RANDOM URINE PROTEIN/CREATININE RATIO READILY PREDICTS PROTEINURIA IN PREECLAMPSIA

권자영 ( Ja Young Kwon ),( Jung Hwa Park ),( Dawn Chung ),( Hee Young Cho ),( Young Han Kim ),( Ga Hyun Son ),( Yong Won Park ) 대한산부인과학회 2014 대한산부인과학회 학술대회 Vol.100 No.-

Objective: To assess the diagnostic accuracy of random urine protein-creatinine (P/C) ratio for prediction of significant proteinuria in preeclampsia as an alternative to the time-consuming 24-hour urine protein collection. Methods: Retrospective record analysis was performed on 140 pregnant women who were admitted with suspicion for preeclampsia from January 2006 to June 2011. Random urine protein and/or 24-hour urine protein levels were assessed and their correlation to random urine P/C ratio and 24-hour urine protein excretion was evaluated. Results: Out of 140 patients, random urine P/C ratio or/and 24-hour urine protein was performed in 79 patients to evaluate significant proteinuria. Of 79 patients, 46 (58%) underwent both tests whereas in 33 women (42%) 24-hour urine collection was not available due to urgent delivery. In 39 cases (85%), significant proteinuria (≥300 mg/24 hr) was detected with 6 cases (13%) having values over 5,000 mg/24 hr, corresponding to the diagnosis of severe preeclampsia. Random urine P/C ratio highly correlated with 24-hour urine protein excretion (r=0.823, P<0.01). The optimal random urine P/C ratio cutoff points were 0.63 and 4.68 for 300 mg/24 hr and 5,000 mg/24 hr of protein excretion, respectively. with each sensitivity, specificity, and positive and negative predictive values of 87.1%, 100%, 100%, and 58.3%; and 100%, 85%, 50%, and 100%, for significant and severe preeclampsia, respectively. Conclusion: Random urine P/C ratio is a reliable indicator of significant proteinuria in preeclampsia and may be better at providing earlier diagnostic information than the 24-hour urine protein excretion with more accuracy than the urinary dipstick test.

실종아동부모가 경험한 가족의 삶

권자영 ( Ja Young Kwon ),박향경 ( Hyang Kyung Park ) 한국가족사회복지학회 2015 한국가족복지학 Vol.48 No.-

This study deeply explored the experiences of the family life of parents after their children goes missing through phenomenological research methods. Eight different parents of missing children were selected as research participants. The family life experience of parents after their children goes missing was considered in four different aspects: at the time of the child’s disappearance, balancing between child-searching and caring for the remaining family, efforts to maintain the family, and the days to come. Research participants experienced a“heart-wrenching separation like a bolt from the blue”due to the sudden disappearance of their children. Afterwards, in the process of searching for the missing child, the living foundation of research participants lay in waste, family lives became trapped in the moment of the child’s disappearance, and the parents encountered crises of destruction of marital relations and physical and psychological devastation, which were all experienced as“hellish pandemonium.”Eventually, research participants showed efforts to survive this living hell. Research participants utilized self-reliance efforts, self-support groups, and family support services during this process, which were experienced as“last-ditch efforts to clutch at any straws.”The present and future lives of research participants were experienced as searching for“the one they cannot give up”and “coexisting symbiotically”with the remaining family, “the ones they cannot lose.”Finally, the implications for family social welfare in order to support families of missing children exposed to dangers are discussed.

