발달장애아 어머니 양육스트레스와 자녀수용개선을 위한 인지행동적용 집단미술치료

곽경화,정현희 한국미술치료학회 2010 美術治療硏究 Vol.17 No.4

본 연구는 인지행동적용 집단미술치료가 발달장애아 어머니의 양육스트레스와 자녀수용에 효과가 있는가를 보고자 하였다. 대상자는 발달장애아 어머니로 실험집단과 통제집단에 각각 9명 총 18명이었다. 프로그램 실시기간은 2009년 6월부터 2009년 9월이었고, 주 1회 90분씩 10회기를 실시하였다. 어머니 양육스트레스와 자녀수용의 변화를 알아보기 위해 회기진행 과정에서 어머니 양육스트레스와 자녀수용에 대한 변화를 보았다. 또한 양육스트레스 척도와 자녀수용 척도를 사전, 사후, 추후로 실시하여 반복측정분산분석을 하였다. 이에 대한 결과는 다음과 같다. 첫째, 집단미술치료는 양육스트레스에 긍정적 변화를 가져왔다. 회기진행 후기에 양육스트레스 감소가 나타났고, 양육스트레스 점수도 실험집단에서 유의미하게 낮아졌다. 둘째, 집단미술치료는 자녀수용에 긍정적 변화를 가져왔다. 회기진행 후기에 자녀수용 증가를 볼 수 있었고, 자녀수용점수도 실험집단에서 유의미하게 향상되었다. This study examined the effect of cognitive-behavioral group art therapy on fostering stress & parental acceptance in mother of child with developmental disorder. The subjects were 9 mothers in an experimental group & 9 mothers in a control group. Group art therapy had been conducted once a week from June through September, 2009. There were 10 sessions and each session lasted 90 minutes. The changes of fostering stress & parental acceptance during the sessions and the inventory on fostering stress & parental acceptance were used to verify the its effect. With the inventory, pre-test, post-test, & follow-up-test were executed and ANOVA with repeated measures was conducted. As the results, first, group art therapy was effective in reducing fostering stress. There were changes of fostering stress during the sessions. Also there was significant change in the inventory on fostering stress in the experimental group. Second, group art therapy was effective in improving parental acceptance. There were changes of parental acceptance during the sessions. Also there was significant change in the inventory on parental acceptance in the experimental group.

Small Dose of Midazolam Added to Fentanyl-Ropivacaine for Patient Controlled Epidural Analgesia after Subtotal Gastrectomy

곽경화 대한마취통증의학회 2008 Anesthesia and pain medicine Vol.3 No.1

Background: Midazolam has been reported to have a spinally mediated antinociceptive effect. In this randomized, double-blind study, we evaluated whether a small dose of midazolam added to fentanyl-ropivacaine mixture for PCEA (patient controlled epidural analgesia) improves epidural analgesia in patients underwent elective subtotal gastrectomy. Methods: Forty five patients, ASA physical status I and II, undergoing subtotal gastrectomy were randomly allocated to receive 0.2% ropivacaine mixed with fentanyl 4μg/ml or 0.2% ropivacaine mixed with fentanyl 4μg/ml and midazolam 0.2 mg/ml. The infusion rate was set to deliver 4 ml/hr of the study solution, with a bolus of 2 ml per demand and a 20 minutes lockout time. Results: Infused volume (P < 0.05) and VAS scores (P < 0.05) was significantly lower in the patients receiving midazolam. However, there were no differences in requiring rescue analgesics, PONV (postoperative nausea and vomiting), sedation scores, urinary retention, and pruritus between groups. Conclusions: Small dose of midazolam could augment analgesia without adverse effects when added to thoracic epidural infusion of fentanyl and ropivacaine.

Meningioma related trigeminal neuralgia presenting as odontalgia -A case report-

곽경화,이정은,한재경,황두윤,김민지,전영훈,여진석 대한마취통증의학회 2013 Anesthesia and pain medicine Vol.8 No.2

Classical trigeminal neuralgia is characterized by recurrent attacks of lancinating pain in the trigeminal nerve distribution, and no cause of the symptoms can be identified, other than vascular compression. This type of injury may rarely be caused by identifiable conditions,including tumor in the cerebellopontine angle. If the patient is suspected for secondary trigeminal neuralgia, further evaluation is required to diagnose and treat correctly. We report a case of a 49-year-old woman with a 1-month history of facial pain, who was initially misdiagnosed as odontalgia, and even treated with the extraction of her molar teeth. This case with the review of secondary trigeminal neuralgia may highlight the difficulties of diagnosis, and the importance of early diagnostic imaging, when trigeminal neuralgia occurs with a brain tumor.

