요통 동태손상증후군 설문지 개발 : 신뢰도 및 타당도 검증

박문석 경희대학교 대학원 2017 국내석사

Background : The lumbar movement system impairment syndromes(MSIS) questionnaire was developed to diagnose MSIS by asking an informant regarding person`s pain in a specific posture and person`s behavioral characteristics. Objectives : This study aimed to verify the reliability and validity of the lumbar MSIS questionnaire, and to conduct domestic demographic survey according to MSIS and Oswestry disability index(ODI) questionnaire. Methods : This study included 154 participants. First, participants completed the ODI questionnaire and the lumbar MSIS questionnaire. Next, MSIS test was conducted. Domestic demographic survey according to MSIS and ODI questionnaire was conducted. The internal consistency reliability of the lumbar MSIS questionnaire was analyzed by using Cronbach's alpha coefficient. The receiver operating characteristics curve(ROC curve) and Pearson correlation analyses were performed. Result : 1. Among the total 154 subjects, 97 subjects were diagnosed as MSIS. 40 subjects of extension rotation syndrome, 23 subjects of extension syndrome, 15 subjects of rotation syndrome, 12 subjects of flexion rotation syndrome, and 7 subjects of flexion syndrome were listed. 2. In the total 154 subjects of the ODI questionnaire, 95 subjects were less than 20 points, 54 subjects were in the range of 21 points to 40 points, 5 subjects were in the range of 41 points to 60 points, no subjects were 61 points or more. 3. When the item importance were not added up, Cronbach's alpha coefficient were 0.74 for flexion syndorme, 0.82 for extension syndrome, 0.77 for rotation syndrome. When the item importance were added up, Cronbach's alpha coefficient were 0.71 for flexion syndorme, 0.80 for extension syndrome, 0.78 for rotation syndrome. 4. When the item importance were not added up, area under curve(AUC) of ROC curve were 0.85 for flexion syndorme, 0.83 for extension syndrome, 0.81 for rotation syndrome. When the item importance were added up, AUC of ROC curve were 0.85 for flexion syndorme, 0.85 for extension syndrome, 0.81 for rotation syndrome. 5. When the item importance were not added up, Pearson correlation coefficient was 0.89. When the item importance were added up, Pearson correlation coefficient was 0.90. conclusion : 1. Reliability was verified with the Cronbach`s alpha coefficient. 2. Validity was verified by ROC curve between the MSIS test and the lumbar MSIS questionnaire, and the cut-off values ​​applicable to the clinic were calculated through sensitivity and specificity analysis. 3. Validity was verified by Pearson correlation coefficient between ODI questionnaire and the lumbar MSIS questionnaire. 4. The improvement of the validity was confirmed when the item importance were added up.

