타 정신병 환자군과 알코올중독 장애 환자군에 비하여 유의하게 높은 점수를 보였으며, 입원형태에 있어서는 자발적 입원군이 강제 입원군에 비하여 전체 만족점수가 유의하게 높았다. 그러나 성별, 월수입, 학력, 직업, 종교, 결혼상태 등의 변수에서는 서비스 만족척도의 전체 점수에서 유의한 차이가 발견되지 않았으며, 마찬가지로 연령, 입원일수, 입원횟수, 첫 발병나이, 유병기간 등의 임상적 변수에서도 서비스 만족척도의 전체 점수와 유의한 관계를 보이지 않았다. 서비스 만족척도의 전체점수에서 대학병원 환자군이 정신병원 환자군과 종합병원 환자군에 비하여 각각 유의하게 높았다. 결론 결론적으로 국내 정신의료기관에 입원한 환자들의 서비스 만족을 평가하기 위한 목적으로 개발된 본 척도는 높은 수준의 신뢰도와 타당도를 보였으며, 또 국내 정신의료 환경에 맞는 요인구조를 보였다. 따라서 정신의료 서비스에 대한 정신과 환자의 만족도에 대한 연구가 거의 없는 실정에서 본 척도의 개발은 향후 국내 정신의료의 질과 치료결과를 높이는 도구로 활용될 수 있을 것으로 기대된다. Objectives : To develop and test the validity and reliability of a brief self-completed questionnaire (Service Satisfaction Scale : SSS) for routinely assessing the quality of service in psychiatric ward inpatients. Methods : A 30-item multidimensional questionnaire was developed by several steps of face validity and content validity. The questionnaire was administered to inpatients (n=348) discharged from psychiatric hospitals, general hospitals, and University hospitals. Construct validity was supported by performing principal component analysis. Reliability was estimated by calculating internal consistency of Cronbach's alpha. Results : Factor analysis yielded five factors comprising staff attitude, treatment quality, ward environment, access/cost, and ward rule, which account for 63.04% of the common variance. The internal consistency of the scale was high (Cronbach's alpha=0.95). The concurrent validity was supported by the significant correlation of each of five factors with item that measured overall satisfaction of SSS. Patients with neurosis (anxiety disorder, somatoform disorder, obsessive compulsive disorder) and mood disorders were significantly satisfied than those with psychosis and alcoholic disorders. Patients who admitted voluntarily were more significantly satisfied than those who admitted involuntarily. Sociodemographic variables such as age, gender, marital status, monthly income, education level, employment status and religion were not significantly different at the total scores of SSS. Similarly, clinical characteristics such as age of onset, duration of illness, lengths of hospital stay and number of previous hospitalization did not associate significantly with the total scores of SSS. Patients discharged from university hospitals were significantly more satisfied than those of the general and psychiatric hospitals. Conclusion : SSS performed well in the validity and reliability, indicating that it can be a useful tool for measuring Satisfaction of psychiatric inpatients in Korea.

알데히드탈수소효소 2(ALDH2) 및 CYP2E1 유전자 다형성에 따른 요중 뮤콘산 농도와 요중 8-hydroxydeoxyguanosine과의 관련성

김용대,강종원,엄상용,장연위,김성훈,김은영,이철호,문재동,김헌 대한산업의학회 2007 대한직업환경의학회지 Vol.19 No.2

정신분열병 환자의 주 보호자와 형제 자매에서의 부담에 대한 연구

김철권,김진원,서지민,이길자,김길중,변원탄 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.1

연구목적: 정신분열병 환자의 가족 부담에 영향을 미치는 요인들을 알아보기 위함이다. 방 법: 92명의 정신분열병 환자의 주 보호자 92명과 그들의 형제 자매 68명을 대상으로 자가보고 척도를 사용하여 가족부담, 환자의 문제행동, 가족의 죄책감 정도를 평가하였다. 그리고 환자의 양성증상 행동과 음성증상 행동, 환자의 임상적·사회인구학적 변인, 주 보호자의 사회인구학적 변인, 그리고 가족의 죄책감 등이 주 보호자 및 형제 자매의 주관적·객관적 부담에 어떤 영향을 미치는지를 조사하였다. 결 과: 1) 객관적 부담과 주관적 부담에서 주 보호자군이 형제 자매군에 비해 약간 높은 경향을 보였지만 양군간에 유의한 차이가 없었다. 2) 정신분열병 환자의 임상적·사회인구학적 변인들 중에서는 환자의 연령, 유병기간, 총 입원기간이 주 보호자 또는 형제 자매의 부담에 유의한 영향을 주었다. 그리고 주 보호자의 사회 인구학적 변인들 중에서는 매달 수입 정도와 가족교육 여부가 주 보호자의 부담에 유의한 영향을 주었다. 3) 문제행동들을 양성증상, 음성증상, 기타증상으로 분류한 후 주 보호자 및 형제 자매의 객관적 부담과 주관적 부담과의 상관성을 검증한 결과, 양군 모두에서 3가지 증상 행동이 객관적 및 주관적 부담과 각각 유의한 상관성을 보였다. 그리고 양군에서 양성증상 행동과 음성증상 행동이 객관적 부담보다는 주관적 부담과의 상관성이 상대적으로 더 높은 양상을 보였다. 또 형제 자매의 경우에는 양성증상 행동이 음성증상 행동에 비해 객관적 및 주관적 부담과의 상관성이 더 높았다. 4) 죄책감과 부담간의 상관성에서는 주 보호자에서만 유의한 상관성을 보였다. 결 론: 본 연구 결과는 정신분열병 환자의 가족 부담을 줄일 수 있는 보다 효과적인 가족중재 기법을 개발하는데 있어 유용한 자료가 될 것으로 생각된다. In order to investigate the factors associated with family burdens of schizophrenics, 92 primary caregivers and 68 siblings of 92 persons with schizophrenia were examined by means of self-report scales about the effect of positive and negative symptom behaviors, clinical and sociodemographic variables, and guilty feelings toward patient on the objective and subjective burden. The results were as follows. 1) There was no difference in the objective and subjective burden scores between the primary caregivers and siblings, even though the former showed a higher scores compared to the latter. 2) Burden scores were significantly affected by the factors such as age of patients, duration of illness, total duration of hospitalizations, monthly family income, and the experience of family education in the primary caregivers or siblings of schizophrenics. 3) Objective and subjective burden were related to both the severity of positive, negative, and the other symptom behaviors in the primary caregivers and siblings. The positive and negative symptom behaviors were more related to subjective burdens compared to objective burdens in the primary caregivers and siblings. The positive symptom behaviors were more related to perceived objective and subjective burdens compared to negative symptom behaviors in the siblings. 4) The correlations between guilty feelings toward patient and burden scores was significant only in the primary caregivers. These results could be used as useful datas to develop the more effective family intervention for reducing family burden.

