발달장애아 어머니의 비합리적 신념과 우울 감소를 위한 인지행동적용 집단미술치료

곽경화,정현희 한국재활심리학회 2010 재활심리연구 Vol.17 No.2

This study examined the effect of cognitive-behavioral group art therapy on irrational beliefs & depression of mother with developmental disorder child. The subjects were 9 mothers in an experimental group & 9 mothers in a control group. Group art therapy had been conducted once a week from June through September, 2009. There were 10 sessions and each session lasted 90 minutes. The changes of irrational beliefs & depression during the sessions and inventory on irrational beliefs & depression were used to verify the its effect. With inventory, pre-test, post-test, & follow-up-test were executed and ANOVA with repeated measures was conducted. As the results, first, group art therapy was effective in reducing irrational beliefs. There were changes of irrational beliefs during the sessions. Also there was significant change in the inventory on irrational beliefs in the experimental group. Second, group art therapy was effective in reducing depression. There were changes of depression during the sessions. Also there was significant change in the inventory on depression in the experimental group.

Small Dose of Midazolam Added to Fentanyl-Ropivacaine for Patient Controlled Epidural Analgesia after Subtotal Gastrectomy

곽경화 대한마취통증의학회 2008 Anesthesia and pain medicine Vol.3 No.1

Background: Midazolam has been reported to have a spinally mediated antinociceptive effect. In this randomized, double-blind study, we evaluated whether a small dose of midazolam added to fentanyl-ropivacaine mixture for PCEA (patient controlled epidural analgesia) improves epidural analgesia in patients underwent elective subtotal gastrectomy. Methods: Forty five patients, ASA physical status I and II, undergoing subtotal gastrectomy were randomly allocated to receive 0.2% ropivacaine mixed with fentanyl 4μg/ml or 0.2% ropivacaine mixed with fentanyl 4μg/ml and midazolam 0.2 mg/ml. The infusion rate was set to deliver 4 ml/hr of the study solution, with a bolus of 2 ml per demand and a 20 minutes lockout time. Results: Infused volume (P < 0.05) and VAS scores (P < 0.05) was significantly lower in the patients receiving midazolam. However, there were no differences in requiring rescue analgesics, PONV (postoperative nausea and vomiting), sedation scores, urinary retention, and pruritus between groups. Conclusions: Small dose of midazolam could augment analgesia without adverse effects when added to thoracic epidural infusion of fentanyl and ropivacaine.

Meningioma related trigeminal neuralgia presenting as odontalgia -A case report-

곽경화,이정은,한재경,황두윤,김민지,전영훈,여진석 대한마취통증의학회 2013 Anesthesia and pain medicine Vol.8 No.2

Classical trigeminal neuralgia is characterized by recurrent attacks of lancinating pain in the trigeminal nerve distribution, and no cause of the symptoms can be identified, other than vascular compression. This type of injury may rarely be caused by identifiable conditions,including tumor in the cerebellopontine angle. If the patient is suspected for secondary trigeminal neuralgia, further evaluation is required to diagnose and treat correctly. We report a case of a 49-year-old woman with a 1-month history of facial pain, who was initially misdiagnosed as odontalgia, and even treated with the extraction of her molar teeth. This case with the review of secondary trigeminal neuralgia may highlight the difficulties of diagnosis, and the importance of early diagnostic imaging, when trigeminal neuralgia occurs with a brain tumor.

노인 수술환자의 부위마취관리

곽경화,박성식 대한의사협회 2017 대한의사협회지 Vol.60 No.5

디지털 역량에 대한 예비 유아교사의 주관적 인식 유형 연구

곽경화,심재연 한국열린유아교육학회 2024 열린유아교육연구 Vol.29 No.2

본 연구는 Q-방법론을 활용하여 예비 유아교사의 디지털 역량에 대한 주관적 인식유형 및 유형별 특성을 알아봄으로써 예비 유아교사의 디지털 역량 관련 주관적 인식에 대한 기초자료를 대학 기관과 연수 지원 기관에 제공하고자 하였다. 이에 따라 디지털 역량에 대한 문헌과 선행연구를 고찰하고, 예비 유아교사 유아교육과 4학년 학생 250명을 임의표집 하였으며, 총 320개의 Q모집단을 구성하는 진술문을 추출하였다. 수집한 320개의 Q모집단을 반복해서 읽으면서 중복되는 문항은 범주화하고 제외할 문항은 삭제하여 최종 44개의 Q-표본을 선정하였다. 선정된 Q-표본을 34명의 예비 유아교사에게 9단계로 Q-분류하도록 하였으며, 분류한 자료는 SPSS 21.0 사용하여공통 요인 모형과 직각 회전 방법으로 회전하여 최종 요인 구조를 산출하였다. 그 결과 예비 유아교사들의 디지털 역량에 대한 주관적 인식 유형은 3개 유형으로 분류되었고, ‘유아교육 관련 자료 제작 및 소통에 도움받는 디지털 기반 활용형’, ‘디지털 시민의식을 갖춘 디지털 학습자형’, ‘디지털 실천 주체인 유아를 위한 디지털 놀이 제공자형’으로 분석되어 나타났다. This study aims to explore pre-service early childhood educators’ perceptions of their digital competence in colleges and training support institutions, and provide pertinent foundational data. Using Q methodology, the study assessed different perceptions and characteristics of digital competence. The literature and previous studies on digital competence were reviewed, and a random sample of 250 senior students from early childhood education departments was collected. A set of 320 Q statements was extracted and refined through repeated reading to categorize and exclude overlapping items, resulting in a final selection of 44 Q samples. The selected Q samples were then Q sorted into nine stages by 34 pre-service early childhood educators. The sorted data were analyzed using SPSS 21.0 through common factor model and orthogonal rotation to determine the final factor structure. The subjective perception types of digital competence among pre-service early childhood educators were classified into three types: “Digital-based Utilizers for Creating and Communicating Early Childhood Education-Related Materials,” “Digitally Competent Learners with Digital Citizenship,” and “Digital Play Providers for Children Practicing Digitally.” These three perception types illustrate the range of skills and knowledge necessary to enhance the digital competence of pre-service early childhood educators.

