초등학교 ADHD아동을 위한 중재적 개입 국내 연구 동향 및 질적 지표 분석

하명숙(MyungSook Ha), 지은(Eun Ji) 학습자중심교과교육학회 2023 학습자중심교과교육연구 Vol.23 No.9

목적 초등학교 ADHD아동의 중재개입 프로그램 관련 국내 연구물을 검토하고 이를 바탕으로 효과적인 중재 프로그램 개발 및 적용을 할 수 있는 방향성을 도출해 보고자 한다. 방법 국내에서 연구된 초등학교 ADHD아동의 중재적 개입 연구동향을 알고자 2009년부터 2022년 12월까지 연구된 국내 학술지를 중심으로 연구 문헌 검색 및 논문을 선정하였다. 이를 위해 선정된 41편의 연구를 대상으로 논문 분석틀에 따라 분석을 하였으며 집단 대상 연구와 단일대상 연구의 질적지표를 분석하여 증거기반 중재를 살펴보았다. 결과 저학년(1~3)의 학생 수가 고학년(4~6)보다 많았으며, 남자 아동을 대상으로 하는 연구가 많이 되었음을 알 수 있다. 선행연구에서 중재 장소와 중재 환경에 대한 구체적인 기술이 되지 않았다. 중재 연구 프로그램은 예술 활동 기반 중재연구가 많이 제공이 되었으며 종속변인에 따른 분석은 ADHD아동의 인지⋅행동적 측면의 연구가 다수 되었다. 집단대상 중재 연구 프로그램의 질적 지표는 수행 및 운영자의 정보기술, 비교집단의 교수 기술은 충족하는 연구가 부족하였다. 단일대상 중재 연구 프로그램의 질적 지표는 환경기술, 측정 타당도의 기술, 종속변수 기초선 측정, 기초선 기간의 기술을 충족하는 연구가 부족했다. 결론 연구에서 제언하는바 초등학교 ADHD아동의 중재 연구에서 연구의 신뢰도와 타당도를 높이는 연구 설계가 필요하며 연구대상자 중재 환경 기술을 명확히 하는 것이 요구된다. 본 연구 결과를 통해 초등학교 ADHD아동의 중재 효과성과 질적 지표 분석의 증거 기반을 고려한 연구를 통해 향후 이를 반영한 연구가 진행되어야 한다. Objectives Domestic studies related to intervention programs for children with ADHD in elementary school are reviewed, and based on this, a direction for developing and applying effective intervention programs is sought. Methods In order to know the research trend of interventional intervention for children with ADHD in elementary school studied in Korea, research literature was searched and papers were selected, focusing on domestic academic journals studied from 2009 to December 2022. For this purpose, 41 selected studies were analyzed according to the thesis analysis framework, and the evidence-based intervention was reviewed by analyzing the qualitative indicators of group-subject studies and single-subject studies. Results As a result of the research analysis, the number of students in the lower grades (1 to 3) was higher than that in the upper grades (4 to 6), and it can be seen that there are many studies targeting boys. In previous studies, there was no detailed description of the intervention site and intervention environment. As for the intervention research program, many art activity-based intervention studies were provided, and analysis according to the dependent variable involved a number of studies on the cognitive and behavioral aspects of children with ADHD. As for the qualitative indicators of group targeting intervention research programs, there was a lack of studies that satisfied performance, operator's information technology, and comparative group's teaching skills. As for the qualitative indicators of single-subject intervention research programs, there were insufficient studies that satisfied the environmental description, description of measurement validity, baseline measurement of the dependent variable, and description of the baseline period. Conclusions The study suggests that intervention studies of children with primary school ADHD need to be designed to increase the reliability and validity of the studies, and to clarify the description of the subjects' intervention environment. Through the results of this study, studies reflecting this should be conducted in the future by considering the evidence-based analysis of the effectiveness and qualitative indicators of interventions for children with ADHD in elementary school.

