Therapeutic Science for Rehabilitation (재활치료과학)

Korean Society of Neurological Occupational Therapy (대한신경계작업치료학회)
권호 표지
DOI QR코드

DOI QR Code

Experience of Agent Orange and Depression and Quality of Life: Mixed Method

고엽제 노출 경험과 우울 및 삶의 질: 통합방법론

  • Joo, Eun-Woo (Dept. of Occupational Therapy, Busan Veterans Hospital) ;
  • Lee, Jae-Shin (Dept. of Occupational Therapy, College of Medical Science, Konyang University) ;
  • Kim, Soo-Kyoung (Dept. of Occupational Therapy, College of Medical Science, Konyang University) ;
  • Cha, Tae-Hyun (Dept. of Occupational Therapy, College of Medical Science, Konyang University)
  • 주은우 (부산보훈병원 작업치료실) ;
  • 이재신 (건양대학교 작업치료학과) ;
  • 김수경 (건양대학교 작업치료학과) ;
  • 차태현 (건양대학교 작업치료학과)
  • Received : 2020.02.27
  • Accepted : 2020.05.21
  • Published : 2020.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: This study used a mixed methods analytical approach to analyze the level of depression in and quality of life of patients who had been exposure to Agent Orange. Methods: Data on the general characteristics, depression level, and the quality of life of 29 patients who were hospitalized because of exposure to Agent Orange were collected. Focus group interviews were conducted with 17 of these 29 patients. Regarding mixed methods, the sequential integrated design model proposed by Teddlie and Tashakkori (2003) was employed. The analytical methods were as follows: (1) general characteristics were examined using frequencies and proportional distributions; (2) depression scores and quality of life scores were assessed using descriptive statistical analysis; and (3) content analysis was used to examine the focus group interview data. Results: The average K-GDS depression score was 19.24 points, and the average WHOQOL-BREF quality of life score was 57.66 points. The focus group interview data yielded 3 topics were named "deployment route", "the manner of exposure to Agent Orange", and "life after Agent Orange exposure". Conclusion: There is an urgent need to increase public awareness, develop a public policy response, and conduct additional research on ground occupational therapy programs that include physical therapy.

목적 : 본 연구는 통합방법론을 이용하여 고엽제 환자의 우울 및 삶의 질을 심층적으로 알아보고자 하였다. 연구방법: D병원에 입원한 고엽제 환자 29명을 대상으로 일반적인 특성, 우울, 삶의 질과 29명의 대상자 중 17명을 대상으로 포커스그룹 면담을 실시하였다. 통합방법론은 모형 중 Teddlie와 Tashakkori(2003)가 제시한 순차적 통합설계를 사용하였다. 분석방법으로는 일반적인 특성은 빈도 및 백분율로 산출하고 우울 및 삶의 질은 기술통계 분석, 포커스그룹 면담은 내용분석방법을 사용하였다. 고엽제 환자의 우울 및 삶의 질은 순차적 통합설계 방법을 통해 심층적으로 분석하였다. 결과: 고엽제 환자의 연령은 75세~79세(58.6%)가 가장 많았고, 70~74세(34.3%), 85세 이상(3.4%), 65~69세(3.4%) 순이었다. 고엽제 환자의 우울은 19.24점, 삶의 질은 평균 57.66점으로 나타났다. 포커스그룹 면담 결과 3가지의 주제와 7개의 구성 요소, 14개의 하위구성 요소로 3가지의 주제는 "파병 경로", "고엽제 노출 경로", "고엽제 노출 이후의 삶"으로 나타났다. 결론: 본 연구는 통합방법론을 이용하여 선행연구들과는 차별되게 고엽제 환자의 우울 및 삶의 질을 심층적으로 분석할 수 있었다. 향후 고엽제 환자의 우울 및 삶의 질을 개선할 수 있는 신체활동이 포함된 집단작업치료 프로그램을 개발하고 적용하는 연구와 사회적 관심과 제도적 지원도 적극적으로 이루어져야 할 것이다.