정신장애인의 입원경험

권자영(Ja Young Kwon),박향경(Hyang Kyung Park) 한국사회복지교육협의회 2022 한국사회복지교육 Vol.60 No.-

본 연구는 정신질환 발병 이후 수차례의 입원경험이 있는 정신장애인의 입원경험을 탐색한 질적 연구이다. 특히 2017년 정신건강복지법 개정이 정신장애인의 입원경험에 어떤 변화를 주었는지를 탐색하고 전반적인 정신장애인의 입원치료에 대한 인식과 경험을 살펴보고자 했다. 연구참여자는 유의표집방법으로 선정된 총 8명의 정신장애인으로, 개별 심층면접방법을 활용하여 자료를 수집하였다. 주제분석방법으로 자료를 분석한 결과, 다음 네 주제가 도출되었다. 첫째, 입원 과정과 입원 생활 : 나를 드러내지 않아야 가능한 생활(당사자의 의사가 배제된 입원과 치료과정, 환대 없는 병동 환경, 무료한 생활에 의욕없는 사람이 되어감, 체념과 순응으로 가능한 입원 생활, 기약없는 퇴원, 삶의 바닥을 경험함), 둘째, 비자의입원과 자의입원 : 입원선택 주체에 따라 달라지는 입원생활과 관계변화(비자의 입원이유와 영향, 자의입원을 알게 된 계기, 자의입원 선택 이유와 영향), 셋째, 입원에 대한 인식 : 너무 긴 입원기간과 멀리하기 어려운 삶의 일부(희망과 다른 긴 입원기간, 하고 싶지는 않으나 필요하면 해야 하는 입원), 넷째, 입원경험이 삶에 미친 영향 : 고통스럽던 경험이 나와 다른 사람을 도움(입원하지 않으려 꾸준한 관리, 현재의 삶이 행복임을 느낌, 동료지원 활동에 도움이 되고 일이 즐거움)이다. 이러한 연구 결과를 바탕으로 입원 과정에 대한 민주적 절차와 지원, 입원경험으로 인한 외상에 대한 실천적 접근, 인권친화적인 치료적 병동 환경개선과 사회복지교육적 측면에서 종사자의 인권교육 및 정신건강 관련 교과목에서 입원치료경험의 시사점을 다룰 것을 제안하였다. This study is a qualitative study exploring the admission experiences of persons with mental disorder that have multiple admission experiences after onset of mental illness. Especially, the study explores how the amended 2017 Mental Health Act affected the admission experiences of persons with mental disorder and looks into the overall awareness and experience of their inpatient treatment. Subjects of the study consist of eight people with mental disorders selected using the purposive sampling method, and data was collected through individual in depth interviews. The following four themes were derived from the results based on data analysis using subject analysis method. First, admission process and inpatient life: Life that is only possible by not revealing oneself(admission and treatment that marginalizes the patient’s intention, unwelcoming inpatient environment, becoming lethargic due to dull ward life, inpatient life that is only possible through resignation and compliance, indefinite amount time till discharge, experiencing bottom of life). Second, voluntary and involuntary admission: differing inpatient life and changes in relationships depending on the ‘decision-maker’(the reason for and impact of involuntary admission, realizing the opportunity of voluntary admission, reason for and impact of voluntary admission). Third, awareness of hospitalization: lengthened hospitalization inevitable part of life(unexpected long term hospitalization, unwanted but necessary hospitalization).Fourth, how the experience of hospitalization affected life: helping other people based on one’s painful experience(consistent management to avoid hospitalization, appreciating present life as happiness, helpful for carrying out peer support work and enjoying it). Based on these research results, democratic procedures and support for hospitalization processes, practical approach to trauma caused by hospitalization experience, ways to improve human rights-friendly therapeutic ward environments improvement, and hospitalization in human rights education and mental health-related subjects in terms of social welfare education It was suggested to address the implications of the hospitalization experience.

