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한국 임상심리학자들의 역할과 활동: 2007년 조사 보고서
권정혜 한국임상심리학회 2008 Korean Journal of Clinical Psychology Vol.27 No.2
The present study examined the current status, major rolesand activities of Korean clinical psychologists. A questionnaire was e-mailed to 457 members of the KCPA (Korean Clinical Psychology Association). The response rate was approximately 33%, and 150 people completed the questionnaires. The participants were asked to complete 8 items on the demographic characteristics, educational experiences, employment settings, professional activities, theoretical orientation and career satisfaction. The results showed that the majority (74.7%) identified themselves primarily as clinical practitioners, followed by academicians and researchers. The psychologists' primary employment settings were universities, psychiatric hospitals and private practice. The major professional activities of the Korean clinical psychologists were psychotherapy (35.4%), diagnosis/assessment (33.0%), research/writing (21.0%), teaching (19.2%), clinical supervision (18.1%) and administration (10.5%). Among various theoretical orientations, eclecticism/integration (50.0%) was the most popular orientation and the next-most-popular orientation was a cognitive-behavioral orientation (32.0%). The level of subjective satisfaction with their career was moderate (Mean: 3.27, SD: 1.14 on the 5-point scale). The implications and future direction was discussed.
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권정혜,백선경,김봉석,고수진,안희경,임주한,임치연,김도연 대한내과학회 2019 The Korean Journal of Internal Medicine Vol.34 No.3
Background/Aims: Despite increased demand for cancer patient’s to make their own decisions based on an adequate understanding of what is involved in chemotherapy, the primary signing agent and the reasons for surrogate signing have not been appropriately evaluated. Methods: The ethics committee of the palliative medicine subgroup of the Korean Cancer Study Group designed this study and solid cancer patients to whom chemotherapy was offered, from seven institutions, were evaluated. The details relating to surrogate’s signing of chemotherapy consent were evaluated. Then, we analyzed the factors associated with surrogate’s signing according to patient’s demographics and characteristics related to chemotherapy consent. Results: Surrogate’s signing was noted for 20.7% (84/405) of patient and over half of surrogate signings were performed by the patients’ son or daughter (60.7%). Two main reasons for surrogate signing were patient’s incapacity (34.5%) and taking over authorization from patients (33.3%). The factors associated with more frequent surrogate’s signing were absence of spouse, lower education level, outpatient, and when residents played a role as a principle provider of chemotherapy consent. Conclusions: This study suggests the lack of patients’ own decision making for chemotherapy in some situations. This ethical dilemma must be considered for adequately informed decision making for chemotherapy while ensuring the patients’ autonomy is maintained.
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권정혜,Kwon, Jung Hye 한국호스피스완화의료학회 2015 한국호스피스.완화의료학회지 Vol.18 No.3
환자가 죽음에 임박했을 때 환자, 보호자, 의사 사이에서 심폐소생술에 대한 논의는 피할 수 없는 주제이다. 환자가 회복 불가능한 말기의 암환자인 경우에는 환자의 품위 있는 죽음을 고려하여 심폐소생술을 시행하지 않음(Do-not-resuscitate, DNR)을 결정하게 된다. 그러나 DNR에 대한 선택은 환자와 보호자의 심폐소생술과 DNR의 의미 및 그 결과에 대한 이해를 바탕으로 한다. DNR에 대하여 환자, 보호자, 의료진이 상담을 할 때는 환자의 질환이 더 이상 치료가 불가능하며, 심폐소생술이 환자의 생명을 연장시키는 것이 아니라 죽음의 과정을 연장시키는 것이며, 심폐소생술 이후에 삶의 질이 급격히 나빠질 수 있는 상황이라는 합의가 필요하다. 충분한 이해는 환자 또는 보호자가 품위 있는 죽음을 위한 DNR을 선택하도록 한다. 국내에서는 DNR 자체 보다는 이미 생명유지장치를 가지고 있는 환자에서의 생명유지장치의 제거에 대한 법적인 문제가 2차례 발생하면서 사회적으로 품위 있는 죽음에 대한 일반 대중의 관심이 이전보다 증가하였다. 환자와 의료진을 대상으로 한 설문에서는 DNR에 대한 인식과 의지가 80년대에 비해 2000년대 초반에 이르러 상당히 증가하였으나, 실제 의료 현장에서는 DNR의 결정에 있어 환자가 직접 관여를 하는 경우는 많지 않았고 DNR 작성 시점과 사망 시점과의 시간 간격이 1주 이내로 환자가 관여를 하거나 임종시기의 의료를 결정하기에는 너무 짧은 문제가 있었다. 이러한 문제는 조기 완화의료의 확산을 통하여 개선이 가능할 것으로 생각된다. 일부에서는 DNR이라는 용어보다는 자연적인 죽음을 허용함(Allow-Natural-Death)이라는 용어로 바꾸어서 설명하는 것이 이해를 돕고 선택의 갈등을 줄인다는 보고를 하여 DNR 논의와 결정에 있어서 적절한 시기 이외에도 환자와 보호자에게 많은 어려움이 있다는 것을 보여 주고 있다. DNR은 말기암환자에서 품위 있는 죽음을 위해 고려해야 하는 사항이며, 임상에서 DNR이 잘 시행되도록 임상적, 제도적 노력이 필요하다.
