The Journal of Korean society of community based occupational therapy (대한지역사회작업치료학회지)

Korean Society of Community Based Occupational Therapy Association (대한지역사회작업치료학회)
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The Effect of Internalized Shame and Self-Control on Interpersonal Relationships in Stroke Patients

내면화된 수치심과 자기통제력이 뇌졸중 환자의 대인관계에 미치는 영향

  • Hwang, Jung-Ha (Dept. of Occupational Therapy, Gwangyang Health Science University) ;
  • Lim, Jae-Ho (Dept. of Occupational Therapy, Gangwon Do Rehabilitation Hospital)
  • 황정하 (광양보건대학교 작업치료과) ;
  • 임재호 (강원도재활병원 작업치료실)
  • Received : 2020.10.22
  • Accepted : 2020.12.29
  • Published : 2020.12.31
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Abstract

Objective : The purpose of this study is to investigate the influence of internal shame and self-control on interpersonal relationships in stroke patients, and to provide evidence and information necessary for clinical trials by analyzing the relationship. Methods : For this study, 150 stroke patients receiving occupational therapy services at institutions where occupational therapists work in Jeollanam-do and Chungnam regions were targeted through email and mail from March 1, 2019 to April 30, 2019. The questionnaire was conducted using general characteristics, Relationship Change Scales(RCS), Self-Control Scales(SCS), and Internalized Shame Scale(ISS) questionnaire. Descriptive statistical analysis was performed for the general characteristics of the study subjects, and t-test and one-way batch variance analysis (ANOVA) were used to compare interpersonal relationships according to general characteristics. The relationship between internalized shame, self-control, and interpersonal competence was analyzed by Pearson's correlation coefficient, and multiple regression analysis was performed to determine the factors affecting interpersonal relationships of stroke patients. Results : As a result of comparing interpersonal competence according to general characteristics, significant differences were found in terms of age and education level. Interpersonal relationships and internalized shame, internalized shame and self-control showed a negative correlation, and self-control and interpersonal relationships had a positive correlation, but self-control was the sub-factors of interpersonal relationships such as openness, sensitivity, intimacy, It was not statistically significant with the communication item. In addition, the items of inadequacy (β =-0.32) and adventure seeking (β =-0.23), which are sub-areas of internalized shame, affect the negative direction, and physical activity (β =0.22), which is the sub-area of self-control and the self-centered (β =0.24) item was found to have an effect on the positive direction. Conclusion : Therefore, additional research is needed that can operate a rehabilitation treatment program that applies various psychological factors for the formation of interpersonal relationships among stroke patients.

목적 : 본 연구의 목적은 뇌졸중 환자를 대상으로 내적 수치심과 자기통제력이 대인관계에 어떠한 영향을 미치는가를 조사하고, 그 관련성을 분석함으로써 임상에 필요한 근거와 정보를 제공하고자 한다. 연구방법 : 본 연구를 위해 전라남도 및 충청남도 지역 소재에 작업치료사가 근무하고 있는 기관에서 작업치료 서비스를 받고 있는 뇌졸중 환자 150명을 대상으로 2019년 3월 1일부터 2019년 4월 30일까지 일반적 특성, 대인관계(RCS), 자기통제력(SCS), 내면화된 수치심 척도(ISS) 설문지를 사용하여 설문을 실시하였다. 연구 대상자의 일반적인 특성은 빈도분석과 기술통계를 실시하였고, 일반적 특성에 따른 대인관계를 비교하기 위해 독립표본 t검정(t-test)과 일원배치분산분석(ANOVA)을 사용하였다. 내면화된 수치심과 자기통제력 그리고 대인관계의 관련성은 피어슨 상관계수로 분석하였고, 뇌졸중 환자의 대인관계에 미치는 영향요인을 파악하기 위하여 다중 회귀분석을 실시하였다. 결과 : 일반적 특성에 따른 대인관계를 비교한 결과, 연령과 교육수준 항목에서 유의한 차이가 나타났다. 내면화된 수치심과 대인관계, 자기통제력과 내면화된 수치심은 유의한 역상관 관계를 나타내었고, 자기통제력과 대인관계는 정적인 상관관계가 나타났지만, 대인관계 하위요인인 개방성, 민감성, 친밀감, 의사소통 항목과 자기통제력은 통계적으로 유의하지 않았다. 또한, 내면화된 수치심의 하위 영역인 부적절함(β =-0.32)과 모험 추구(β =-0.23) 항목은 역방향으로 영향을 미치고, 자기통제력의 하위 영역인 신체활동(β =-0.22)과 자기중심(β =0.24) 항목은 정방향으로 영향을 미치는 것으로 나타났다. 결론 : 따라서 뇌졸중 환자의 대인관계 형성을 위해서는 다양한 심리적인 요인이 적용된 재활치료 프로그램이 운영될 수 있는 추가적인 연구가 필요하다.

