Surgical impact on anxiety of patients with breast cancer: 12-month follow-up prospective longitudinal study

Jiyoung Kim,Juhee Cho,Se Kyung Lee,Eun-Kyung Choi,Im-Ryung Kim,Jeong Eon Lee,Seok Won Kim,Seok-Jin Nam 대한외과학회 2020 Annals of Surgical Treatment and Research(ASRT) Vol.98 No.5

Purpose: Breast cancer diagnosis and treatment often produce stress in patients. Anxiety is one of the most prevalent psychological symptoms perceived by breast cancer patients. This study aims to evaluate the temporal patterns of anxiety and find factors associated with persistent anxiety during breast cancer treatment. Methods: This is prospective cohort study. Between July 2010 and July 2011, we recruited patients with nonmetastatic breast cancer who were expected to receive adjuvant chemotherapy (n = 411) from 2 cancer hospitals in Seoul, Korea. Anxiety was measured using the Hospital Anxiety and Depression Scale. Results: The mean age of the participants was 46.4 ± 7.9 years. Preoperatively, 44.5% (183 of 411) of the patients showed abnormal anxiety. The proportion of the abnormal anxiety group significantly decreased after surgery (P < 0.01) and this phenomenon continued until the 12-month follow-up point. Patients experienced renewed anxiety at 12 months when the main adjuvant therapies were finished. Socioeconomic factors were not associated with persistent anxiety. Pain, breast, and arm symptoms were significantly higher in the persistently abnormal group, especially at postoperative months 6 and 12. Conclusion: Surgery was a major relieving factor of anxiety, and patients who finished their main adjuvant treatment experienced renewed anxiety. Surgeons should be the main detectors and care-givers with respect to psychological distress in breast cancer patients. To reduce persistent anxiety, caring for the patient’s physical symptoms is important.

Anxiety attacks with or without life-threatening situations, major depressive disorder, and suicide attempt: a nationwide community sample of Korean adults

Kim, Hyewon,Choi, Kwan Woo,Na, Eun Jin,Hong, Jin Pyo,Fava, Maurizio,Mischoulon, David,Cho, Hana,Jeon, Hong Jin Elsevier 2018 Psychiatry Research Vol.270 No.-

<P><B>Abstract</B></P> <P>Regardless of categorical diagnosis, many psychiatric patients suffer from sudden attack of fear or intense anxiety. In this study, we defined anxiety attacks to refer to these phenomena and investigated their association with depression and suicide attempts. A total of 12,532 adults randomly selected population through the one-person-per-household method completed a face-to-face interview using the Korean version of Composite International Diagnostic Interview (K-CIDI). A total of 5.88% reported to have experienced anxiety attacks. Among them, 46.5% reported to have experienced anxiety attacks without life-threatening situations. ‘Anxiety attacks’ group reported more suicidal ideation, plan, and attempts, which were even higher frequencies in ‘anxiety attacks without life-threatening situations’ group than ‘anxiety attacks only with life-threatening situations’ group and showed stronger association with lifetime suicide attempts when it had comorbid major depressive disorder (MDD) (AOR = 9.69, 95%CI 5.90–15.90), compared with ‘never’ group. There was no association between each symptom of patients with anxiety attacks and their lifetime suicide attempt. In conclusion, the finding suggests that there are as many individuals who experience anxiety attacks without life-threatening situations as those with life-threatening situations. And anxiety attacks appear to be relevant to an increased risk of suicide attempt, especially without life-threatening situations and with comorbid MDD.</P> <P><B>Highlights</B></P> <P> <UL> <LI> An anxiety attack means “a sudden attack of fear or intense anxiety”. </LI> <LI> Many people experienced anxiety attacks even without life-threatening situations. </LI> <LI> Anxiety attacks were relevant to an increased suicide risk, especially without life-threatening situations and with comorbid MDD. </LI> </UL> </P>

임상실습전 간호학생의 불안과 대응양상과의 관계

허혜경 연세대학교 원주의과대학 1997 원주의대논문집 Vol.10 No.1

Effects of shirodhara in generalized anxiety disorder

Rastogi, Sanjeev,Baiswar, Antriksha,Nischal, Anil,Srivastava, Prem Swarup,Nischal, Anuradha Cellmed Orthocellular Medicine and Pharmaceutical 2016 셀메드 (CellMed) Vol.6 No.4

Anxiety is a common clinical presentation. Primary anxiety poses a significant problem in its management. Many among the current treatment options of anxiety are habit forming causing significant withdrawal symptoms. There are dose dependent responses often associated with drug adversities. Day time sedation is an undesired effect of many drugs used for anxiety management limiting its usage. Ayurveda recommends a bio- physical procedure to manage anxiety. Shirodhara, a dripping procedure is utilized as a front line therapy for anxiety in Ayurveda. Seeing the limitations of conventional biomedical management of anxiety requiring an improvement upon the existing protocols of managements, and also seeing the use of shirodhara for anxiety management in ayurvedic clinics, a pragmatic study to evaluate the effect of shirodhara in generalized anxiety disorder was done. This was a pragmatic study consisting of shirodhara with ksheer bala oil as an intervention upon generalized anxiety disorder patients. The study was conducted upon 13 patients and observations were done for six weeks. The responses observed through the changes in Hamilton Anxiety Scale were evaluated using paired t test to observe the pre-post significance.

