자문의뢰된 입원환자의 특성과 정신과 치료 순응도에 대한 연구

심인보,고영훈,이문수,김용구,한창수,Shim, In-Bo,Ko, Young-Hoon,Lee, Moon-Soo,Kim, Yong-Ku,Han, Chang-Su 한국정신신체의학회 2011 정신신체의학 Vol.19 No.2

연구목적: 종합병원에서 정신과에 자문 의뢰된 입원 환자 및 그 자문의뢰의 특성을 살펴보고 이를 통해 정신과 치료의 순응도에 관련된 요인을 찾아보고자 하였다. 방 법: 2009년 9월 1일부터 2010년 8월 31일까지 고려대학교 안산병원에서 정신과에 자문 의뢰된 입원환자 333명을 대상으로 자문기록지와 의무기록을 참고하여 연구를 진행하였다. 기본적인 인구 역학적 정보, 자문을 의뢰한 임상 각과, 의뢰 요청자, 의뢰된 사유, 정신과적 진단과 과거력, 입원 중 정신과 치료의 시행 여부 및 추후 통원 치료의 여부 등을 조사하였다. 이들 중 정신과 치료의 시행 여부 및 통원 치료의 여부를 치료순응도로 정하였다. 순응도와 기타 변수간의 이분형로지스틱 회귀분석을 시행하여 순응도에 영향을 미치는 요인을 확인하였다. 결 과: 입원 중 정신과 치료를 권유 받은 310명의 환자들 중, 치료에 순응한 환자는 82.9%이었으며, 외래 통원치료를 권유 받은 111명의 환자들 중에는 통원치료에 순응한 환자가 55.8%이었다. 64세 이하 연령층보다 65세 이상의 노인에서 입원 중 치료에 대한 순응도가 높았다(OR=4.838, p=0.004). 외래 통원치료를 권유받은 환자들 중 내과적 질환으로 인해 이차적인 정신과적 증상이 나타난 경우가 외래 순응도가 더 높았다(OR=8.520, p=0.008). 결 론: 노인 환자는 입원중 정신과 치료에 대해서는 순응도가 높았으나 신체 질환의경과에 영향을 미치는 섬망 및 기분장애가 흔하므로 정신과적 증상에 대한 평가와 치료가 보다 적극적으로 이루어져야 할 것이다. 또한, 내외과적 질환과 관련이 없는 정신과 문제로 자문 의뢰된 환자들은 외래 통원치료 순응도가 낮으므로 치료순응도를 높이기 위해 다방면의 치료적 접근 방법을 모색하여야 할 것으로 판단된다. Objectives:The present study investigates the status of inpatient psychiatric consultations at a general hospital in order to find factors that contribute to treatment compliance related to psychiatric consultations. Methods:The subjects were 333 patients who were hospitalized at Korea University Medical Center Ansan Hospital from 1 September 2009 to 31 July 2010.The patients were referred for psychiatric consultation during hospitalization. This study investigates demographic data, request department, referral causes, requestor, psychiatric history and diagnosis, andpsychiatric treatment compliance. Treatment compliance was defined as whether or not the patient had accepted psychiatric treatment during hospitalization or outpatient department(OPD) follow-up. This study ascertains the factors that have impact on compliance, by taking binary logistic regression with compliance and other variables. Results:Among the patients that were offered psychiatric treatment during hospitalization(N=310), treatment compliance was 82.9%. Among the patients that were offered OPD treatment(N=111), compliance was 55.8%. Elderly group(>65 years) showed better compliance to treatment during hospitalization than the younger patient group(OR=4.838, p=0.004). Patients with secondary psychiatric disorders showed better OPD follow-up compliance than patients with secondary psychiatric disorders(OR=8.520, p=.008). Conclusion:Elderly patients showed better compliance for psychiatric treatment during hospitalization. However they commonly have disorders such as delirium and mood disorders that have impact on the patient's physical state, hence further active measures should be carried out. Patients referred due to primary psychiatric disorders showed poor OPD compliance. Therefore clinicians have to suggest multidisciplinary interventions that will improve treatment compliance of such patients.

대학병원 건강검진센터 내원자의 스트레스 지각 정도, 우울 증상 및 신체질환 이환율

심인보,조숙행,함병주,한창수,정현강,고영훈,Shim, In-Bo,Joe, Sook-Haeng,Ham, Byung-Joo,Han, Changsu,Jeong, Hyun-Ghang,Ko, Young-Hoon 한국정신신체의학회 2013 정신신체의학 Vol.21 No.1