부모 성찰기능 척도와 청소년 성찰기능 척도의 타당화 및 적용 연구 : 청소년의 심리사회적 적응과의 관련성을 중심으로

박민경 서울여자대학교 특수치료전문대학원 2019 국내박사

본 연구는 부모 성찰기능과 청소년 자녀의 성찰기능간의 관계를 살펴보고자 하였다. 이러한 목적으로 본 연구에서는 먼저 Luyten 등(2017)이 개발한 ‘부모 성찰기능 척도’와 Duval 등(2018)이 타당화한 ‘청소년 성찰기능 척도’를 타당화하여 그 적용 가능성을 살펴보았다. 다음으로 타당화한 두 척도를 바탕으로 어머니의 성찰기능과 청소년 자녀의 성찰기능의 관계를 탐색해 보기 위한 연구를 추가적으로 실시하였다. 연구 1에서는 부모 성찰기능 척도를 한국어로 번안하여, 만 12-18세 자녀를 가진 어머니를 대상으로 한국판 부모 성찰기능 척도의 신뢰도와 타당도를 검증하였다. 연구결과 2문항이 제외된 총 16문항이 원척도와 동일한 3개의 요인을 통해 확인되었으며, 신뢰도가 확보되었다. 관련 변인들과의 상관을 통해 준거타당도를 검증되었으며, 한국판 부모 성찰기능 척도가 국내에 적용 가능한 신뢰로운 도구임을 확인하였다. 연구 2에서는 청소년 성찰기능 척도를 한국어로 번안하여, 만 13-21세 청소년들을 대상으로 한국판 청소년 성찰기능 척도의 타당도와 신뢰도를 검증하였다. 연구결과, 5문항이 제외된 총 20문항이 원척도와 동일한 3개의 요인구조가 확인되었다. 하위 요인 가운데 관심/호기심 척도의 경우 타인에 초점을 둔 문항들로 구성됨에 따라 원척도와 다르게 ‘타인의 마음상태에 대한 관심/호기심’으로 명명하였는데, 문화에 따른 차이가 한국 청소년의 성찰기능에 반영된 것으로 해석하였다. 신뢰도를 비롯하여 관련 변인들과의 상관을 통해 준거타당도가 검증되었다. 연구 3에서는 연구 1, 2에서 타당화한 두 척도를 바탕으로 어머니의 성찰기능과 청소년 자녀의 성찰기능의 관계를 살펴보았다. 특히 어머니의 성찰기능이 자녀의 심리사회적 적응에 미치는 영향에 자녀의 성찰기능의 매개효과를 살펴보았다. 연구 결과, 어머니의 성찰기능 가운데 부정적 특성을 나타내는 비정신화는 자녀의 성찰기능 및 적응에 부정적인 영향을 미치는 것으로 확인되었다. 긍정적 양육태도와 관련되었던 확실성과 관심/호기심 척도는 다소 상이한 결과가 나타났는데, 어머니 확실성이 주로 자녀의 적응과 긍정적인 성찰기능과 관련이 있었다. 반면 관심/호기심은 자녀의 관심/호기심에 영향을 미쳤으나, 불확실성/혼란과 심리사회적 부적응에도 영향을 미치는 것으로 나타났다. 본 연구는 성찰기능척도의 가장 최근 버전인 부모 성찰기능 척도와 청소년 성찰기능 척도를 타당화하여 국내에서의 적용가능성을 확인하였으며, 어머니와 청소년 자녀의 관계를 성찰기능의 측면에서 살펴보았다는 점에서 의의가 있다. 마지막으로 연구의 제한점과 후속연구를 위한 제언을 논의하였다. This study was conducted to look into relations between the reflective functioning of parents and their teenaged children. For the purpose, validation was sought regarding ‘The Parental Reflective Functioning Questionnaire for Adolescents(Luyten et al., 2017)’ and ‘The Reflective Functioning Questionnaire for Youth(Duval et al., 2018)’ in order to understand the possibility of applying them. Based on these two validated questionnaires, an additional study was executed to investigate relations between the parental reflective functions of mothers and those of their juvenile children. For study 1, The Parental Reflective Functioning Questionnaire was translated into the Korean language to verify the reliability and validity of the Korean-version parental reflective functioning questionnaire regarding mothers of children aged 12-18. According to the study, a total of 16 questions, excluding two questions, were confirmed through three factors that were the same as the original questionnaire and the reliability was secured. Criterion-related validity was verified through connection with related variables. Accordingly, the Korean-version parental reflective functioning questionnaire was confirmed as a reliable scale applicable to Korean people. For study 2, The Reflective Functioning Questionnaire for Youth was translated into the Korean language to verify the reliability and validity of the Korean-version reflective functioning questionnaire for youth about adolescent aged 13-21. According to the study, three factor structures that were the same as the original questionnaire were confirmed in a total of 20 questions, excluding five questions. In the case of the questionnaire about interest and curiosity, the questionnaire was formed with questions focused on other persons and it was named ‘interest/curiosity about the mental states of others’, which was different from the original questionnaire. This apparently was because differences related to culture were reflected in the Korean adolescent reflective function. Criterion-related validity was verified through connection with related variables, including reliability. For study 3, efforts were made to understand relations between the parental reflective functions of mothers and those of their juvenile children based on the two questionnaires validated in studies 1 and 2. Particularly, mediated effects of children were studied regarding the influence of mothers’ reflective functions on the reflective functions of their teenaged children. According to the study, pre-mentalizing in mothers’ reflective functions that reveal adverse features had negative effects on children’s reflective functions and adjustment. Certainty and the interest/curiosity related to positive fostering attitudes showed somewhat different results and, in this case, maternal certainty mostly was connected with adolescent’s adjustment and positive reflective functions. In comparison, mother’s interest/curiosity affected adolescent’s interest/curiosity but affected their uncertainty/ confusion and psychosocial maladjustment as well. This study focused on validating the latest versions of the parental reflective functioning questionnaire and the reflective functioning questionnaire for youth and sought to confirm the possibility of applying them to Korean people. This is meaningful in that relations between mothers and their juvenile children were studied in terms of reflective functions. Finally, discussions were conducted about the limitations of those studies and suggestions for follow-up studies were made.

