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박병강,오한진 대한가정의학회 2007 Korean Journal of Family Medicine Vol.28 No.4
최근 증가하고 있는 생활습관병의 치료적 순서는 약물 치료보다는 생활 습관의 개선이 먼저 요구된다. 일견 쉬워 보이는 음식조절이나 규칙적인 운동을 일상 습관으로 유지하지 못하는 이유는 스트레스와 연관된 중독 차원의 생활습관이 관련되어 있기 때문이다. 생활 스트레스는 단순히 심리 차원에서 그치지 않고 정신 생리 수준의 무의식적인 뇌와 내분비계의 반응이며 습관적 행동은 변화된 학습의 결과다. 이러한 복합적 문제를 접근하기 위해서 중독증후군의 모델을 이용하여 생활습관을 바라보고 가정의학의 포괄적 진료를 행동 의학적 측면에서 이해하고 실천한다면 생활습관병을 치료하는데 특히 잘 해결되지 않는 문제를 풀어나가는 데 큰 도움이 될 것으로 생각한다.
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박병강,이동배,이태용,조영채,권윤형 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1
To compare the clinical usefulness of four alcoholism-screening tests frequently used in Korea such as MAST, NAST, AUDIT, CAST, 96 drinking males were given diagnostic interview based on DSM-IV criteria and scores from four tests were obtained and analyzed. Of 96 subjects, 52.1% were normal without drinking problems, 38.5% with alcohol abuse and 9.4% with alcohol dependence. In terms of reliability of items in screening tests, four items in MAST were not found to have statistically significant item-total correlation. The appropriate cut-off value for screening tests to detect alcohol use disorders were above 15 points in AUDIT, above 5 points in MAST, above one item in NAST and above 2 items in CAGE. In terms of sensitivity for detection of alcohol use disorders, NAST was highest with 93.5%, and specificity, CAGE was highest with 90.0%. Considering the lowest sensitivity of 76.0% in CAGE and 76.J% of specificity in MAST, AUDIT and NAST were the most appropriate in screening alcohol abuse. The appropriate standard values for screening alcohol dependence were above 26 pants in AUDIT, above 13 points in MAST, above 5 items in NAST, and above 3 items in CAGE. In screening alcohol dependence AUDIT had the highest sensitivity of 100.0%, and both AUDIT and NAST had the highest specificity of 94.3%, respectively. The sensitivity of three screening tools except AUDIT were the same with the value of 88.9% and therefore AUDIT were the most appropriate in detecting alcohol dependence taking into consideration the relatively low specificity of 85.1% in CAGE.
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박병강 대한가정의학회 2011 Korean Journal of Family Medicine Vol.32 No.1
The comprehensive medical care delivered by family physicians should involve education and practice of healthsustaining habits such as diet, exercise, relaxation etc. as well as drug prescription. Among those, problem drinking is one of the most frequent issues encountered in health promoting sessions. However they are not competent to cover the realm of counseling in problem drinking in a continuous way. The drinking problems go up, unnoticed and uninhibited, to the self-destructive stages by the process of denial and avoidance on the part of patient as well as therapists. The explanation by which moderate drinking can't be easily embedded into healthy life styles and the practical strategies for dealing with problem drinkers and alcohol dependents will be presented in the context of health-sustaining habits. 가정 의학의 근간을 이루는 포괄적 진료를 완성하기 위해서는 약물 처방뿐 아니라 영양, 운동, 이완 등이 포함되는 건강유지 습관의 교육과 실천이 필요하다. 나아가 가정 의학의 고유하면서도 중요한 진료 영역의 하나인 건강 증진을 다루기위해선 음주에 대한 상담 능력이 뒷받침 되어야 지속적 진료가 가능하다. 그러나 음주는 가장 흔한 상담 주제임에도 불구하고 무의식적으로 회피하거나 도덕적 차원에서 훈계하는 수준으로 그치는 경우가 많다. 음식조절이나 규칙적인 운동과같은 맥락에서 건강 음주 혹은 절주가 일상 습관으로 유지되지 못하는 이유를 스트레스와 연관하여 설명하고 일차 진료현장에서 상담에 실제적으로 도움이 될 수 있도록 구체적 관리 방안과 전략을 제시한다.
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박병강,Park, Byeong-Gang 사단법인 한국당뇨협회 2005 당뇨 Vol.193 No.-
음주문제는 단순히 술 마시는 양이나 횟수의 문제가 아니다. 술 먹는 속도나 양에 대해 조절력을 발휘할 수 없다면 아예 안 마시는 편이 좋다. 한 잔만 마시려고 했는데 반병을 마시게 되었다면 음주에 문제가 있다고 보면 된다.
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박병강,김종성 충남대학교 의학연구소 2001 충남의대잡지 Vol.28 No.2
Alcohol has been suggested to be the principal risk factor for violence. However, few studies have been performed on domestic violence in the context of alcoholism. Authors reviewed the domestic violence patterns of 125 male alcoholics and following results were obtained. 1. The rate of domestic violence in alcoholics during 1-month period prior to admission was 53.6% and the statistically significant factors related to the rate of violence included patient's age(P<0.01), presence of psychiatric diseases(P<0.05), and adaptability of family(P<0.05). 2. The violence patterns showed verbal aggression only(43.4%), verbal and physical aggression(35.8%), and the combination of verbal, physical aggression and weapon use(42.3%). The violence pattern were significantly related to the victim's coping styles to the violence(P<0.05). 3. The objects against which violence was done were spouse and offsprings(40.3%), parents(32.8%), objects as in window smashing(l7.9%) and non-cohabitant(11.9%). The statistically significant variables related to violence objects were marital status(P<0.01) and the family's APGAR scores(P<0.05). 4. Drunken state preceding violence was 83.6% and its statistically significant variable was the victim's coping style(P<0.001). The above results have suggested that comprehensive point of view considering alcoholism as a disease of an alcoholic's whole family and not an individual alcoholic, is required as we approach its treatment.
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