Earticle

침투적 사고는 정상 및 임상 집단 모두에서 빈번한 경험이므로 발생 자체보다는 그에 대한 조절과 통제가 중요할 수 있다. 본 연구는 원치 않는 사고를 통제하는 방략을 측정하는 사고 통제 질문지(Thought Control Questionnaire: TCQ)를 타당화하고자 했다. 이를 위해 사이버대학생 714명(표집 A 370명, 표집 B 344명)을 대 상으로 TCQ, 인지적 회피 질문지, 사고억제 척도, 보속적 사고 질문지 등을 온라인으로 실시했다. TCQ의 내적 구조를 알아보기 위해 표집 A에서 탐색적 요인분석을 하였는데, 평행분석, 적합도 지수, 해석 가능성 등을 종합적으로 고려하였을 때, 5요인 구조가 적절했다. 이중 부하를 해소하기 위해 목표회전을 활용하고, 요인구조를 정제하기 위해 탐색적 구조방정식 모형(ESEM)을 적용한 결과, 최종적으로 선행 연구와 유사하 게 5요인(‘주의분산’, ‘재평가’, ‘사회적 통제’, ‘처벌’, ‘걱정’) 구조가 얻어졌다. 표집 B에서 주의분산을 제외 한 모든 TCQ 통제방략들은 인지적 회피 및 사고억제와 기대한 방향의 상관을 보여서 적절한 수렴 타당도 가 지지되었다. 재평가를 제외한 모든 통제방략들은 침입적 사고 및 반복적 부정 사고와 예측되는 방향의 상관을 보여, 공존 타당도가 지지되었다. TCQ의 다섯 방략들은 내적 일치도가 양호했다. 그러나 6주에 걸 친 검사-재검사 신뢰도는 통제방략에 따라 높은 것부터 낮은 것까지 다양하게 나타났는데, 특히 걱정 방략 이 시간에 따른 안정성이 떨어졌다. TCQ가 침투적 사고에 대한 적응 및 부적응 통제 전략을 타당하게 측 정하는 도구이나, 주의분산과 재평가의 타당성에 부분적으로 제한이 있음을 논의하였고, 연구의 한계와 미 래 연구의 방향을 제시했다.

The intrusive thought (IT) is frequent in both normal and clinical population, so its modulation is more important than its occurrence per se. This study was conducted to validate the Thought Control Questionnaire (TCQ) that measures such strategies. For this purpose, TCQ, Cognitive Avoidance Questionnaire (CAQ), Thought Suppression Inventory (TSI), Perseverative Thought Questionnaire (PTQ) were administered to 714 cyber university students (Sample A of 370 Ss and B of 344 Ss). In Sample A exploratory factor analysis along with target rotation and Exploratory Structural Equation Model yielded a 5-factor solution composed of Distraction, Social Control, Punishment, Reappraisal, and Worry in accordance with the preceding research. Most of control strategies showed correlations with CAQ and “Attempt to Suppress” subscale of TSI in expected directions, confirming the convergent validity of TCQ. Also they displayed correlations with PTQ and “Intrusive Thought” subscale of TSI in expected directions, supporting concurrent validity. Two exceptions were the Distraction strategy that showed moderate correlation with thought suppression and cognitive avoidance and the Reappraisal strategy that showed no association with intrusive thought and PTQ. TCQ showed fair internal consistencies and various test-retest reliabilities over 6 weeks ranging from low to high. These findings suggested that TCQ is a valid tool to measure control strategies for IT. We discussed the limited effect of Distraction and Reappraisal as adaptive strategies and presented limitations of current study along with directions for future research.

