Background/Aims: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the go-to method for obtaining samples from gastrointestinal tract and pancreatic lesions. When the transduodenal approach is utilized, the use of a more flexible needle, such as a nitinol 19-gauge (G) needle, has been recommended. The aim of this study was to evaluate the feasibility and accuracy of 19-G flexible aspiration needles in obtaining samples from solid lesions through a transduodenal approach.
Methods: This was a retrospective analysis of prospectively collected data from eight Italian endoscopy centers. Consecutive patients with solid lesions who underwent transduodenal EUS-FNA with a 19-G flexible needle were included.
Results: A total of 201 patients were enrolled. According to histology, EUS, radiology and 12 months of follow-up, 151 patients had malignant lesions and 50 patients had benign lesions. EUS-FNA was feasible in all cases. An adequate histologic sample was obtained in all except eight cases (96.1%). The sensitivity of EUS-FNA was 92.1% (95% confidence interval [CI], 86.8%-95.7%), and the specificity was 100% (95% CI, 90.5%-100%). The positive predictive value was 100% (95% CI, 93.4%-100%), and the negative predictive value was 74% (95% CI, 62.8%-82.7%). The diagnostic accuracy was 93.5% (95% CI, 89.2%-96.5%).
Conclusions: The transduodenal approach for obtaining samples from solid lesions using a 19-G flexible needle seems feasible and accurate. Clin Endosc 2021;54:229-235

International counseling students enrolled in American counseling programs have received limited attention. This study examined the lived experiences of five international counseling students in an American counseling program regarding their experience of leadership and advocacy. The study identified fourteen themes under three categories and provided recommendations to counselor educators, administrators, and international counseling students.

Over one million survivors have lived more than 25 years after receiving a cancer diagnosis. Researchers proposed employing sandtray therapy as an effective means of exploring the lived experience of cancer patients, survivors, and family members. Three of five support group members participated in the research study. Sandtray therapy provided the participants with the power to increase their understanding about themselves, in addition to experiencing the resilience of achieving wellness. Participants used sandtrays to depict their lived experience, discover essential phenomena, and explore resilience.

The main purpose of the current study was twofold: (a) to examine the effects of intrusive rumination and deliberate rumination on posttraumatic growth and (b) to test the mediated moderating effect of psychological acceptance on posttraumatic growth. For this study, 334 South Korean adults completed questionnaires which included demographic information, K-ERRI, K-PTGI, and K-AAQ-II. After data cleaning, a total of 292 responses were analyzed by structural equation modeling. As a result, the initial model which hypothesized that deliberate rumination would predict present intrusive rumination was rejected. In addition, psychological acceptance had a moderating effect on the relationship between past intrusive rumination and present intrusive rumination. The implications for counselors and counseling researchers are discussed.

This study aims to develop career competency factors based on the career capital of female vocational high school students in Korea. Related literature analysis was conducted to explore factors of career competency and then a draft was prepared by classifying the factors of career competency based on career capital. A focus group interview was conducted for career and education experts who work with female vocational high school students; the draft was completed by reflecting expert opinions. In addition, validity verification was conducted. As a result of this study, the career capital-based career competency factors included career attitude, career awareness, career knowledge skills, career experience and career communication. The findings provide the significance of career capital-based career competency factors development. Suggestions for career counseling research were also made.

본 연구는 이태원 클럽발 집단감염사태에서 나타난 윤리 딜레마적 요소들을 살펴보고, 이것이 상담자들에게 어떠한 함의를 주는지 분석하기 위해 수행되었다. 이를 위해 치명적인 감염병에 걸렸거나 감염 위험이 있는 성 소수자 내담자와의 상담과 관련하여 국내·외 윤리강령들을 검토하고, 국내의 감염병과 관련된 법률들을 분석하였다. 분석 결과, 성 소수자가 감염병에 걸렸거나, 감염 위험성이 높은 경우 중 제3자에 대한 위험이 있는 매우 특수한 경우에, 신중한 의사결정을 거쳐 비밀보장을 파기할 수 있으나, 이 과정에서 내담자는 성적 지향이 드러나 혐오와 차별에 노출될 수 있기에 상담자는 다각적인 요소를 고려해 최고의 신중을 기해야 한다. 이와 같은 과정에 대해 국내 학회들의 윤리강령들은 누락하고 있는 내용 요소들이 상당히 있었으며, 별도의 지침이나 보조 조항들도 부재하였다. 다음으로 보다 넓은 맥락에서 감염병과 관련된 두 가지의 국내 현행법을 분석한 결과, 경고 의무에 해당하는 상황에 대해 상담자의 신고 의무를 규정한 법률은 없으나, 감염병의 종류와 상황에 따라 내담자의 상담자 방문 사실에 대한 신고가 필요한 상황은 발생할 수 있었다. 그러나 법적인 신고의 의무가 없다고 해도, 상담자에게는 Tarasoff 판례를 통해 각인되어 있는 자신과 타인에 의한 위험 경고의 의무가 여전히 존재한다. 이에 본 연구에서는 선행 연구 분석을 통하여 상담자들이 성 소수자의 감염병 관련 비밀보장에 대한 윤리적 의사결정 상황에서 참고할만한 사실 정보들과 상담자 성찰을 위한 질문들, 의사결정 단계에 대한 정보를 제공하고자 하였다.

