PURPOSE: As midwives witness and attend the whole process of childbirth, they have a better understanding of which factors may cause traumatic childbirth. However, because most of the studies paid their attention on mothers, little is known about psychological birth trauma from the perspective of midwives. This study aims to gain a full understanding of which factors may contribute to psychological traumatic childbirth from the perspective of midwives.METHODS: A qualitative research was conducted using in-depth interviews, which involved fourteen midwives from the maternal ward of a tertiary hospital. The interviews were recorded and transcribed, and then, Colaizzi's method was used to analyze the contents of the interviews.RESULTS: We proposed four themes and eight subthemes on the influencing factors of psychological traumatic childbirth from the perspective of midwives: low perceived social support (lack of support from family and lack of support from medical staff), hard times (protracted labor in the first stage and futile efforts during the second stage), poor birth outcomes (poor birth outcomes of the mother and poor birth outcomes of the baby), and excruciating pain (unbearable pain of uterine contraction and labor pain was incongruent with the mother's expectations).CONCLUSION: Medical staff should pay attention to psychological traumatic childbirth and its effects, and emphasis on the screening and assessment of birthing women with negative feelings so that their psychological traumatic childbirth can be prevented and decreased.
Female ; Humans ; Labor Pain ; Mass Screening ; Medical Staff ; Methods ; Midwifery ; Mothers ; Natural Childbirth ; Parturition ; Pregnancy ; Psychological Trauma ; Qualitative Research ; Tertiary Care Centers ; Uterine Contraction

The Motor Vessel Sewol accident was a horrible accident, and it had complex ripple effects in various areas such as politics, economy, and culture. In particular, the psychological impact of each individual in Korean society was great, and various explanations for the causes of such psychological mass trauma would be possible. One of these important causes is the historical memory about common cultural custom. Therefore, the historical and cultural memory of the school trips shared by members of Korean society may be one of the causes of the psychological trauma. This paper aims to explain the cultural and social functions of school trips in East Asian societies from a historical point of view. In addition, we will also analyse the reasons why shared cultural memories contributed to the formation of collective trauma of the accident from a cultural, anthropological and psychiatric point of view.
Asian Continental Ancestry Group ; Humans ; Memory ; Politics ; Psychological Trauma ; Stress Disorders, Post-Traumatic

PURPOSE: The purpose of this study was to identify the moderating effect of interpersonal skills on the relationship between childhood emotional trauma and depression. METHODS: From June to July, 2017, a convenience sample of 226 nursing students was recruited. Research data were collected through self-report questionnaires and analyzed using SPSS version 22.0. RESULTS: 68.1% (154) respondents experienced emotional abuse, and 48.1% (110) emotional neglect in childhood emotional trauma. The average depression score was 10.76. There were 54.4% (123), 34.5% (78), 12.8% (29), and 7.1% (16) of respondents with mild, moderate, and severe depression, respectively. The average interpersonal skills score was 3.59. There was a significant correlation between childhood emotional trauma (emotional abuse, emotional neglect), interpersonal skills and depression. And the moderating effect of interpersonal skills on the relationship between childhood emotional neglect and depression was significant. CONCLUSION: Interpersonal skills play a role as a moderating variable influencing the relationship between emotional neglect of childhood emotional trauma and depression, and also reduce the effects of childhood emotional trauma on depression. When developing a depression prevention program for nursing college students, such programs should consider strategies to reduce the negative effects of childhood emotional trauma and to improve interpersonal skills.
Depression ; Humans ; Nursing ; Psychological Trauma ; Social Skills ; Students, Nursing ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to construct and test a hypothetical model about impact of parents' problem drinking on suicidal ideation of their children who are university students and the multiple mediating effects of childhood trauma, experiential avoidance, and depression based on stress-vulnerability model. METHODS: A purposive sample of 400 university students was recruited from three universities in provincial areas and the data were collected between October and November 2016. The collected data were then analyzed using SPSS 20.0 and AMOS 20.0 programs. For data analysis, descriptive statistics, factor analysis, and structural equation modeling were performed. Multiple mediating effects analysis using phantom variable and bootstrapping were implemented to verify the mediating effect of the research model. RESULTS: We found no significant direct effect on depression and suicidal ideation of parents' problem drinking, but multiple mediating effects of childhood trauma and experiential avoidance between parents' problem drinking and depression (B=.38, p=.001). The path from parents' problem drinking to suicidal ideation was significantly mediated by childhood trauma and depression (B=.02, p=.016) and by childhood trauma, experiential avoidance, and depression (B=.05, p=.011), but experiential avoidance did not have a significant direct effect on suicidal ideation (B=.02, p=.616). CONCLUSION: Based on the results of this study, it can be suggested that in order to decrease depression and prevent suicide of university students, considering of parents' problem drinking and childhood trauma, intervention methods that decreased chronic use of experiential avoidance and strengthen acceptance should be developed and made available to them.
Child* ; Depression* ; Drinking* ; Humans ; Negotiating* ; Parents ; Psychological Trauma ; Statistics as Topic ; Suicidal Ideation* ; Suicide