Purpose: This study aims to investigate two different distraction methods, distraction cards and kaleidoscope, on pain and anxiety relief of children during phlebotomy. Methods: This study is a prospective, randomized and controlled trial. The sample consisted of 7-11 year-old children who required blood tests. Children were randomized into three groups: the distraction cards group, the kaleidoscope group, and the control group. Data were obtained by interviewing the children with their parents and the observer before and after the procedure. The pain levels of the children were assessed by the parent and observer reports as well as self report using the Wong Baker FACES Pain Rating Scale. The anxiety levels of children were assessed by parent and observer reports using Children Fear Scale. Results: One hundred and eighty-eight children (mean age, 8.8 ± 1.5 years) were included. The pain levels of children showed significant differences among the groups (p = .005). Both the distraction card group (2.41 ± 2.49) and the kaleidoscope group (3.10 ± 2.16) had lower pain levels than the control group did (4.44 ± 3.64). The distraction card group had the lowest pain levels (2.41 ± 2.49) among all groups. The procedural anxiety levels of children were significantly different among the groups (p <.001). Both the distraction card group (1.10 ± 1.20) and the kaleidoscope group (1.61 ± 1.12) had lower anxiety levels than the control group did (2.41 ± 1.30). The distraction card group had the lowest anxiety levels (p <.001). Conclusion: The distraction cards were the most effective method for pain and anxiety relief of children during phlebotomy. Also the distraction method with kaleidoscope was an effective method for pain and anxiety relief during phlebotomy in children.

Purpose: In this study, we aimed to compare the effects of two distraction interven- tions?DistrACTION Cards and Buzzy?on pain relief in children undergoing intrave- nous infusions in the emergency department. Methods: A quasi-randomized controlled trial was conducted in children aged 4?6 years receiving intravenous infusions in a single emergency department. Participants were as- signed to the DistrACTION Cards group (n=31), Buzzy group (n=30), or control group (n=31). Pain was assessed using the pulse rate, Faces Pain Rating Scale, and Face, Legs, Activity, Cry, Consolability scale. Results: Both distraction interventions significantly reduced observed pain (Face, Legs, Activity, Cry, Consolability scores) compared to that in the control group. The DistrAC- TION Cards group showed significantly lower pain scores than the control group during the procedure (p<.05) and demonstrated a consistent trend of pain reduction across all phases. Self-reported pain scores (Faces Pain Rating Scale) after the procedure were sig- nificantly lower in both intervention groups compared to those in the control group (p<.05); however, no significant differences were found in the extent of change between groups. No significant group differences were observed in pulse rate. Conclusion: Both DistrACTION Cards and Buzzy effectively reduced intravenous infu- sion-related pain in preschool children. DistrACTION Cards showed greater consistency than Buzzy in pain reduction as measured by the Face, Legs, Activity, Cry, Consolability scale, suggesting they may be considered as a preferred option in clinical practice. Fur- ther research in diverse clinical settings is needed to confirm these findings.

Objective: This study aimed to investigate the short-term effects of flexion-distraction spinal manipulation on intervertebral height, pain, spine mobility in patients with lumbar degenerative disc disease. Design: Randomized controlled trial with a pretest-posttest control group design Methods: A total of 96 participants with degenerative disc disease participated in the study and were randomly divided into two groups. Both groups received intervention for 3-5 minutes a day. The experimental group (n=48) underwent flexion-distraction spinal manipulation for 3-5 minutes, and the control group (n=48) was maintained in the same position as the experimental group for 5 minutes without any intervention. The intervertebral height was measured by computed tomography, pain was assessed using visual analog scale, and the spine in flexion mobility was measured using the finger-to-floor distance test and passive straight leg raise test. Pre-test and post-test measurements were obtained. Results: The experimental group showed significant improvement in intervertebral height, degree of pain, and spinal mobility (p<0.05). The intervertebral height increased from 6.32±1.90 to 6.93±1.85 mm (p<0.05), lower back pain decreased from 69.17±13.35 mm to 48.48±12.20 mm (p<0.05), lumbar spine mobility changed from 17.37±4.49 to 12.69±4.34 cm (p<0.05), and passive straight leg raise test range increased from 46.94±13.05° to 56.01±12.20° (p<0.05). Conclusions: This study suggests that flexion-distraction spinal manipulation could be an effective treatment for decreasing pain and improving function in patients with degenerative disc disease.