한국어판 정신건강자신감 척도 타당화 연구

권자영(Ja Young Kwon) 한국정신건강사회복지학회 2014 정신보건과 사회사업 Vol.42 No.1

본 연구는 정신장애인의 정신건강효능감을 측정하기 위해 개발된 정신건강자신감 척도(Mental Health Confidence Scale, MHCS: Carpinello, Knight, Markowitz and Pease, 2000) 한국어판의 타당도를 검증하기 위한 것이다. 이를 위해 전국 32개 사회복귀시설의 정신장애인 564명을 대상으로 한국어판 정신건강자신감 척도(MHCS-K)의 신뢰도와 타당도를 평가하였다. 연구결과 탐색적 요인분석에서는 원척도와 마찬가지로 ``낙관성``, ``대처``, ``옹호``의 3개 요인이 적합한 것으로 확인되었다. 확인적 요인분석을 통해 3요인 구조를 확인하였으며, 모델의 적합도도 수용할만한 수준으로 평가되었다. 또한 구성타당도, 판별타당도, 공인타당도를 확보하였다. 내적일관성 신뢰도 Cronbach``s α = .938로 신뢰할 만한 수준으로 나타났다. 그러므로 한국어판 정신건강자신감 척도(MHCS-K)는 정신장애인의 정신건강효능감을 측정하는 도구로 한국의 정신보건 실천현장에서도 활용하기에 적합한 척도로 평가된다. 이러한 연구결과를 바탕으로 정신보건 사회복지 분야에서의 함의를 제안하였다. This study attempts to validate the Korean version of Mental Health Confidence Scale (MHCS-K), which has been developed to measure the self-efficacy of a person with mental disorders. In order to examine this study, 564 persons with mental disorders in 32 social rehabilitation centers were surveyed as research subjects for the MHCS-K scale. The results of the explanatory factor analysis on MHCS-K found that, as in the original scale, the three-factor structure of optimism, coping, and advocacy was appropriate. The construct validity, discriminant validity and 3 factor structure of the MHCS-K were confirmed through the confirmatory factor analysis. The goodness of fit of the model is acceptable. The reliability of MHCS-K was Cronbach`s α=.938. These study results show that the MHCS-K Scale can be used as a scale tool in measuring the self-efficacy of a person with mental disorders and is a useful scale in the mental health practice field in Korea. Based on these results, implications for mental health social work were suggested.

노인의 자살행동을 결정하는 영향 요인에 관한 연구

권자영(Kwon Ja young),전희정(Jeon Hee jeong) 연세대학교 사회복지연구소 2017 한국사회복지조사연구 Vol.52 No.-

본 연구는 농촌지역 영구임대아파트에 거주하는 노인들의 자살행동(suicidal behaviors)에 영향을 미치는 요인에 관한 연구이다. 특히 이미 초고령사회로 진입하고 있는 농촌지역과 저소득 독거노인의 자살이 급증하고 있는 사회현상에 기반하여, 자살행동의 위험 수준에 따라 영향을 미치는 요인들을 탐색함으로서 농촌지역 저소득 노인의 자살예방을 위한 정보를 제공하고자 한다. 60세 이상 노인 211명을 대상으로 조사하였으며, 분석을 위해서는 단변량분석과 다항로 지스틱 회귀분석을 활용하였다. 노인들의 자살행동의 위험 수준이 다를 때 어떤 요인들이 영향을 미치는지 파악하고자 하였다. 이를 위해 일반 노인군, 자살행동 잠재위험군, 자살행동 고위험군으로 나누어 영향을 미치는 요인들의 차이를 파악하였다. 분석결과 자살행동 잠재위험군은 교육수준에서 유의미하게 차이가 있었으며, 자살행동 고위험군의 경우는 우울과 삶의 만족, 주관적 건강인식이 유의미하게 영향을 미치는 것으로 나타났다. 본 연구는 그동안 노인자살에 영향을 미치는 다양한 요인들에 대한 일반적이고 광범위한 연구들이 간과한 자살위험의 수준에 따라 영향을 미치는 요인을 밝히고 있다는 점에서 의미가 있다. 이를 통해 노인자살행동의 위험수준에 따라 차별화된 자살예방접근이 필요함을 제시하였다. This study is on the influence factors of suicidal behavior of elders residing in rural area permanent rental apartments by their risk level. It aims to provide information on preventing suicides of rural area low income elders by exploring influence factors depending on suicidal risk level, especially based on entry of rural areas into a super-aged societies and the increasing rate of low-income single household elders. A total of 211 elders who are above 60 years of age were studied using univariate analysis and multinomial logistic analysis. . Subjects were divided into non-risk, risk, and high-risk elderly suicidal behavior and accordingly studied for influence factors. According to results, education level was statistically significant for risk level elderly suicidal behavior, and depression and subjective perception of health had significance for high-risk level elderly suicidal behavior. This study, unlike other studies that broadly and generally study various factors that affect elderly suicide, discovered the difference in influence factors between elders with high-risk and low-risk suicidal behavior, allowing for a practical indicator for early prediction and selection for high-risk suicidal behavior.