BACKGROUND: Posttraumatic stress symptoms (PTSS) in patients with psychological trauma lead to poor health-related quality of life. Understanding of the relationships among PTSS, anxiety, depression, and illness intrusiveness will guide the development of efficient approaches to enhance subjective well-being in patients with psychological trauma. This study investigated whether anxiety and depression mediate the relationship between PTSS and illness intrusiveness in the hope of providing more comprehensive and effective trauma treatment. METHODS: Psychiatric outpatients who visited the trauma clinic of a university hospital (n = 260) participated in this study. Assessments were conducted for PTSS, anxiety, depression, and illness intrusiveness. Structural equation modeling and path analysis were performed to analyze the mediating effects of anxiety and depression on the relationship between PTSS and illness intrusiveness. RESULTS: PTSS had both direct and indirect exacerbating effects on illness intrusiveness. Anxiety exhibited the largest direct exacerbating effect on illness intrusiveness. The indirect effects of PTSS on illness intrusiveness through anxiety alone and through a depression-to-anxiety pathway were significant, but the indirect effect through depression alone was not. CONCLUSION: The findings demonstrate that anxiety, both independently and as part of an interrelated pathway with depression, partially mediates the relationship between PTSS and illness intrusiveness. Appropriate interventions and a comprehensive approach to alleviate anxiety and depression could mitigate the negative effects of PTSS on illness intrusiveness in patients with psychological trauma.
Anxiety* ; Depression* ; Hope ; Humans ; Negotiating* ; Outpatients ; Psychological Trauma ; Quality of Life

BACKGROUND: Temporomandibular disorder (TMD) represents a subgroup of painful orofacial disorders involving pain in the temporomandibular joint (TMJ) region, fatigue of the cranio-cervico-facial muscles (especially masticatory muscles), limitation of mandible movement, and the presence of a clicking sound in the TMJ. TMD is associated with multiple factors and systemic diseases. This study aimed to assess the prevalence of TMD in Nepalese subjects for the first time. METHODS: A total of 500 medical and dental students (127 men and 373 women) participated in this study from May 2016 to September 2016. The Fonseca questionnaire was used as a tool to evaluate the prevalence of TMD, and Fonseca's Anamnestic Index (FAI) was used to classify the severity of TMD. RESULTS: The majority of the participants with TMD had a history of head trauma, psychological stress, and dental treatment or dental problems. The prevalence of TMD in Nepalese students was mild to moderate. CONCLUSIONS: The prevalence of TMD in Nepalese subjects was mild to moderate. The majority of the study subjects had eyesight problems, history of head trauma, psychological stress, and drinking alcohol and had received dental treatments.
Craniocerebral Trauma ; Dentistry ; Drinking ; Epidemiologic Studies ; Fatigue ; Humans ; Male ; Mandible ; Muscles ; Prevalence ; Stress, Psychological ; Students, Dental ; Temporomandibular Joint ; Temporomandibular Joint Disorders

PURPOSE: The purpose of this study was to test the effectiveness of a post-traumatic stress disorder management program in reducing firefighters' post-traumatic stress and depression. METHODS: This study employed a nonequivalent control group design using pretest and posttest measurements. Sampling was conducted with a convenient method. 44 firefighters (experimental group=22, control group=22) who were at high risk of post-traumatic stress disorder (PTSD) and depression were selected from 1,337 firefighters working in fire stations in multiple sites. Data were collected between August and October 2016. The post-traumatic stress disorder management program was provided to the experimental group for 8 weeks. Data were analyzed using descriptive statistics and chi-squared and independent t-tests. RESULTS: Compared with the control group, participants in the experimental group showed significantly decreased scores for PTSD (t=−3.34, p=.002) and depression (t=−2.09, p=.043). CONCLUSION: Our study findings show that firefighters' PTSD and depression can be systematically managed. Clinical practice should strengthen the ability to cope with PTSD by relieving the psychological trauma of firefighters who experience repeated traumatic events.
Depression ; Firefighters ; Fires ; Humans ; Methods ; Psychological Trauma ; Stress Disorders, Post-Traumatic

