정신신체의학 (Korean Journal of Psychosomatic Medicine)

한국정신신체의학회 (Korean Psychosomatic Society)
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섬망 환자의 지각된 낙인 척도 개발 및 타당성 검증

Development and Validation of Perceived Stigma of Delirium Scale

  • 김선영 (화순전남대학교병원 정신건강클리닉) ;
  • 김성완 (전남대학교 의과대학 정신건강의학교실) ;
  • 김재민 (전남대학교 의과대학 정신건강의학교실) ;
  • 신일선 (전남대학교 의과대학 정신건강의학교실) ;
  • 윤진상 (전남대학교 의과대학 정신건강의학교실)
  • Kim, Seon-Young (Mental Health Clinic, Chonnam National University Hwasun Hospital) ;
  • Kim, Sung-Wan (Departments of Psychiatry, Chonnam National University Medical School) ;
  • Kim, Jae-Min (Departments of Psychiatry, Chonnam National University Medical School) ;
  • Shin, Il-Seon (Departments of Psychiatry, Chonnam National University Medical School) ;
  • Yoon, Jin-Sang (Departments of Psychiatry, Chonnam National University Medical School)
  • 투고 : 2015.09.30
  • 심사 : 2015.12.16
  • 발행 : 2015.12.31
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초록

연구목적 본 연구는 '섬망환자의 지각된 낙인 척도(Perceived Stigma of Delirium Scale, PSDS)'를 개발하고 신뢰도와 타당도를 평가하여 섬망을 경험한 환자의 지각된 낙인을 측정하고자 시행되었다. 방 법 기존 문헌과 낙인 관련 척도를 고찰 및 참고하여 7문항의 PSDS 예비 척도를 구성하고, 섬망에서 회복된 128명의 환자를 대상으로 PSDS와 디스트레스 온도계(Distress Thermometer, DT)를 측정하였다. 탐색적 요인 분석을 시행하여 낙인 척도의 요인 구조를 확인하였다. 신뢰도 검증을 위해 내적 일치도와 검사-재검사 신뢰도를 분석하였다. 공시타당도는 PSDS 총점과 DT의 상관 분석을 통해 확인하였다. 결 과 예비 척도의 요인 분석을 시행한 결과 단일 요인이 추출되었다. 예비 척도 7문항 중 1개 문항은 낮은 요인 부하량을 가져 제외하였다. PSDS의 내적 일치도의 분석을 위해 시행한 Cronbach's ${\alpha}$ 값은 0.85였다. PSDS 총점의 검사-재검사간 상관 계수는 0.71이었으며, 각 문항별 상관 계수는 0.58에서 0.83사이었다. PSDS의 총점과 DT는 유의한 상관관계를 보였다. 결 론 본 연구는 PSDS가 섬망에서 회복된 환자의 지각된 낙인을 측정하는데 있어서 신뢰할만한 도구임을 확인하 였다. 본 척도 연구를 기반으로, 후속 연구와 다기관 연구를 통해 임상적 유용성의 평가가 이루어져야 할 것이다.

Objectives : This study developed and validated the Perceived Stigma of Delirium Scale(PSDS), which is designed to measure perceived stigma associated with delirium in patients suffering from that disorder. Methods : Based on a literature review of scales assessing stigma, a preliminary scale comprising seven items was developed. After recovering from delirium, 128 patients completed the PSDS and the Distress Thermometer (DT). Factor analysis was used to examine construct validity, and internal consistency and test-retest reliability were examined to ensure reliability. Concurrent validity was assessed using the correlation between the total scores on the PSDS and the DT. Results : Factor analysis yielded a single-factor structure from the seven candidate items. One item was excluded due to low factor loading. The internal consistency was computed and Cronbach's ${\alpha}$ was 0.85 for the total score. The overall test-retest reliability was 0.71, with items ranging from 0.58 to 0.83. The total score on the PSDS was significantly correlated with the DT score. Conclusions : The PSDS may be a reliable, valid instrument for evaluating perceived stigma in patients who have recovered from delirium. Further study of the perceived stigma by delirium patients is required to assess the implications of the PSDS for clinical practice and research.

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