정신장애인의 자립생활경험 연구 : 초기적응을 중심으로

권자영(Kwon, Ja Young),배은미(Bae, Eun Mi),박향경(Park, Hyang Kyung) 한국정신건강사회복지학회 2021 정신보건과 사회사업 Vol.49 No.1

본 연구는 T정신재활시설의 자립생활지원서비스를 이용하여 자립생활을 시작한 6명의 정신장애인의 약 1년 동안의 자립생활 초기적응 경험에 대한 사례연구이다. 자료수집은 2019.6-2020.5 사이에 심층면접방법으로 총 2회(자립생활 약 5개월, 11개월 시기) 실시하였다. 수집된 자료의 분석은 질적 사례연구방법의 사례내분석, 사례간분석을 활용하였다. 분석 결과는 걱정과 설렘 속에 자립생활을 시작함, 실생활과 뒤엉켜 나타나는 문제들, 자립생활을 익힘, 자립생활로 바뀐 내 생활, 1년의 자립생활로 미래를 꿈꿈으로 도출되었다. 연구결과를 통해 자립생활을 위한 개별화된 지원 및 서비스제공자의 생활양식에 대한 고정관념 점검의 필요성, 일상의 사소한 일들이 야기하는 문제에 대한 접근, 외로움 등 정서적 문제에 대한 접근, 삶을 지원하는 공간으로서 정신재활시설의 중요성, 자립생활유지에서 일과수행의 중요성 등 자립생활지원 방안에 대한 실천적 함의를 제시하였다. This study is a case study on the 1-year independent living experience of six people with mental diseases. They started living independently with the help of ‘T’ mental rehabilitation facility"s independent living support service. Data collection was conducted twice in an in-depth interview between 2019.6-2020.5(approximately at the 5-month period and 11-month period). Collected data was analyzed using intra-case analysis and inter-case analysis of qualitative case study methods. Analysis results were began indpendent living with concerns and excitement, arising problems intertwined with real life, becoming familiar with independent living, changes in daily life due to independent living, dreaming of the future due to 1-year independent living experience. Based on these results, the following practical implications are suggested : individualized support for independent living and the need to examine service providers" stereotyped presumptions about lifestyle, approach to the problems of everyday trifles, coping with emotional problems such as loneliness, the importance of mental rehabilitation facilities as a space to support life, importance of completing daily tasks to maintain independent living, and independent living support measures.

침윤성 자궁경부암 환자의 치료전 개복수술후 조직 병리학적 고위험 예후인자에 따른 보조요법

권자영 ( Ja Young Kwon ),모형진 ( Hyoung Jin Mo ),김상운 ( Sang Wun Kim ),김성훈 ( Sung Hoon Kim ),김수녕 ( Soo Nyung Kim ),박찬규 ( Tchan Kyu Park ) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.9

Objective : To evaluate the efficacy of postoperative adjuvant therapy was evaluated in preventing treatment failure occurring after primary treatment with surgery in early invasive cervical cancer patients associated with histopathologic high risk factors such as lymph node metastasis, either macroscopic or microscopic, parametrial extension, lymphovascular permeation and depth of invasion ≥10 ㎜. Methods : Postoperative adjuvant concurrent chemoradiotherapy (PCCRT), postoperative adjuvant chemotherapy (PCT) or postoperative adjuvant radiotherapy (PRT) alone was administered to the 80 early invasive cervical cancers with at least one of the high risk factors. Each of 61 patients was received three to six cycles of chemotherapy at about 3-weeks intervals. For squamous cell carcinoma, cisplatin 100 ㎎/㎡ Ⅳ, or paraplatin 350 ㎎/㎡ Ⅳ was infused followed by 5-FU 1000 ㎎/㎡ Ⅳ infusion for 5 days. Twenty three patients were treated with PCCRT, 38 patients were treated with PCT alone. And 19 patients received PRT. Results : The five-year survival rate of patients with macroscopic metastasis was 66.7% and 35.7%, in PCCRT and PRT, respectively. With microscopic lymph node metastasis, the 5-year survival rate was 83.3%, 60.0%, and 70.1% in PCCRT, PCT and PRT, respectively. With parametrial extension, the 5-year survival rate was 58.1% in PCCRT. The five-year survival rate of patients with lymphovascular permeation was 100% 90.9% and 66.7% in PCCRT, PCT and PRT, respectively. With depth of invasion ≥10 ㎜, the 5-year survival rate was 100% and 91.3%, in PCCRT and PCT, respectively. Conclusion : PCCRT appears to be superior to PRT or PCT alone in early invasive cervical cancer patients with histopathologic high risk factors.