정신분열병 외래환자에서 사회기능, 정신병리, 그리고 주의력 결손간의 관계

김철권,정순민,김진원,김상수,변원탄 大韓神經精神醫學會 2000 신경정신의학 Vol.39 No.1

본 연구의 목적은 증상이 안정된 83명의 정신분열병 외래 환자들을 대상으로 증상, 사회적응, 그리고 주의력간의 연관성을 알아보기 위한 것이다. 정상 대조군은 정신분열병 환자군과 교육수준, 나이, 성별등이 비슷한 60명으로 하였다. 증상은 양성 및 음성증상 증후군 척도(PANSS)를 이용하여 평가하였고, 사회적응은 한국판 사회적응 척도를 이용하였다. 그리고 주의력은 지속수행 검사(Continuous Performance Test)와 정보 감지능력검사(Span of Apprehension Task)를 사용하였다. 그 결과는 다음과 같다. 1) 정신분열병 환자군이 정상 대조군에 비해 지속수행 검사와 정보 감지능력 검사 모두에서 유의한 결손을 보였다. 또 사회적용 척도의 총 점수와 10개 소영역의 점수에서도 정신분열병 환자군이 정상 대조군에 비해 유의하게 낮았다. 2) 사회기능과 증상군의 연관성에서는 양성증상, 음상증상, 일반증상 모두 사회기능의 총 점수와 연관성이 없었다. 그러나 사회적 여가활동 소영역에서는 음성증상과 유의한 상관성이 있었다. 3) 사회적응 척도의 총 점수와 지속수행 검사에서 가장 중요한 변인인 민감도와의 상관관계에서는 유의한 상관성을 보였다. 그러나 사회적응 척도의 총 점수와 정보 감지능력 검사에서 가장 중요한 변인인 정답반응 횟수간에는 유의한 상관성을 보이지 않았다. 사회적응 척도중 도구적 역할 소영역은 민감도 및 정답반응 횟수와 상관성이 있었다.그리고 친구관계 소영역은 민감도와 유의한 상관성을 보였다. 4) 증상과 주의력과의 상관관계에서는 지속수행 검사의 민감도와 음성증상간에 유의한 상관성을 보였다. 이러한 결과는 증상이 안정된 정신분열병 외래환자에서 지속적 주의력이 전반적인 사회 기능을 예측하는 한 인자가 될 수 있음을 시사한다. In order to study the relations between attentional deficits and social functioning of the schizophrenia, 83 stable outpatients with DSM-Ⅳ schizophrenia and matched 60 normal controls were examined for their sustained attention, sensory register, and social functioning by means of Continuous performance test(CPT), Span apprehension task(SPAN), and Korean version of Social Adjustment Scale Ⅱ-Revised Version(KSAS Ⅱ-RV) respectively. Psychopathology was assessed using the Positive and Negative Syndrome Scale(PANSS). The results were as follows. 1) Schizophrenic patients showed a significant deficit in the sustained attention and sensory register as manifested in the data of CPT and SPAN, compared with the matched normal controls. Schizophrenic patients also showed a significantly poor social functioning in measure of KSAS Ⅱ-RV compared with the matched normal controls. 2) There was no correlation between three type of symptoms(positive/negative/general) and total scores of social functioning. But negative symptoms was correlated with the social leisure subarea of KSASⅡ-RV. 3) CPT was correlated with total scores of social functioning including the instrumental role and friend relation subareas of KSASⅡ-RV, whereas SPAN was only correlated with instrumental role subarea of social functioning. 4) In the relations between attention and symptoms, CPT was correlated with negative symptoms. These results suggest that the deficit of the sustained attention may be a predictive factor of social functioning in the schizophrenic outpatients.

체성감각유발전위검사를 이용한 척추기형교정수술 시의 수술중 감시

김철,이창헌,김창효,석세일,김진혁,김원중,홍기혁 大韓再活醫學會 1999 Annals of Rehabilitation Medicine Vol.23 No.3