Keywords

References

  1. Amini, D. A., Kannenberg, K., Bodison, S., Chang, P. F., Colaianni, D., Goodrich, B., et al (2017). Occupational therapy practice framework: Domain & process(3rd ed.). American Journal of Occupational Therapy, 68(1), S1-S48. doi:10.5014/ajot.2014.682006
  2. An, B. H. (2011). The effect of covert narcissism and inthernalized shame on interpersonal problems. published master's thesis, Hankuk University of Foreign Studies, Seoul.
  3. Astrom, M., Asplund, K., & Astrom, T. (1992). Psycho-social function and life satisfaction after stroke. Stroke, 23(4), 527-531. https://doi.org/10.1161/01.STR.23.4.527
  4. Campos, J., Mumme, D., Kermoian, R., & Campos, R. G. (1994). A functionalist perspective on the nature of emotion. Monographs of the Society for Research in Child Development, 59, 284-303. doi.org/10.4092/jsre.2.1
  5. Clinical Research Center for Stroke. (2015). Clinical pra ctice guidelines for stroke, Stroke evaluation result. Retrieved Aug, from http://www.stroke-crc.or.kr
  6. Dayapoglu, N., & Tan, M. (2010). Quality of life in stroke patients. Neurology India, 58(5), 697-701. https://doi.org/10.4103/0028-3886.72165
  7. Ghika-Schmid, F., & Bogousslavsky, J. (1997). Affective disorders following stroke. European Neurology, 38(2), 75-81. https://doi.org/10.1159/000113164
  8. Gottfredson, M. R., & Hirschi, T. (1990). A general theory of crime. Stanford CA: Stanford University Press.
  9. Gunaydin, R., Karatepe, A. G., Kaya, T., & Ulutas, O. (2011). Determinants of quality of life(QOL) in elderly stroke patients: A short-term follow-up study. Archives of Gerontology and Geriatrics, 53, 19-23. doi.org/10.1016/j.archger.2010.06.004
  10. Gwon, S. M. (2017). Psychology of human relationships. Seoul: hakjida.
  11. Ha, C. S., & Kim, B. S. (2005). A exploratory factor analysis of Korean version of the self-control scale. The Korea Journal of Counseling, 6(4), 1175-1188.
  12. Henshaw, E., Polatajko, H., McEwen, S., Ryan, J. D., & Baum, C. M. (2011). Cognitive approach to improving participation after stroke: two case studies. The American Journal of Occupational Therapy, 65(1), 55-63. https://doi.org/10.5014/ajot.2011.09010
  13. Hood, T. C., & Back, K. W. (1971). Self-disclosure and the volunteer: A source of bias in laboratory experiments. Journal of Personality and Social Psychology, 17, 130-136. https://doi.org/10.1037/h0030380
  14. Houglan Adkins, E. R. (1993). Quality of life after stroke: Exposing a gap in nursing literature. Rehabilitation Nursing, 18(3), 144-147. doi.org/10.1002/j.2048-7940.1993.tb00742.x
  15. Jeon, S. G. (1994). A study on the effectiveness of social skills training program for rehabilitation of patients with schizophrenia. published master's thesis, University of soongsil, Seoul.
  16. Jung, Y. B., & Heo, N. S. (2020). The mediating effects of openness and social anxiety in the relationship between college students' internalized shame and their social efficacy. The Korea Association of Yeolin Education, 28(2), 321-339. doi.org/10.18230/tjye.2020.28.2.321
  17. Kim, E. J. (2019). Correlation of between social participatio n and interpersonal relationship of stroke. Journal of The Korean Society of Integrative Medicine, 7(2), 31-38. doi.org/10.15268/ksim.2019.7.2.031