Purpose: This study examined whether popular science journalism can be a distraction from war news, as the life of all citizens in Ukraine has changed significantly since the beginning of the full-scale Russian invasion of Ukraine on February 24, 2022.Methods: This article presents an audience survey on whether they viewed science content as a distraction from war news. In addition, an analysis of 10 Ukrainian YouTube channels was conducted. All videos that were published after February 24, 2022, the start date of Russia’s full-scale invasion of Ukraine, were processed.Results: Out of 460 audience members of TV programs and YouTube channels, 64.8% of respondents considered watching popular science or entertainment programs as a distraction from the war. An analysis of the content of popular science YouTube channels during the first 2 months of the war showed that every active channel was reformatted according to the realities of wartime. In addition, the audience survey demonstrated that even during the war, this type of content has remained relevant.Conclusion: The Ukrainian audience needed scientific content as a distraction from the war. The majority of respondents, regardless of gender, needed to divert their attention from military operations. Ukrainian science journalists also joined the information war against the foreign invasion.

Purpose: This study aimed to evaluate the effects of an intervention combining warm therapy (via a thermoelectric-element tourniquet) and a distraction-based approach (via an augmented reality-based app known as TWINKLE) on pain, stress, and satisfaction during intravenous catheterization in adults. Methods: A randomized controlled trial was conducted in South Korea with 93 healthy adults who were randomly assigned to one of three groups: the experimental group (TWINKLE app with warm therapy), the comparison group (warm therapy only), and the control group (no treatment). Participants’ pain, stress, and satisfaction, as well as practitioner satisfaction, were measured after the intervention. Results: Pain scores differed significantly among the three groups (F = 5.68, p = .005), with the experimental group showing significantly lower scores than the control group (p = .003). Stress levels were also significantly lower in the experimental group than in the other groups (F = 9.42, p < .001). Participant satisfaction was highest in the experimental group (F = 17.65, p < .001), while nurse satisfaction was significantly higher in the comparison group than in the experimental and control groups (F = 67.91, p < .001), suggesting that the additional distraction intervention may have increased nurses’ workload. Conclusion: Combining digital distraction with warm therapy using a thermoelectric-element tourniquet effectively reduces pain and stress while improving patient satisfaction during intravenous catheterization. Further research is needed to optimize this approach, with a particular focus on targeting digital distraction interventions to patients with higher levels of procedural anxiety and finding ways to minimize practitioner workload.

Purpose: This study examined the effects of self-volar gliding combined with a strap and wrist distraction on pain and the active and passive wrist extension range of motion (ROM) in subjects with dorsal wrist pain during partial weight bearing of the hand. Methods: Thirty subjects (14 males and 16 females) with dorsal wrist pain during partial weight bearing through the hand participated in this study. The two different self-volar gliding techniques were performed for each group. Self-volar gliding using a strap (SVGS) and SVGS and wrist distraction (SVGSD) were performed five times for one week for each group. The active and passive ROM of wrist extension and the peak pressure pushed by the hand at pain (PPHP) were measured. An independent t-test was used to compare the improvements of these elements between the two different self-volar gliding techniques. The level of statistical significance was at ${\alpha}=0.05$. Results: The active and passive ROM of wrist extension and PPHP were greater in both self-volar gliding groups after the one week intervention. On the other hand, these parameters were greater in the SVGSD group than in the SVGS group (p<0.05) Conclusion: SVGSD is recommended to improve the active and passive ROM of wrist extension and PPHP in subjects with dorsal wrist pain during partial weight bearing of the hand.

