폐암 환자의 활동상태, 불안, 우울, 사회적 지지, 증상경험과 기능적 상태의 관계: 불쾌감이론 기반으로

김금순 ( Keum Soon Kim ),이명선 ( Myung Sun Yi ),방경숙 ( Kyung Sook Bang ),조용애 ( Young Ae Cho ),이정림 ( Jung Lim Lee ),이은 ( Eun Lee ) 서울대학교 간호과학연구소 2013 간호학의 지평 Vol.10 No.2

본 연구는 불쾌감 이론을 기반으로 생리적 요인(폐암 병기와 활동상태), 심리적 요인(불안과 우울), 상황적 요인(사회적 지지)과 증상경험 및 기능적 상태와의 관계를 파악하여 폐암 환자의 증상경험을 관리하는 간호실무에 적용하고자 시행되었다. 본 연구에서 대상자가 지각하는 증상경험은 일반 암 관련 증상과 폐암 특이 증상 점수를 합친 것으로 평균 12.62점이었다. 이는 일반 암 관련 증상을 살펴 본 Baek10)의 27.7점과 Lee와 Kim19)의 23.1점과 비교 시 낮았으며, 일반 암 관련 증상과 폐암 특이 증상 점수를 함께 측정한 Lee3)의 평균 17.15점보다 낮은 점수였다. 이러한 차이는 연령과 현재 치료에 의한 것으로 생각된다. 본 연구의 대상자는 70세 미만으로 60대가 50.5%를 차지한 반면에 Baek10)의 연구에서는 60대 이상이 66.5%인 것을 보면 연령이 증가할수록 증상이 심하다는 연구 결과7)를 지지하고 있다. 특히, 폐암은 연령이 증가할수록 발생이 높아져 70대에서의 발생이 34.5%로 가장 높은 것을 볼 때 증상관리에 대한 요구가 높음을 알 수 있다.2) 또한 본 연구에서는 현재 치료를 받고 있는 대상자가 38.6%로 Lee3)의 43.9%와 전체 대상자가 항암화학요법을 받고 있는 Baek10)의 연구와 비교 시 낮았기에 증상경험이 낮은 것으로 생각된다. 또한 대상자가 지각하는 영양상태나 건강상태가 좋을수록 증상경험은 낮은 것을 발견하였다. 그러나 본 연구대상자들의 56.4%가 암을 진단받은 지 2년이 경과하였고, 38.6%가 현재 치료를 받고 있음에도 불구하고 영양상태가 나쁘다고 인지하는 경우는 3.0%였으며 또한 지난 한달 간 4 kg 이상의 체중감소가 있었던 경우도 2.0%에 불과하였다. 또한 대상자의 80.2%가 현재 건강상태를 보통 이상으로 지각하고 있었다. 따라서 추후에 대상자의 영양과 건강상태에 대한 지각이 증상에 미치는 영향을 규명할 필요가 있다고 생각된다. 생리적 요인인 폐암 병기, 활동상태와 증상경험 간의 관계를 살펴보면, 폐암 병기와 증상경험 간에는 유의한 상관관계를 보이지 않았으나 활동상태와 증상경험 간에는 유의한 중등도의 순상관관계를 보여 활동상태가 저하될수록 증상경험이 심한 것으로 나타났다. 폐암 환자에 있어서 병기는 치료의 방향을 결정하는데 중요한 변수이나 대상자가 경험하는 증상과는 유의한 관계를 보이지 않았고, 오히려 병기와 상관없이 현재 항암화학요법과 같은 치료 중에 있는 대상자의 증상경험이 더 심각한 것으로 나타났다.3,19) 그러나 본 연구에서는 항암화학요법을 받고 있는 대상자의 증상점수가 그렇지 않은 대상자보다 높았지만 유의한 차이는 아니었기에, 질병 관련 생리적 요인에 대한 추가적인 탐색이 필요하다고 사료된다. 본 연구는 외래를 방문하는 환자를 대상으로 하여 활동상태가 ECOG PS 0에서 2단계로 활동상태가 저하될수록 증상경험은 유의하게 높았고, 이는 선행연구의 결과를 뒷받침하고 있다.3,10,11) 심리적 요인인 불안, 우울과 증상경험 간의 관계를 살펴보면, 불안과 우울 모두 증상경험과 유의한 중등도의 순상관관계를 보여 불안, 우울과 같은 심리적 디스트레스가 높을수록 증상경험이 심하게 나타난다는 선행연구의 결과와 일치한다.20,21) Lee3)의 연구에서 비소세포폐암 환자들이 지각하는 불안과 우울과 같은 디스트레스는 증상경험에 직접적인 영향을 주며, 증상경험을 통해 삶의 질에 매우 부정적인 영향을 주는 요인으로 밝혀졌다. 따라서 NCCN (National Comprehensive Cancer Network)의 권고와 같이 암의 진행단계마다 대상자의 불안과 우울을 평가하여 필요시 적절한 도움을 제공해야 하며,22) 이때 환자의 내적 능력인 극복력의 개념을 도입하는 것은 Lee3)의 연구에서 입증하였듯이 유용한 간호접근이 될 수 있다고 생각한다. 상황적 요인인 사회적 지지와 증상경험 간에는 유의한 상관 관계가 나타나지 않았으며, 이는 사회적 지지와 증상 간에 유의한 직접적인 관계가 나타나지 않았던 선행연구와 일치하였다.3,23) 그러나 Lee3)의 연구에서 사회적 지지는 극복력을 매개로 디 스트레스에 영향을 줌으로써 증상부담에 영향을 미치는 것으로 밝혀졌다. 또한 본 연구의 대상자가 지각하는 사회적 지지를 살펴보면, 20점 만점에 가족지지는 평균 17.69점, 친구지지는 13.63점, 의료인지지는 10.26점으로, 의료인 지지가 가장 낮으며, 이는 선행연구의 결과와 유사하였다.3,10) 이는 직접간호제공자일 뿐 아니라 옹호자, 지지자로서의 간호사의 역할 수행에 대한 도전적인 결과라 할 수 있다. 따라서 간호사의 지지를 증진시킬 수 있는 방법들에 대한 적극적인 모색이 필요하며, 아울러 증상경험에 영향을 미치는 상황적 요인들에 대한 추가적인 파악이 필요하다고 사료된다. 증상경험과 증상경험의 결과, 즉 기능적 상태와의 관계를 살펴보면, 유의하게 높은 역상관관계를 보여 증상경험이 심할수록 기능적 상태는 저하됨을 보여주고 있다. 