부모의 놀이신념과 놀이참여태도가 유아의 자아탄력성에 미치는 영향

곽경화,최진숙,백승선 한국영유아교원교육학회 2020 유아교육학논집 Vol.24 No.5

The objective of this study was to examine the relationship between parent's play beliefs and play participation attitudes alongside children’s ego-resiliency, and then look into the effects of parent's play beliefs and play participation attitudes on children’s ego-resiliency. Data was collected from 250 children of 3-5 years of age who were attending kindergartens and child-care centers in Jeollabuk-do and also from 250 parents. The study’s findings are as follows: First, a parent's support for play, a sub-variable of a parent's play beliefs, and a parent's play participation attitude itself and its sub-factors such as playing sensitively, playing responsively, and playing merrily had positive effects on children's ego-resiliency. Second, step-wise regression analysis presented the fact that variables that had effects on children’s ego-resiliency were support for play, a sub-variable of parent's play beliefs, and playing merrily, a sub-variable of a parent's play participation attitude. Study findings show the fact that support for play, a sub-variable of a parent's play beliefs, and the parent's play participation attitude have a correlated effect on children’s ego-resiliency. Therefore, in order to increase children’s ego-resiliency, it is necessary for parents to improve their play beliefs and play participation attitudes. 본 연구는 부모의 놀이신념과 놀이참여태도 및 유아의 자아탄력성과의 상관관계를 알아보고, 부모의 놀이신념과 놀이참여태도가 유아의 자아탄력성에 미치는 영향력을 살펴보기 위한것이다. J도에 위치한 어린이집과 유치원에 다니는 만 3~5세 유아와 부모 각각 250명을 대상으로 자료를 수집하고 분석하였다. 분석 결과 첫째, 부모의 놀이신념 중 놀이지지와 부모의놀이참여태도 전체 및 하위변인인 민감하게 놀기, 반응적으로 놀기, 즐겁게 놀기는 유아의 자아탄력성에 정적 상관관계가 있었다. 둘째, 단계적 회귀분석 결과 유아의 자아탄력성에 영향을 미치는 변인은 부모의 놀이신념의 하위변인 중 놀이지지와 부모의 놀이참여태도의 하위요인 중 즐겁게 놀기와 반응적으로 놀기로 나타났다. 본 연구를 통해 부모의 놀이신념 중 놀이지지와 놀이참여태도가 유아의 자아탄력성에 영향을 미치는 것을 알 수 있고, 유아의 자아탄력성을 높이기 위해서는 부모의 놀이신념과 놀이참여태도 증진을 위한 노력이 필요함을 시사한다.

Postdural puncture headache

곽경화 대한마취통증의학회 2017 Korean Journal of Anesthesiology Vol.70 No.2

Postdural puncture headache (PDPH) is a common complication after inadvertent dural puncture. Risks factors include female sex, young age, pregnancy, vaginal delivery, low body mass index, and being a non-smoker. Needle size, design, and the technique used also affect the risk. Because PDPH can be incapacitating, prompt diagnosis and treatment are mandatory. A diagnostic hallmark of PDPH is a postural headache that worsens with sitting or standing, and improves with lying down. Conservative therapies such as bed rest, hydration, and caffeine are commonly used as prophylaxis and treatment for this condition; however, no substantial evidence supports routine bed rest and aggressive hydration. An epidural blood patch is the most effective treatment option for patients with unsuccessful conservative management. Various other prophylactic and treatment interventions have been suggested. However, due to a lack of conclusive evidence supporting their use, the potential benefits of such interventions should be weighed carefully against the risks. This article reviews the current literature on the diagnosis, risk factors, pathophysiology, prevention, and treatment of PDPH.