목적 본 연구의 목적은 아동의 처치관련 통증을 경감시키기 위한 관심전환중재를 적용한 국내 중재연구들을 분석, 평가하고, 추후 아동의 처치관련 통증을 경감시키기 위한 관심전환중재 연구의 발전방향을 제시하기 위한 근거자료를 제공하고자 함이다. 방법 본 연구는 통증과 관련하여 아동을 대상으로 실시된 관심전환요법의 국내 간호연구 동향을 파악하고 실무 및 연구의 발전방향을 모색하기 위한 비판적 고찰 연구이다. 결과 국내에서 실시된 관심전환을 중재로 적용한 연구는 대부분이 학령전기 및 학령기 초기 아동을 대상으로 실시한 유사실험연구 설계였으며,시청각 자극을 통해 관심을 전환하는 방법을 가장 많이 사용하였다. 관심전환중재는 아동의 통증과 두려움 등의 행동반응 결과변수의 변화에는 분석 연구의 대부분에서 효과가 있는 것으로 그리고 생리적 반응결과변수의 변화에는 분석 연구의 46.7%에서 효과가 있는 것으로 나타났다. 그러나 분석에 포함된 논문들의 연구설계, 시행, 보고 등에 있어서방법론적인 엄격성이 부족하였다. 또한 각 연구들은 시행한 관심전환중재의 절차에 대한 제한된 정보만을 제시하여 다른 연구자들이 반복연구를 시행한다거나 중재를 실무로 중개하는 데 한계가 있었다. 결론 관심전환요법이 아동의 절차관련 통증과 두려움을 경감시키는 데효과가 있는지에 대한 근거를 좀 더 확실하게 파악하기 위해서는 방법론적 엄격함이 요구된다. 추후 연구에서는 관심전환중재의 임상적 활용성을 파악하기 위해 비용과 시간 효과성 그리고 보호자와 건강관리제공자의 만족도를 밝히기 위한 연구가 요구된다.

Purpose: The purpose of this study was to provide a critical assessment of evidence-based Korean pediatric research that can inform clinicalpracticability of, and future research on distraction interventions for pediatric procedural pain management. Methods: A critical review of evidence-based Korean pediatric research was conducted. Databases were searched to identify research that included an evaluation of a distractionintervention as an intervention for pediatric procedural pain management. The search yielded 68 studies. Results: From these studies, 14 wereincluded for this review and all were recently published (2003-2014). Quasi experimental designs were most frequently used (n=12) and for71.4% the focus was preschoolers. Audiovisual techniques were the most common form of distraction. In most studies clinical utility of the distractionintervention was not examined. Fairly consistent reductions in behavioral measures of pain in association with the distraction interventionwere found but less consistent results were found for physiological measures. Conclusion: Lack of methodological rigor limits the evidencefor distraction interventions to reduce pain and fear experienced by children during painful procedures. Further research to analyze the costand time-effectiveness and to identify consumer and provider satisfaction with distraction interventions is needed to determine whether distractioninterventions are clinically relevant.

Purpose: This study attempted to discover the effects of distraction on the hospitalized children's fear of the hospital and needle-related pain. Methods: The experimental group was given visual stimulation using a character from the injection room entrance. In addition, the video recording of 'bambarabam' was provided for visual and auditory stimulation to distract the children. The research tools included the hospital-related fear scale, Faces Pain Rating Scale (Wong & Baker, 1988) and Procedure Behaviour Check List (Lebaron&Zeltzer, 1984). For statistical analysis, the SPSS 19.0 program was used on the collected data for $X^2$-test and Mann-Whitney U test. Results: The experimental group showed significantly less fear ofthe hospital compared to the control group (U=151.50, p=.024). The experimental group showed significantly lower pain on both Faces Pain Rating Scale (U=167.50, p=.043) and the Procedure Behaviour Check List (U=106.00, p=.001) compared to the control group. Conclusion: These results suggest that distraction was effective in reducing the child's fear of the hospital and injection pain.

