폭식행동자를 위한 인지행동 집단치료의 도중탈락 예측요인

공성숙 ( Seong Suk Kong ) 한국정신간호학회 2000 정신간호학회지 Vol.9 No.3

Background and purpose : Cognitivebehavioral grouptherapy has become the most popular form of treatment for binge eaters, as it has been demonstrated to be a highly cost-effective method of treating bulimic patients. Unfortunately drop-out rate from group CBT is relatively high. The purpose of this study was to identify predictors of drop-out from cognitive-behavioral group therapy for binge eaters. Prior to treatment, all subjects completed the EDI-2(Eating Disorders Inventory-2), the Rosenberg`s Self-Esteem Scale, the BDI(Beck Depression Inventory), and interviewed the binge and purge frequency per week. In this study, among 41 binge eaters who participated 10-week cognitive-behavioral group therapy, drop-out rate was 36.6%(15 binge eaters). Binge eaters were all women and mean ages of them were 24 years and 95.1% of them were unmarried. 75.6% of them were bulimia nervosa, and the remainders were anorexia nervosa and binge eating disorders. To examine the predictors of drop-out, discriminant analysis was used. The completers were significantly higher in binge frequency and were lower in interpersonal distrust than drop-outs, and in duration of illness the completers also tended to be longer but these univariate differences didn`t reach statistical significance. Wilk`s Lamda was .776 indicating that differences between the completers and drop-outs were significant. The discriminant function analysis was able to successfully predict drop-outs and completers of treatment in 73.2% of cases. Predicted dropouts were correctly identified in 86.7% of cases whereas predicted completers were correctly identified in 65.4% of cases. In conclusion, binge frequency, interpersonal distrust, and duration of illness predicted drop-out from cognitive-behavioral grouptherapy for binge eaters. This results would enable clinicians to more effectively utilize pretreatment assessment information in planning treatment for binge eaters. If patients at risk for dropping out group CBT can be identified at assessment, they may be referred instead to individual CBT, where the likelihood of dropping out is lower. Further research with the larger sample size, and included family factors and personality variables was suggested.

일반 부부와 부부클리닉 방문부부의 결혼만족도에 영향을 미치는 요인

공성숙 ( Seong Suk Kong ) 한국정신간호학회 2006 정신간호학회지 Vol.15 No.4

입원한 정신질환자 가족의 가정간호 요구도와 가족부담감

김소야자,현명선,성경미,공성숙,Kim, So-Ya-Ja,Hyun, Hyung-Sun,Sung, Kung-Mi,Kong, Seong-Suk 대한간호협회 1993 대한간호 Vol.32 No.3

This study was designed to investigate the family burden, family home care needs and to identify the relationship between family burden and home care needs for families of psychiatric in-patients. The subjects for this study were 104 family members of psychiatric in-patients at two private hospitals and one municipal hospital. The data were collected during the period from February 1. 1993 to March 30. 1993. The questionnaire developed by Montgomery to measure the family burden was used as modified by the research team for this study. The questionnaire was developed by Garrad to measure the home care need was also used as modifed by the research team. The data was analyzed using descriptive statistics, t-test, ANOV A and Pearson Correlation Coeffcient. with the SPSS program. The Result of this study can be summarized as follows ; 1. For perceived family burden, the meanscore as measured by the guestionnaire was 70.6 of a possible to total of 110. 2. For home care need. the meanscore as measured by the questionnaire was 44.8 fo a possible total of 66. 3. The results showed a higher score for cases from the municipal hospital for family burden and a higher score for cases at the private hospitals for home care need. 4. Ther was a statistically significantly higher score on family burden for female family member (T =-2.77. P<.05) and for bereaved family members. (F=2.862. p<.05) 5. There was a statistically significantly higher score (F= 10.3535, P<.001) for family burden when the hospitalization period was between 7~ 12 months and a statistically significantly higher score (F =7.679.P<.001) for home care need when the hospitalization period was over 37 months. 6. Ther was a significant correlation between family burden and home care need. (r=.4002, P<.05) The conclusion that can be drawn from this study is that addressing home care needs would contribute to reduce family burden.