Chronic postsurgical pain (CPSP) is an unwanted adverse event in any operation. It leads to functional limitations and psychological trauma for patients, and leaves the operative team with feelings of failure and humiliation. Therefore, it is crucial that preventive strategies for CPSP are considered in high-risk operations. Various techniques have been implemented to reduce the risk with variable success. Identifying the risk factors for each patient and applying a timely preventive strategy may help patients avoid the distress of chronic pain. The preventive strategies include modification of the surgical technique, good pain control throughout the perioperative period, and preoperative psychological intervention focusing on the psychosocial and cognitive risk factors. Appropriate management of CPSP patients is also necessary to reduce their suffering. CPSP usually has a neuropathic pain component; therefore, the current recommendations are based on data on chronic neuropathic pain. Hence, voltage-dependent calcium channel antagonists, antidepressants, topical lidocaine and topical capsaicin are the main pharmacological treatments. Paracetamol, NSAIDs and weak opioids can be used according to symptom severity, but strong opioids should be used with great caution and are not recommended. Other drugs that may be helpful are ketamine, clonidine, and intravenous lidocaine infusion. For patients with failed pharmacological treatment, consideration should be given to pain interventions; examples include transcutaneous electrical nerve stimulation, botulinum toxin injections, pulsed radiofrequency, nerve blocks, nerve ablation, neuromodulation and surgical management. Physical therapy, cognitive behavioral therapy and lifestyle modifications are also useful for relieving the pain and distress experienced by CPSP patients.
Acetaminophen ; Analgesics, Opioid ; Anti-Inflammatory Agents, Non-Steroidal ; Antidepressive Agents ; Botulinum Toxins ; Calcium Channel Blockers ; Capsaicin ; Chronic Pain ; Clonidine ; Cognitive Therapy ; Drug Therapy ; Humans ; Incidence ; Ketamine ; Lidocaine ; Life Style ; Nerve Block ; Neuralgia ; Pain Management ; Pain, Intractable ; Pain, Postoperative ; Perioperative Period ; Physical Therapy Modalities ; Psychological Trauma ; Risk Factors ; Surgical Procedures, Operative ; Transcutaneous Electric Nerve Stimulation

Ischemic priapism is a urological emergency that has been associated with long-standing and irreversible adverse effects on erectile function. Studies have demonstrated a linear relationship between the duration of critically ischemic episodes and the subsequent development of corporal fibrosis and irreversible erectile function loss. Placement of a penile prosthesis is a well-established therapeutic option for the management of erectile dysfunction secondary to ischemic priapism, and will be the focus of this review. Review of the current literature demonstrates a growing utilization of penile prostheses in the treatment of erectile dysfunction secondary to ischemic priapism. Unfortunately, there is a paucity of randomized-controlled trials describing the use of prosthesis in ischemic priapism. As a result, there is a lack of consensus regarding the type of prosthesis (malleable vs. inflatable), timing of surgery (acute vs. delayed), and anticipated complications for each approach. Both types of prostheses yielded comparable complication rates, but the inflatable penile prosthesis have higher satisfaction rates. Acute treatment of priapism was associated with increased risk of prosthetic infection, and could potentially cause psychological trauma, whereas delayed implantation was associated with greater corporal fibrosis, loss of penile length, and increased technical difficulty of implantation. The paucity of high-level evidence fuels the ongoing discussion of optimal use and timing of penile prosthesis implantation. Current guidance is based on consensus expert opinion derived from small, retrospective studies. Until more robust data is available, a patient-centered approach and joint decision-making between the patient and his urologist is recommended.
Consensus ; Emergencies ; Erectile Dysfunction ; Expert Testimony ; Fibrosis ; Humans ; Joints ; Male ; Penile Implantation ; Penile Prosthesis ; Priapism ; Prostheses and Implants ; Psychological Trauma ; Retrospective Studies

OBJECTIVES: The purpose of this study was to assess physical illnesses, psychological difficulties, and daily life function of victims' family members one year after the Sewol ferry disaster, in order to establish a basis of strategies to promote their mental health and resilience. METHODS: We statistically analyzed self-reported data collected from a survey conducted between March 22 and 28, 2015 with 139 family members of victims. RESULTS: All respondents complained about one or more psychological difficulties, and 95.4% of them had newly diagnosed or exacerbated physical illnesses. An increased number of psychological difficulties was associated with a greater tendency to present physical illnesses including chronic headache, gastrointestinal, musculoskeletal, obstetrico-gynecological, genitourinary, and cardiovascular disease. In addition, the majority of respondents reported a decrease in life functioning. Specifically, 71.9% reported interpersonal avoidance and 63.9% reported difficulty in returning to work. CONCLUSIONS: Not only psychological trauma but also physical illness and daily functioning should be evaluated in detail and actively addressed in the bereaved family members after a catastrophe.
Cardiovascular Diseases ; Disasters ; Headache Disorders ; Humans ; Mental Health ; Psychological Trauma ; Surveys and Questionnaires