=Efects of Distraction by Cel Phone on Pain and Fear During Venipuncture Procedures for Hospitalized Preschol ChildrenLim, Jung-He1)Shin, Yeongee2)1) Nurse, Dongsan Medical Center, Keimyung University, 2) Profesor, College of Nursing, Keimyung University Purpose:during venipuncture procedures in hospitalized preschool children. Method: Fifty four preschool children, ages 3-6, were recruited from one university affiliated hospital in Daegu. Participants were asigned to the control group (n= was used to asses children's pain, and the visual analogue scale (VAS) to asses each mothers' perceptions of her child's pain. For assesment of fear, the Procedure Behavioral Checklist developed by Lebaron and Zeltzer was used.

Purpose: This study was done to evaluate the effects of distraction using balloon art on pain experienced by preschool children when undergoing an intravenous injection. Methods: Participants were 40 hospitalized preschool children. Children in the experimental group (20) were distracted by balloon art while undergoing an intravenous injection. Children in the control group (20) received regular care. Pain experienced by the children was measured using self-report, observation tools, heart rate and oxygen saturation. The data were analyzed using the SAS program. Results: Compared with the control group, children in the experimental group showed significant difference in pain as shown by pulse rate. However, children in the experimental group did not show a decrease in pain in the self-report or behavior observation when compared with children in the control group. Conclusion: Distraction using balloon art can be used to reduce pain for preschool children when undergoing an intravenous injection. Further nursing interventions need to be developed and provided to preschool children when undergoing painful procedures.

Purpose: The purpose of this study was to investigate the effect on pain of distraction with an operating doll in preschool children(3-6 years old) during an IV catheter insertion. Method: The research design was a nonequivalent control group posttest design, and the participants were 22 children in the experimental group, and 23 children in the control group. The children were hospitalized for enteritis and pharyngitis in a university hospital. The subjective pain was measured using FACES Pain Rating Scale by self report, and the pain behavior responses were scored using Procedure Behavior Check List by observing a film of the entire procedure, and changes in pulse and oxygen saturation as the physiological pain responses were measured by pulse oximeter. Data were analyzed with the SPSS Win 10.0 program. Result: The degree of subjective pain, pain behavior responses, and changes in pulse during IV catheter insertion were significantly lower in the experimental group. But there was no significant difference in O₂ saturation between the two groups. Conclusion: Distraction using an operating doll was effective in decreasing pain during inserting the IV catheter in preschool children.

Purpose: This study was conducted to investigate the effect of distraction manipulation on the pain and. intervertebral disc angle in patients with herniated intervertebral lumbar discs. Methods: 30 patients who visited to receive the treatments of the physical therapy in W pain clinic in Daejeon. All subjects had been treated with flexion-distraction manipulation for 30 minutes per day and three times a week during 12 weeks period from June 10 to 19 August 2006. They were randomly divided into two groups: lumbar 4 and lumbar 5 group. Results: Pain of L4 and L5 group was significantly reduced after than before treatment(p<0.05). The intervertebral lumbar disc angle was significantly improved after than before treatment(p<0.05). Conclusion: These results indicated that distraction manipulation has a effectiveness in patients with herniated lumbar disc.

본 연구에서는 주의분산이 우울 증상에 미치는 영향이 몰입에 의해 조절되는지를 검증하였다. 즉, 몰입 수준이 높을수록 주의분산이 우울 증상의 감소에 더 크게 영향을 미치는지를 검증하였다. 이를 위해, 대학생 326명을 대상으로 반응양식 질문지(RSQ)와 몰입 추구 질문지(TAS), 그리고 한국판 CES-D를 실시하였다. 연구 결과, 주의분산과 몰입의 상호작용이 유의하게 나타남에 따라, 주의분산이 우울 증상에 미치는 영향을 몰입이 조절하는 것으로 나타났다. 몰입 수준이 높을 때에는 주의분산이 높을수록 우울 증상이 감소하는 경향이 유의하게 나타났지만, 몰입 수준이 낮을 때에는 주의분산이 우울 증상에 미치는 영향이 유의하지 않게 나타났다. 마지막으로, 이러한 결과가 갖는 임상적 함의에 대해 논의하였고, 향후 연구의 방향을 제안하였다.