청소년 약물남용 실태에 관한 연구 -서울지역을 중심으로-

강소야자 ( Kim So Ya Ja ),현명선 ( Hyun Myung Sun ),성경미 ( Sung Kung Mi ),공성숙 ( Kong Seong Suk ) 한국간호과학회 1993 Journal of Korean Academy of Nursing Vol.23 No.3

This study was designed to investigate the situation of adolescent drug use in Seoul, and to compare this with the 1991 survey in order to better understand the present situation. The subject for this study were 1000 students in High School and Middle School. The data were collected during the period from September 1, 1992 to December 1992. The questionnaire developed by Kim So Ya Ja (1991) to survey adolescent drug use was used. The data was analyzed using descriptive statistics, t -test and ANOVA with the SPSS program. The results of this study can be summarized as follows 1. Prevalence of Substance use : Antihistamines were used by 0.3% of adolescent, Sedatives 0.6%, Stimulants 8.1%, Hallucinogens 0.9%, Inhalants 3.2%, Narcotics 1, 7% and Analgetics 154.3%. 2. Trend in substance use compared to the 1991 surbey : Alcohol use increased from 52.8% to 63.7% and narcotics from 0.6% to 1.7%, while Smoking, Analgetics, Antihistamines, Sedatives, and Inhalants showed a decrease. 3. Smoking and Alcohol use : Twenty five percent of school adolescent had experienced cigarette smoking and 63.7% of school adolescent had experienced alcohol use. 4. Motives for drug use : The highest was avoidance of sleep at 49.4% and the next highest was adventure seeking at 27.7%. As to feeling after drug use, 34.3% felt apathy, 22.8% had feelings of sleepiness and unconsciousness. 5. Places were dreg were purchased : The most frequent was the drug store(78.3%) and 84.4% of the respondents answered that drug purchase was easy and 86.7% that drug use was mainly at home. 6. Related Variables : There was a statistically significant high score for drug and alcohol use by adolescents whose fathers used drugs.(PC, 05) In conclusion, adolescents in Seoul showed in decrease in the tendency to use drugs compared to the 1991 survey, however drugs which are habit - forming and lead to dependency are still being abused. Therefore, counter-plans and preventive strategies are important.

폭식 행동에 대한 인지행동 집단치료의 효과

공성숙,김준기,배재현 대한신경정신의학회 2000 신경정신의학 Vol.39 No.6

연구목적 : 본 연구는 폭식행동을 보이는 대상자에게 인지행동 집단치료를 시행하고 폭식이나 구토 등의 식이행위와 식이태도, 자아존중감, 우울에 미치는 효과를 평가하여, 현재 우리 나라에 급증하고 있는 폭식행동자에게 경제적이고 효과적인 치료모델을 제시하는 데에 있다. 방 법 : 식이장애 전문 클리닉인 M병원에 내원한 대상자 중 EAT-26 검사에서 17점 이상인 44명을 대상으로 5차례에 나누어 8-10명 단위로 각 10회의 인지행동 집단치료를 시행하였으며 도중탈락자를 제외한 27명이 참여하였다. 치료 전후에 식이행위 기록지, 다차원적 식이태도 검사(EDI), Rosenberg 자아존중감 척도, 우울 척도(BDI)를 통해 자료를 수집하였으며 식이행위 기록지는 대상자가 매일 적도록 하여 주단위로 변화양상을 분석하였다. 통계방법은 백분율과 paired t-test를 사용하였다. 결 과 : 1) 폭식과 구토빈도는 식이행위 기록지를 분석한 결과 치료 후에 유의하게 감소하였으며, 변화양상은 치료 2주째 급격한 감소를 보였고 초기부터 종결까지 하향곡선을 나타냈다. 2) 식이태도는 '다차원적 식이태도 검사 (EDI)'로 평가한 결과 8개 소척도 중에서 마르고 싶은 욕망, 폭식경험, 신체불만족, 무능감, 내면자각에서는 유의한 감소를 보인 반면, 완벽주의, 대인관계 불신감, 성장 공포에서는 유의한 차이가 없었다. 3) 자아존중감과 우울은 치료 후에 유의하게 감소되었다. 결 론 : 폭식행동자를 대상으로 인지행동 집단치료를 시행한 결과 폭식 및 구토 등의 식이행위와 자아존중감, 우울, 그리고 식이태도의 일부에서 유의한 호전을 보였으나, 식이태도 중 완벽주의, 성장공포, 대인관계 불신감에서 유의한 효과를 보이지 않았다. 이 세 변인들은 인지행동 치료를 통해 변화되기 어려운 성격적 요인으로 생각되며, 폭식행동의 감소와 같은 중요한 변인들에 유의한 효과가 있었으므로 인지행동 집단치료는 향후 우리 나라에서도 폭식행동자를 위한 경제적, 효과적인 치료모델로 제시될 수 있다고 본다. Objectives : The binge eaters are increasing rapidly since 1990's in Korea. The purpose of this study was to examine the effect of cognitive-behavioral group therapy on improving the frequency of binging and purging, eating attitude, self-esteem, and depression. Method : The subjects were 27 women who showed over 17 on the EAT-26 among binge eaters visited at eating disorders clinic "M". 10 sessions of cognitive-behavioral group therapy were provided to each group composed of 8-10 binge eaters. All subjects completed the Eating Disorders Inventory(EDI), Rosenberg Self-Eesteem Scale, Beck Depression Inventory(BDI) pre-and post intervention, and recorded daily food records. Paired t-test was used for the comparison of EDI subscales before and after treatment. Results : Frequency of binging and purging, self-Esteem, depression, drive for thinness, bulimia, body dissatisfaction, ineffectiveness, interoceptive awareness subscales of EDI showed significant immprovement but perfectionism, interpersoual distrust, maturity fear subscales of DEI showed no improvement after the cognitive-behavioral group therapy. Frequency of binging and purging per week showed a general trend of decline from the beginning to the end of the treatment and a rapid decrease at the second week was noticed. Conclusion : The results of this preliminary study suggest that cognitive-behavioral group therapy may be an effective initial approach for the treatment of binge eating. Future research aimed at replicating these initial results and providing systematic long-term evaluation is needed.