  18. Kim, H. (2012). The influence of activity-oriented music therapy upon interpersonal relationships in patients with schizophrenia of rehabilitation centers. Master's Thesis, Seoul Jangsin University. Kyeong-Ki.
  19. Kim, H. J. (2008). A case study on the group art therapy to improve the self-expression of old-aged stroke survivors. Korean Journal of Art Therapy, 15(4), 741-760. https://doi.org/10.35594/KATA.2008.15.4.005
  20. Kim, J. J., & Choi, E. Y. (2005). The effects of group art therapy to psychological rehabilitation of patients with stroke. Transactional Analysis and Psychosocial Therapy, 3, 30-54.
  21. Kim, J. M., Talbot, N. L., & Cicchetti, D. (2009). Childhood abuse and current family conflict: The role of shame. Child Abuse & Neglect, 33(6), 362-371. doi.org/10.1016/j.chiabu.2008.10.003
  22. Kim, J. Y., Park, H. J., & Lee, I. S. (2012). The effects of group art therapy with Hanji, Korean paper, to improve the quality of life of elderly stroke patients. Journal of the Korean Gerontological Society, 32(1), 87-102.
  23. Kim. D. H., Oh, M. H., CHung, H. A., & Kim, J. J. (2013). The relationships among adl, self-esteem, and motivation for rehabilitation of stroke patients. The Journal of Korean Society of Occupational Therapy, 21(4), 59-70. https://doi.org/10.14519/jksot.2013.21.4.06
  24. Korean Statistical Information Service. (2019). Stroke prevalence. http://kosis.kr/index/index.do
  25. Kumar, R., Kaur, S., & Reddemma, K. (2015). Needs, burden, coping and quality of life in stroke caregivers-a pilot survey. Nursing and Midwifery Research Journal, 11(2), 57-67.
  26. Kwon, Y. C., & Park, J. H. (1989). Standardization of Korean version of Mini-Mental State Examination (MMSE-K). Journal of the Korean Neuropsyciatric Association, 28(1), 125-135.
  27. La Rose, R., Lin, C. A., & Eastin, M. S. (2009). Unregulated internet usage: Addiction, habit, or deficient self-regulation? Media Psychology, 5(3), 225-253. doi.org/10.1207/S1532785XMEP0503_01
  28. Lee, I. G., Han, H. Y., Kim, H. S., Na, Y. S., & An, K. H. (1998). Emotional disorder of stroke patients. Annals of Rehabilitation Medicine, 12(1), 33-38.
  29. Lee, I. S., & Choi, H. R. (2005). Assessment of shame and its relationship with maternal attachment, hypersensitive narcissism and loneliness. Korean Journal Of Counseling And Psychotherapy, 17(3), 651-669.
  30. Lee, J. M. (2012). The effects of computerized cognitive rehabilitation on personal relationship ability for patients with stroke. The Journal of Korean Society of Cognitive Rehabilitation, 1(1), 23-35.
  31. Lee, Y. E., & Hong, S. J. (2009). A study on the art therapy with game activity for the enhancement of the hand function and human relationship of the stroke elderly. The Korea Journal of Counseling, 10(1), 1-16. https://doi.org/10.15703/kjc.10.1.200903.1
  32. Lim, Y. M., & Yoo, D. H. (2019). The effects of emotional awareness level and stress on social participation in stroke disabled persons living in the community. The Journal of the Korea Contents Association, 19 (8), 323-331. doi.org/10.5392/JKCA.2019.19.08.323
  33. Luckmann, J., & Sarensen, R. (1980). Medical-surgical nursing, a psycho-physiologic approach (2ed.). W. P. Philadephia Saunder's company.