화병군과 건강군의 호흡기능 비교와 변증 설문의 상관성 연구

강은영 경희대학교 대학원 2019 국내석사

Objective In Korean medicine, breathing is an important factor in health and is related to the body and mind. Hwa-Byung refers to an anger syndrome and includes both mental and physical symptoms. There have been no studies of the relationship between Hwa-Byung and respiratory function. In the present study, we compared the respiratory function of Hwa-Byung and healthy groups, and examined the association between hyperventilation and various pathological patterns. Methods Respiration was measured in 34 Hwa-Byung patients and 33 healthy participants. Respiration was measured using a capnometer and a nasal thermistor. The Hwa-Byung Questionnaire (HBQ), the Nijmegen Questionnaire (NQ, Korean version), and questionnaires to assess Cold-Heat, Seven Emotions, Lao Juan, Phlegm, Food retention, Blood stasis, and Yin Deficiency patterns were used. For statistical analysis, the Mann-Whitney U test was used for comparison between groups and the Spearman coefficient was used for correlation analysis in each group. Conclusion 1. There was a difference in Negative peak variability in respiration in the Hwa-Byung and healthy groups. 2. There was a significant difference between the two groups in terms of HBQ, KNQ, and all pathological pattern questionnaires. 3. The respiratory function in the Hwa-Byung group showed a correlation with HBQ, Seven Emotions, Lao Juan, Phlegm, and Yin Deficiency patterns, and the respiratory function in the healthy group showed a correlation with HBQ, KNQ, Lao Juan, Phlegm, Food retention, Blood stasis, and Yin Deficiency pattern questionnaires. Key words Hwa-Byung, Respiratory function, Respiratory variability, Nijmegen Questionnaire, Pattern Questionnaire, Cold-Heat Questionnaire, Seven Emotions Questionnaire, Lao Juan Questionnaire, Phlegm Questionnaire, Food retention Questionnaire, Blood stasis Questionnaire, Yin Deficiency Questionnaire

편두통 환자에서 광공포증 설문지의 유용성

최정윤 고려대학교 대학원 2009 국내석사

Photophobia is an important criterion for the diagnosis of migraine. However, several Asian epidemiologic surveys about migraine showed lower prevalence of photophobia than that of Western studies. This discrepancy is probably caused by underestimation of photophobia due to inappropriate questioning of patients by physicians. To investigate this issue, we developed a questionnaire about photophobia and evaluated its usefulness in 103 patients with migraine. In phase 1 of the study, we found good repeatability of the questionnaire with a 0.826 kappa coefficient. In phase 2 of the study, the prevalence of photophobia from interviews and that from the questionnaire were compared. The prevalence of interview-documented photophobia was 51.5% and questionnaire-documented photophobia was 82.5% (p<0.001). In phase 3, we attempted to make a short-form questionnaire with the same detection power of the whole questionnaire. Two short-form questionnaires were identified as a useful method for detecting photophobia. The prevalence of photophobia could be underreported via interview, especially in Asian migraineurs. Using this questionnaire to test for photophobia, the diagnostic rate of photophobia and migraine could be improved. 광공포증은 편두통 진단에 있어 중요한 인자이다. 그러나 아시아인을 대상으로 하는 많은 편두 역학조사에서는 서양인을 대상으로 하는 연구에서 보다 상대적으로 낮은 빈도의 광공포증이 관찰되고 있다. 이와 같은 광공포증의 저 평가는 환자에 대한 올바르지 못한 질문에 기인한 것으로 추정된다. 저자는 이에 대한 적절한 평가를 위하여 8개의 질문으로 구성된 광공포증 설문지를 작성하였으며, 이를 103명의 편두통 환자를 대상으로 하여 유용성을 평가하였다. 첫 번째 분석에서 광공포증 설문지의 적절한 재현성을 확인할 수 있었다. 두 번째 분석에서는 인터뷰와 설문지에 의한 광공포증의 양성률을 비교하였고 인터뷰에 의한 양성률 (51.5%) 에 비하여 설문지의 양성률 (82.5%) 이 유의하게 높은 것을 확인하였다. 또한 세 번째 분석에서는 전체 광공포증 설문지와 동일한 양성률을 가지는 축소된 설문지 또는 질문의 조합을 확인하고자 하였으며, 각각 3개의 질문으로 구성된 2개의 축소된 설문지가 도출되었다. 본 연구는 아시아의 편두통 환자에서 짧은 인터뷰를 통해서는 광공포증의 존재가 저평가될 수 있음을 확인하였다. 또한 설문지를 이용하면 광공포증의 양성률 및 편두통의 진단률을 향상시킬 수 있을 것이다.