The purpose of this study was to examine flow as a moderator of the relation between the conceptual elements of distraction and depression. The study clarified that the effect of distraction on depression would be increased when the flow level is higher in an individual. There were three hundred and twenty-six undergraduate students who participated in the study and who completed the following testing questionnaire: the Response Style Questionnaire(RSQ), Tellegen Absorption Scale(TAS), and The Center for Epidemiological Studies-Depression Scale (CES-D) examinations. Afterwards, the hierarchical regression analyses was reviewed and studied, which indicated that the interaction effect of distraction and flow on depression is significant in an individual experiencing these components. Our study revealed that in the case where the flow level was considered high, the effect of distraction on depression was significant, while when the flow level was identified as low, there was no significant result. Finally, we conclude with the implications and the limitations of this study, and suggestions for future directions were discussed based on our results of the current study parameters.

사람들은 자신의 부정적인 정서를 조절하기 위해 다양한 전략들을 사용한다. 본 연구에서는 실험 연구를 통해 분노를 조절하기 위한 다양한 전략 - 반추, 주의분산, 긍정적 재평가가 기분과 혈압에 어떠한 영향을 미치는지 알아보았다. 피험자는 44명의 대학생들로 반추 집단 14명(남자 8명, 여자 6명), 주의분산 집단 15명(남자 8명, 여자 7명), 긍정적 재평가 집단 15명(남자 8명, 6여자 명)에 무작위로 할당되었다. 피험자는 실험 보조자와 함께 과제를 실시하는 사회적 상호작용 속에서 실험 보조자에 의해 불이익을 받는 상황을 통해 분노가 유발되었다. 피험자의 기분 변화는 연구자가 구성한 기분 질문지로 측정하였다. 피험자는 분노 유발 후 반추, 주의분산, 긍정적 재평가 전략 과제를 수행하도록 요청받았다. 분노 유발과 정서조절 전략 과제 실시 이후의 기분과 혈압의 변화를 살펴보기 위해서, 피험자는 분노 유발 전후와 정서조절 전략 과제 실시 이후에 기분 질문지와 혈압을 측정하였다. 이를 통해 사람들이 분노를 경험한 뒤 기분과 혈압에 어떠한 변화를 보이고, 분노에 효과적인 정서조절 전략이 무엇인지 알아보았다. 실험 결과 피험자들은 분노 유발 후 분노 기분이 증가하고, 긍정적 기분은 감소하는 기분 변화를 보였다. 하지만 혈압의 변화는 유의하지 않았다. 그리고 반추, 주의분산, 긍정적 재평가 전략을 실시한 집단 모두 분노 기분이 감소하였고 긍정적 기분은 증가하였다. 분노 기분 감소에 있어서 집단 간 차이는 유의하지 않았지만 긍정적 기분에 있어서는 집단 간 차이가 있었다. 즉 반추, 주의분산, 긍정적 재평가 전략 모두 분노 기분을 감소시켜 주었고, 특히 주의분산 전략은 다른 전략보다 긍정적 기분을 더 증가시켜 주었다. 혈압 변화에 있어서 수축기 혈압은 집단 간 차이나 정서조절 전후의 시기별 차이가 유의하지 않았고, 이완기 혈압은 집단 간 차이는 유의하지 않았지만 정서조절 전후의 시기별 차이는 유의하였다. 즉 반추, 주의분산, 긍정적 재평가 전략이 이완기 혈압을 감소시켜 주었다. 이러한 결과들은 정서조절 전략들이 분노를 조절하는데 효과적이었음을 시사한다.