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권정혜,백선경,김도연,김유정,이명아,최혜진,변자민,정진영,Sam H Ahmedzai,장근두 대한암학회 2021 Cancer Research and Treatment Vol.53 No.1
Purpose This study aimed to validate the Sheffield Profile for Assessment and Referral to Care (SPARC) as an effective tool for screening palliative care needs among Korean cancer patients. Materials and Methods The English version of the SPARC was translated by four Korean oncologists and reconciled by a Korean language specialist and a medical oncologist fluent in English. After the first version of the Korean SPARC (K-SPARC) was developed, back-translation into English was performed by a professional translator and bilingual oncologist. The back-translated version was reviewed by the original author (S.H.A.), and modifications were made (ver. 2). The second version of the K-SPARC was tested against other questionnaires, including the Functional Assessment of Cancer Therapy-General (FACT-G) and the Edmonton Symptom Assessment System (ESAS). Results Thirty patients were enrolled in the pilot trial. Fifteen were male, and the median age was 64.5 years. Six patients had an Eastern Cooperative Oncology Group performance status of 2 or more. All patients except one were receiving chemotherapy. Regarding internal consistency, the Cronbach’s α scores for physical symptoms, psychological issues, religious and spiritual issues, independency and activity, family and social issues, and treatment issues were 0.812, 0.804, 0.589, 0.843, 0.754, and 0.822, respectively. The correlation coefficients between the SPARC and FACT-G were 0.479 (p=0.007) for the physical domain and –0.130 (p=0.493) for the social domain. Conclusion This pilot study indicates that the K-SPARC could be a reliable tool to screen for palliative care needs among Korean cancer patients. A further study to validate our findings is ongoing.
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청소년의 인터넷 게임 중독: 시간에 따른 변화와 이에 영향을 미치는 변인들
권정혜 한국임상심리학회 2005 Korean Journal of Clinical Psychology Vol.24 No.2
This study aimed to examine temporal changes in the internet game addiction of adolescents and related psychological variables using a prospective design. A total of 1279 middle high school students at five schools were assessed twice 6 month apart on measures of internet game addiction, self-escape tendency, real-ideal self discrepancy, negative affect, peer relationship, parent-child relationship, and parental supervision. Results indicated that the internet game addiction score of the first assessment was highly correlated with the score of the second assessment, r = .66, p < .001. In 30 % of students who demonstrated a severe level of internet game addiction at the first assessment, their score decreased more than 1 standard deviation at the second assessment. The ANCOVA analysis showed that the self-escape tendency was the only significant difference between the adolescents maintaining a severe level of internet game addiction and those with decreasing use of internet game. The multiple regression analysis showed that the internet game addiction, the self-escape tendency, negative affect at the first assessment predicted the internet game addiction of 6 months after. These results indicated that internet game addiction is a rather stable phenomenon although there was a room for change. The self-escape tendency seemed to be a stronger predictor of continued internet game use than parental supervision and other interpersonal relationships.
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