Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
권호 표지

Medical-and-Psychosocial Factors Influencing on the Quality of Life in Patients with Cervix Cancer

자궁경부암환자의 삶의 질에 영향을 미치는 치료관련 및 심리사회적 요인

  • Chun, Mi-Son (Departments of Radiation Oncology Ajou University School of Medicine) ;
  • Lee, Eun-Hyun (Graduate School of Public Health, Ajou University) ;
  • Moon, Seong-Mi (Department of Radioation Oncology, Ajou University Hospital) ;
  • Kang, Seung-Hee (Departments of Radiation Oncology Ajou University School of Medicine) ;
  • Ryu, Hee-Sug (Departments of Obstetrics and Gynecology, Ajou University School of Medicine)
  • 전미선 (아주대학교 의과대학 방사선종양학교실) ;
  • 이은현 (아주대학교 보건대학원) ;
  • 문성미 (아주대학교병원 방사선종양학과) ;
  • 강승희 (아주대학교 의과대학 방사선종양학교실) ;
  • 유희석 (아주대학교 의과대학 산부인과학교실)
  • Published : 2005.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Quality of life in patients with cancer may be influenced by various kinds of variables, such as personal, environmental, and medical factors. The purpose of this study was to identity the influencing factors on the quality of life in patients with cancer. Materials and Methods: One hundred and forty seven patients, who were taking medical therapy or following up after surgery for cervix cancer, participated in the present study. Quality of life, medical variables (cancer stage, types of treatment, follow-up status, and symptom distress), and psychosocial variables (mood disturbance, orientation to life, and social support) were measured. The obtained data were computed using multiple regression analyses. Results: The medical-and-psychosocial variables explained 63.3% of the total variance in the quality of life ($R^2=0.633$ F:16.959, p=.000). Cancer stage, symptom distress, mood disturbance, social support(family), and optimistic orientation to life were significant factors influencing on the quality of life in patients with cervix cancer. Conclusion: An integrative care program which includes medical - and - psychosocial characteristics of patients is essential to improve quality of life in patients with cervix cancer.

목적: 본 연구의 목적은 자궁경부암 환자의 삶의 질에 영향을 미치는 치료관련요인과 심리사회적 요인을 파악하기 위함이다. 대상 및 방법: 경기도 A 대학병원에서 자궁경부암 진단을 받고 치료 중이거나 추후관리 중인 환자 147명을 대상으로 삶의 질과 심리사회적 변수(기분장애, 삶의 성향, 사회적 지지)에 대해 설문조사하였다. 그리고 치료관련 변수로 암의 병기, 치료방법, 추후관리기간은 의무기록을 통해 조사하였고 증상 경험은 설문조사하였다. 결과: 치료관련 변수들과 심리사회적 변수들은 자궁경부암 환자의 전체 삶의 질의 63.3%를 설명하였다($R^2=0.533$, F=16.969, p=.000). 암의 병기, 증상 경험, 기분장애정도, 사회적지지 중 가족지지, 그리고 삶의 성향은 자궁경부암 환자의 삶의 질에 영향을 주는 유의한 요인이었으며 이 중 가족지지가 가장 영향력이 큰 변수였다. 결론: 자궁경부암 환자의 삶의 질을 증진시키기 위해서는 환자의 증상관리 뿐만 아니라 심리사회적 중재가 치료와 함께 병행되어야 하며 그 내용으로 기분조절, 사회적 지지, 삶에 대한 긍정적인 태도를 취하는 것이 포함되어야 한다.