PONV prevention: still not enough

곽경화 대한마취통증의학회 2017 Korean Journal of Anesthesiology Vol.70 No.5

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Need for an optimal regimen of programmed intermittent epidural bolus administration for maintenance of labor analgesia

곽경화 대한마취통증의학회 2019 Korean Journal of Anesthesiology Vol.72 No.5

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과학교사 전문성 기준 : 포스터 발표 ; 논의 과정을 이용한 과학 교수,학습 전략이 중학생들의 인지발달 및 과학 학습에 미치는 영향

곽경화,강순민,남정희 한국과학교육학회 2004 한국과학교육학회 학술발표 및 세미나집 Vol.- No.-

경북대학교병원 외래환자수술실의 현황

곽경화,문철원,박성식,임동건,박진웅 대한정맥마취학회 2001 정맥마취 Vol.5 No.4

Background: Outpatient surgery has been continuously expanded around the world because of its cost-effectiveness and benefits for patients. Additionally, advances in anesthesia and surgical procedure have facilitated the rapid growth in day surgery. The purpose of this article is to analyze our 2 years' experience in day surgery center and therefore, to improve the management and effectiveness of day surgery center. Methods: We retrospectively analyzed 1,160 patients who were monitored and maintained by anesthesiologist except 6,549 patients who were done under local anesthetics during 2 years from Feb. 1998 to Jan. 2000. Patients were evaluated for ratio of outpatients to total surgery patients, male to female ratio, age distribution, ASA classification, participating departments, anesthetic techniques and aesthesia time. Results: The mean ratio of outpatients to total surgery patients was 4.6%. The sex ratio of outpatient surgery was similar and the age of patients was distributed 34.6 of under 20 years of age, 63.7 of 20-59 years of age and 12% of over 60 years of age. ASA physical status 1 and 2 occupied most of proportion of patients by 77.4 and 21.7% respectively. In our outpatient surgery center, all case was dane under general anesthesia and otolaryngologic surgery (47.5), orthopedic surgery (10.6), cardiac surgery (10.3), gynecologic sugery (10.1) and general surgery (10.0%) in ascending order. General anesthesia using propofol (88.2%) was commonly used and the airway has been kept with endotracheal tube (61.0), mask or manual (22.6), LMA (14.0) and COPA (2.4%). Anesthesia time less than 30 minutes was most common (42.2%), and most of the cases were done in less than 60 minutes (71.2%). Conclusions: The rate of outpatient surgery was very low compared to other countries but continuously has been increased. In this period, I think that the role of anesthesiologist is very important for faclitating outpatient surgery and improving both quantity and quality of outpatient surgery center.

경요도 전립선절제술에서 척추마취 시 소용량 Bupivacaine-Fentanyl의 병용투여와 상용용량 Bupivacaine의 임상 효과 비교

곽경화,이수현,전영훈,문철원,백운이 대한마취과학회 2002 Korean Journal of Anesthesiology Vol.43 No.4

Background: The combination of local anesthetics and opioids in the spinal anesthesia has a synergic analgesic effect, Therefore, we compated intraoperative conditions and clinical effects of low dose (5 mg) bupivacaine added with fentanyl versus a conventional dose(10 mg) of bupivacaine in spinal anesthesia for a transurethral resection of the prostate (TURP). Methods: Forty five ASA class 1 and 2 patients scheduled for a TURP were randomly divided into three groups. Group B (n = 15) received bupivacaine 10 mg, group BF (n = 15) received bupivacaine 5 mg added with fentanyl 20 ㎍, and group BFE received bupivacaine 5 mg added with fentanyl 20 ㎍ and 0.2 mg epinephrine. Blood pressure and heart rate were recorded every 5 minutes before and after spinal anesthesia. Sensory blockade was measured by a pin-prick test and motor blockade was evaluated by the Bromage motor scale. Side effects including pruritus, nausea, vomiting, respiratory depression, and intraoperative pain were observed. Results: The duration of sensory and motor blockade in group BF was significantly shorter than in group B and group BFE (P < 0.05). Without statistical significance, hypotension (6.7%) and bradycardia (13.3%) were observed in group B and pruritus (26.7%) and nausea (13.3%) occurred in all patients who received fentanyl. Conclusions: The addition of fentanyl 20 ㎍ to low dose bupivacaine 5 mg resulted in short lasting motor and sensory block, compared with conventional dose bupivacaine 10 mg. Therefore, we concluded that the clinical application of this method could provide adequate analgesia with early discharge and no serious side effects for TURP patients. (Korean J Anesthesiol 2002; 43: 418~423)