People use a variety of strategies to regulate their negative moods. Some strategies are more effective than others at reducing these moods. In this study, we investigated the effect of rumination, distraction, and positive reappraisal strategies on angry mood and blood pressure. A total of 44 college students participated, and were randomly assigned to a rumination group(N=14; 8 males, 6 females), a distraction group(N=15; 8 males, 7 females), or a positive reappraisal group(N=15; 8 males, 6 females). Participants received a penalty if they caused anger in the social interaction situation. Participants were instructed to cause anger, ruminate, practice distraction, and perform positive reappraisal strategies. Researchers measure participants mood and blood pressure before and after the feeling of anger and after the emotion regulation. In this way, we investigated effective emotion regulation strategies with respect to anger. Results indicate that rumination, distraction, and positive reappraisal strategies were able to decrease angry mood and increased positive mood. Also, all strategies decreased minimum blood pressure.

Background: In order to find out the effect of therapy methods through Flexion-distraction technique and drop technique on pain, sacral angle of patients with lumbar herniated intervertebral disc targeting patients with lumbar herniated intervertebral disc due to L5-S1. Method: This study was to present the directivity of the therapy method for lumbar herniated intervertebral disc by comparing and analyzing the spinal decompression therapy and provide an effective treatment method to patients with lumbar herniated intervertebral disc by identifying the therapeutic effect of Flexion-distraction technique and drop technique. The research period is March 1, 2018 to June 30, 2018 and subjects are the patients diagnosed as lumbar herniated intervertebral disc due to L5-S1 by their doctor through clinical findings and medical equipment such as X-ray, CT, MRI etc. Among patients who visited and hospitalized in S Orthopaedics located in Daegu and 30 female patients with sacral angle of more than $30^{\circ}$ were randomly classified into 15 people and we carried out treatment three times a week for 8 weeks for 15 people in the experimental group applying Flexion-distraction technique and drop technique and 15 people in the control group applying spinal decompression therapy to compare and analyze the changes in pain, sacral angle of patients with lumbar herniated intervertebral disc. Result: According to the results of this study, changes in the Visual Analogue Scale showed statistically significant differences in both the experimental group and control group(p<.05), while there was statistically significant difference in the comparison between groups before and after measurement of experimental group (p<.05). In the comparison within two groups of sacral angle, both groups showed statistically significant difference(p<.05) but there was no statistically significant difference in the comparison of scores between groups before and after measurement of each group(p>.05). Discussion: All those results the above proved that we need to confirm various benefits of the therapy with the flexion-distraction technique and drop technique, and the findings of the concerned study will possibly become useful information when doctors actually work on a therapy to treat patients with the lumbar herniated intervertebral disc.

운전 시뮬레이션을 사용하여 차량 전방의 장애물 출현으로 인해 제어권 인수가 요구되는 3-수준 자율주행 상황에서 운전자의 주의분산 및 도로혼잡도 조건에 따른 제어권 인수시간(takeover time: TOT)과 장애물 회피에 대한 정신적, 신체적 작업부하에서의 차이를 비교하였다. 실험참가자들은 연령대에 따라 20대의 청년운전자 집단과 65세 이상의 고령운전자 집단으로 구분하였다. 주의분산은 자율주행 중 운전과 직접적으로 관련없는 과제(non-driving task: NDT)의 수행으로 유도되었고, 도로혼잡도 조건은 실험참가자 차량 주변의 차량 대수를 달리하여 조작하였다. 본 연구의 주요 결과와 시사점은 다음과 같다. 첫째, 자율주행 중의 NDT 미수행 조건에 비해 수행 조건에서, 그리고 한산도로보다는 혼잡도로에서 실험참가자들의 TOT가 유의하게 지체되었고, 제어권 인수 이후 장애물 회피 과정에서 경험하는 정신적, 신체적 작업부하의 수준도 유의하게 더 높았다. 둘째, 특히 이러한 경향은 청년운전자 집단에 비해 고령운전자 집단에서 더 뚜렷하였다. 이러한 결과는 혼잡한 도로에서 주의가 시각적, 청각적으로 분산될 경우 고령운전자 집단은 차량 전방의 장애물에 대한 안전하고 효과적인 회피 수행에서 어려움이 더 증가할 수 있다는 것을 시사한다.