이는 다발성 증상군의 경증군은 중증군에 비해 기능이 더 좋았다는 Lee와 Park4)의 연구결과와 호흡곤란 증상이 심할수록 기능상태는 저하되었다는 Mohan 등13)의 연구결과와 일치하였다. 또한 부작용 증상을 심하게 호소할수록 기능적 상태가 저하되었다는 Baek10)의 연구결과를 뒷받침하고 있다. 본 연구에서 폐암 환자가 지각하는 증상경험에 영향을 미치는 요인은 심리적 요인(불안과 우울), 생리적 요인(활동상태), 상황적 요인(사회적 지지)의 순으로 나타났으며, 이러한 요인들은 증상경험의 57.8%를 설명하는 것으로 나타났다. 구체적으로 살펴보면, 우울에 의해 증상경험이 43.4% 설명되었으며, 우울과 불안에 의해서는 50.7%설명되었다. 이는 Lee3)의 연구에서 폐암 환자를 대상으로 불안과 우울로 측정한 디 스트레스에 의해 증상부담이 62.8% 설명되었다는 결과보다는 낮았지만, 두 연구결과 모두 불안과 우울이 증상경험에 미치는 영향이 매우 큼을 보여주고 있다. 또한 활동상태가 증상경험에 미치는 영향을 고려하여 활동상태가 매우 저하된 중증의 환자에서의 반복연구가 필요하다고 생각된다. 또한 간호사는 폐암 환자의 증상에 대한 주기적인 평가를 기반으로 체계적인 관리를 제공함으로써 기능상태를 증진시키고 나아가 삶의 질 향상을 도모하는데 주도적인 역할을 담당해야 한다. 폐암 환자가 지각하는 증상경험, 영향요인들과 증상경험 간의 관계, 증상경험과 기능적 상태 간의 관계를 종합해 볼 때, 불쾌감 이론은 폐암 환자의 증상경험을 설명하는데 적합함을 알 수 있었다. 폐암 환자의 증상경험을 적절히 관리하기 위해서는 반드시 불안과 우울과 같은 심리적 요인들에 대한 평가와 환자상태에 맞는 간호접근이 선행되어야 하며, 이러한 과정에 간호사가 적극적으로 개입함으로써 환자 지지자로서의 역할을 수행해야 한다. 또한 불쾌감 이론과 같은 중범위 이론의 간호실무 적용이 더욱 활성화된다면 이론과 실무의 차이를 줄이고 간호실무가 과학적인 배경을 가지고 더욱 발전될 수 있으리라 사료된다. Purpose: The purpose of this study was to investigate the relationships of activity status, anxiety, depression, social support, symptom experience, and functional status in patients with lung cancer based on the theory of unpleasant symptoms. Methods: The participants for this study were 101 lung cancer patients who visited the outpatient department for treatment or follow-up at one hospital in Seoul. Data were collected from January 1 to February 8, 2013 using self-reported questionnaires and clinical records. To measure variables, the functional scale and symptom scale of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30, EORTC QLQ-Lung Cancer 13, Eastern Cooperative Oncology Group Performance Status, Hospital Anxiety and Depression Scale, and Multidimensional Scale of Perceived Social Support were used in this study. The data were analyzed using SPSS 19.0 software for Windows. Results: The symptom experience showed more severity in patients with lower activity status, higher anxiety and depression. With lower activity status and social support, functional status was lower. When anxiety, depression, and symptom experience were higher, functional status was also lower. The significant factors predicting symptom experience were depression, anxiety, activity status, and social support, which explained 57.8% of the variance. Conclusion: These results suggest that psychological factors such as anxiety and depression had a negative influence on the symptom experience of lung cancer patients. Therefore, providing emotional support based on the patients` needs prior to providing symptom management could be a useful strategy for improving symptom experience and functional status.

