Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
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A Correlational Study among Perceived Stress, Anger Expression, and Depression in Cancer Patients*

암 환자의 지각된 스트레스, 분노표현방식과 우울간의 관계

  • Published : 2005.01.01
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Abstract

Purpose: This study was to identify the relationship between perceived stress, anger expression, and level of depression in cancer patients. Method: A cross-sectional descriptive study design was used. Data was collected by uestionnaires from 185 in- and out-patients who were diagnosed with cancer at 3 university hospitals and the National Cancer Center using Spielberger et al.’s Anger Expression Scale, Cohen, Kamarch & Mermelstein's Perceived Stress, and Derogatise's SCL-90. The data was analyzed using descriptive statistics, Pearson correlation coefficient, and stepwise multiple regression with SAS/PC. Result: The perceived stress in cancer patients indicated a significant positive correlation to anger-in(r=.288, p=.000), anger-out(r=.232, p=.001), and depression(r=.68, p=.000), but no significant correlation to anger-control. The anger-in of cancer patients showed a significant positive relationship to anger-out(r=.53, p=.000), and depression(r=.383, p=.000), but no significant correlation to anger-control. Anger-out showed a significantly negative correlation to anger-control (r=-.248, p=.001) and a positive correlation to depression (r=.240, p=.001). The most significant predictor which influenced depression in cancer patients was perceived stress, followed by anger-in and hobby, and these factors explained their depression with a variance of 54%. Conclusion: These results suggested that cancer patients with a high degree of perceived stress are likely to be high in anger-out and anger-in. Perceived stress and anger-in are major factors which affect depression in cancer patients.