일반청소년과 정신장애 청소년의 가족기능

공성숙 대한간호학회정신간호학회 1992 정신간호학회지 Vol.1 No.-

The family is a system which maintains homeostasis through the relationship between family members and interaction with environment. So, the family is of crucial importance to the menta health of the family members who make up the family system. In the adolescent developmental stage, adolescents are very vulnerable mentally because they are irritable emotionally. There are many studies that have reported mental disorders in adolescence as being related to family factors such as difficulties in family interaction and relationship between family members. Most studies about adolescents with mental disorders have dealt with the relationship between varied factors within the family. This descriptive study was done to provide the basic data on adolescents with mental disorders by testing Olson's Circomplex Model which is based on family systems theory. Fifty four adolescents with mental disorders admitted to or attending three hospitals in Seoul for psychiatric care made up the sample for this study. The comparative group was made up of 124 high school and college students with no reported history of psychiatric care. Data collection was carried out by the researcher from March 21 to May 10, 1992. The data were analyzed by SPSS program and the hypotheses were tested using mean score, SD, t-test, x2-test, ANOVA and ANCOVA. The results of this study are as follows : 1. The mean score for the normal adolescents was 34.36, and the mean score for the adolescents with mental disorders was. 31.90. The first hypotheses that there is a difference between the two groups as to the mean score of family cohesion was supported (F=5.2573, p<.05). 2. The mean score for the normal adolescents was 20.10, and the mean score for the adolescents with mental disorders was 27.33. The second hypotheses that there is a difference between the two groups as to the mean score of family adaptability was supported(F=8.7236, p<.05). 3. In normal adolescents, 'Balanced types' was found in 25.0% of the sample, 'Mid-range types' in 58.9%, and 'Extreme types' in 16.1%. In adolescents with mental disorders, 'Balanced types' was found in 35.2% of the sample, 'Mid-range types' in 59.3%, and 'Extreme types' in 5.3%. The third hypotheses that there is a difference between the two groups as to family types was not supported(x2=4.6450, p<.05). 4. Adolescent's age and education level, mother's age, mental disorders in parents and whether the parents were the real parents or not were related to the mean score of family cohesion. Father's education level, mental disorders in parents and whether the parents were the real parents or not were related to the mean score of family adaptability. No statistically significant relation was found between any of the adolescent's characteristics and family types. 5. In the test of difference in the mean score of family cohesion and adaptability between the two groups when the four variables-father's age and job, mental disorders in parents, whether the real parents or not which showed a difference between two groups were controlled, it was found for the varibles father's age and job, there was a difference between the sores for two groups on family cohesion and adaptability. But, for the variables mental disorders in parents and whether the real parents or not, it was found that there was no difference the scores for between two groups on family cohesion and adaptability. This study suggests that there is a need for more studies with matched samples including age and education level of adolescent, age of mother, education level of father, parents with mental disorders and addressing the question of whether parents are the real parents or not as well as more studies with samples including other family members in addition to the adolescents.