스테로이드 치료후 발생한 중심성장액맥락망막병증 1례

하명숙(Myung Sook Ha),이종훈(Jong Hoon Lee) 대한안과학회 1999 대한안과학회지 Vol.40 No.6

녹내장 환자의 불안과 우울상태에 대한 고찰

하명숙 ( Myung Sook Ha ),장무환 ( Moo Hwan Chang ),이종훈 ( Jong Hoon Lee ) 대한안과학회 2002 대한안과학회지 Vol.43 No.2

당뇨환자에서 백내장 제거술 후 삽입된 Hydrophilic Acrylic IOL 표면의 칼슘침착 3례

하명숙 ( Myung Sook Ha ),강병도 ( Byung Do Kang ),명나혜 ( Na Hae Myung ),장무환 ( Moo Hwan Chang ) 대한안과학회 2002 대한안과학회지 Vol.43 No.2

학업중단 청소년 지원 프로그램 효과 메타 분석

하명숙(Myungsook Ha),이민정(Minjeong Lee),신주연(JooYeon Shin) 한국열린교육학회 2023 열린교육연구 Vol.31 No.3

본 연구는 학업중단 청소년을 위한 지원 프로그램의 효과를 종합적으로 이해하고자 2002년부터 2022년 12월까지 국내 출판된 연구 중 PICOS의 선정기준에 부합하는 35편의 논문을 최종 선정하여 메타분석을 실시하였다. 연구결과는 다음과 같다. 학업중단 청소년 지원 프로그램의 전체 효과크기는 1.35로 높은 수준으로 나타났다. 프로그램의 유형별 분석결과, 진로지원 프로그램이 가장 큰 효과를 보였고, 학교생활적응지원 프로그램, 심리지원 프로그램 순으로 나타났다. 결과변인 분석 결과, 진로관련 변인의 효과가 가장 높았고, 인지적 측면, 사회적 측면, 정서적 측면 순으로 나타났다. 중재회기는 10회기 이상 실시되었을 때가 10회기 미만이었을 때 보다 더 효과적이었으며, 보호시설에 거주하는 학업중단 청소년의 경우가 그렇지 않은 경우보다 더 효과적인 것으로 나타났다. 본 연구는 학업중단 청소년 지원 프로그램의 효과성에 대하여 종합적이고 체계적인 이해를 도모하여, 학업중단 청소년을 위한 프로그램 설계 시 고려할 사항들을 제안하였다는 점에 의의가 있으며, 본 연구의 제한점과 후속 연구의 방향을 논의하였다. The purpose of this study is to comprehensively understand the effectiveness of the support programs for youth school dropouts by conducting a meta-analysis with 35 domestic studies published from 2002 to 2022. The results of the study are as follows. The overall effect size of the school dropouts support programs was 1.35, which was considered high. Among the four types of the support programs, the career support program showed the greatest effect, followed by the school life adaptation support program and the psychological support program. Among the four areas of the resulting variables, the variables related to career aspects showed the highest effect size, followed by cognitive aspects, social aspects, and emotional aspects. The programs with more than 10 sessions showed higher effectiveness compared to programs with less than 10 sessions. Programs conducted with adolescents living in group residential youth facilities showed better effects compared to programs with youths living in their own home. This study provides a comprehensive and systematic understanding of the effectiveness of support programs for school dropouts. Implications and limitations for future research were also discussed.

전산화 단층촬영으로 측정한 정상 한국인의 눈물샘 부피

민성규,하명숙 대한안과학회 2015 대한안과학회지 Vol.56 No.1

Purpose: We used computed tomography (CT) scans to describe normal Korean lacrimal gland volume and lacrimal gland size and then examined their correlations with patient age. Methods: CT scans were obtained in 213 orbits of 111 patients who underwent CT from January to August of 2013. Aquarius iNtuition (TeraRecon, Foster City, CA, USA) software was used to outline the lacrimal gland in consecutive axial slices and to calculate the volume. Results: The mean volume of the lacrimal gland was 0.589 cm in right orbits (SD = 0.090), 0.583 cm in left orbits (SD = 0.289), 0.596 cm in males (SD = 0.083), and 0.575 cm in females (SD = 0.094). There was no significant difference in mean lacrimal gland volume according to laterality (p = 0.614) or sex (p = 0.102) (2-sample t-tests). We investigated mean lacrimal gland volume in 3 age groups. Mean lacrimal gland volume was 0.630 cm (SD = 0.080) for the 20 to 40 year old group, 0.553 cm (SD = 0.734) for the 41 to 60 year old group, and 0.544 cm (SD = 0.885) for the older than 60 years old group. There was an inverse relationship between gland volume and age (Pearson r = −0.384, p = 0.00). Conclusions: The mean volume of the lacrimal gland decreased with age and there was no significant difference between right and left orbits or between male and female patients. J Korean Ophthalmol Soc 2015;56(1):1-5