Keywords

References

  1. Cull A, Cowie DIM, Farquharson JRB, et al. Early stage cervical cancer: psychological and sexual outcomes of treatment. Br J Cancer 1993;68:1216-1220 https://doi.org/10.1038/bjc.1993.507
  2. Chung CW, Kim MJ, Rhee MH, Do HG. Functional status and psychosocial adjustment in gynecologic cancer patients receiving chemotherapy. Korean J Women Health Nurs 2005; 11:58-66
  3. Schover LR. Quality Counts: The value of women's perceived qualtiy of life after cervical cancer. Gynecologic Oncology 2000;76:3-4 https://doi.org/10.1006/gyno.1999.5692
  4. Cella DF, Tulsky DS, Gray G, et al. The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol 1993;11:570-579
  5. Miller BE, Pittman B, Case D, McQuellon RP. Quality of life after treatment for gynecologic malignancies: A pilot study in an outpatient clinic. Gynecologic Oncology 2002;87:178-184 https://doi.org/10.1006/gyno.2002.6812
  6. Klee M, Thranov I, Machin D. Life after radiotherapy: The psychological and social effects experiences by women treated for advanced stages of cervical cancer. Gynecologic Oncology 2000;76:5-13 https://doi.org/10.1006/gyno.1999.5644
  7. Klee M, Thranov I, Machin D. The patients' perspective on physical symptoms after radiotherapy for cervical cancer. Gynecologic Oncology 2000;76:14-23 https://doi.org/10.1006/gyno.1999.5642
  8. Hawighorst-Knapstein S, Fusshoeller C, Franz C, et al. The impact of treatment for genital cancer on quality of life and body image-results of a prospective longitudinal 10-year study. Gynecologic Oncology 2004;94:398-403 https://doi.org/10.1016/j.ygyno.2004.04.025
  9. Sutherland HJ, Walker P, Till JE. The development of a method for determining on oncology patient's emotional distress using linear analogue scale. Cancer Nurs 1988;11:303-308 https://doi.org/10.1097/00002820-198810000-00006
  10. Sutherland HJ, Lockwood GA, Cunningham AJ, et al. A simple, rapid method for assessing psychological distress in cancer patients: Evidence of validity for Linear Analogue Scales. J Psychosoc Oncol 1989;7:31-43 https://doi.org/10.1300/J077v07n01_03
  11. Samarel N, Leddy SK, Greco K, et al. Development and testing of the symptom experience scales. J Pain Symptom Manage 1996;12:221-228 https://doi.org/10.1016/0885-3924(96)00150-9
  12. Tae YS. A study on the correlation between perceived social support and depression in patients with cancer. Unpublished master's thesis. Ewha Women's University: Seoul, Korea, 1985
  13. Scheier MF, Carver CS. Optimism, coping and health: assessment and implications of generalized outcome expectancies. Health Psychol 1985;4:219-247 https://doi.org/10.1037/0278-6133.4.3.219
  14. Lee SH, Im JI, Lee HK, et al. A grounded-theory approach to the process of life adaptation in women with cervical cancer. Korean J Women Health Nurs 2004;10:32-41
  15. Spiegel D, Bloom JR, Kraemer HC, Gottheil E. Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet 1989;2:888-891 https://doi.org/10.1016/S0140-6736(89)91551-1
  16. Fawzy FI, Fawzy NW, Hyun CS, et al. Malignant melanoma: effects of an early structured psychiatric intervention, copping, and affective state on recurrence and survival six years later. Arch Gen Psych 1993;50:681-689 https://doi.org/10.1001/archpsyc.1993.01820210015002
  17. Fawzy FI, Canada AL, Fawzy NW. Malignant melanoma: effects of a brief, structured psychiatric intervention on survival and recurrence at 10-year follow-up. Arch Gen Psych 2003; 60;100-103 https://doi.org/10.1001/archpsyc.60.1.100
  18. Park HJ. The effect of social support which influences on the quality of life in breast cancer patients. Master''s thesis, Youngnam University 2002
  19. Creuss DG, Antoni MH, McGregor BA, et al. Congitivebehavioral stress management reduces serum cortisol by enhancing benefit finding among women being treated for early stage breast cancer. Psychosom Med 2000;62:304-308 https://doi.org/10.1097/00006842-200005000-00002
  20. Yang JC, Chung WK. Psychology and quality of life in cancer patients on radiation therapy. J Korean Soc Ther Radiol Oncol 2004;224:271-279
  21. Li C, Samsioe G, Iosif C. Quality of life in long-term survivors of cervical cancer. Maturitas 1999;32:95-102 https://doi.org/10.1016/S0378-5122(99)00020-1
  22. Hawighorst S, Schoenefuss G, Fusshoeller C, et al. The physician-patient relationship before cancer treatment: a prospective longitudinal study. Gynecologic Oncology 2004;94: 93-97 https://doi.org/10.1016/j.ygyno.2004.03.033
  23. piegel D, Giese-Davis J. Depression and Cancer: Mechanisms and disease progression. Biol Psychiatry 2003;54:269-282 https://doi.org/10.1016/S0006-3223(03)00566-3
  24. Chun KK, Whang WW, Kim JW, Park HK. Emotional stress and Hwabyung (an anger syndrome). Korean Journal of Health Psychology 1997;2:170-187 https://doi.org/10.1177/135910539700200212
  25. Kiecolt-Glaser JK, McGuire L, Robles TF, Glaser R. Emotions, morbidity, and mortality. New perspectives for psychoneuroimmunology. Annuals Review of Psychology 2002;53: 83-107 https://doi.org/10.1146/annurev.psych.53.100901.135217
  26. Tae YS, Youn SJ, Woo YJ, Lee HJ, Cha YJ, Cha YJ. Correlation between 'anger-in' and qualtiy of life in female cancer patients. Kosin University Nursing Science Research Institute Journal 2003;2:75-92
  27. Kim ES. The effects of dynamic imagery therapy on 'angerin' and immune function in patients with breast cancer. J Kor Adult Nur 2003;15:639-649
  28. Lee EH, Chung BY, Park HB, Chun KH. Relationship of mood disturbance and social support to symptom experience in Korean women with breast cancer. J Pain Symptom Manage 2004;27:425-433 https://doi.org/10.1016/j.jpainsymman.2003.10.007
  29. Juraskova I, Butow P, Robertson R, Sharpe L, McLeod C, Hacker N. Post-treatment sexual adjustment following cervical and endometrial cancer: A qualitative insight. Psycho- Oncol 2003;12:267-279 https://doi.org/10.1002/pon.639
  30. Morris T, Pettingale K, Haybittle J. Psychological response to cancer diagnosis and disease outcome in patients with breast cancer and lymphoma. Psycho-Oncol 1992;1:105- 114 https://doi.org/10.1002/pon.2960010207
  31. Lutgendorf SK, Anderson B, Rothrock N, Buller RE, Sood AK, Sorosky JI. Quality of life and mood in women receiving extensive chemotherapy for gynecologic cancer. Cancer 2000;89:1402-1411 https://doi.org/10.1002/1097-0142(20000915)89:6<1402::AID-CNCR26>3.0.CO;2-H