불안장애 및 우울장애에 따른 불안민감성(Anxiety Sensitivity)의 차별성

김예원,이정애,오강섭,임세원 한국임상심리학회 2011 Korean Journal of Clinical Psychology Vol.30 No.1

Anxiety sensitivity is the fear of anxiety-related symptoms, arising from beliefs that the sensation has harmful physical, social, or psychological consequences. To measure anxiety sensitivity, the Anxiety Sensitivity Index(ASI) is commonly used. Several studies have show the relationship between depression and anxiety disorder assuming multidimensional structure. In this study, ASI, BDI, and BAI were administered to 611 adult males and females, who had been -diagnosed with depression and anxiety disorder, upon visiting the psychiatric clinic. Exploratory factor and Confirmatory factor analyses were employed to test competing models, and the results suggested that the hierarchical model(comprising three first-order factors corresponding to physical concern, social concern and cognition concern) provided the best fit to the data. This finding was consistent with the results of previous studies. The current study also investigated(using an ANCOVA) differences with respect to the three factors of anxiety sensitivity in four clinical groups of patients who had been diagnosed either with social anxiety disorder(n=101), panic disorder(n=145), generalized anxiety disorder(n=33) or depressive disorder(n=135) and had been free of comorbidity. Results indicated that physical concern was significantly higher in panic disorder patients compared with the other three groups, and that social concern was significantly higher in social anxiety disorder patients. Further, generalized anxiety disorder patients and depressive disorder patients had more cognitive concern than social anxiety disorder patients. The implications and limitations of this study were also discussed.

Factors Related to Anxiety in Predialysis Patients with Chronic Kidney Disease

Su-Jeong Han,Hye-Won Kim 보안공학연구지원센터 2015 International Journal of Bio-Science and Bio-Techn Vol.7 No.4

Anxiety is common emotions in predialysis patients with chronic kidney disease (CKD). The purpose of this study was to measure the anxiety in predialysis patients and to identify clinical variables that are associated with anxiety. The subjects for this study were 102 patients who visited the nephrology outpatient department of a tertiary hospital in Seoul between October 12th and October 26th, 2013 and consented to participate in the study. The collected data were analyzed by the SPSS WIN 12.0 program. The mean score of anxiety was 12.2 which means their experience of high level anxiety and moderate and severe symptoms of anxiety were identified in 59.8% of the patients. There were significantly negative correlations between anxiety and residual renal function (r=-.221, p=.026). There was a significant difference in the anxiety of the subjects at each stage (F=4.54, p=.013). The Scheffe post hoc test confirmed that patients at Stage 5 had highest levels of anxiety. There were significantly positive correlations between anxiety and uremic symptoms (r=.481, p<.001). There were significantly negative correlations between anxiety and age (r=-.201, p=.045) and comorbidities (r=-.218, p=.028). Also, Age, GFRs, comorbidities and uremic symptoms predicted value accounted for 57.2% of the variance on anxiety (F=11.77, p<.001). Hence, health care providers should be concerned about helping to slow the progression of renal failure and considered related variables when planning an approach towards managing the anxiety in predialysis patients with CKD.

Prevalence of Anxiety May Not be Elevated in Thai Ovarian Cancer Patients Following Treatment

Chittrakul, Saranya,Charoenkwan, Kittipat,Wongpakaran, Nahathai Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.3

Background: To compare prevalence of anxiety in ovarian cancer patients following primary treatment to that of normal women and to examine predicting factor. Materials and Methods: In this cross-sectional study, 56 ovarian cancer patients who had primary surgical treatment within the past five years (cancer group) and 56 age-matched women who attended an outpatient clinic for check-ups (non-cancer group) were recruited from June 2013 to January 2014. The hospital anxiety and depression scale (HADS), was used to determine anxiety level of the participants with the score of ${\geq}11$ suggestive of anxiety. The prevalence of anxiety symptoms and mean HADS scores for anxiety were compared between the study groups. For those with ovarian cancer, associations of demographic and clinical factors with anxiety was examined. A p-value of <0.05 was considered significant. Results: Participants in the non-cancer group had higher rate of medical comorbidity, higher salary, and more frequent university education. The prevalence of anxiety was not different between the groups, at 7.1% each. The mean HADS scores for anxiety subscale were not significantly different between the groups, 5.0 in the cancer group vs 6.1 in the non-cancer group (p=0.09). On multivariable analysis, no demographic or clinical factors significantly associated with anxiety were identified. For the cancer group, no association between any particular factors and anxiety was demonstrated. Conclusions: The prevalence of anxiety in women with ovarian cancer following primary treatment was comparable to that of normal women seeking routine check-up.