복시가 동반된 안와골절 환자의 임상양상

강효정,하명숙 대한안과학회 2009 대한안과학회지 Vol.50 No.7

conservative treatment group. Methods: The study comprised of 109 eyes of 109 patients with orbital wall fracture and diplopia. The patients were divided into two groups: the surgical treatment group (59 cases) and the conservative treatment group (50 cases). The groups were analyzed retrospectively according to age, gender, cause, CT, the period and severity of diplopia, and enophthalmos with time. Results: In the conservative treatment group, 38 cases (64.4%) had medial wall fracture, and the average fracture size was 26% of the inferior wall and 33% of the medial wall. In addition, at the first visit, the patients showed diplopia within 45.5 degrees, and diplopia disappeared completely within 17 days on average (57 cases, 96.6%). In the group that underwent the reconstruction of orbital wall fracture, 27 cases (54.0%) had inferior wall fracture, and the average fracture size was 41% of the inferior wall and 35% of the medial wall. Additionally, in the first visit, the patients showed diplopia within 20.3 degrees. The muscle incarceration occurred in 12 cases (24%). In the surgical treatment group, diplopia disappeared completely within 30 days on average (45 cases, 90.0%). Conclusion: In the group of conservative treatment, they showed diplopia within 45.5 degrees at the first visit. Diplopia disappeared completely within 17 days on average (57 cases, 96.6%). In the group of surgical treatment, they showed diplopia within 20.3 degrees at the first visit. Diplopia disappeared completely within 30 days on average (45 cases, 90.0%). 목적: 복시가 동반된 안와골절 환자에서의 수술적 치료와 보존적 치료를 시행한 경우의 임상양상을 각각 분석하고자 한다. 대상과 방법: 복시가 동반된 안와골절 환자 중 보존적 치료를 시행한 59명 59안과 수술적 치료를 시행한 50명 50안에 대해 나이, 성별, 발생원인, 전산화단층촬영 소견 및 시간에 따른 복시의 변화를 후향적으로 각각 분석하였다. 결과: 보존치료군은 내벽골절이 38명(64.4%)이고 평균 하벽의 26%, 내벽의 33% 크기의 골절을 보였고 초진 시 평균 45.5도의 복시를 보였으며 57명(96.6%)에서 평균 17일 이내 복시의 완전소실을 보였다. 수술치료군은 하벽골절이 27명(54.0%)이었으며 하벽의 41%, 내벽의 35% 크기의 골절을 보였고 초진 시 평균 20.3도의 복시를 보였다. 외안근 감돈은 12명(24%)이었고 45명(90%)의 환자에서 평균 30일 후 복시의 완전소실을 보였다. 결론: 보존치료군의 초기 복시각은 45.5도, 복시의 소실시기는 17일, 6개월 후 96.6%의 환자에서 복시의 회복을 보였고 수술치료군은 초기 복시각 35.0도, 복시의 소실시기 30일, 6개월 후 90%에서 복시가 회복되었다.

비강상태에 따른 비내시경적 누낭비강문합술의 결과 분석

백승국,하명숙,Seung Kook Baek,MD,Myung Sook Ha,MD 대한안과학회 2014 대한안과학회지 Vol.55 No.5

Purpose: This study evaluated the relationship of nasal cavity state and surgical results after endonasal dacryocystorhinostomy (DCR).<br /> Methods: We retrospectively analyzed 306 eyes of 204 patients between January 2007 and December 2011. The correlation between the existence of preoperative nasal cavity abnormality, postoperative nasal cavity complications after proper management of nasal cavity abnormality, and postoperative nasal cavity complications according to nasal packing material were investigated. We analyzed the success rates and the correlation between each set of factors.<br /> Results: The success rate of primary operations performed six months after tube removal was 87.3% (267/306). The success rate after secondary revision, granuloma removal and punctoplasty was 90.5% (277/306). Postoperative nasal cavity complications were inspected in 40 eyes. Of the 306 eyes, patients treated with Nasopore showed significantly more postoperative nasal cavity complications (47.8%, 32/67) than in patients treated with Merocel (3.3%, 8/239). The rate of postoperative nasal cavity complications was 8.7% in patients with normal nasal cavity, 16.7% in patients who received treatment, and 20% in patients without treatment, with significant statistical increase if the nasal cavity was abnormal (p = 0.019). The incidence of complications influenced the primary success rate (p = 0.008); however, preoperative nasal cavity abnormalities were not correlated with primary success (p = 0.479).<br /> Conclusions: In the case of endonasal DCR, preoperative nasal cavity abnormality and type of nasal packing material used did not affect the success rate but significantly affected postoperative nasal cavity complications. In conclusion, endonasal DCR with preoperative treatment of nasal cavity abnormality and Merocel packing is expected to reduce postoperative nasal cavity complications and increase patient satisfaction.<br /> J Korean Ophthalmol Soc 2014;55(5):633-639