CALIBRATION AND VALIDATION OF THE BODY SELF-IMAGE QUESTIONNAIRE USING THE RASCH ANALYSIS

정혁 The University of Georgia 2005 해외박사

본 연구에서는 Rasch 분석을 이용하여 신체자아상 설문지(the Body Self-Image Questionnaire)의 심리측정학적 특성을 검사하였다. 문항반응이론의 범주에 속하는 Rasch 분석의 적용은 전통적 검사 이론이 갖는 문제점인 서열척도 자료를 이용한 총점 계산의 부적절성 그리고, 상호 의존적인 문항 난이도와 피험자 능력수준의 산출과정 등을 해결하는 것으로 알려져 왔다. 신체자아상 설문지는 신체상과 연관된 9개 요인을 측정하는 39개 문항으로 구성되어 있고 5점 리커트 척도가 반응범주로 사용되었다. 설문에 참가한 학부생 1,021명의 문항반응을 분석하였다. 신체자아상 설문지를 통해 수집된 문항반응을 요인에 따라 9개의 하위척도로 나누었으며, 각 하위척도별로 Rasch 분석방법의 한 종류인 평정척도 모형을 이용하여 반응범주의 기능과 문항의 적합성을 검사하였다. 초기 Rasch 분석을 통해 비만평가(Fatness Evaluation), 사회 종속성(Social Dependence), 신장 불만(Height Dissatisfaction), 그리고 이상적 투자(Investment in Ideals) 등 네 개의 하위척도에서 반응범주의 부적합성이 발견되었다. 최적 범주화에 의해 세 번째와 네 번째 선택보기인 ‘중간정도 사실이다’와 ‘대부분 사실이다’를 병합한 4점 서열척도가 부적합성을 보인 네 개 하위척도에 적합한 것으로 나타났으며, 다른 5개의 하위척도에는 기존의 5점 리커트 척도가 적합한 것으로 나타났다. 문항검사에서는 39개 문항 중 3개의 문항이 적합도 기준을 벗어났으며 이들 문항은 차후 분석에서 제외되었다. 다음 단계로 1,021명을 포함하는 전체 표본에서 510명을 무선표집하여 타당도검사를 위한 표본을 구성하였으며, 수정된 반응범주와 선택된 문항을 타당도검사 표본을 이용하여 재분석하였다. 반응범주 기능은 신장 불만 요인을 제외한 다른 모든 하위척도에서 초기 Rasch 분석과 유사한 결과를 나타났다. 문항 난이도의 구조는 전체 표본을 이용한 분석에서 얻어진 계층적 순서와 동일하였다. 또한, 구인타당도 검사를 위해, 피험자를 신체질량지수(BMI) 점수에 따라 저체중, 정상, 과체중 등 세 집단으로 나누었다. Rasch 분석을 통해 동간성 자료로 변환된 로지트 점수를 이용하여 각 집단의 신체자아상 만족도를 각 하위척도별로 비교하였다. 세 개의 하위척도에서 유의한 차이가 발견되었으며 나머지 하위척도에서도 저체중 집단은 높은 신체상 만족도를 반영하는 반응을 선택하는 반면, 과체중 집단은 낮은 만족도를 반영하는 반응을 선택하는 경향을 보였다. 이러한 결과는 신체자아상 설문지를 통해 얻어진 서열척도 자료가 평정척도 모형을 이용한 분석에 적합하며 또한, 평정척도 모형이 문항과 피험자를 각 난이도와 만족수준에 따라 효과적으로 판별하는데 효과적임을 의미한다. 결론적으로 평정척도 모형은 서열척도에서 얻어진 자료를 변환시켜 동간성을 부여하고, 신체자아상 설문지의 선택범주 기능을 실험적으로 검사하는 방법을 제공하며, 그리고 문항과 피험자를 각각의 난이도와 만족도에 따라 단일선형척도 상에서 비교할 수 있는 등의 장점을 제공한다. The purpose of this study was to calibrate and validate the Body Self-Image Questionnaire using the Rasch analysis. The data from 1021 undergraduate students were used for this study. The Body Self-Image Questionnaire consists of 39 items under the nine factors related to the body image construct and a Likert-type five-point response scale for each item. The data from each subscale of the questionnaire were initially calibrated using the rating scale model for investigating category function and item structure. Violations in category function were found from the initial calibrations for the fatness evaluation (FE), social dependence (SD), height dissatisfaction (HD), and investment to ideals (Ⅱ) subscales, and the optimal categorization was determined for those subscales. The collapsed four-point categorization obtained by combining categories three and four functioned better than other combinations for the FE, SD, HD, and Ⅱ subscales and the original categorization was retained for the other subscales. Three misfitting items were also identified and deleted from corresponding subscales for further analysis. The revised categorization and item structure were cross-validated using a validation sample (n=510) randomly selected from the total sample. Similar patterns of categorization were observed and confirmed except for the categorization for the HD subscale. Hierarchical orders of item difficulties for the validation sample were identical to the total sample. To Provide evidence of construct validity, three groups were formed based on body mass index (BMI) scores and the means in logits for the three BMI-based groups were compared and contrasted. Overall discrimination among groups for each subscale was effective. The result showed that the underweight BMI group tended to endorse categories indicating higher satisfaction with body image while the overweight BMI group tended to endorse categories indicating lower satisfaction with body image. The findings from these analyses supported that the data fitted the rating scale model well in terms of fit statistics, and the rating scale model adequately contrasted items and participants according to their measures in logits. The rating scale model provided a way to transform the ordinal data into interval and to investigate the category function of Body Self-Image Questionnaire.