도플러 초음파 신호에서의 태아 심박 검출 개선

권자영(Ja Young Kwon),이유빈(Yu Bin Lee),조주현(Ju Hyun Cho),이유진(Yoo Jin Lee),최영득(Young Deuk Choi),남기창(Ki Chang Nam) 대한전자공학회 2012 전자공학회논문지 Vol.49 No.9

현대 패션디자인의 연속 표현(serial expression)형식에 관한 연구

권자영(Ja Young Kwon),금기숙(Key Sook Geum) 한국복식학회 2007 服飾(복식) Vol.57 No.8

한국형 실천관계 척도 정신장애인 용 개발 연구

권자영(Kwon, Ja-Young) 한국사회복지학회 2013 한국사회복지학 Vol.65 No.3

본 연구는 정신장애인과 사례관리자간의 ‘실천관계(Working Relationship)’를 측정하는 한국형 실천관계 척도 정신장애인 용의 개발 및 타당화를 위해 진행되었다. 척도개발을 위해 첫째, 문헌연구와 정신장애인을 대상으로 3회의 포커스면접을 통해 실천관계척도의 예비문항을 구성하였다. 둘째, 정신장애인과 정신보건사회복지전공 사회복지학과 교수 2인 및 1급 정신보건사회복지사인 실무자 2인의 검토를 통해 최종 예비문항을 선정하였다. 셋째, 최종 선정된 예비문항을 569명의 정신장애인 대상의 실증조사연구를 통해 척도의 신뢰도와 타당도를 검증하였다. 수집된 자료를 무선 분할하여 먼저 탐색적 요인분석(exploratory factor analysis)을 실시한 결과, 3개의 요인구조를 확인하였다. 요인 1은 사례관리자의 전문적 실천과 관련된 ‘전문가 기여’, 요인 2는 ‘부정적인 실천관계’, 요인 3은 사례관리 자와 정신장애인간의 친밀감을 나타내는 ‘정서적 유대’로 나타났다. 나머지 표본을 가지고 확인적 요인 분석(confirmatory factor analysis)을 실시한 결과 모델의 적합도는 우수한 것으로 나타났다. 이러한 연구결과를 바탕으로 최종 33문항의 한국형 실천관계 척도 정신장애인 용을 개발 제시하였으며, 본 연구의 사회복지적 함의를 논하였다. This research was carried out in order to develop and validate the Korean Version of Working Relationship Scale for Mentally Disabled Persons, which measures the working relationship between a mentally disabled person and his or her case manager. The first step taken to develop this scale was to construct sample items for the Working Relationship Scale using literature research and three focus group interviews of mentally disabled persons who use local mental health services. Secondly, mentally disabled people were surveyed with these sample items and two professors from the department of social work who specialize in mental health social work and two licensed mental health social workers working in the community mental health field reviewed these sample items to select and compile a final version of the scale. Lastly, the scale’s reliability and validity was verified through an empirical study of 569 mentally disabled persons who surveyed the final selection of items. An explanatory factor analysis showed that the sample items can be grouped into three factors. Factor 1 is ‘Professional Contribution Factor,’ which is related to the professional practice of the case manager; Factor 2 is ‘Negative Working Relationship Factor’; and Factor 3 is ‘Emotional Bond Factor,’ which measures the intimacy between the case manager and the mentally disabled person. A confirmatory analysis of the three-factor format that was discovered in the explanatory factor analysis was carried out with the rest of the randomly divided data, which showed that the model demonstrated a goodness-of-fit. The convergence validity between similar concepts appeared to be appropriate as well. Based on these results, the Korean Version of Working Relationship Scale for Mentally Disabled Persons consisting of a final 33 items is developed and proposed and its implications in social work are discussed.