The Effect of a Job Stress Management Program Based on Acceptance-Commitment Therapy for Firefighting Paramedics / 기본간호학회지

Purpose@#The purpose of this study was to develop an acceptance-commitment therapy (ACT) based job stress management programs for firefighting paramedics and to examine the effects on the psychological flexibility, job stress (i.e. psychological, physiological and behavioral areas) and quality of life. @*Methods@#This study consisted of a pre-test-posttest for a nonequivalent control group design. Participants were 45 firefighting paramedics working at two fire stations located in specific areas (experimental group: 22, control group: 23). The experimental group received the ACT based job stress management program twice a week for a total of 3 weeks. The study was carried out from August 12 to 31, 2019, and data were analyzed using IBM SPSS/WIN 25.0 with a x2 test, Fisher's exact test, and independent t-test. @*Results@#The differences between experimental and control groups were statistically significant for psychological flexibility (t=4.91, p<.001), psychological job stress (t=-6.10, p<.001) and quality of life (t=3.78, p<.001). However, physiological stress (t=-1.91, p=.063) and behavioral stress (t=-1.18, p=.243) were not significantly different between the two groups. @*Conclusion@#The results of this study suggest that ACT based job stress management program can be used as an effective community mental health nursing intervention to improve the psychological flexibility, psychological job stress and quality of life of firefighting paramedics.

Emotional Distress of the COVID-19 Cluster Infection on Health Care Workers Working at a National Hospital in Korea

Background@#Frontline healthcare workers responding to coronavirus disease 2019 (COVID-19) inevitably face tremendous psychological burden. Thus, the present study aimed to identify the psychological impact and the factors contributing to the likely increase in emotional distress of healthcare workers. @*Methods@#The participants include a total of 99 healthcare workers at Bugok National Hospital. Psychometric scales were used to assess emotional distress (12-item General Health Questionnaire; GHQ-12), depression symptoms (Patient Health Questionnaire-9; PHQ-9), and post-traumatic stress disorder-related symptoms (Impact of Events Scale-Revised; IES-R). A supplementary questionnaire was administered to investigate the experience of healthcare workers exposed to COVID-19-infected patients. Based on the results of GHQ-12 survey, participants were categorized into two groups: distress and non-distress. All the assessed scores were compared between the two groups. A logistic regression model was constructed to identify factors associated with emotional distress. @*Results@#Emotional distress was reported by 45.3% (n = 45) of all participants. The emotionally distressed group was more likely to be female, manage close contacts, have higher scores on PHQ-9 and IES-R, feel increased professional risk, and report that proper infection control training was not provided. Female gender, managing close contacts, higher scores on PHQ-9, and a feeling that proper infection control training was not provided were associated with emotional distress in logistic regression. @*Conclusion@#Frontline healthcare workers face tremendous psychological burden during the COVID-19 pandemic. Therefore, appropriate psychological interventions should be provided to the HCWs engaged in the management of COVID-19-infected patients.

Effects of Basic Psychological Needs and Support of Health Professionals on Self Care Agency in Inpatients with Schizophrenia: Based on the Self-determination Theory / 정신간호학회지

Purpose@#The purpose of this study was to identify the effects of basic psychological needs and support of health professionals on the self care agency of inpatients with schizophrenia. @*Methods@#This descriptive correlational study was based on the basic psychological needs theory, a sub-theory of the self-determination theory (SDT). Participants were 172 inpatients with schizophrenia from four mental hospitals in two areas. Data were collected from self-report questionnaires administered June-September 2019. Data were analyzed using the t-test, one-way ANOVAs with Scheffé’s test, Pearson’s correlation coefficients, multiple regression and PROCESS macro mediation analysis with IBM SPSS 22.0. @*Results@#Basic psychological needs and support of health professionals showed a positive correlation with the self care agency. The results of the regression indicate the basic psychological needs and support of health professionals were predictors of self care agency. @*Conclusion@#The results suggest that basic psychological needs and support of health professionals are needed to improve the self care agency of inpatients with schizophrenia. Thus, the mental nursing practice needs a program for improving the self-care agency of inpatients with schizophrenia.

Association of Basic Psychological Needs with Recovery Attitude in Inpatients with Alcohol Use Disorders based on the Self-Determination Theory / 정신간호학회지

PURPOSE: The purpose of this study was to examine the impact of autonomy, competence, and relationship on the recovery attitude of inpatients with alcohol use disorder.METHODS: This descriptive correlational study was based on the basic psychological needs theory, which is a sub-theory of self-determination theory (SDT). Study participants were 158 inpatients with alcohol use disorder from four mental hospitals in two areas. Data were collected from self-report questionnaires administered in September and October 2019. Data were analyzed using the t-test, one-way ANOVA, Pearson's correlation coefficients, and the multiple linear regression with IBM SPSS 22.0.RESULTS: Recovery attitude showed a positive correlation with autonomy (r=.62, p < .001), competence (r=.40, p < .001), and relationship (r=.33, p < .001). The results of the regression indicate the autonomy and competence explained 39% of the recovery attitude (R2=.40, F=51.04, p < .001).CONCLUSION: The results suggest that autonomy and competence play integral roles in the recovery attitude of inpatients with alcohol use disorders. Thus, mental health practitioners should develop psychological need-based interventions to improve the autonomy, competence, and recovery attitude of inpatients' with alcohol use disorder.