과호흡 유형과 병증 및 감정, 피로에 따른 호흡변이도의 특성 연구

김선애 경희대학교 대학원 2017 국내석사

Background : It is well known that respiratory variability can be a physiological and pathological index, reflecting the flexibility of the body and evaluating the stability of the respiration. Objectives : The present study aimed to investigate various aspects of respiratory variability using hyperventilation provocation test(HVPT) and several Questionnaires. Methods : Twenty-six healthy subjects underwent a hyperventilation provocation test(HVPT) while simultaneously measuring respiratory variability. They were asked to complete Nijmegen Questionnaire, cold–heat pattern questionnaire, phlegm pattern questionnaire, Yin deficiency scale, Lao Juan (劳倦) questionnaire, K-POMS, Chalder Fatigue Scale. The Mann-Whitney U test was used to verify the difference in respiratory variability between normal and control subjects. and Pearson correlation analysis between the questionnaires and respiratory variability was performed. The Questionnaires were formed of several factors so each factor and respiratory variability were also analyzed. Conclusion : 1. In the Symptomatic hyperventilation group, negavariate was significantly higher than the control group during recovery. 2. There was no significant result in the chemical hyperventilation group. 3. In Respiratory periodic hyperventilation groups, posivariate, respiravariate, pvdiffervariate were significantly higher than the control group during recovery. 4. In the correlation study between K-POMS and respiratory variability, there was a positive correlation between posimean and pvdiffermean in the factor 2(active and comfortable) during baseline. there was a negative correlation between negamean in the factor 2 during baseline. 5. In the correlation study between phlegm pattern and respiratory variability, there was a positive correlation between posivariate and factor 1(Neuropsychology) during hyperventilation. there was a positive correlation between negamean and factor 2(Respiratory system) during recovery. 6. In the correlation study between Lao Juan(劳倦) and respiratory variability, there was a positive correlation between posivariate and factor 2(Overwork) during hyperventilation. 7. In the correlation study between CFS and respiratory variability, there was a positive correlation between total score of CFS and posivariate during hyperventilation. also, there was a positive correlation between factor 1(physical) and posivariate during hyperventilation. 8. In the correlation study between Nijmegen Questionnaire and respiratory variability, there was a positive correlation between total score of NQ and posivariate during hyperventilation. and there was a positive correlation between posivariate and factor 1(Neuropsychology) during hyperventilation. also, there was a positive correlation between posivariate and factor 2(Respiratory system) during hyperventilation. and there was a positive correlation between posivariate and factor 4(Neuromuscular) during hyperventilation.