Keywords

References

  1. 국가법령정보센터. (2019). 고엽제후유의증 등 환자지원 및 단체 설립에 관한 법률. Retrieved from http://www.law.go.kr
  2. American Occupational Therapy Association. (2002). Occupational therapy practice framework: Domain and process. The American Journal of Occupational Therapy, 56(6), 609-639. doi:10.5014/ajot.56.6.609
  3. An, Y. J. (2018). The effects of physical activity on depression and quality of life in patients with Agent Orange (Master's thesis). Woosong university, Daejeon.
  4. Fortes, C., Farchi, S., Forastiere, F., Agabiti, N., Pacifici, R., Zuccaro, P., & Ebrahim, S. (2003). Depressive symptoms lead to impaired cellular immune response. Psychotherapy and Psychosomatics, 72(5), 253-260. doi:10.1159/000071896
  5. Gough, M. (1986). Nobody wanted Dioxin. In M. Gough (Ed.), Dioxin, Agent Orange (1st ed., pp. 34-52). New York: Plenum Press. doi:10.1007/978-1-4899-6130-3
  6. Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24(2), 105-112. doi:10.1016/j.nedt.2003.10.001
  7. Han, K. S. (2003). Perceived stress, mood state and symptoms of stress of the patient with chronic illness. Journal of Korean Academy Nursing, 33(1), 87-94. doi:10.4040/jkan.2003.33.1.87
  8. Hiesh, H. F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277-1288. doi:10.1177/1049732305276687
  9. Hopkins, H. L., & Smith, H. D. (1993). In H. L. Hopkins, & H. D. Smith (Eds), Willard and Spackman occupational therapy (8th ed, pp. 118-131). Philladelpia: JB Lippincott Co.
  10. Johnson, R. B., & Onwuegbuzie, A. J. (2004). Mixed methods research: A research paradigm whose time has come. Educational Researcher, 33(7), 14-26. doi:10.3102/0013189x033007014
  11. Jung, I. K., Kwak, D. I., Shin, D. K., Lee, M. S., Lee, H. S., & Kim, J. Y. (1997). A reliability and validity study of Geriatric Depression Scale. Journal of Korean Neuropsychiatry Association, 36(1), 103-112.
  12. Kang, Y. J. (2016). The effect on group intervention program on COPM-performance, COPM-satisfaction, self-efficacy, depression and quality of life in patient with work-related injury: A case study. Journal of Korean Society of Cognitive Rehabilitation, 5(2), 17-34.
  13. Kim, J. S., Lim, H. S., Lee, H. B., Lee, W. Y., Park, Y. J., & Kim S. S. (1994). A preliminary epidemiologic study on Korean veterans exposed to herbicides in Vietnam War. Korea Journal of Preventive Medicine, 27(4), 711-734.
  14. Kim, N. H., & Jung, M. S. (2017). The influence of elderly social activity and depression on elderly well being. The Journal of the Korea Contents Association, 17(3), 496-506. doi:10.5392/JKCA.2017.17.03.496
  15. Kim, S. J., Kim, H. J., Lee, K. J., & Lee, S. O. (2000). Focus group method (1st ed.). Seoul: Hyunmoon.
  16. Kim, T. Y. (2006). A study on the quality of life about the Agent Orange patient on available WHOQOL-BREF. Journal of Patriots and Veterans Affairs in the Republic of Korea, 5(1), 129-152.
  17. Kim, T. Y. (2011). A corroborative study on th depression of Agent Orange patients - SGDS scale focus on. Journal of Patriots and Veterans Affairs in the Republic of Korea, 10(2), 53-77.
  18. Kim, W. O., Kang, H. S., Wang, M. J., Kim, J. H., & Choi, J. Y. (2007). Relationships among activity of daily living, depression, and quality of life (QOL) in patients with stroke. Journal of East-West Nursing Research, 13(2), 138-146.
  19. Kim, Y. C., Kim, K. S., & Lee, H. C. (2011). Mixed research method in educational research. The Journal of Elementary Education, 24(1), 305-328.
  20. Krueger, R. A., & Casy, M. A. (2014). Moderating Skills. In R. A. Krueger, & M. A. Casy (Eds.), Focus groups: Apractical guide for applied research (5th ed., pp. 115-121). CA: Sage Publications, Inc.
