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1조현병 환자의 내재화된 낙인에 영향을 미치는 요인

저자 : 김미영 ( Mi Young Kim ) , 전성숙 ( Seong Sook Jun )

발행기관 : 한국간호과학회 정신간호학회(구 대한간호학회정신간호학회) 간행물 : 정신간호학회지 21권 2호 발행 연도 : 2012 페이지 : pp. 108-117 (10 pages)

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Purpose: The purpose of this study was to explore internalized stigma of patients with schizophrenia and examine factors contributing to their internalized stigma. Methods: Participants in this study were 173 patients schizophrenia living in Busan. Data were collected between January 2 to 16, 2012 using the Korean version of the Internalized Stigma of Mental Illness Scale (ISMI), and measurements of Self-esteem, Depression, Family and Social support, and Insight. Data were analyzed using the SPSS/WIN 18.0 program. Results: The mean score for internalized stigma was 68.8±12.15. The significant factors influencing internalized stigma were depression, insight, admission status, mental health center services, number of admissions, self-esteem, and family support. These factors explained 40.8% of the variance. Conclusion: The results suggest that in development and practice of programs to decrease internalized stigma in patients with schizophrenia factors identified in this study as influencing internalized stigma should be considered.

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2사회복귀시설 조현병 환자의 독서치료 프로그램 참여 경험에 대한 현상학적 연구

저자 : 심유지 ( Sim Yu-ji ) , 이명우 ( Lee Myung-woo )

발행기관 : 대구대학교 특수교육재활과학연구소 간행물 : 특수교육재활과학연구 56권 2호 발행 연도 : 2017 페이지 : pp. 1-29 (29 pages)

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본 연구의 목적은 사회복귀시설 조현병 환자가 독서치료 프로그램 참여를 통해 어떠한 경험을 하는지 탐색하고 경험의 의미와 본질적 구조를 이해하는 데 있다. 이를 위해 집단 독서치료 참여 경험이 있는 조현병 환자 7명을 대상으로 심층면담을 수행하고 질적연구 방법 중 현상학적 연구방법을 적용하였다. 연구결과 170개의 의미단위, 33개의 도출(드러난)주제, 9개의 본질적 주제를 구성하였다. 본질적 주제는 초기 불안과 저항, 매체와의 상호작용, 집단원과의 상호작용, 참여자의 자발적 노력, 치료자와의 상호작용, 독서치료 과정의 구체적 활동, 지속적 참여 촉진 요인, 독서치료 경험의 의미 발견, 성숙한 삶의 태도변화와 사회적 기능 증진으로 나타났다. 독서치료 경험의 의미 발견은 연구 참여자의 성숙한 삶의 태도변화와 사회적 기능을 증진시키는 효과를 가져왔음을 알 수 있었다. 본 연구는 조현병 환자의 독서치료 프로그램 참여 경험에 대한 질적 분석을 처음 시도하여 경험의 의미와 구조를 밝힘으로써 조현병 환자의 사회적 기능 향상에 도움을 줄 수 있는 독서치료 프로그램 개발을 위한 기초자료의 기틀을 제공해 주었다는 데 의의가 있다.


The purpose of this study is to explore what patients with schizophrenia in Rehabilitation facility experience through participation in the Bibliotherapy program and to understand the meaning and the essential structure of the experience. For this study, in-depth interviews were conducted on seven patients with schizophrenia who experienced collective Bibliotherapy program and the phenomenological method was applied among qualitative methods. As a result of the study, 170 semantic units, 33 derived themes, and 9 essential themes were formed. The essential themes were identified as the initial anxiety and resistance, the interaction with media, the interaction with members of the group, the voluntary efforts of participants, the interaction with helper, the specific activities in bibliotherapy process, the continuous participation promotion factor, the finding meanings in the experiences of bibliotherapy, and mature change of life attitude and the improvement of social functioning. The discovery of the meanings in bibliotherapy experience has resulted in mature change of life attitude and the improvement of social functioning. The study has revealed the meaning and structure of experience through experimenting with qualitative analysis of the schizophrenia patients` experience of the bibliotherapy program for the first time and has shown that it provided the foundation for basic data for developing the bibliotherapy program that could help the patients with schizophrenia improve the social skills.