虹彩 體質 分析에서 心腎結合組織의 虛弱 體質과 高血壓 家族歷과 관련성 硏究

金鐘牛,黃祐準,琴坰樹,李始炯,李宗淳,都金錄,趙在運,趙州掌,金鐘煜 한국전통의학연구소 2002 한국전통의학지 Vol.12 No.1

Iridology, developed more than 100 years ago, is the diagnosis of medical conditions through noting irregularities of the pigmentation in the iris The purpose of this study is to compare interrelation between CVA, hypertension family history and cardio-renal connective tissue in Iris Constitution through iris constitution examination. The subjects consist of 114 patients who were examined in Iris Constitution at Chonju Oriental Medicine Hospital attached to Wonkwang Univ. from September. 1St. 2000 to August. 31th. 2002. 1. In the distribution of Iris Constitution, among of 79cases, There are neurogenic type 13cases, abdominal connective tissue weakness constitution 31 cases, cardio-renal connective tissue weakness constitution 6 cases, cholesterol 7 cases and others 22 case in control group. 2. There are familial history of CVA and hypertention 32 cases, no familial history of CVA and hypertention1 3 cases, in 35cases of experimental group. These results imply that there is meaningfulness of interrelation between cardio-renal connective tissue weakness constitution and. CVA, hypertention.

요실금이 있는 중년여성의 일상생활불편감 및 우울에 관한 연구

김금순,이윤정,서문자,박영숙 서울대학교 간호대학 간호과학연구소 1999 간호학 논문집 Vol.13 No.1

The purpose of this study was to explore the relating factors, discomfort and depression due to urinary incontinence in middle-aged women. The subjects were 215 women in the age 35-65 years old who dewelled in community. The data were collected from August to December in 1996 with interview using structured questionaire composing of items of general characteristics, obsteric characterisitcs, disease charactteristics, situation of experiencing urinary incontinence, discomfort, and terapeutic method, and Beck's depression inventory. The data were analysed using SPSS/PC+ program; Cronbach's, frequency, percentage, Spearman's or pearson's coefficient correlation. The results of this study were as follows: 1) The mean duration of experiencing the urinary incontinence was 36.16 moths and the 60.9% of the respondents experienced a few frequency of urinary incontinence and the 77.2% was somewhat small expressed as "wetting their clothes". 2) The urinary incontinence induced situations were coughing, sneezing, hasty, and ascending abdominal pressure. 3) The ost common situations of discomforts associated with hrinary incontinence were diversional activity such as exercise, long period journey, and interpersonal relations. 4) The 80.5% of ascending abdominal pressure experienced the urinary incontinence, and the most common symptom of urinary incontinence was the frequent urine(43.3%) 5) The urinary incontinence correlated with menopause, age of menopause(p<.05) and age group(p<.01) significantly. 6) The 89.7% of urinary incontinence were not treated, but they wanted to try noninvasive methods such as the herb medicine(27.4%), pelvic muscle exercise(27.0%), and biofeeback(4.2%). 7) situation of experiencing urinary incontinence, discomfort and symptoms of depression correlated with urinary incontinence significantly(p<.05). In conclusion, we need to develop and provide various nursing interventions such as the pelvic muscle exericse, biofeedback and stress & depresion management program in middle-aged women who dewells in community in view of quality of life, health maintenance and promotion.