연구 목적 일반 인구에서 스트레스, 우울 정도, 신체질환 간의 관계와 우울증의 위험 요인을 확인하고자 연구를 진행하였다. 방 법 2009년 1월부터 2009년 12월까지 고려대학교 구로병원 건강검진센터에 내원한 일반인 1,764명에서 인구역학 자료를 조사하고 PSS와 PHQ-9 설문지를 시행하였다. 스트레스군, 우울군, 신체질환군을 구분하여 스트레스, 우울, 신체질환 간의 상관분석과 로지스틱 회귀분석을 시행하였다. 결 과 1,476명의 연구 대상자 중 198명(11.8%)이 우울군에 해당되었으며, 평균 PSS 점수(23.19점)와 평균 PHQ-9 점수(12.95점) 모두 정상군에 비해 높았다. 스트레스가 높을수록, 신체질환이 많을수록 우울 점수도 증가하였다. 여성, 최근의 건강이상으로 내원한 사람, 불규칙적인 운동과 흡연력, 협심증과 뇌경색 기왕력이 있는 군에서는 우울증의 위험도가 증가하였다. 결 론 본 연구에서 PSS, PHQ-9은 건강검진센터에서 정신건강 선별검사를 시행할 수 있는 유용한 기회를 제공하였다. 스트레스를 많이 받고 신체질환이 많을수록 우울증의 위험도가 증가하므로, 신체질환이 동반되었거나 건강하지 못한 생활습관을 지닌 개인에서 정신질환 선별검사가 필요하겠다. Objectives : We surveyed this study for knowing the relation within stress, depression and medical comorbidities, and finding the risk factors of major depression. Methods : 1764 subjects were enrolled from Jan. 2009 to Dec. 2009 who visit Korea University Guro hospital healthcare center. The subjects answered the questionnaire of PSS(Perceived Stress Scale), PHQ-9(Patient Health Questionnaire-9) and the demographic data. We categorized them as the stress group, depressive group, medical comorbidity group and analyzed the correlation analyses and logistic regression analyses. Results : 198 of 1764 subjects(11.8%) were applied to major depression, and the depressive group showed the higher mean stress score(23.19) and mean depression score(12.95) than the normal group. The total PHQ-9 score was increased by perceiving more stress, having more medical comorbidities. The subjects with female, visiting due to recent health problems, irregular exercise, current smoking, history of angina and cerebrovascular disease showed the increased risk of major depression. Conclusions : In this study, we find the PSS, PHQ-9 were valuable for mental health screening in healthcare center. As perceiving more stress and having more medical comorbidity, risk of major depression were increased. Accordingly the individuals with medical diseases or unhealthy lifestyle would need the mental health screen.

원전 주제어실 기밀도 시험에서 추적가스희석법의 시험원 신뢰성 데이터 검증

성지훈(Ji Hun Sung),노영진(Young Jin Noh),조재호(Jae Ho Cho),채영종(Young Jong Chae),심인보(In Bo Shim),배희수(Hee Soo Bae) 대한설비공학회 2017 대한설비공학회 학술발표대회논문집 Vol.2017 No.6

혁신주의 시대 NCF와 이민 정책

심인보 ( Shim In-bo ) 한국미국사학회 2024 미국사연구 Vol.59 No.0

This article examines the foreign immigration policy of the NCF during the Progressive Era. The NCF became interested in immigration issues because it believed that the Immigration Act of 1903, which was a restrictive law, was flawed. The law was based on unreliable data and failed to consider the potential benefits of immigration to the United States. In general, the NCF supported an open immigration policy. However, due to the prevailing anti-immigrant sentiment at the turn of the 20th century, the NCF's stance on immigration faced serious criticism. As a driving force behind major reforms during the Progressive Era, the NCF aimed to collaborate with immigration opponents to analyze the costs and benefits of immigration and the future of immigration from legal and political economy perspectives. In 1906, the NCF's Immigration Department organized a National Immigration Conference in New York City that brought together individuals representing various partisan interests in immigration. Although there were heated arguments for and against immigration at the conference, a wide range of opinions were shared. The result was a set of resolutions calling for amendments to the Immigration Act of 1903, and many of these recommendations were incorporated into the Immigration Act of 1907. The NCF advocated for a policy of distributing the surplus of immigrant labor to regions with high labor demand. It collaborated with railroad and land development companies to relocate new immigrants to the South and West. These regions had the greatest need for labor and were also considered conducive to immigrant assimilation into American society. Simultaneously, the distribution of immigrant labor had a Turnerian safety valve effect, alleviating population pressure in the large cities where immigrants primarily settled. The NCF also aimed to assist immigrants in assimilating into American society. For this purpose, it established the Immigrant Welfare Committee and published the Immigrant Handbook, a guide to life in the United States. The handbook provided information on American politics, history, geography, and employment. The NCF recognized immigrants as potential Americans and advocated for policies that would increase the influx of immigrants, believing that the United States could benefit from their presence.