3노인 조현병 환자에서 인지기능과 호모시스테인 농도의 관계

저자 : 박지용 ( Ji Yong Park ) , 전진숙 ( Jin Sook Cheon )

발행기관 : 한국정신병리진단분류학회 간행물 : 정신병리학 23권 1호 발행 연도 : 2015 페이지 : pp. 21-34 (14 pages)

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목적 : 본 연구 목적은 노인 조현병 환자에서 나타나는 인지 장애의 빈도와 호모시스테인(Hcy) 농도 증가의 연관성을 알아보기 위함이다. 방법 : 조현병으로 입원한 65세 이상의 노인환자 108명(남자 59명, 여자 49명)을 대상으로 반구조적 면담과 인지기능(MMSE-K, MoCA-K), 정신증의 심한 정도(K-PANSS), 우울증의 심한 정도(K-GDS)를 평가하였다. 결과 : 1) 호모시스테인 증가군에서 남성이 유의하게 더 많았고, 조현병 유병기간이 유의하게 더 길었다. 2) MMSE-K와 MoCA-K로 평가한 인지 장애 빈도는 호모시스테인 정상군에서는 각각 67.86%, 96.43%, 호모시 스테인 증가군에서는 두 검사 모두에서 100%이지만, MMSE-K 검사에서만 두 군간에 통계학적으로 유의한 차이를 보였다. 3) 호모시스테인 증가군에서만 MMSE-K 및 MoCA-K의 총점수와 소검사 점수는 유의하게 더 낮았다. 4) 호모시스테인 농도 증가와 MMSE-K 총점은 유의한 역 상관관계가 있었다. 인지 기능 중에서 특히 시간/장소 지남력, 기억 회상, 언어 관련 기능과 시공간 구성 능력에 유의한 역의 연관성이 있었다. 결론 : 본 연구를 통하여 호모시스테인 농도 증가가 노인 조현병 환자에서 인지 장애의 병인에 밀접한 연관성이 있음을 시사한다.


Objectives : The aims of this study were to identify the frequency of cognitive disorders and association with homocysteine levels in old age schizophrenics. Methods : The data were obtained from admitted schizophrenics with age over 65 (N=108, male 59, female 49) by semistructured interviews and measurements of cognitive function using the MMSE and the MoCA-K, severity of psychosis using the K-PANSS and depression using the K-GDS. Results : 1) The old age schizophrenics with increased homocysteine levels had significantly more males and longer duration of schizophrenia. 2) The frequency of cognitive disorder measured by the MMSE-K and the MoCA-K was 67.86% vs 96.43% in schizophrenics with normal homocysteine, and both 100% in schizophrenics with increased homocysteine. However, statistically significant difference was only found in those measured by the MMSE-K. 3) The total scores and subtests scores of the MMSE-K and the MoCA-K were significantly lower in old age scizophrenics with increased homocysteine levels. 4) The increase of homocysteine levels had significant negative correlation with total scores of the MMSE-K and subtests scores of time/place orientation, recall, languse and visuospatial function. Conclusions : These findings suggest that increased homocysteine levels may be closely associated with pathogenesis of cognitive disorder in old age schizophrenics

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Purpose: This study was to examine the effects of tailored drug-related side effects management program using video designed to help patients with schizophrenia with self-control ability of drug-related side effects, attitude, and adherence to medication. Methods: A non-equivalent control group, pretest-posttest design was used. The participants were 51 patients with schizophrenia, 26 in the experimental group and 25 in the control group. The tailored drug-related side effects management program using video was conducted for the experimental group twice a week for 60 minutes/session for 4 weeks. The self-control ability for drug-related side effects, attitude and adherence of medication were measured before and after the experiment. Data were analyzed by using IBM SPSS/WIN 20.0 program. Results: At follow-up, we found statistically significant increases in self-control ability for drug-related side effects, attitude and adherence of medication for the experimental group. Conclusion: The results of this study suggest that tailored drug-related side effects management program using video was to increase self-control ability for drug-related side effects, attitude and adherence of medication in patients with schizophrenia.