젊은 성인에서 한글판 patient health questionnaire-9의 유용성 평가

윤서영 고려대학교 대학원 2013 국내석사

연구 목적 Patient health questionnaire-9(PHQ-9)은 우울장애의 자가 보고형 평가척도로, 본 연구에서는 한글판 PHQ-9의 젊은 성인군에서의 신뢰도와 타당도를 평가하고 그 유용성을 밝히고자 하였다. 연구 방법 고려대학교 의과대학에 재학중인 학생들을 대상으로 하여, 자가 보고형 평가 척도인 PHQ-9, Beck depression inventory(BDI), Patient health questionnaire-15(PHQ-15), Beck anxiety inventory(BAI), Perceived stress scale(PSS)와 인구 사회학적인 자료 수집을 위한 설문문항에 답하도록 하였다. 수집된 자료를 토대로 PHQ-9의 신뢰도와 타당도를 평가하였으며, 요인분석을 시행하였다. PHQ-9 코딩 알고리즘에 따라 참여자를 진단군에 따라 분류하였으며, 진단별 분류와 PHQ-9, 인구사회학적 변수와의 연관관계를 평가하였다. 연구 결과 본 연구에서 PHQ-9의 Cronbach’s alpha 값은 0.837로 나타났으며, 검사-재검사 신뢰도는 0.65로 나타나 젊은 성인군에서 신뢰성이 있는 검사임을 보였다. PHQ-9은 BDI, PHQ-15, BAI, PSS와 임상적으로 유의한 상관관계를 보여(순서대로, 0.721, 0.604, 0.712, 0.660) 외적 타당도를 입증하였다. 요인 분석에서 PHQ-9은 3개의 요인구조를 보였으며, 제 1요인은 부정적인 정서와 인지 요인, 제 2요인은 신체 증상 및 생장증상, 제 3요인은 주의집중의 어려움과 정신운동성 초조 혹은 지체로 나타났다. 참여자들의 PHQ-9 평균점수는 5.80 ±4.59으로 나타났으며, 148명(85.1%)이 비우울장애군, 26명(14.9%)이 우울장애군으로 분류되었으며, 우울장애군은 7.5%의 주요우울장애군과 7.5%의 기타 우울장애군으로 나뉘어진다. 결론 본 연구는 한글판 PHQ-9이 젊은 성인의 우울증상을 평가하는데 있어 신뢰성과 타당성이 있는 유용한 도구임을 밝혔으며, 이러한 결과는 한글판 PHQ-9이 좀 더 넓은 범위의 인구 군에서 적용하기에 적합하다는 점을 지지한다. Objectives Patient health questionnaire-9(PHQ-9) is a self-report inventory for depression. The aim of this study was to evaluate the validity and reliability of the Korean version of the PHQ-9 in Korean young adults. Methods The PHQ-9, Beck depression inventory(BDI), Patient health questionnaire-15(PHQ-15), Beck anxiety inventory(BAI), Perceived stress scale(PSS) and the survey questionnaires for demographic information were administered to 174 college students(male 96; female 78). Inter-item correlation, test-retest correlation, and convergent validity were tested. Factor analysis among the items were performed. The diagnostic subgroups were classified according to PHQ-9 coding algorithm and their relationship between PHQ-9 score and between demographic variables were assessed. Results The Cronbach’s alpha coefficient of the Korean version of the PHQ-9 was 0.84 and test-retest reliability coefficient was 0.65. The convergent validity with BDI, PHQ-15, BAI, PSS was significantly positive (0.72, 0.60, 0.71, 0.66, respectively). The factor analysis of the PHQ-9 yielded 3 factors. Factor 1 represented ‘negative affect and cognition’, factor 2 represented ‘somatic and vegetative symptoms’ and factor 3 represented ‘concentration difficulty, psychomotor retardation or agitation’. The mean score of the PHQ-9 reported in this sample was 5.80 ±4.59. The 148(85.1%) subjects were rated as non-depressive group and 26(14.9%) subjects were rated as depressive group, 7.5% as other depressive group and 7.5% as major depressive group respectively. Conclusions This study suggests that the Korean version of PHQ-9 is a reliable and valid tool for assessing depression in young adults. These results support the use of PHQ-9 in large sections of the population in Korea.

과호흡 유형에 따른 병증과 감정 특성 및 호흡기능 분석

윤우석 경희대학교 대학원 2017 국내박사

Objective Hyperventilation is affected by physical and mental conditions. Therefore, it is important to consider physical and mental factors in assessing hyperventilation. However, no study has examined the effect of the Nijmegen Questionnaire(NQ) and PCO2 on the respiration rate. Therefore, in this study, we examined the differences in the effects of the results of NQ and PCO2 on the respiratory rate. Methods Twenty healthy men and women were to complete NQ and Chalder Fatigue Scale(CFS), Cold-Heat pattern, Phlegm, Lao Juan Questionnaire, Korean-Profile of Mood States(K-POMS) aimed at subjects (13 men, 12 women). The subjects were divided into four groups according to NQ and PCO2. By attaching a capnograph to the nasal cavity portion, PCO2 was measured. Also, markers were attached at Zhangmen, Juque, Shuifen. The movement of the markers were taken by a web camera. For statistical analysis Mann Whitney U test was used for the nonparametric methods. Results & Conclusion The group with high scores of NQ showed a tendency of cold, Phlegm, Lao Juan compared with the other groups, and showed more mental fatigue in CFS and K-POMS. In addition, the normal group with low NQ score tended to be more abdominal respiration than the other groups, and respiratory variation was also stable. In conclusion, the NQ has a greater influence on the evaluation of hyperventilation than PCO2. Therefore, the results of this study suggest that NQ and PCO2 are used simultaneously in evaluating and evaluating hyperventilation.