혁신주의시대 연방주의와 통일주법운동

심인보 ( In-bo Shim ) 한국미국사학회 2009 미국사연구 Vol.29 No.-

The changing conditions of American life at the turn of the twentieth century gave rise to debate among many segments of the polity over the role of government. While most of the liberals recommended an active federal government and its direct involvement in the nation’s economy, the American Bar Association(ABA) and the National Civic Federation(NCF) cautioned against too strong central authorities as a danger to free enterprise. Instead, the NCF suggested that the state government to take the role of an umpire on the socio-economic issues. Though assumed that the state governments having such an authority, the state legislatures resulted in passing many different and often conflicting legislations over the identical socio-economic matters. Since there were so many states, they had liberty to enact laws which could be contradictory or often cancelling each other. To remedy this situation, the ABA and the NCF wished to legislate. “Uniform State Law,” under which the state legislatures were obliged to pass the same kind of law over the identical issue. The idea behind the “Uniform State Law Movement” was a product of the careful consideration to upkeep American federalism that the constitution provided each state the power to reserve. Three years after the ABA and the NCF holding the national conference for “the State Uniform Law,” Woodrow Wilson was duly elected as the President of the United States. Under the Wilson administration, a series of reform bills were passed in Congress and enacted into law of the country, and the federal government was given more and more power to enforce such law. In spite of the Uniform State Law Movement’s set goal and its tireless efforts for the state right system, the centralization by the federal government had been continued without interruption as the country going through the Great Depression and experiencing World War I.

OK-432를 사용한 소아 림프관종 치료효과

정성은,김대연,심인보,이성철,박귀원,김우기,Jung, Sung-Eun,Kim, Dae-Yeon,Shim, In-Bo,Lee, Seong-Cheol,Park, Kwi-Won,Kim, Woo-Ki 대한소아외과학회 1998 소아외과 Vol.4 No.2

Lymphangioma is a congenital malformation of the lymphatic system that expands into the surrounding tissues in a manner similar to a malignant tumor. Surgical excision has been the treatment of choice, but the results are often unsatisfactory due to incomplete resection, fluid collection and recurrences. Intralesional injection of OK-432(lyophilized incubation mixture of Group A Streptococcus pyogenes of human origin) was employed in treating 24 patients with lymphangiomas between 1992 and 1997. The method was used in 21 patients as a primary therapy, and in 3 patients for unresectable or recurrent cases as a secondary treatment. The results were excellent in 8 patients (33.3%), good in 7 patients (21.8 %) and poor in 7 patients (21.8 %). The side effects were fever under $39^{\circ}C$ and local inflammation. However these symptoms subsided in a few days without serious sequelae. These results suggest that intralesional injection of OK-432 is safe and effective treatment for primary lymphangioma as well as a secondary therapy for unresectable or recurrent cases.

Charles Olson의 사상

심인보(Shim, In-Bo) 부산대학교 인문학연구소 1997 코기토 Vol.51 No.-

Sol - gel 법에 의한 LSMO Granular 박막에서의 촉매의 영향

심인보(In-Bo Shim),안근영(Geun Young Ahn),조영석(Young Suk Cho),윤성로(Sung Ro Yoon),김철성(Chul Sung Kim) 한국자기학회 2001 한국자기학회 학술연구발표회 논문개요집 Vol.11 No.1

항공기 외부소음 예측기법의 개발

심인보(In Bo Shim),이덕주(Duck Joo Lee) 한국소음진동공학회 2000 한국소음진동공학회 학술대회논문집 Vol.2000 No.1

연구논문 : 미국 현대 환경주의의 등장

심인보 ( In Bo Shim ) 동국사학회 2013 동국사학 Vol.54 No.-

이 글의 목적은 1960년대 미국 환경주의의 등장 배경을 살펴보는 데 있다. 이 시기 환경운동은 자연자원의 효율적 이용을 목적으로 하는 20세기 중엽까지의 자연보존운동과 다른 것이었다. 환경주의는 운동의 강조점을 삶의 질의 문제에 두면서 대중들의 주목을 받게 되었다. 그러므로 현대 환경주의는 자연환경에 대한 대중적 관심이 확대되며 시작되었다. 대중들은 핵실험에 의한 방사성 낙진, 독성 화학물질에 대한 공포, 그리고 1960년대 미국이 경험한 일련의 사회경제적 상황과 상호 영향을 주고 받으며 환경운동의 주체로 나서게 되었다. 그리고 현대 환경운동의 기념비적인 저서 레이첼 카슨이『침묵의 봄』은 생태계와 인간 사이의 상관관계를 대중들에게 환기 시키고 그 과학적 근거를 제공하였다. 현대 환경주의는 이러한 요인들을 통해 자연에 대한 대중들의 사회적 통념을 바꾸며 등장하였다. The aim of this paper is to examine the emergence background of the American environmentalism in the 1960s.The environmental movement differed markedly from conservation movement that was an effort to bring about more efficient development of physical resources to the mid-20th. By comparison with conservation, the environment was far more widespread and popular, involving public value that stressed the quality of the human environment and hence of life. In this regard, the modern environmentalism emerged with expanding public concern for nature. Growing worries about radioactive fallout and toxic chemicals gave rise to public concern about human health. The socio-economic changes in 1960s also had mutual influence on these public fear. And Rachel Carson`s book Silent Spring spread the word about ecological system, provided a scientific basis about environmentalism to the public. Proceeding from this facts, the modern American environmentalism began to emerge with the changing conventional wisdom for nature.