Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Association between Spiritual Well-Being and Pain, Anxiety and Depression in Terminal Cancer Patients: A Pilot Study

말기암환자의 영적 안녕과 통증, 불안 및 우울과의 연관성: 예비 연구

  • Lee, Yong Joo (Department of Palliative Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Kim, Chul-Min (Department of Palliative Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Linton, John A. (Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Duk Chul (Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Suh, Sang-Yeon (Department of Family Medicine, Dongguk University Ilsan Hospital) ;
  • Seo, Ah-Ram (Department of Statistics, Dongguk University) ;
  • Ahn, Hong-Yup (Department of Statistics, Dongguk University)
  • 이용주 (가톨릭대학교 서울성모병원 완화의학과) ;
  • 김철민 (가톨릭대학교 서울성모병원 완화의학과) ;
  • 인요한 (연세대학교 의과대학 세브란스병원 가정의학과) ;
  • 이덕철 (연세대학교 의과대학 세브란스병원 가정의학과) ;
  • 서상연 (동국대학교 일산병원 가정의학과) ;
  • 서아람 (동국대학교 통계학과) ;
  • 안홍엽 (동국대학교 통계학과)
  • Received : 2013.05.10
  • Accepted : 2013.05.28
  • Published : 2013.09.01
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Abstract

Purpose: Spirituality is an important domain and is related with physical and psychological symptoms in terminal cancer patient. The aim of this study is to examine how patients' spirituality is associated with their physical and psychological symptoms as it has been explored by few studies. Methods: In this cross sectional study, 50 patients in the palliative ward of a tertiary hospital were interviewed. Spiritual well-being, depression, anxiety and pain is measured by Functional Assessment of Chronic-Illness Therapy-Spirituality (FACIT-Sp), hospital anxiety and depression scale (HADS) and the Korean version of the Brief Pain Inventory (BPI-K). The correlations between patients' spiritual well-being and anxiety, depression and pain were analysed. The association between spiritual well-being and age, gender, palliative performance scale (PPS), religion, mean pain intensity, anxiety, depression were assessed by univariate and multivariate regression analyses. Results: Spiritual well-being was negatively correlated with the mean pain intensity (r=-0.283, P<0.05), anxiety (r=-0.613, P<0.05) and depression (r=-0.526, P<0.05). In multivariate regression analysis, spiritual well-being showed negative association with anxiety (OR=-1.03, 95% CI=-1.657~-0.403, P=0.002) and positive association with the existence of religion (OR=9.193, 95% CI=4.158~14.229, P<0.001). Conclusion: In this study, patients' anxiety and existence of religion were significantly associated with spiritual well-being after adjusting age, gender, PPS, mean pain intensity, depression. Prospective studies are warranted.

목적: 말기암환자의 영성은 호스피스완화의료에서 중요하게 고려되어야 할 영역이지만 아직 이에 대한 연구자료가 부족하다. 따라서 이번 연구에서는 호스피스 병동에 입원해 있는 말기 암환자들을 대상으로 영적 안녕과 통증, 불안 및 우울과의 연관성에 대하여 살펴보았다. 방법: 서울소재 일개 대학병원에 입원해 있는 환자를 대상으로 연구자와 연구간호사가 연구에 동의한 50명의 환자에게 자기 기입식 설문지를 배부하는 방법으로 설문을 시행하였다. 영적 안녕지수의 측정은 Functional Assessment of Chronic-Illness Therapy-Spirituality (FACIT-Sp)의 영적 상태 12문항을 이용하였으며 병원 우울불안지수는 Hospital anxiety and depression scale (HADS), 통증지수의 측정은 BPI-K를 이용하였다. 수집된 자료는 Spearmans' rank test, T-test, univariate and multivariate regression analysis를 이용하여 분석하였다. 결과: 영적 안녕은 평균 통증 강도(r=-0.283, P<0.05), 불안 하부척도(HADS-A)(r=-0.613, P<0.05), 우울 하부척도(HADS-D)(r=-0.526, P<0.05)와 상관관계를 보였다. 다른 변수들의 영향을 보정한 뒤에도 영적 안녕은 종교유무(OR=9.193, 95% CI=4.158~14.229, P<0.001)와 불안하부척도(OR=-1.03, 95% CI=-1.657~-0.403, P=0.002)와 유의한 상관관계를 보였다. 결론: 말기암환자의 영적 안녕감은 통증, 우울, 불안 점수와 유의한 상관관계를 가졌으며 종교가 있고 우울지수가 낮은 경우 영적 안녕감의 증가와 유의한 상관관계를 가졌다. 추후 전향적 연구를 통한 영적 말기암환자의 영적 중재 및 영적 지지에 대한 노력이 필요할 것으로 생각된다.

Keywords

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