KCI등재

5조현병 환자의 삶의 질 관련 중재에 대한 통합적 문헌고찰

저자 : 김고운 ( Kim Go-un ) , 정은영 ( Jung Eun Young )

발행기관 : 한국간호과학회 정신간호학회(구 대한간호학회정신간호학회) 간행물 : 정신간호학회지 27권 1호 발행 연도 : 2018 페이지 : pp. 28-39 (12 pages)

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Purpose: The purposes of this study are to review the literature on quality of life intervention programs and to recommend further research and clinical considerations to improve the quality of life among patients with schizophrenia. Methods: Three electronic databases - PubMed, CHINAHL and RISS - were searched using the search terms of “schizophrenia” AND “quality of life” AND “intervention*” OR “program*.” The search was limited to studies published in English and Korean. Results: Ten studies were selected for the final analysis and evaluated in terms of contextual and methodological quality. The 10 studies consisted of 5 randomized controlled trials, 4 quasi-experimental studies, and 1 case report. The selected studies utilized an educational program, art and music therapy, physical activity therapy, and community-based integrated programs to alleviate psychological symptoms and showed effectiveness in improving quality of life. Conclusion: Interdisciplinary interventions and programs using multiple components reduced psychological symptoms and improved the quality of life of patients with schizophrenia.

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6조현병 환자 배우자의 돌봄 경험

저자 : 채공주 ( Gong Ju Chai ) , 남은숙 ( Eun Sook Nam )

발행기관 : 한국간호과학회 정신간호학회(구 대한간호학회정신간호학회) 간행물 : 정신간호학회지 25권 2호 발행 연도 : 2016 페이지 : pp. 133-146 (14 pages)

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Purpose: The aim of this phenomenological study was to qualitatively classify the experience of spouses caring for patients with schizophrenia. Methods: Data were gathered using 2 hour in-depth, unstructured interviews with nine spouses of patients with schizophrenia. The data collection period was 2012 to 2013. Colaizzi``s phenomenological method was used to analyze the resulting data. Results: Five clusters of themes were identified. These were termed according to the experiences described by the spouses, as: suffering from falling into the abyss of despair; deepening heartbreak, clouds of misery hanging over one``s family; possibly of losing the bond between family members; getting over one``s hurt and stepping forward to the future. Participants experienced many burdens while caring for their spouse, however, they showed the ability to overcome difficulties positively and actively. Conclusion: The results of this study indicate that the spouse of a patient with schizophrenia experiences multiple sources of distress, and suggests a process to overcoming them. Recommendations include helping nurses be aware of the sufferings of both the patient and the spouse and to plan and provide for psychological interventions, such as stress management programs and informational support on social welfare programs.

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7현실치료 기법을 적용한 자기주장훈련이 조현병 환자의 자아존중감과 내재화된 낙인에 미치는 효과

저자 : 김나라 ( Kim Na-ra ) , 장미희 ( Jang Mi Heui )

발행기관 : 한국간호과학회 정신간호학회(구 대한간호학회정신간호학회) 간행물 : 정신간호학회지 28권 1호 발행 연도 : 2019 페이지 : pp. 37-49 (13 pages)

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Purpose: The aim of this study was to examine the effect of self-assertive training applying the reality therapy techniques (SATART) on self-esteem and internalized stigma of schizophrenia patients. Methods: This study was a non-equivalent control group pretest-posttest design and enrolled 55 people with schizophrenia (experimental group=27, control group=28) from two community mental health centers. The SATART was offered twice a week for 6 weeks in a total 12 sessions. Data were collected from February to April, 2017, using the Korean version of the Internalized Stigma of Mental Illness Scale and Rosenberg Self-Esteem Scale. The collected data was analyzed using x2 test, independent t-test, one-way ANCOVA, and repeated measures ANOVA with using the SPSS/WIN 22.0 program. Results: The experimental group showed significant improvements in self-esteem and recudction of internalized stigma compared to the control group. However, there was no significant improvement on stigma resistance measurement among the subscales of internalized stigma between two groups. Conclusion: The findings indicate that the SATART program is effective and could be recommended as a psychosocial intervention for selfesteem enhancement and internalized stigma reduction of people with schizophrenia.

KCI등재

8환자의 질병 체험 내러티브가 조현병에 대한 지식, 정신질환에 대한 태도, 학습만족도에 미치는 효과

저자 : 안영미 ( Ahn Youngmi ) , 유영미 ( Ryu Young Mi )

발행기관 : 한국간호과학회 정신간호학회(구 대한간호학회정신간호학회) 간행물 : 정신간호학회지 27권 2호 발행 연도 : 2018 페이지 : pp. 189-197 (9 pages)