선천성 코눈물관 폐쇄증의 임상양상과 치료

서신초,하명숙 대한안과학회 2009 대한안과학회지 Vol.50 No.6

Purpose: A comparison analysis of the clinical characteristics and treatment results of congenital NLD obstruction. Methods: The present study involved 216 pediatric patients (258 eyes) diagnosed with and treated for congenital NLD obstruction. Treatment was applied step by step starting with conservative massaging, lacrimal probing, and silicone tube intubation. Results: The treatment results of congenital NLD obstruction in pediatric patients under 12 months of age showed an 87.3% success rate after an average of 4.3 months of treatment in the group using lacrimal sac massage and antibiotic eye drops (conservative treatment). The group treated by correct massaging techniques showed a 93.6% success rate after an average of 3.8 months of treatment. The success rate of lacrimal probing, applied to patients not showing improvement after massage therapy was 77.8%. Pediatric patients not showing improvement after lacrimal probing underwent silicone tube intubation. All patients showed improvement except in 1 case that had an early silicone tube dislocation. Discussion: A step-by-step approach is effective in treating congenital NLD obstruction patients, and correct lacrimal massage techniques improve the success rate during conservative therapy. The period of conservative treatment and number of probing times did not have a statistically significant correlation with the success rate of lacrimal silicone tube intubation. Silicone tube intubation showed a high success rate in patients sustaining the silicone tube for a minimum of 2.1 months. 목적: 선천성 코눈물관 폐쇄증의 임상양상 및 치료효과에 대해 비교 분석하였다. 대상과 방법: 2001년 3월부터 2007년 10월까지 선천성 코눈물관 폐쇄증으로 진단받고 치료받은 소아환자 216명(258안)을 대상으로 하였다. 치료는 단계별로 보존적 마사지 치료, 코눈물관 탐침법, 실리콘관 삽입술을 시행하였다. 결과: 선천성 코눈물관 폐쇄증의 치료효과는 생후 12개월 이내의 소아환자에서 보존적 치료군이 평균 4.3개월 치료 후 87.3%의 성공률을 보였다. 올바른 마사지법을 알고 시행한 군은 평균 3.8개월 치료 후 93.6% 성공률을 나타냈다. 마사지법으로 호전이 없는 경우 시행한 탐침술의 성공률은 77.8%이었다. 코눈물관탐침술로 호전되지 않은 경우 실리콘관 삽입술을 시행하였고, 조기에 실리콘관이 이탈된 1예를 제외하고 모든 환아에서 증상호전을 보였다. 결론: 선천성 코눈물관 폐쇄증이 있는 소아환자의 치료에서 보존적 치료 시 올바른 누낭마사지법의 사용이 성공률을 높일 수 있는 것으로 나타났다. 실리콘관 삽일술의 경우 술 전 보존적 치료 기간 및 probing 횟수는 성공률에 유의한 관계가 없었으며, 실리콘관 유지기간이 최소 3개월 이상에서 높은 성공률을 보였다.

경도 눈꺼풀처짐 환자에서 결막뮬러근 절제술의 결과

배준성,하명숙,이지영,김성주,장재우 대한안과학회 2008 대한안과학회지 Vol.49 No.9

Purpose: To assess surgical outcomes after adjusting the amount of resection of the conjunctiva and the Müller muscle according to 10% phenylephrine test results. Methods: The charts of 32 patients (32 eyes) with mild upper eyelid ptosis were reviewed retrospectively. They all had conjunctiva-Müller muscle resections. A preoperative 10% phenylephrine test was performed to determine the resection amount of the Müller muscle and conjunctiva. An 8 mm resection was performed when phenylephrine raised the ptotic lid to the same level as that of the contralateral lid. A 7 mm resection was performed when the ptotic lid was raised to a level higher than that of the contralateral lid. A 9 mm resection was performed when the ptotic lid was raised to a level not quite to the level of the contralateral lid. Results: Of the 32 patients, 28 were female and 4 were male. The mean age of the patients was 30.8±10.2 years. Patients were followed up for an average of 40.2±36.8 days, postoperatively. Postoperative upper lid positions were exactly symmetrical in 26 of the 32 patients. Five patients showed undercorrection, and 1 patient showed overcorrection. Conclusions: Excellent results were obtained by resecting the conjunctiva and Müller muscle according to the phenylephrine reaction of a ptotic eyelid. J Korean Ophthalmol Soc 2008;49(9):1365-1370