This study was conducted to examine the ethical dilemma that emerged from the Itaewon club mass infection case and to analyze the implications for counselors. To this end, counseling ethical codes of Korean and American counseling related associations, and current Korean laws regarding the infectious diseases were analyzed in connection to counseling with sexual minorities. The result shows that in very special cases if sexual minorities have an infectious disease or are at high risk to third parties, the confidentiality can be revoked through careful decision-making. However, the counselor should be careful in consideration of various factors, as the sexual orientation of the client can be exposed to public disgust and discrimination. Regarding that considerable point, content elements were significantly missing in the code of ethics of Korean academic socities, and there were no separate guidelines or supplementary provisions. Next, an analysis of two current Korean laws related to infectious diseases in a broader context indicated that no laws stipulated the obligation of counselors to report the specific counseling content but depending on the type and circumstances of the infectious disease, there could be situations in which reporting of the client list was required. However, even if there is no legal obligation to report, the counselor still must warn clients themselves and others of risk based on the professional ethics, which is imprinted through the Tarasoff precedent. In this study, the factual information that counselors can refer to in ethical decision-making situations regarding the confidentiality of infectious diseases of sexual minorities, questions for counselors' reflection, and information on decision-making step are provided through the analysis of precedent researches.

본 연구는 집단상담의 수행을 위해 필요한 집단상담자 능력에 대한 확신의 정도를 측정하기 위해 Page, Pietrzak과 Lewis(2001)이 개발한 집단상담자 자기효능감 척도를 타당화하려는 목적으로 진행되었다. 이를 위해, 서울을 포함한 전국의 대학상담실, 청소년상담센터와 개인 상담실에서 집단상담을 수행하고 있거나 수련 중인 209명(여자 186명, 남자 23명)의 상담자들을 대상으로 집단상담자 자기효능감 척도 설문을 실시하고 신뢰도 및 타당도를 확인하였다. 탐색적 요인분석 결과, 집단상담자 자기효능감은 세부상담 기술, 과정 기술 및 차이를 다루는 기술 등 3개의 하위 요인으로 구성되어 있으며 각각의 하위 요인들은 적절한 수준의 신뢰도를 지닌 것으로 나타났다. 확인적 요인분석 결과, 미국인 상담훈련생들을 대상으로 조사됐던 원척도가 1요인으로 구성된 것으로 보고된 것과는 달리 우리나라의 상담자들을 대상으로 한 본 조사에서는 3요인 구조 모형이 보다 양호한 적합도를 가지는 것으로 나타났다. 집단상담자 자기효능감 척도는 집단상담자 발달 척도와 높은 정적 상관을, 사회적 바람직성 척도와는 낮은 정적 상관을, 상태불안 척도와는 중간 수준의 부적 상관을 나타냈다. 집단상담 참여시간을 기준으로 초심, 중급 및 숙련 집단상담자를 분류하였을 때, 집단상담자 자기효능감 척도는 경험 수준이 다른 상담자들을 구분할 수 있을 만큼의 변별력을 가지는 것으로 나타났다. 아울러 본 연구에서 국내 타당화한 본 척도의 활용방안, 시사점, 제한점 및 향후 연구주제에 대해 논의하였다.