  21. Kwon, K. I., & Yang, J. Y. (2014). Trends in mixed methods research in counseling. Journal of Education Studies, 35(1), 103-124. doi:10.18612/cnujes.2014.35.1.103
  22. Lee, H. G. (2003). The relationship between participation in physical activity after school and social support, stress among the adolescents. Korean Journal of Sport Studies, 42(5), 147-157.
  23. Lee, I. J. (2007). Sex differences in the effects of psychosocial factors on depression and life satisfaction of older persons. International Journal of Welfare for the Aged, 36(2), 159-180.
  24. Lee, I. J. (2017). Comparison of level and correlates of depression among the young old, the older old, and the oldest old:Focused on moderating role of psychosocial resources on the effect of worry. Journal of Korean Social Welfare Education, 38, 1-23.
  25. Lee, P. S., Sohn, J. N., Lee, Y. M., & Kang, H. C. (2005). Prediction model on mental health status in middle aged women of an urban area. Journal of Korean Academy Nursing, 35(2), 239-251. doi:10.4040/jkan.2005.35.2.239
  26. Lim, J. H. (2014). The relationship among depressive symptoms and chronic diseases in the elderly. Journal of Digital Convergence, 12(6), 481-490. doi:10.14400/jdc.2014.12.6.481
  27. Min, S. K., Kim, K. I., Suh. S. Y., & Kim, D. K. (2000). Development of the Korean version of the World Health Organization Quality of Life Scale (WHOQOL). The Journal of Korea Neuropsychiatric Association, 39(1), 78-88.
  28. Park, I. S., & Kim, Y. H. (2011). Influence of line dance participants' physical self-efficacy and heath promotion acts on mental happiness. Journal of Sport and Leisure Studies, 43(1), 127-139. https://doi.org/10.51979/KSSLS.2011.02.43.127
  29. Ragin, C. (1987). Case-oriented comparative methods. In C. Ragin (Ed.), The comparative method: Moving beyond qualitative and quantitative methods (1st ed., pp. 31-54). Barkeley: University of California Press.
  30. Robinowitz, R., Roberts, W. R., Dolan, M. P., Patterson, E. T., Charles, H. L., Atkins, H. G., & Penk, W. E. (1989). Carcinogenicity and teratogenicity vs. psychogenicity: Psychological characteristics associated with self-reported agent orange exposure among Vietnam combat veterans who seek treatment for substance abuse. Journal of Clinical Psychology, 45(5), 718-728. doi:10.1002/1097-4679(198909)45:5<718::aid-jclp2270450506>3.0.co;2-o
  31. Teddlie, C., & Tashakkori, A. (2003). Major issues and controveries in the use of mixed methods in the social and behavioral sciences. In A. Tashakkori, & C. Teddlie (1st ed., pp. 3-50), Handbook of mixed methods in social & behavioral research. CA: Sage Publication.
  32. Vogt, D. S. B. N. K. D. W., Smith, B. N., King, D. W., & King, L. A. (2012). Manual for the Deployment Risk and Resilience Inventory-2 (DRRI-2): A collection of measures for studying deployment related experiences of military veterans. Boston, MA: National Center for PTSD. Retrieved from https://www.ptsd.va.gov/professional/assessment/deployment/index.asp
  33. World Health Organization. (1996). World Health Organization Quality of Life Assessment Instrument. Short Version (WHOQOL-Bref). Retrieved from https://apps.who.int/iris/bitstream/handle/10665/63529/WHOQOL-BREF.pdf
  34. Yang, S. E. (2006). An inquiry about mixed methodology for family studies. International Journal of Human Ecology, 44(9), 1-8.
  35. Yesavage, J. A., Brink, T. L., Rose, T. L., & Adey, M. (1983). The geriatric depression rating scale: Comparison with other self-report and psychiatric rating scales. Assessment in geriatric psychopharmacology, 25(12), 153-167.
  36. Yi, S. W., Ohrr, H., & Lim, H. S. (2013). Agent Orange-related chemical exposure: Health effects and compensation policy in Korea. Korean Journal of Environmental Health Sciences, 39(3), 197-210. doi:10.5668/jehs.2013.39.3.197