Effects of Acceptance Commitment Therapy Based Recovery Enhancement Program on Psychological Flexibility, Recovery Attitude, and Quality of Life for Inpatients with Mental Illness / 정신간호학회지

PURPOSE: The purpose of this study was to (1) develop an acceptance commitment therapy (ACT) based recovery enhancement program for inpatients with mental illness and (2) test the effects of the program on patients' psychological flexibility, recovery attitude, and quality of life. METHODS: A mixed methods design was used: a combination of a repeated-measure design with a non-equivalent control group and qualitative data collection. The participants were 41 inpatients with mental illness (experimental group: 20, control group: 21). The ACT based recovery enhancement program was conducted over four sessions for a total of two weeks. Data were collected from December 2018 to January 2019. RESULTS: Study results revealed that the ACT based recovery enhancement program was effective for psychological flexibility (F=150.71, p<.001), recovery attitude (F=60.22, p<.001), and quality of life (F=31.59, p<.001) for inpatients with mental illness. CONCLUSION: The results of this study suggest that the ACT based recovery enhancement program can be used as an effective mental health nursing intervention for psychological flexibility, recovery attitude, and quality of life of inpatients with mental illness.

The Effects of an Acceptance-Commitment Therapy Based Stress Management Program on Hospitalization Stress, Self-Efficacy and Psychological Well-Being of Inpatients with Schizophrenia

PURPOSE: The purpose of this study was to construct an acceptance-commitment therapy (ACT)-based stress management program for inpatients with schizophrenia and to examine its effects on hospitalization stress, self-efficacy, and psychological well-being. METHODS: A non-equivalent control group pretest-posttest design was used. Participants were 44 inpatients with a diagnosis of schizophrenia. The experimental group (n=22) received the ACT-based stress management program twice a week for a total of four weeks. The control group (n=22) received the usual care from their primary health care providers. The study was carried out from August 7 to September 1, 2017, and data were analyzed using IBM SPSS/WIN 22.0 with a Chi-square test, Fisher's exact test, and an independent t-test. RESULTS: The experimental group showed a significant decrease in hospitalization stress (t=5.09, p < .001) and an increase in self-efficacy (t=2.44, p=.019). However, there was no significant difference in psychological well-being between the two groups (t=0.13, p=.894). CONCLUSION: The results of this study suggest that the ACT-based stress management program can be used as an effective mental health nursing intervention for hospitalization stress and self-efficacy for inpatients with schizophrenia.

Development and Effects of an Acceptance Commitment-based Cognitive Behavioral Program for Patients with Schizophrenia / 정신간호학회지

PURPOSE: The purposes of this study were to develop an acceptance commitment-based cognitive behavioral program for patients with schizophrenia and to use it as an intervention tool for psychiatric mental health nursing and thereby confirm the program's effects on patients' psychological flexibility, psychological well-being, and treatment adherence including insight and attitude toward treatment. METHODS: This study consisted of a pretest, posttest 1, and posttest 2 for a nonequivalent control group design. The participants were 42 patients with schizophrenia (experimental group: 21, control group: 21). The acceptance commitment-based cognitive behavioral program was conducted in 10 sessions for 5 weeks. Data collected from February to April 2018 were analyzed using the SPSS/WIN 25.0 for χ2 test, Fisher's exact test, independent t-test, and repeated measurement ANOVA. RESULTS: The differences between experimental and control groups were statistically significant regarding psychological flexibility, psychological well-being, and insight. CONCLUSION: This study findings suggest that the acceptance commitment-based cognitive behavioral program can be used as an effective mental health nursing intervention for psychological flexibility, psychological well-being, and insight of patients with schizophrenia.

Mediating Effect of Psychological Flexibility on Quality of Life in Inpatients with Schizophrenia / 정신간호학회지

PURPOSE: This study was conducted to explore psychological flexibility's mediating effect on the relationship between symptoms, social functioning and quality of life among inpatients with schizophrenia. METHODS: Participants were 190 inpatients with schizophrenia from five mental hospitals in three areas. Data were collected from self-report questionnaires administered from June to July 2018. Data were analyzed using Pearson's correlation coefficients and the Baron and Kenny method with IBM SPSS 22.0. RESULTS: Quality of life showed a positive correlation with psychological flexibility (r=.52, p < .001), but a negative correlation with symptoms (r=−.39, p < .001) and social functioning (r=−.42, p < .001). Psychological flexibility had a full mediating effect on the relationship between symptoms and quality of life. Psychological flexibility also showed partial mediating effects on social functioning and quality of life. CONCLUSION: The results suggest that psychological flexibility plays an important role in the quality of life of inpatients with schizophrenia. Therefore, mental health practitioners should focus on interventions to improve their social functioning and psychological flexibility to improve their quality of life.