청소년 약물남용 예방대책 : - 양호교사의 약물교육 효과 연구 -

김소야자,현명선,성경미,공성숙 연세대학교 교육대학원 1993 연세교육과학 Vol.42 No.1

This study was designed to investigate the knowledge about, and attitude to drugs as found in School Nurses and Education on School Nurses and School Adolescents, and to develop drug abuse prevention strategies. The subject for this studg were 70 School Nurses (42 from Middle schools, 24 from High Schools) and 965 School adolescents(253 Male Middle School Students, 263 Male High School Students, 249 Female Middle School Students, 200 Female High School Students). The Drug Abuse education for the School Nurses was given by this research team during the period from september 22 to 23, 1993 (16 hours). The Drug Abuse education for the School Adolescents was given by the School Nurses for a total of 4 hours. Before and after each Education program, a questionnaire was completed by each subject to evaluate the effect of the Drug abuse Education. The Drug Abuse Prevention Teaching Material for both School Nurses and the School Adolescents was developed by this research team. The questionnaire which measured knowledge about and attitude to drugs was also developed by the research team. The data was analyzed using descriptive Statistics, t-test, ANOVA and Pearson Correlation, with the SPSS program. The result of this study can be summarized as forllows : 1. There was a statistically signifcant difference in knowledge about and attitude to drugs, alcohol, and moking for the School Nurese after the drug abuse educalion program. 2. There was a statistically significant difference in knowledge about and attitude to drugs, alcohol, and Smoking for the School Adolescents after the drug abuse education program. 3. A relationship was found betweed drug use by the fathers of the School adolescent and the School adolescent's Knowledge about and attitude to drugs. As a result of this study, it can be concluded that drug abuse education for school Nurses is necessary. Further this study showed that drug abuse education by School Nurses can deceease in School Adolescents an attitude which is accepting of drugs and increase Knowledge about drugs. Therefore, this Study suggests directions for adolescent drug abuse prevention stratedise and the Role of the School Nurses in adolescent drug abuse prevention.

청소년 약물남용 예방대책 : 양호교사의 약물교육 효과 연구

김소야자,현명선,성경미,공성숙 연세대학교 교육대학원 1993 연세교육과학 Vol.42 No.-

This study was designed to investigate the knowledge about, and attitude to drugs as found in School Nurses and Education on School Nurses and School Adolescents, and to develop drug abuse prevention strategies. The subject for this studg were 70 School Nurses (42 from Middle schools, 24 from High Schools)and 965 School adolescents(253 Male Middle School Students, 263 Male High School Students, 249 Female Middle School Students, 200 Female High School Students) The Drug Abuse education for the School Nurses was given by this research team during the period from september 22 to 23, 1993 (16 hours). The Drug Abuse education for the School Adolescents was given by the School Nurses for a total of 4 hours. Before and after each Education program, a questionnaire was completed by each subject to evaluate the effect of the Drug abuse Education. The Drug Abuse Prevention Teaching Material for both school Nurses and the School Adolescents was developed by this research team. The questionnaire which measured knowledge about and attitude to drugs was also developed by the research team. The data was analyzed using descriptive Statistics, t-test, ANOVA and Pearson Correlation, with the SPSS program. The result of this study can be summarized as forllows: 1. There was a statistically signifcant difference in knowledge about and attitude to drugs, alcohol, and moking for the School Nurese after the drug abuse educalion program. 2. There was a statistically significant difference in knowledge about and attitude to drugs, alcohol, and Smoking for the School Adolescents after the drug abuse education program. 3. A relationship was found betweed drug use by the fathers of the School adolescent and the School adolescent's Knowledge about and attitude to drugs. As a result of this study, it can be concluded that drug abuse education for school Nurses is neccessary. Further this study showed that drug abuse education by School Nurses can deceease in School Adolescents an attitude which is accepting of drugs and increase Knowledge about drugs. Therefore, this Study suggests directions for adolescent drug abuse prevention stratedise and the Role of the School Nurses in adolescent drug abuse prevention.