This driving simulation study compared differences in driver’s takeover time (TOT) and subjective workload for obstacle avoidance under different conditions of road complexity and attention distraction in in a level-3 automated driving. Participants were divided into two groups: young drivers in their 20s and older drivers aged 65 or older. Attention distraction was induced by performing a non-driving task (NDT) during autonomous driving, and road complexity was manipulated by varying the number of vehicles surrounding the drivers’ vehicle. The main findings and implications of this study are as follows. First, drivers’ TOT was significantly delayed in the NDT condition compared to the non-NDT condition during automated driving, and in the congested traffic condition compared to the clear road condition. Furthermore, the level of mental and physical workload during obstacle avoidance through manual driving after control takeover was significantly higher. Second, this tendency was particularly pronounced in the older driver group compared to the younger driver group. The results of this study suggested that older drivers may experience increased difficulties in safe and effective avoidance regarding obstacles ahead of their vehicle when visually and audibly distracted on congested roads.

=The Effects of Character Distraction on Intravenous Injection Pain of Hospitalized Preschooler

본 연구는 예방접종을 위해 병원을 방문한 학령전기 아동을 대상으로 관심전환 중재를 제공하고, 중재가 그들의 통증반응에 미치는 효과를 확인하고자 시도되었다. 실험 1군에는 수동적 관심전환 중재(만화 동영상)를, 실험 2군은 능동적 관심전환 중재(상호작용이 가능한 장난감)를 제공한 후 일상적인 통증관리 이외에 관심전환 중재를 제공하지 않은 대조군과 비교한 비동등성 대조군 사후설계를 이용한 유사실험연구이다. 자료는 2014년 10월 22일부터 11월 5일까지 집단 별로 30명씩 수집하였고, 통증반응은 아동, 부모 및 연구자에 의해 측정되었다. 연구 결과 관심전환 중재를 제공받은 실험군(수동적 관심전환 중재군, 능동적 관심전환 중재군)과 대조군은 아동이 자가보고한 통증반응(F=68.92, p=< .001), 부모가 지각한 아동의 통증반응(F=42.63, p=< .001) 및 연구자가 관찰한 아동의 통증반응(F=114.56, p=< .001)에서 유의한 차이가 있었으며, 실험 집단 간에도 유의한 차이가 있는 것으로 나타났다. 관심전환 중재가 학령전기 아동의 예방접종과 관련된 통증을 경감시키는 데 효과적인 중재이고, 수동적 방법이 능동적 방법보다 효과적인 것으로 나타났으며, 추후 연구에서는 관심전환 중재 및 관심전환 중재물의 형태에 따른 효과를 검증하기 위한 반복연구가 요구된다.

The purposes of this study were to identify the effects of distraction strategies compared to usual pain management, and to compare the effects of passive and active distraction on pain responses of preschool children during immunization. A quasi experimental with non-equivalent control group posttest design was used. Participants for each group were 30 preschool children who visited a pediatric clinic to have influenza immunization. Children in experimental groups selected one of two distraction types. Pain responses were measured by children, parents, and researcher. Pain responses by children, parents, and researcher during immunization were significantly different between groups. Children in passive or active distraction group were more distracted than children in control group. Moreover, self-reported pain response by children($2.70{\pm}0.88$) and researcher($12.97{\pm}2.39$) in active group were higher than pain scores by children($2.27{\pm}0.64$) and researcher($10.63{\pm}1.65$) in passive group. Results of this study identified that distraction intervention is an effective method for decreasing pain responses in preschool children during immunization. Passive distraction is more effective than active distraction. Use of distraction strategies during immunization should be facilitated. Further research comparing distraction strategies by types and forms is needed.