젊은 주부들의 식품구매 행동에 관한 연구 : High - Educated Young Mothers

김금숙,최봉순 대구효성가톨릭대학교 응용과학연구소 1995 응용과학연구논문집 Vol.4 No.-

본 연구에서는 대구지역 고학력 젊은주부들의 식품 구매행동과 식품사용에 대해 2개 유치원 원아 어머니 268명을 대상으로 조사 분석한 결과는 다음과 같다. 1. 식품 구매행동 (1) 식단계획 : 식단을 계획하여 생활하는 주부는(44.9%) 정도로 그 다음이 「가끔 정한다(40.5%)」, 「정하지 않는다(14.7%)」순으로 나타났으며, 취업 주부보다 비취업 주부가 식단계획을 하는 비율이 높게 나타났다(p<0.01). (2) 식품 구입 : 식품 구매에 영향을 미치는 인자를 보면, 「가족의 기호(43.97%)」로 가장 높았고 그 다음으로 「아버지 기호(32.70%)」순 이었다. (3) 외식빈도 : 가족이 함께하는 외식빈도는 「한달에 2-3번(34.2%)」이 가장 많았고, 그 다음이 「한달에 1번(25.0%)」, 「일주일에 1번(19.1%)」순이었다. 주부의 교육수준이 높을수록 월 총수입과 식생활비가 많을수록 외식빈도가 높게 나타났다. 2. 조리, 영양에 대한 관심도 (1) 조리할 때 중점 두는 것 : 조리할 때 중점두는 것으로는 「가족의 기호(53.7%)」, 「맛(26.3%)」, 「영양(19.2%)」순으로 나타났다. (2) 식사준비시 가족의 영양에 대한 고려도 : 가족의 영양에 대한 고려도는 대체로 고려하는 편이다.(80.8%)로 가장 높았고, 그 다음으로 매우 고려한다(13.4%)순이었다. 3. 식품 사용빈도 및 기호도 (1) 식품 사용빈도 : 하루 평균 식품 사용횟수로 첫째, 곡류 및 감자류(2.82±0.06), 둘째, 우유 및 유제품(1.82±0.06), 세째, 과일류(1.58±0.05)순이었다. (2) 식품 기호도 : 어머니가 매우 좋아하는 식품으로는 과일류(53.8%), 야채(31.1%), 해조류(21.7%) 순이었고, 싫어하는 식품으로는 Cheese(40.5%), ham·bacon(32.9%), 참치캔(22.0%), 돼지고기(20.9%) 순이었다. 어린이가 매우 좋아하는 식품으로는 과일류(44.8%), 닭고기(31.1%), 우유(29.4%) 순이었고, 싫어하는 식품으로는 콩류(32.5%), 버섯류(30.6%), 야채(25.7%), 조개류(25.7%) 순이었다. This study showed food-purchase behavior and extend of food usage of highly educated young women, residing in Tae-gu Area. The results are as follows : 1) Food Purchase Behavior Meal planning : 44.9% of study women always planned their meals, whereas 40.5% and 14.7% of them did sometimes and never, respectively. Working women planned meals more regulary than full time housewifes. Food Purchase : Family members' preference(43.97%) influenced most on their food pur-chase. Father's preference(32.70%) was the enxt strongest factor for it. Frequency of outside meals : 34% of families dined outside 2 - 3 times a month, 25% once a month and 19% once a week. 2. Interests of cooking and nutrition Factors considered during cooking : Families' perference(53.7%), taste(26.8%) and nutri-tion(19.2%) were the important factors in cooking. Extent of consideration on families' health during preparin the meals : most women(80.0%) answered they considered families' health moderately, while only 13.4% of them consid-ered it highly. 3. Frequency of food usage and food preference Frequency of food usage : They used grains and potatoes most frequently(2.82±0.06) per day. Usage of milk products was 1.82±0.06 per day and fruits was 1.58±0.05 Food preference : Food - like of the study mothers were in the order of fruits(58.3%), vegetables(31.1%) and seaweed(21.3%) and food-dislikes of them were cheese(40.5%), ham and bacon(32.9%), can of tuna(22.0%) and pork(20.9%). Children's preferred foods were in the order of fruits(44.8%), chicken(31.1%) and milk(29.4%), non-preferred foods were various beans(32.5%), mushrooms(30.6%), veget ables(25.7%) and shellfishes(25.7%).