급성 단순 하부 요로 감염증 여성에서 일반 증상의 유병율 및 강도

양희조 순천향대학교 대학원 2007 국내석사

Purpose: Although acute uncomplicated lower urinary tract infection (UTI) is relatively common and a risk factor for lower urinary tract symptoms (LUTS), there have been a few studies on LUTS related to this infection. A well-designed symptom questionnaire regarding acute uncomplicated lower UTI will be able to provide criteria for clinical workup and thus help evaluate treatment outcomes of this disease. The aim of this study was to assess characteristic symptoms in female patients with acute uncomplicated lower UTI using a symptom questionnaire designed at our clinic. Materials and Methods: Routine urinalysis and urine cultures were performed in 310 who had visited our clinic between January 2005 and June 2006. Of these patients, 172 who had pyuria (mean age, 47.4 ± 15.3 years) were screened for major symptoms using the questionnaire. The questionnaire included 4 categories of symptoms (14 symptoms): LUTS (frequency, urgency, hematuria, and sense of residual urine), local symptoms (pressure on genital area and low back pain), general symptoms (unwell, weak and tired, irritable, feeling hot, shivers, and nausea), and pain-related symptoms (low abdominal discomfort and dysuria). The severity of symptoms was rated on a 4-point scale from 0 (no symptom) to 3 (severe symptom). The severity of symptoms was compared with the results of routine urinalysis and urine cultures. Results: Urine cultures were positive in 107 (62.2%) of total 172 patients. The most frequent and distressing symptom was dysuria, a pain-related symptom (89.0%, 1.78 points). Frequency was most common among LUTS (71.5%), and unwell was most common among general symptoms (87.2%). In patients who were positive for urine cultures, the occurrence rate of low abdominal discomfort (81.3%, p=0.038) and irritability (72.9%, p=0.026) were significantly higher than that of other symptoms. There was no significant difference in LUTS according to the patient's age. Conclusion: We assessed distressing symptoms in female patients with acute uncomplicated lower UTI using a questionnaire designed at our clinic. The questionnaire may be useful to assess duration and relief time of LUTS and to determine the progress and treatment outcomes of lower UTI. Further studies using an internationally acceptable symptom questionnaire will be required to investigate the effects of lower UTI on LUTS and the adjacent organs. 여성에서 급성 단순 하부요로 감염은 흔하나, 이와 연관된 하부요로 증상의 표준화된 연구는 부족한 실정이다. 급성 단순 하부요로감염에 사용할 수 있는 증상점수표가 있다면, 증상을 객관화하고 질환의 진행과 치료효과를 평가하는데 유용하게 사용될 수 있을 것이다. 2005년 1월부터 2006년 6월까지 급성 단순 하부요로 감염증상으로 비뇨기과 외래에 내원한 전체 310명의 성인 여성을 대상으로 일반 뇨검사와 요배양 검사를 실시하였고, 이중 농뇨가 있는 172명 (평균 47.4±15.3세)을 대상으로 불편한 증상에 대해 자체 제작한 설문지를 통하여 조사하였다. 설문지는 4가지 범주로 1.하부요로 증상 (빈뇨, 요절박, 육안적 혈뇨, 배뇨후중감), 2.국소증상 (성기부위 통증, 요통), 3.전신 증상 (불쾌감, 쇄약감, 짜증, 열감, 오한, 구역감) 4.통증 관련 증상 (배뇨통, 하복부 불쾌감)의 14가지 증상으로 구성되었으며 증상의 정도는 4등급으로 나누어 증상이 없는 경우를 0점, 심한 경우를 3점으로 하였다. 각각 증상의 정도와 요 배양 검사와의 관계 및 나이에 따른 증상의 차이를 비교 분석하였다. 총 172명의 환자 중 요배양 검사 양성은 107명 (62.2%)에서 나타났고, 환자들이 가장 많이 응답하고 가장 불편해 하는 증상은 통증과 관련된 배뇨통 (89.0%, 1.78점)이었다. 하부 요로 증상으로는 빈뇨 (71.5%)를, 전신 증상으로는 불쾌감 (87.2%)을 가장 많이 호소하였다. 요 배양 양성군에서는 하복부 불쾌감 (81.3%, p=0.038)과 짜증 (72.9%, p=0.026)이 유의하게 많았다. 나이에 따른 증상의 차이는 보이지 않았다. 여성의 급성 단순 하부요로 감염에서 증상 점수표를 이용하여 환자가 가장 불편해 하는 증상을 정량화 할 수 있었으며, 앞으로 증상의 지속 시간 등을 조사하여 감염질환의 진행 및 치료 경과를 평가하는 데에도 이용될 수 있을 것으로 생각된다.