The purpose of this study was to validate the Korean version of the Group Leader Self-Efficacy Instrument (K-GLSI), which had been originally developed by Page, Pietrzak, and Lewis to assess self-efficacy of group leader for performing group counseling. Validity and reliability of GLSI were confirmed by using data collected from 209 group counselors(186 female, 23 male) who worked at university counseling centers, local youth counseling centers and private counseling facilities nationwide. Exploratory factor analysis yielded 3 factors of K-GLSI, which implied micro-skill(8 items), process skill(22 items) and skill for dealing with individual differences(7 items). Each factor showed adequate internal consistency(Cronbach's α= .87∼.96). As a result of confirmatory factor analysis, it was shown that the 3-factor structural model has better fit than the 1-factor model, which are somewhat different from that of the original GLSI. The results of the study indicated that the K-GLSI scores strongly and positively correlated with the group leader level, moderately and positively correlated with social desirability and negatively correlated with state anxiety, which demonstrate satisfactory convergent validity and discriminant validity. Futhermore, GLSI was demonstrated to be able to discern group leaders with a different level of group counseling experience. In addition, study Implications for the practical use of the K-GLSI and the limitation of study were discussed.

본 연구에서는 맞벌이 기혼남성을 대상으로 전통적인 성역할태도와 직무소진간의 관계에서 (부부사이의) 기본 심리적 욕구(유능성, 관계성, 자율성) 만족을 통한 일→가정 갈등의 조절된 매개효과를 확인하였다. 이를 위해, 200명의 맞벌이 기혼남성을 대상으로 전통적인 성역할태도, 기본 심리적 욕구만족, 일→가정 갈등, 직무소진을 측정하였고, SPSS Macro를 통해 분석을 실시하였다. 그 결과, 먼저, 일→가정 갈등이 전통적인 성역할태도와 직무소진간의 관계를 완전 매개하는 것으로 나타났는데, 즉, 성역할태도가 전통적일수록, 일→가정 갈등을 많이 경험하고 궁극적으로 직무소진을 경험할 가능성이 높은 것으로 확인되었다. 둘째, 세 가지 기본 심리적 욕구 만족 중 유능성 욕구 만족이 전통적인 성역할태도와 일→가정 갈등을 조절하는 것으로 나타났는데, 이는 배우자와의 관계에서 유능성 욕구를 만족할수록, 전통적인 성역할태도가 일→가정 갈등에 미치는 영향이 감소한다는 것을 의미한다. 셋째, 전통적인 성역할태도가 직무소진에 미치는 영향에서 유능성 욕구 만족을 통한 일→가정갈등의 매개된 조절효과가 나타났다. 즉, 유능성 욕구 만족이 낮거나 보통인 사람은 전통적인 성역할태도가 높을수록 일→가정 갈등을 많이 겪어 직무소진에 취약하지만, 유능성 욕구 만족이 높은 사람은 전통적인 성역할태도가 높더라도 일→가정 갈등을 많이 겪지 않아 직무소진에 취약하지 않다는 것이다.

The purpose of this study was to examine the moderated mediating effect of work-to-family conflict through satisfaction of basic psychological needs (competence, relatedness, and autonomy) in the relationship between traditional gender-role attitudes and job burnout of double-income married men. For this, traditional gender-role attitude, basic psychological needs satisfaction, work-to-family conflict, and job burnout were measured for 200 double-income married men, and analysis was conducted through SPSS Macro. As a result, work-to-family conflict fully mediated the relationship between traditional gender-role attitudes and job burnout. That is, as people have more traditional gender-role attitudes, they are more likely to experience job burnout via work-to-family conflict. Second, among the three basic psychological needs satisfaction, competence needs satisfaction was found to moderate the association between traditional gender role attitudes and work-to-family conflict. It means that the impact of traditional gender attitude on work-to-family conflict could be reduced when the competence need is satisfied within the relationship with spouse. Third, the moderated mediating model was supported in that the mediating effect of work-to-family conflict on the relationship between traditional gender-role attitudes and job burnout. That is, those who have low or average competence needs satisfaction are more vulnerable to job burnout due to more work-family conflict as their traditional gender role attitude increases, but those who have high competence needs satisfaction are not vulnerable to job burnout because they do not experience much conflict between work-to-family, even if they have a high traditional gender role attitude.