일개도시 남성 노인의 삶의 만족도와 자가간호역량

신동순,김금숙 충남대학교 간호과학연구소 2006 충남대 간호학술지 Vol.9 No.1

This study was conducted to investigate the relationship between self-care agency and life satisfaction of man elderly. The subjects of this study were 77 elders, man, over 65, who were sampled in Daejeon city. The measurement tools were Self-As Carer Inventory developed by Geden and Taylor and translated by Park for self-care agency, and LSI-A(Life Satisfaction Index-A) developed by Havighurst and others for life satisfaction. The relationships between the self-care agency and life satisfaction were investigated by the use of t-test ANOVA and Pearson Correlation Coefficient. The result of this study were summarized as follows: 1. The mean of self-care agency was 103.71(SD=l8.36) and the mean of life satisfaction was 50.44(SD=10.52). 2. The degree of self-care agency according to demographic characteristics was significantly different in married and economic status. 3. The degree of lif satisfaction according to demographic characteristics was significantly different in married, family types, and having a job now. 4. There was a significant positive correlation between self-care agency and life satisfaction.

음악요법이 정신질환자의 우울과 정신병적 행동에 미치는 영향

박영숙,김금순 서울대학교 간호대학 간호과학연구소 1996 간호학 논문집 Vol.10 No.1

The purpose of this study was to identify the effects of singing & listening of music therapy for the inpatients with depressive mood and psychiatric behavior. Music therapy was programmed of listening and singing using rhythmic instruments systemmatically. The study was designed with nonequivalent control group repeated measures design. The subjects were selected from the 2 neuropsychiatric wards of Seoul National University Hospital. They were composed of 44 patients: 22 patients were assigned to the experimental group in the one ward and the rests of them to control group in the other ward. The experimental group was received the music therapy for 35-45 minutes 8 times during 2 weeks. On the other hand, the control group had the tea time instead of music therapy. The tools of this study were Brief Psychiatric Rating Scale(BPRS), Depressive Adjective Mood Scale, Music Preference Questionnaire and Music Therapy Evaluation Questionnaire. BPRS consists of 18 items, including 4 factors: anxious depression behavior, withdrawal-retardation behavior, hostile suspiciousness behavior and thinking disturbance behavior. The data were collected from December, 26, 1994 to January, 17, 1995. The data were analyzed using the SPSS/PC+ program: Chi-Square Test and t-test were used to test the homogeneity of the general characteristics, extraneous variable, depressive mood and psychiatric behavior before intervention between the two group ; Chronbach's (-model was used to test reliability of BPRS and between the raters; ANCOVA, t-test and paired t-test were used to test the homogeneity of the depressive mood and psychiatric behavior after intervention between the two groups. The results of the study were as follows: There was no significant difference in the general characteristics, extraneous variable, depressive mood and psychiatric behavior before intervention between the experimental and the control group except anxious depression behavior. There was significant difference in depressive mood and some psychiatric behavior after intervention between the two groups. That is, there was significant difference in withdrawalretardation behavior, hostile suspiciousness behavior and thinking disturbance behavior at 8th session. And there was significant difference in depressive mood at only 1st session between the two groups and the therapeutic effects maintained. Experimental group had more anxious depression behavior than control group at 2nd and 4th sessions temporarily. But we should remember one point that there was no significant difference after that time. In conclusion, the finding of this study showed that group music therapy, systematically programmed of listening and singing using rhythmic instruments, had therapeutic effects for the inpatients with depressive mood and psychiatric behavior. The data in this study suggest that music therapy requires at least 8 sessions and is good nursing intervention of neuropsychiatric inpatient. Finally, I suggest that further researches for the effects of music therapy in contrast to other therapeutic activities should be followed.