  34. Madden, S., Hopman, W. M., Bagg, S., Verner, J., & O'Challaghan, C. J. (2006). Functional status and health-related quality of life during inpatient stroke rehabilitation. American Journal of Physical Medicine and Rehabilitation, 85, 831-838. doi:10.1097/01.phm.0000240666.24142.f7
  35. Matthias, B., & Simone, B. (2006). Self-conscious emotions and depression: Rumination explains why shame but not guilt is maladaptive. Personality and Social Psychology Bulletin, 32(12), 1608-1619. https://doi.org/10.1177/0146167206292958
  36. Miller, J. H. (1983). Powerlessness: Coping with chronic illness. Philadelphia. F. A. Davis.
  37. Nam, S. Y. (1997). Study of CVA patients' experience of the illness. Journal of Korean Academy of Nursing, 28(2), 479-489. https://doi.org/10.4040/jkan.1998.28.2.479
  38. Patterson, C. J., & Mischel, W. (1976). Effect of temptation-inhibiting and task-facilitating plans on self-control. Journal of Personality and Social Psychology, 33(2), 209-217. doi.org/10.1037/0022-3514.33.2.209
  39. Rutledge, T., Linke, S. E., Olson, M. B., Francis, J., Johnson, B. D., Bittner, V., et al. (2008). Social networks and incident stroke among women with suspected myocardial ischemia. Psychosomatic Medicine, 70(3), 282-287. https://doi.org/10.1097/PSY.0b013e3181656e09
  40. Sarason, I. G., Levine, H. M., Basham, R. B., & Sarason, B. R. (1983). Assessing social support questionnaire. Journal of Personality & Social Psychology, 44(1), 127-139. doi.org/10.1037/0022-3514.44.1.127
  41. Scott, C. L., Phillips, L. H. Johnston, M., Whyte, M. M., & MacLeod, M. J. (2012). Emotion processing and social participation following stroke: study protocol. BMC Neurology, 12(1), 1-7. doi:10.1186/1471-2377-12-56
  42. Shin, K. E., Oh, M. W., Jung, H. A., & Kim, H. D. (2017). Effect of virtual reality game on old patients depression, relationship and life satisfaction. Journal of Rehabilitation Research, 21(4), 101-118. doi.org/10.16884/JRR.2017.21.4.101
  43. Suh, M. J., Noh, S., Devins, G. M., Kim, K. S., Kim, K. G., Song, J. Y., et al., (1999). Readjustment and social support of the post hospitalized stroke patients. Korean Society of Nursing Science, 29(3), 639-655.
  44. Tangney, J. P. (1992). Situational Detenninants of shame and guild in young adulthood. Personality and Social Psychology Bulletin, 18, 199-206. doi.org/10.1177/0146167292182011
  45. Tangney, J. P., Baumeister, R. F., & Boone, A. L. (2004). High self-control predicts good adjustment, less pathology, better grades and interpersonal success. Journal of Personality, 72(2), 271-324. doi.org/10.1111/j. 0022-3506.2004.00263.x
  46. Vincent-Onabajo, G. O., Ihaza, L. O., Ali, U. M., Masta, M. A., Majidadi, R., Modu, A., et al., (2016). Impact of social support on participation after stroke in Nigeria. Top Stroke Rehabilitation, 23(5), 305-310. doi.org/10.1080/10749357.2016.1155279
  47. Youn, J. H., & Shin, H. S. (2005). An effect of self-disclosure training on anxiety and personal relations of the elderly with stroke. Dongduk Journal of Life Science Studies, 10, 125-135.
  48. Yu, J. S., & Kim, J. Y. (2019). The relationship between perceived parental overprotection and interpersonal relationships of university students: Focused on the mediating effect of shame. The Journal of the Korea Contents Association, 19(10), 677-684. doi.org/10.5392/JKCA.2019.19.10.677