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Purpose: The aim of this study was to identify effects of a psychiatric and mental health nursing class to improve knowledge about schizophrenia, attitudes toward mental illness, and learning satisfaction after using an illness narrative of a patient with schizophrenia. Methods: This study was in nonequivalent control group and a pretest-posttest design. Of the 88 nursing students, the 34 in the experimental group received 5 hours of lectures on schizophrenia plus 2 hours of learning using a patient's illness narrative. The control group (n=54) received only the 5 hours of lectures on schizophrenia. During September, 2017, an online survey was used to collect data before and after the intervention. Data were analyzed using t-tests and Mann-Whitney U tests with SPSS Statistics version 22.0. Results: There were no differences for knowledge on schizophrenia or for attitudes toward mental illness between the experimental group and the control group after the intervention. However, learning satisfaction was significantly higher in the experimental group compared to the control group (Z=-2.18, p=.029). Conclusion: Findings indicate that patient illness narratives could be a useful tool to improve learning satisfaction in nursing students. Therefore, using patient illness narratives in nursing classes is recommended.

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9입원한 조현병 환자의 치료적 단계에 따른 스트레스, 대처방식, 자살 위험성 및 자살사고

저자 : 함진희 ( Ham Jin Hee ) , 성경미 ( Sung Kyung Mi )

발행기관 : 한국간호과학회 정신간호학회(구 대한간호학회정신간호학회) 간행물 : 정신간호학회지 25권 4호 발행 연도 : 2016 페이지 : pp. 338-346 (9 pages)

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Purpose: This study was done to evaluate the relationship of stress, coping skill, suicide risk, and suicidal ideation according to treatment phases in patients hospitalized with schizophrenia. Methods: Participants, 111 patients hospi-talized with schizophrenia, were selected from three psychiatric hospitals in G province. Data were collected from March 5 to April 15, 2016 and analyzed using t-test, x2 test, Fisher`s exact test, Pearson correlation coefficient, one-way ANOVA, and Scheffe`s test analysis with the SPSS/WIN 18.0 program. Results: Based on NOSIE-30, the treatment phases were divided into Beginning, Intermediate, and Completion stages. Patients in the Intermediate stage showed a higher stress level (F=5.13, p=.007) and active coping skills (F=6.70, p=.002) than patients in other stages. They also showed the highest suicide risk (F=7.42, p=.001), and the patients in the beginning stage had the highest suicidal ideation (F=20.20, p<.001. There were significant relationships between study variables at each stage. Conclusion: The findings from this study show differences in levels of stress, coping skill, suicide risk, and suicidal ideation according to treatment phases and indicate the need to develop suitable nursing intervention pro-grams according to patients` treatment phases.

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10중고령 조현병 환자의 우울 영향요인에 대한 탐색적 연구

저자 : 김선미 ( Sunmi Kim )

발행기관 : (사)아시아문화학술원 간행물 : 인문사회 21 9권 6호 발행 연도 : 2018 페이지 : pp. 59-74 (16 pages)

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고령화로 인해 빠르게 증가하고 있는 지역사회 거주 중고령 조현병 환자들은 노령화를 고려한 차별화되고 개별적인 정신건강서비스를 제공받아야 하며, 자살과 관련된 주요 요인인 우울에 관심을 가질 필요가 있다. 본 연구의 목적은 중고령 조현병 환자의 우울정도와 어떠한 차이가 있는지, 우울에 영향을 주는 요인이 무엇인지 탐색하고자 하는 것이다. 조사대상자는 135명의 중고령 조현병 환자로 유의표집 하였으며, 자기기입식 설문지를 통해 자료를 수집하고, 위계적 다중회귀분석방법을 사용해 자료를 분석하였다. 연구결과 사회적 낙인감이 높을수록, 자아존중감이 낮을수록, 직업이 없는 경우 중고령 조현병 환자의 우울이 높아지는 것으로 나타났다. 이를 통해 본 연구의 결과, 중고령 조현병 환자의 우울을 감소시키기 위한 방안을 탐색하기 위한 실천방안을 수립하는 데 주는 실천적 함의를 제시하였다.


The rapidly growing population of middle-aged and older persons with schizophrenia aging needs to be provided with differentiated and individual mental health services considering aging, and attention should be concerned about depression, a major factor related to suicide. The subjects were 135 middle-aged and older persons with schizophrenia. The data were collected through self-reporting questionnaires and analyzed using hierarchical multiple regression analysis. The results of the study showed that the higher the social stigma, the lower the self esteem, the less the occupation, the higher the depression of middle-aged and older persons people with schizophrenia. As a result of this study, we suggest the practical implications to find out the practical plans to reduce depression.

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