Cross-cultural adaptation and validation of a Korean version of the work, osteoarthritis or joint-replacement questionnaire

이규완 Graduate School, Yonsei University 2021 국내박사

본 연구에 참여한 대상자는 퇴행성 및 외상성 통증으로 인해 무릎 손상 진단을 받은 110명의 환자가 참여하였다. 설문지를 완성하지 못한 23 명의 환자는 제외되었고 최종적으로 87명의 대상자 (여성 71명, 남성 16명)가 연구에 참여하였다. 이 연구는 두 단계로 진행되었다. 첫 번째로는 영문으로 개발된 WORQ의 원본을 국내 임상 현장과 연구 분양에서 적합하게 사용할 수 있도록 역번역 방법을 사용하여 체계적으로 한국어로 번역한 후 번역 적합성을 검증하였다. 두 번째로는 번역된 K-WORQ의 임상적 적용을 통한 신뢰도와 타당도를 확인하는 과정을 진행하였다. K-WORQ의 임상계측학적 질을 평가하기 위해서 내적 일관성 (크론바하의 알파), 신뢰도 (급간 내 상관 계수) 검사를 시행하였고, 동시 타당도 (스피어만의 상관 계수) 검사와 요인분석을 통해 설문지의 주요 구성 요소 및 구성 타당도를 확인하였다. 본 연구 결과, 내적 일관성과 급간 내 상관 계수에서 K-WORQ의 신뢰도가 매우 우수한 것으로 나타났다. K-WORQ는 Korean Western Ontario and McMaster Universities Osteoarthritis Index (K-WOMAC)와 강한 양의 상관 관계를 가졌으며 요인 분석에서 세 가지 요소 (힘든 작업, 무릎 협응조절, 과도한 무릎 굽힘)가 추출되었다. 본 연구결과를 바탕으로 K-WORQ는 무릎 기능 손상 환자의 신체적 어려움을 평가하기에 적합한 신뢰도와 타당도를 갖춘 평가도구임이 증명되었다. The Work osteoarthritis or joint-replacement questionnaire (WORQ) was developed to assess the physical difficulty experienced in patients with a knee dysfunction in the Netherlands. The assessment tool developed in other countries should be translated into the Korean language using rigorous methodological approaches in order to be used in Korea. Also, it needs to establish the cross-cultural and linguistic equivalence and statistical methods. The aim of this study was to translate the Work osteoarthritis or joint-replacement questionnaire into Korean (K-WORQ) and to verify its reliability and validity. A total of 110 patients who were diagnosed with a knee injury including degenerative and traumatic knee pain recruited in this study. Twenty-three patients who were not able to complete the questionnaires were excluded, and 87 patients (female=71; male=16) were enrolled. This study was divided into two stages. First, the original (English) version of the WORQ was translated into the Korean language by means of a back-translation method. Second, the translated version was tested for reliability and validity. The internal consistency (Cronbach’s alpha) and reliability (intra-class correlation coefficients) of the K-WORQ were evaluated. In addition, the concurrent validity of the K-WORQ were tested by comparing with the Korean Western Ontario and McMaster Universities (K-WOMAC) Osteoarthritis Index using the Spearman’s correlation coefficient. Factor analysis was carried out to identify the principal components of the questionnaire. Both the internal consistency and intra-class correlation coefficients showed the reliability of the K-WORQ to be excellent. The K-WORQ had a strong positive correlation with the K-WOMAC and three components (heavy work, knee coordination, excessive knee flexion) were extracted in factor analysis. Based on these results, the K-WORQ is a reliable, valid, and suitable questionnaire for assessing the disability levels of patients with knee injuries.