중환자실 환자의 우발적인 기관튜브이탈 관련요인 연구

최윤경,김금순 한국의료QA학회 2002 한국의료질향상학회지 Vol.9 No.1

Background : The purpose of this study was to investigate the incidence of unplanned endotracheal extubation and to identify the influencing factor of unplanned extibation in ICUs for providing baseline data in developing prevention strategies and administrative standards. Methods : the 942 intubated ICU patients information from March,2000. to February,2001 in a tertiary university hospital was used as a source of data from the medical records and hospital information system. In order to analyze factors related to unplanned extubation, the subjects of this study were divided by unplanned extubation group and planned extubation group and were matched by its sex, age, and disease groups in a ratio of one to two. The data were analyzed by descriptive statistics, x^(2)-test. T-test, Fisher’s exact test, and logistic regression analysis with SPSSWIN 10.0 program. Result : 1) Forty-seven(4.99%) of 942 intubated patients experienced unplanned extubation 65 times during the twelve-month period. Thirty-four(72.34%) of 47 unplanned extubated patients required reintubation, whereas thirteen patients(27.66%) did not. 2) About half of unplanned extubation(46.8%) occurred during the night shift. 3) As for the nursing activity, respiratory nursing activity score(P=.0.06) and total nursing activity score(P=.011) showed statistically significant differences between unplanned extubation group and planned extubation group. 4) As for the patients status, unplanned extubation group showed more lower consciousness level(P=.000), more irritable or agitated behavior(P=.000), and had more apllied physical restraints(P=.000) than planned extubation group. 5) As for the untubation related variables, unplanned extubation group revealed more untubated with respiratory failure(P=.000), more dependent on mechanical ventilation(P=.015) than planned extubation group. 6) Factors affecting unplanned extubations in intensive care unit patients were irritable or agitated behavior(odds ratio-13.757), night shift(odds ratio=7.166), and mechanical ventilation(odds ratio=6.257) from conditional logistic regression analysis. Conclusion : The most affecting factor of unplanned extubation was agitated or irritable behavior. Therefore the results of this study could be helpful to ICU nurses for meticulous care, decision making, timely intervention, and development of intervention strategies for preventing unplanned extubation.

바이오 휘드백 훈련을 통한 이완요법이 생리통 및 스트레스반응경감에 미치는 영향

이소우,김금순,최명애,이명선 서울대학교 간호대학 간호과학연구소 1999 간호학 논문집 Vol.13 No.1

The purpose of this study was to investigate the effects of a 4-week relaxation therapy using biofeedback on menstrual pain and stress for 35 sophomore and junior baccalaureate nursing students. A quasi-experimental pretest-posttest control group design was used. The relaxation therapy group included training sessions using respiration therapy augmented with biofeedback techniques for self-relaxation. A significant reduction of pain (P<.05) on the 1st and 2nd day of menstruation was reported on the visual analogue scale by the experimental groups, while that the control groups remained relatively unchanged. Also a significant reduction of pain (P<.05) was reported on the delivery pain scale by the experimental groups on the 2nd day of menstruation, while that of the control groups remained unchanged. However, there were no significant differences of pain on the 3rd and 4th day of menstruation between the two groups. A significant reduction of state of anxiety (P<0.5) was reported by experimental groups, while that of the control groups remained relatively unchanged. There were no significant changes in stress measured by the symptom of stress. The results of the study support the benefits of relaxation therapy using biofeedback on pain relief and stress.

남제주 화력발전소의 증설과 저감대대책의 영향 분석

이화운,김유근,정우식,오은주,임헌호,노순아,반수진,최현정,김민선,김헌숙 부산대학교 환경문제연구소 2002 環境硏究報 Vol.20 No.-

In the view of the results investigated the effect of air pollutants that is emitted from a new generator facilities, the total estimated concentration which is the summation of a contributional concentration and observational concentration is much less than that of atmospheric environment criterion for the air pollutants. So we can predict that the operation of the new generator facilities with mitigation equipment don't seriously affect around environment. At the same time, we compared the contributional concentration of before mitigation equipment with that of after it to examine the decreasing amount due to mitigation equipment. The result showed that the concentration of SO2, NO2 and PM-10 is reduced to 25%, 30% and 26% of original value, respectively.

과민성 장 증후군의 증상 경감을 위한 비약물적 접근 고찰

최명애,김금순,안경주,채영란,최정안,홍해숙,박미정,이경숙,신기수,정재심 대한기초간호자연과학회 2005 Journal of korean biological nursing science Vol.7 No.2

There have been many trials of clinical efficacy of multicomponent and single component treatments for irritable bowel syndrome(IBS). We reviewed effects of non phamacological treatments in the IBS. Though the efficacy of multi-component approaches was unclear, several results suggest that cognitive behavioral therapy was effective in improving gastrointestinal symptoms of IBS. As a single component, cognitive therapy and relaxation with or without biofeedback could improve the symptoms and psychological health of IBS patients. Yoga, meditation, self-help information and hypnotherapy could be applicable to IBS.