Impact of Internalized Stigma, Anger Expression Style, and Mental Health Service Satisfaction on Self-esteem in Inpatients with Schizophrenia / 정신간호학회지

PURPOSE: This study was performed to identify how internalized stigma, anger expression style, and mental health service satisfaction impact on the self-esteem of inpatients with schizophrenia. METHODS: For this descriptive correlational study, 191 inpatients with schizophrenia participated. They had been admitted to one of six mental hospitals in three areas of South Korea. Data were collected from August 1 to November 30, 2016 using self-report questionnaires and data were analyzed using t-test, one-way ANOVA, Pearson correlation coefficients, and stepwise multiple regression with IBM SPSS 22.0. RESULTS: The significant predictors of self-esteem in inpatients with schizophrenia were internalized stigma, anger expression style, and mental health service satisfaction, explaining 36% of the variance in self-esteem. The most significant predictor of self-esteem in inpatients with schizophrenia was internalized stigma. CONCLUSION: Study findings suggest that a significant reduction in the internalized stigma of inpatients with schizophrenia increases their self-esteem. It is also, necessary to improve adaptive anger expression style and mental health service satisfaction.

Mucocele of the Nasal Septum: Case Report and Review of the Literature

Mucoceles are relatively common cystic lesions of the paranasal sinuses. However, mucocele of the nasal septum is extremely rare. We report a case of a mucocele present in this unusual location. Mucocele of the nasal septum should be considered in the differential diagnosis of a mass of the nasal septum and/or median canthal region. Nasal septal mucocele can be effectively treated with endoscopic marsupialization or complete excision.

Guillain-Barre Syndrome Presenting as Bilateral Vocal Cord Paralysis / 대한이비인후과학회지

Guillain-Barre syndrome (GBS) presenting as bilateral vocal cord paralysis is extremely rare. We report an unusual case of GBS in which the patient manifested hoarseness resulting from bilateral vocal cord paralysis. In conclusion, GBS needs to be considered as possible causes of new onset bilateral vocal cord paralysis. We emphasize that early recognition of atypical presentations of GBS warrants further evaluation and appropriate management.

A Case of Macroglossia due to Amyloidosis Associated with Multiple Myeloma / 대한이비인후과학회지

Amyloidosis is a condition of abnormal deposition of extracellular insoluble fibrillar proteins, termed amyloid, in tissue and organs throughout the body. Systemic amyloidosis, consisting of light amyloid protein (AL protein), the spectrum of multiple myeloma and plasmacytoma, is categorized as a primary amyloidosis; secondary amyloidosis consists of an acute phase reactant serum amyloid A protein (AA protein), which is associated with neoplasm. Amyloid involvement of the tongue is almost always secondary to systemic AL amyloidosis. Macroglossia due to amyloid depositions can lead to serious airway obstruction. We report a case of a 68-year-old woman suffering from dyspnea due to macroglossia. She was diagnosed with amyloidosis associated with multiple myeloma.

Nasopharynx Obstruction by Huge Nasal Polyp with Metaplastic Ossification

We present a case of huge nasal polyp with metaplastic ossification, which obstructed left nasal cavity and nasopharynx, and provoked both nasal obstruction and sleep apnea. The patient had a history of previous sinus surgery at local hospital 30 years ago. Nasal polyp with metaplstic ossification was removed by endoscopic sinus surgery. This case highlights the importance of including metaplastic ossification of nasal polyp in the differential diagnosis of nasal cavity mass.

Nasopharynx Obstruction by Huge Nasal Polyp with Metaplastic Ossification

We present a case of huge nasal polyp with metaplastic ossification, which obstructed left nasal cavity and nasopharynx, and provoked both nasal obstruction and sleep apnea. The patient had a history of previous sinus surgery at local hospital 30 years ago. Nasal polyp with metaplstic ossification was removed by endoscopic sinus surgery. This case highlights the importance of including metaplastic ossification of nasal polyp in the differential diagnosis of nasal cavity mass.

A Case of Vascular Leiomyoma of the Nasal Vestibule

Leiomyoma is a benign neoplasm that are thought to originate from the vascular smooth muscle. Leiomyoma more commonly found in the uterus, gastrointestinal tract, and skin. The nasal cavity is an uncommon site for a leiomyoma. We experienced a case of leiomyoma originating in the left nasal vestibule in a 64-year-old female. It was successfully removed by endoscopic surgery, and we report this case with a review of the related literatures.