준고령층의 소득계층에 따른 건강 및 의료비 지출 차이에 대한 종단연구

곽경화 한국보건사회학회 2017 보건과 사회과학 Vol.0 No.46

본 연구는 준고령층의 소득 계층의 변화 과정의 특성을 공유하는 하위집단, 즉 잠재계층들을 구분하고, 소득 계층의 변화유형에 따른 건강 및 의료 이용의 불평등을 알아보기 위하여 각 소득 변화의하위 집단별 만성질환 수와 주관적 건강상태 및 의료비 지출의 변화 궤적을 살펴보았다. 본 연구는2008년부터 2013년까지 이루어진 한국의료패널 자료를 사용하였으며, 2008년을 기준으로 55세~64 세에 해당하는 준고령층 2,340명을 대상으로 분석하였다. 연구문제를 해결하기 위해, 잠재계층성장분석과 잠재성장곡선분석을 실시하였다. 준고령층의 소득 계층 변화궤적은 4개의 하위집단으로 분류되었으며, 각각 하위계층 감소집단, 중하위계층 감소집단, 중상위계층 유지집단, 상위계층 유지집단으로구분하였다. 이러한 4개의 하위집단 중, 하위계층 감소집단과 중하위계층 감소집단이 중상위계층 유지집단과 상위계층 유지집단에 비해서 객관적 건강 및 주관적 건강 모두 초기 수준에서 차이가 나며, 시간이 지날수록 건강이 악화되는 것으로 나타났다. 이는 소득 계층별 건강불평등을 종단적으로 입증하는 결과이다. 또한, 이러한 4개의 하위집단별 개인의료비 지출에서는 큰 차이가 없는 것으로 나타났으며, 이는 하위계층 감소집단의 소득대비 의료비 과부담을 입증하는 것이다. 하지만, 앞서 하위집단별 건강의 차이가 있다는 결과와 함께 고려해 보건데 소득 계층별 의료비 지출상의 불평등을 입증하는 결과라고 할 수 있다. 즉, 소득 계층별 건강불평등이나 의료 이용의 불평등을 해소하기 위한 보건정책을 필요로 한다. The purpose of this study was to identify the latent classes of income status over time and to investigate socioeconomic disparities in trajectories of health and medical expenditure among adults aged 55 to 64 years. The data for this study came from the Korea Health Panel, collected from 2008 to 2013. To verify the purpose of this study, we performed latent class growth analyses and latent growth curve analyses. Trajectories of income status were categorized into four latent classes, low-decreasing, mid-low-decreasing, mid-high-stable, and high-stable groups. There were chronic diseases and subjective health status were different over time depending on latent classes of income status, supporting health disparities. Although there were no socioeconomic differences of trajectories in medical expenditure, individuals in low income status may have disadvantages in medical expenditure with the consideration of their health status. As a result, findings from the study highlight the importance of more sophisticated public policy to reduce the gap of trajectories in health and medical expenditure across socioeconomic status.

PONV prevention: still not enough

곽경화 대한마취통증의학회 2017 Korean Journal of Anesthesiology Vol.70 No.5

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Need for an optimal regimen of programmed intermittent epidural bolus administration for maintenance of labor analgesia

곽경화 대한마취통증의학회 2019 Korean Journal of Anesthesiology Vol.72 No.5

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과학교사 전문성 기준 : 포스터 발표 ; 논의 과정을 이용한 과학 교수,학습 전략이 중학생들의 인지발달 및 과학 학습에 미치는 영향

곽경화,강순민,남정희 한국과학교육학회 2004 한국과학교육학회 학술발표 및 세미나집 Vol.- No.-

Postdural puncture headache

곽경화 대한마취통증의학회 2017 Korean Journal of Anesthesiology Vol.70 No.2

Postdural puncture headache (PDPH) is a common complication after inadvertent dural puncture. Risks factors include female sex, young age, pregnancy, vaginal delivery, low body mass index, and being a non-smoker. Needle size, design, and the technique used also affect the risk. Because PDPH can be incapacitating, prompt diagnosis and treatment are mandatory. A diagnostic hallmark of PDPH is a postural headache that worsens with sitting or standing, and improves with lying down. Conservative therapies such as bed rest, hydration, and caffeine are commonly used as prophylaxis and treatment for this condition; however, no substantial evidence supports routine bed rest and aggressive hydration. An epidural blood patch is the most effective treatment option for patients with unsuccessful conservative management. Various other prophylactic and treatment interventions have been suggested. However, due to a lack of conclusive evidence supporting their use, the potential benefits of such interventions should be weighed carefully against the risks. This article reviews the current literature on the diagnosis, risk factors, pathophysiology, prevention, and treatment of PDPH.