Anxiety before dental surgery under local anesthesia: reducing the items on state anxiety in the State-Trait Anxiety Inventory-form X

Koga, Sayo,Seto, Mika,Moriyama, Shigeaki,Kikuta, Toshihiro The Korean Dental Society of Anesthsiology 2017 Journal of Dental Anesthesia and Pain Medicine Vol.17 No.3

Background: It is important to evaluate preoperative anxiety and prepare sedation when performing dental surgery under local anesthesia. Spielberger's State-Trait Anxiety Inventory (STAI) is useful for predicting preoperative anxiety. State anxiety is defined as a subjective feeling of nervousness. Reduction in the number of the state anxiety items (questions) will be clinically important in allowing us to predict anxiety more easily. Method: We analyzed the STAI responses from 1,252 patients who visited our institution to undergo dental surgery under local anesthesia. Multiple linear regression analysis was conducted for 9 groups comprising anxiety level determinations using the STAI; we then developed a coefficient of determination and a regression formula. We searched for a group satisfying the largest number of requirements for regression expression while setting any necessary conditions for accurately predicting anxiety before dental surgery under local anesthesia. Results: The regression expression from the group determined as normal for preoperative state anxiety was deemed the most suitable for predicting preoperative anxiety. Conclusion: It was possible to reduce the number of items in the STAI by focusing on "Preoperative anxiety before dental surgery."

The Cross-modality Anxiety Profiles of Korean EFL Learners

강대민 한국영어어문교육학회 2009 영어어문교육 Vol.15 No.1

The present study was conducted to investigate Korean EFL learners' cross-modality anxiety profiles and the impact of proficiency on the profiles, i.e., how their speaking anxiety and writing anxiety were related and how proficiency affected the relationship between their speaking anxiety and writing anxiety. A total of 95 participants, assigned to high, intermediate, and low proficiency groups, completed a questionnaire composed mainly of an adjusted Foreign Language Classroom Anxiety Scale (FLCAS) and the Second Language Writing Anxiety Inventory (SLWAI), and 30 of them took part in a semi-structured interview. Results showed that Korean EFL learners' writing anxiety was significantly stronger than their speaking anxiety, which was attributed to an extensive difference in interest and pedagogical practice between writing and speaking. Regarding the influence of proficiency, it was revealed that proficiency significantly affected the difference between Korean EFL learners' speaking and writing anxiety. What was noteworthy was that the intermediate level EFL learners showed the highest mean difference between speaking and writing anxiety due to their largest difference in readiness between writing and speaking. In terms of pedagogical implications, the study suggests that the EFL cross-modality anxiety should be addressed more adequately taking into account proficiency levels of learners.

한국어 학습자의 현대시 학습 불안감 연구 -중국 내 대학에 재학 중인 고급 학습자를 대상으로-

NING WANG 서울대학교 국어교육연구소 2023 국어교육연구 Vol.51 No.-

This study examines the layered anxiety experienced by Korean learners academically reading modern poetry, and thus formally conceptualizes the phenomenon of “modern Korean poetry learning anxiety.” Sixty-one advanced Korean learners attending D university in China were surveyed. A "Modern Korean Poetry Study Anxiety Questionnaire" was newly designed as a measurement tool based on the existing Foreign Language Classroom Anxiety Scale. Eight factors of modern poetry learning anxiety were extracted using SPSS Ver. 26, and significant differences in the degree of learning anxiety were identified based on four learner variables: gender, region of origin, Korean language learning period, and Korean literature learning career. When learner's anxiety level was divided into three degrees of difficulty—"high-medium-hardness”—there was a significant difference in the degree of learning anxiety according to the level of anxiety under factors 1–6 among the eight factors. Finally, multiple regression analysis was performed to examine the impact of each factor on overall learning anxiety. 본 연구는 ‘한국 현대시 학습 불안감’이라는 개념을 중심으로 한국어 학습자들이 경험하는 현대시 학습에 대한 불안감을 다층위적으로 고찰하고자 한다. 본 연구는 중국 내 D대학교에 재학 중인 학문 목적의 고급 한국어 학습자 총 61인을 선정하여 설문조사를 실시하였다. 본 연구에서는 기존의 '외국어 교실 불안 척도(FLCAS)'를 바탕으로 <현대시 학습 불안 설문지>를 측정 도구로 새로이 설계하였다. SPSS Ver. 26을 활용하여 통계분석을 실시한 결과, 총 8개의 현대시 학습 불안 요인이 추출되었으며, ‘성별’, ‘출신지역’, ‘한국어 학습기간’, 그리고 ‘한국문학 학습경력’의 총 4가지 학습자 변인에 따라 학습 불안 정도에 유의미한 차이가 확인되었다. 또한 학습자의 불안 수준을 ‘고-중-경도’의 세 층위로 나눌 때, 요인①-⑥하에서 불안 수준에 따른 학습 불안 정도에 유의미한 차이가 나타났다. 마지막으로 각 불안 요인이 전체 현대시 학습 불안에 미치는 영향력에 대해 고찰해 보았다. 학습 불안감이 한국 현대시 교육-학습 과정에 영향을 주는 것이 명백하다. 이에 학습자의 현대시 학습 불안감을 완화시킬 수 있는 다양한 교육 방법이 마련되어야 한다.