Keywords

References

  1. Andersen, B. L., Kiecolt-Glaser, J. K, & Glaser, R. (1994). A biobehavioral model of cancer stress and disease course. Am Psychol, 49(5), 389-404 https://doi.org/10.1037/0003-066X.49.5.389
  2. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders. 5th ed. Washington DC
  3. Caplan, G. (1989). Mastery of stress: psychosocial aspects. Am J Psychiatry, 138, 413-420
  4. Chen, M. L., & Chang, H. K (2000). Anxiety and depression in Taiwanese cancer patients with and without pain. Journal of Advanced Nursing, 32(4), 944-951 https://doi.org/10.1046/j.1365-2648.2000.01560.x
  5. Chon, K. G. (1996). Development of the Korean State-Trait anger expression inventory(2). The Korean Journal of Rehabilitation Psychology, 3(1), 53-69
  6. Chon, K. K., Chung, B. D., & Tae, Y. S. (1999). The Role of Depression in Cancer Patients; A prellminary Study. Jounal of Rehabilitation Psychology, 6(1), 59-69
  7. Choi, S. J., Kim, Z. S., Shin, M. S., & Cho, M. J. (2001). Mode of Anger Expression in Relation to Depression and Somatization. J Korean Neuropsychiatr Assoc, 40(3), 425-433
  8. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A gloval measure of perceived stress. J Health Soc Behav, 24(4), 385-396 https://doi.org/10.2307/2136404
  9. Derogatis, L. R. (1977). SCL-90: Administration, scoring, and procedures manual-1 for the revised version. Baltimore: Clinical Psychometrics Research
  10. Derogatis, L. R., Morrow, G. R., Fetting, J., Penman, D., Piasetsky, S., Schmale, A. M., Henrichs, M. & Carnicke, C. L. M. (1983). The prevalence of psychiatric disorders among cancer patients, Journal of the American Medical Association, 249, 751-757 https://doi.org/10.1001/jama.249.6.751
  11. Faber, S., & Burns, J. (1996). Anger management style, degree of expressed anger, an gender influence on cardiovascular recovery from interpersonal harassment. J Behav Med, 19, 31-53 https://doi.org/10.1007/BF01858173
  12. Fox, B. H. (1995). The role of psychological factors in cancer incidence and prognosis. Oncology, 9, 245-253 https://doi.org/10.1159/000216020
  13. Friedman, H. S., & Booth-Kewley, S. (1987). The 'disease-prone personality'; a meta analytic view of the construct. Am Psychol, 42, 539-555 https://doi.org/10.1037/0003-066X.42.6.539
  14. Johnson, E. H., & Broman, C. L. (1985). The relationship of anger expression to health problems among black Americans in a national survey. Journal of Behavioral Medicine, 10, 103-116 https://doi.org/10.1007/BF00846419
  15. Julius, M., Harburg, E., Cottington, E., & Johnson, E. (1986). Anger coping types, blood pressure and all-cause mortality: A follow-up in Tecumseh, Michigan(1971-1983). American Journal of Epidemiology, 124, 220-233
  16. Kim, J. H., & Kim, K. I. (1984). The Standardization Study of Symptom Checklist-90-Revision in Korea III. Mental Health Research. 2. 278-311
  17. Kim, H. S., Yun, Y. H., LEE, S. W., Heo, D. S., Son, H. M., & Huh, B. Y. (1994). The Severety and Variables Influencing Depression in Cancer Patients with Pain. J. Korean Hospice. 2(2), 125-137
  18. Kim, K. H., & Chon, K. K. (1997). Effects of Anger, Hostility, and Stress on Physical Health. Korean Journal of Health Psychology, 2(1), 79-95
  19. Lee, P. S. (2003). Correlational Study among Anger, Perceived Stress and Mental Health Status in Middle Aged Women. J Korean Acad Nurs, 33(6), 856-864
  20. Levy S. (1984). Emotions and the progression of cancer: a review Advances J, 84( 1), 10-15
  21. Massie, M. J. & Holland, J. C. (1992). The cancer patient with pain: psychiatric complications and their management. Journal of Pain and Symptom Management, 72, 99-109
  22. McDaniel, J. S., Musselman, D. L., Porter, M. R., Reed, D. A. & Nemeroff, C. B. (1995). Depression in patients with cancer: diagnosis, biology, and treatment. Archives of General Psychiatry, 52, 89-99 https://doi.org/10.1001/archpsyc.1995.03950140007002
  23. Na, R. H., & Son, C. N. (2000). The difference of Anger Experience, Mode of Anger Expression ,and Depression in the patients with Coronary Heart Disease and the Normal Controls. Korean Journal of Art Therapy, 7(1), 87-102
  24. Spielberger, C. D., Johnson, E. H., Russell, S. F., Crane, R. J., Jacobs, G. A., & Worden, T. J. (1985). The experience and expression of anger: Construction and validation of an anger expression scale. In cardiovascular and behavioral disorders. New York: Hemisphere/McGraw-Hill. 5-30
  25. Suh, S. R., Park, Y. S., & Park, J. H. (1994). A Study on the Depression and Symptom Distress of Cancer Patients. J Korean Acad Nurs, 6(2), 287-298
  26. Temoshok Lydia. (1992). Personality, coping style, emotion and cancer: toward an integrative model. Cancer Surverys, 6, 837-857
  27. Thomas, B. C., Pandy, M., & Nair, M. K. (2002). Psychological distress in cancer patients; hypothesis of a distress model. Eur J Cancer prev, 11(20), 179-185 https://doi.org/10.1097/00008469-200204000-00011
  28. Thomas, S. P. (1989). Gender Differences in Anger Expression: Health Implication. Research in Nursing & Health, 12, 389-398 https://doi.org/10.1002/nur.4770120609
  29. Thomas, S. P., & Atakan, S. A. (1990). Trait Anger, Anger Expression, Stress, and Health Status of American and Turkish Midlife Women. American and Turkish Women's Health, November, 15-17
  30. Thomas, S. P., Goer, M., Davis, M., Droppleman P., Mozingo, J., & Pierce, M. (2000). Anger and Cancer. Cancer Nursing, 23(5), 344-349 https://doi.org/10.1097/00002820-200010000-00003