본 연구는 대학생을 대상으로 불확실성에 대한 인내력 부족과 진로결정수준의 관계에서 정서조절곤란과 계획된 우연기술의 매개효과를 구조방정식모형을 통해 검증하고자 하였다. 이에 따라 4년제 대학교에 재학 중인 대학생 380명을 대상으로 수집한 자료를 분석하였다. 연구 결과는 다음과 같다. 첫째, 불확실성에 대한 인내력 부족은 정서조절곤란과 정적 상관을 보였고, 계획된 우연기술과 진로결정수준과는 부적 상관이 있는 것으로 나타났다. 또한, 정서조절곤란은 계획된 우연기술, 진로결정수준과 부적 상관을, 계획된 우연기술은 진로결정수준과 정적인 관계를 보였다. 둘째, 불확실성에 대한 인내력 부족과 진로결정수준의 관계에서 정서조절곤란과 계획된 우연기술이 유의미한 매개효과를 가진 것으로 나타났다. 셋째, 불확실성에 대한 인내력 부족과 진로결정수준의 관계에서 정서조절 곤란과 계획된 우연기술이 완전이중매개효과가 있는 것으로 나타났다. 이러한 결과를 바탕으로 진로결정에 대한 어려움을 해결하기 위한 효과적인 상담 개입 및 교육 프로그램의 기초자료를 제공하고자 하였다. 마지막으로 후속연구를 위한 제언과 한계점을 논의하였다.

The purpose of this study was to examine the mediating effects of difficulties in emotion regulation and planned happenstance skills in the relation of intolerance of uncertainty and career decision level of university students by using a structural equation model. For this, 380 undergraduate students from four-year universities were surveyed. The results of the study are as follows. First, intolerance of uncertainty had a positive correlation with difficulties in emotion regulation and a negative correlation with planned happenstance skills and career decision level. In addition, difficulties in emotion regulation had a negative correlation with planned happenstance skills and career decision level and planned happenstance skills had a positive correlation with career decision level. Second, difficulties in emotion regulation and planned happenstance skills in the relationship between intolerance of uncertainty and career decision level appeared to have a significant mediating effect. Third, difficulties in emotion regulation and planned happenstance skills had a full dual mediation in the relationship between intolerance of uncertainty and career decision level. Based on the results of the study, the current study tried to provide the basic data for effective intervention of counseling and educational programs to solve the difficulties of career decision. Finally, suggestions for the further study and limitations of this study were discussed.

본 연구에서는 코로나 바이러스 감염증-19(COVID-19)으로 인해 한국인들이 어떤 스트레스를 경험하고 있는지 측정하는 '한국인을 대상으로 한 코로나 19(COVID-19) 스트레스 척도'(COVID-19 Stress Scale for Korean People: CSSK)를 개발 및 타당화하였다. 이를 위해, 선행 연구 고찰과 개방형 설문지를 실시하였고, 전문가 자문을 거쳐 총 39문항의 예비문항을 개발하였다. 이후, 만 19세 이상의 일반성인을 대상으로 탐색적 요인분석을 실시하였고, 그 결과 3 요인, 21문항이 도출되었다. 또한 다른 만 19세 이상의 일반 성인 표본을 대상으로 확인적 요인분석을 실시하여 3요인, 21문항으로 구성된 측정 모형의 적합도를 확인하였다. 또한 CSSK의 수렴 및 준거타당도를 살펴보기 위해 해외에서 개발된 COVID-19 두려움 척도, COVID-19 스트레스 척도, 부적 정서 척도, 우울 척도와의 상관관계를 살펴보았다. 본 연구의 결과를 바탕으로 CSSK의 상담에 대한 시사점 그리고 후속 연구에 대한 제언을 논의하였다.

This study aimed to develop and validate the COVID-19 Stress Scale for Korean People (CSSK) to measure the stress that Korean people experience in the era of COVID-19. For this, based on the literature review and the results of the open-ended questionnaire, and through experts' feedback, we developed 39 items. In the sample of Korean adults, we conducted an exploratory factor analysis and found 3-factor structure, 21 items. Then, we tested the construct validity through confirmatory factor analysis for another sample of adults over the age of 19 and the results reconfirmed the 3-factor structure, 21 items. In addition, convergent and concurrent validities of CSSK were examined via correlations with the Fear of COVID-19 Scale, the COVID Stress Scales, Negative Affect Scale, and Center for Epidemiological Studies Depression Scale developed abroad. Based on these results, we discussed implications for counseling, and recommendations for future research.