A Case of Familial Adenomatous Polyposis Combined with Hepatocellular Carcinoma

Familial adenomatous polyposis (FAP) is an autosomal dominant disease characterized by formation of multiple colorectal adenomas with nearly 100 percent potential for malignant transformation. FAP is a rare condition with an incidence of 1 in 10,000 live births. Germline mutations in the adenomatous polyposis coli gene (APC) located on chromosome 5q21 have been founded in many patients with FAP. Patients with FAP can have extracolonic manifestations of their disease. These include tumors of the upper gastrointestinal tract (hamartomatous polyps, adenomas, carcinomas), small intestine adenomas or cacinoma, bile duct adenomas, papillary thyroid carcinoma, osteomas of the mandible, skull, and long bones, a variety of soft tissue lesions, including fibromas, lipomas, and desmoid tumors, congenital hypertrophy of the retinal pigment epithelium (CHRPE) and hepatoblastoma. Hepatocellular carcinoma combined with FAP is a very rare condition. Just 8 cases of Hepatocellular carcinoma with a history of FAP have been reported in the literature. We now present a report of a case of Hepatocellular carcinoma with FAP (Gardner's syndrome) in a 19 year-old girl.

Dissecting the molecular mechanism of nuclear receptor action: transcription coactivators and corepressors

No abstract available.

Action Mechanisms of Hormone Binding to Nuclear Receptors: Transcriptional Coregulators of the Nuclear Receptor Superfamily / 대한내분비학회지

No Abstract Available.

Clinical and Echocardiographic Outcome of Aortic Intramural Hemorrhage Compared with Acute Aortic Dissection

BACKGROUND: Aortic intramural hemorrhage (IMH), which presents clinical manifestations identical to acute aortic dissection, is suggested to have different pathology and pathophysiology. The purposes of this study were to diagnose IMH by transesophageal echocardiography (TEE) prospectively and to compare clinical and echocardiographic outcome of IMH with those of aortic dissection. METHODS: Between August 1991 and November 1996, 27 IMH and 73 acute aortic dissection were diagnosed using TEE in 202 consecutive patients with suspected aortic dissection. TEE diagnoses of IMH and aortic dissection were initially compared with computed tomography and magnetic resonance imaging and later confirmed by operative findings (n=39) or follow-up changes (n=12). RESULTS: In the 49 patients whose diagnosis was confirmed by operation or follow-up changes, the sensitivity and specificity for the diagnosis of IMH were 27 of 27 (100%) and 20 of 22 (91%), respectively. There were 11 deaths (15%) in acute aortic dissection and 1 death (4%) in IMH during follow-up of 1.7+/-1.5 years (p=NS). Stanford classification and types of treatment were not related to death in both groups. Complications were less frequently noted in IMH (3/27) than in acute aortic dissection (24/73) (p<0.001) and no death occurred in uncomplicated IMH who were medically treated. Follow-up study of 12 IMH patients showed 8 complete resolution, 3 regression, 1 progression. CONCLUSION: TEE is very useful in diagnosis of IMH and IMH has better outcome than the aortic dissection due to absence of communication and intimal tear.

Clinical and Echocardiographic Outcome of Aortic Intramural Hemorrhage Compared with Acute Aortic Dissection

BACKGROUND: Aortic intramural hemorrhage (IMH), which presents clinical manifestations identical to acute aortic dissection, is suggested to have different pathology and pathophysiology. The purposes of this study were to diagnose IMH by transesophageal echocardiography (TEE) prospectively and to compare clinical and echocardiographic outcome of IMH with those of aortic dissection. METHODS: Between August 1991 and November 1996, 27 IMH and 73 acute aortic dissection were diagnosed using TEE in 202 consecutive patients with suspected aortic dissection. TEE diagnoses of IMH and aortic dissection were initially compared with computed tomography and magnetic resonance imaging and later confirmed by operative findings (n=39) or follow-up changes (n=12). RESULTS: In the 49 patients whose diagnosis was confirmed by operation or follow-up changes, the sensitivity and specificity for the diagnosis of IMH were 27 of 27 (100%) and 20 of 22 (91%), respectively. There were 11 deaths (15%) in acute aortic dissection and 1 death (4%) in IMH during follow-up of 1.7+/-1.5 years (p=NS). Stanford classification and types of treatment were not related to death in both groups. Complications were less frequently noted in IMH (3/27) than in acute aortic dissection (24/73) (p<0.001) and no death occurred in uncomplicated IMH who were medically treated. Follow-up study of 12 IMH patients showed 8 complete resolution, 3 regression, 1 progression. CONCLUSION: TEE is very useful in diagnosis of IMH and IMH has better outcome than the aortic dissection due to absence of communication and intimal tear.