• 제목/요약/키워드: 심리적 디스트레스

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부부관계 맥락에서 유방암의 심리사회적 영향 - 국내외 논문분석 - (Breast Cancer in Marital Context: A Critical Review of the Literature)

  • 이인정
    • 사회복지연구
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    • 제40권1호
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    • pp.37-61
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    • 2009
  • 유방암은 진단과 치료과정에서 환자뿐만 아니라 배우자에게 심리사회적 디스트레스를 초래하게 된다. 이러한 배우자의 디스트레스는 다시 유방암환자의 적응, 삶의 질에 영향을 미치게 된다. 이에 따라 부부관계 맥락에서 유방암의 심리사회적 영향을 살펴보아야할 필요성이 제기된다. 이를 위해 유방암환자와 배우자를 대상으로 심리사회적 영향을 조사한 국외 연구 33편, 국내 연구 1편 총 34편을 방법론적 측면과 내용적 측면으로 분석하였다. 분석 결과를 토대로 후속 연구와 임상적 실천에 있어서의 제언점을 제시하였다.

인지행동중재가 암 환자의 심리적 디스트레스, 자기간호 및 삶의 질에 미치는 효과: 메타분석 (Cognitive Behavioral Therapy for Psychological Distress, Self Care and Quality of Life in Patients with Cancer: A Meta-analysis)

  • 오복자;이은애
    • 성인간호학회지
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    • 제25권4호
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    • pp.377-388
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    • 2013
  • Purpose: The purpose of this study was to assess the effects of cognitive behavioral therapy (CBT) on depression, anxiety, self care behavior and quality of life in cancer patients. Methods: Two thousand and eighty three abstracts were identified through six electronic databases (1980 to June 2012) in Korea. Seventeen studies involving 679 participants met the inclusion criteria for meta analysis. Two authors independently assessed trial quality by Cochrane's Risk of Bias and Methodological Items for Non Randomized Studies and extracted data. The data were analyzed by the RevMan 5.2 program of Cochrane library. Results: Overall, study quality was moderate to high. CBT was conducted for a mean of 4.2 weeks, 7 sessions and an average of 36.1-minutes per session. CBT was effective for depression (d=-0.85; 95% CI=-1.09, -0.61), anxiety (d=-0.52; 95% CI=-0.75, -0.29), self care behavior (d=-1.34; 95% CI=-1.93, -0.74), and quality of life (d=-0.42; 95% CI=-0.80, -0.04). Publication bias was not detected as evaluated by funnel plot and Egger's test. Conclusion: CBT has small to large effects on depression, anxiety, self care and quality of life. These finding suggests that various CBT interventions can assist cancer patients in reducing emotional distress and improving self care and quality of life.

위암 환자의 디스트레스 유병률과 관련 위험 인자 (Prevalence and Associated Risk Factors of Psychological Distress in Patients with Gastric Cancer)

  • 전찬수;민정아;마지영;송교영;류인균;이창욱;이철;김태석
    • 정신신체의학
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    • 제20권2호
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    • pp.82-90
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    • 2012
  • 연구목적 : 위암은 국내에서 매우 빈번하게 발생하는 암이지만, 위암과 디스트레스 간의 관련성을 규명한 연구는 거의 없었다. 본 연구에서는 위암 환자의 디스트레스의 유병률을 조사하고 관련 위험인자를 알아보고자 한다. 방 법 : 일 종합병원 암센터에 입원한 274명의 위암 환자가 본 연구에 참여하였다. 모든 참여자에게 디스트레스를 평가하는 병원 불안 우울 척도가 시행되었으며, 사회인구학적 및 암 관련 임상 자료가 조사되었다. 결 과 : 153명(55.8%)의 위암 환자가 유의한 디스트레스를 나타내었다. 로지스틱 회귀분석에서 음주 경험이 있는 경우[오즈비(OR)=2.10, p=0.034]와 수행능력이 저하된 경우(OR=2.40, p=0.002)가 위암 환자의 디스트레스에 유의한 영향을 미치는 요인으로 밝혀졌다. 결 론 : 본 연구에서 약 반 수 이상의 위암 환자가 디스트레스를 겪고 있으며, 음주 경험과 낮은 수행 능력이 관련 위험 인자로 나타났다. 본 연구의 결과로 위암 환자의 디스트레스에 대한 선별 평가 및 심리사회적 중재의 필요성을 확인하였다.

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암환자교육이 암환자의 심리적 디스트레스와 자가간호지식 및 자가간호행위에 미치는 효과: 메타분석 (The Effect of Patient Education Interventions on Distress, Self-Care Knowledge and Self-Care Behavior of Oncology Patients: A Meta-Analysis)

  • 오복자;최형지
    • 종양간호연구
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    • 제12권4호
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    • pp.257-266
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    • 2012
  • Purpose: The purpose of this study was to evaluate the effectiveness of patient education interventions on distress, self-care knowledge and self-care behavior in cancer patients. Methods: A total of 1,102 studies were retrieved from 6 electronic databases in Korea. From these studies, 18 studies met the inclusion criteria with a total of 850 participants. Two authors independently assessed the methodological quality by Cochrane's Risk of Bias and Methodological Items for Non Randomized Studies. The data were analyzed by the RevMan 5.1 program of Cochrane library. Results: Overall effect size of education interventions on anxiety was -2.12 (95% CI:-3.90, -0.34) (p<.001). The effects on self-care knowledge and self care behavior were -1.08 (95% CI:-1.73, -0.43) (p=.001), and -1.41 (95% CI:-2.13, -0.68) (p<.001), respectively. Publication bias was detected as evaluated by funnel plot, but the fail-safe number was moderate. Conclusion: This study suggests that patient education interventions can relieve anxiety and self-care. Further randomized controlled trials studies are needed to evaluate the effects of patient education intervention on depression.

허혈성 뇌졸중 환자의 디스트레스 측정도구 개발 및 평가 (Development and Psychometric Evaluation of the Ischemic Stroke Distress Scale (ISDS))

  • 강재진;유양숙
    • 대한간호학회지
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    • 제53권1호
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    • pp.12-27
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    • 2023
  • Purpose: This study aimed to develop a scale to measure distress in patients with ischemic stroke and verify its validity and reliability. Methods: Preliminary items were developed from literature review and in-depth interviews. The final preliminary scale was confirmed through a content validity test of eight experts and a preliminary survey of 10 stroke patients. The participants for psychometric testing were 305 stroke patients in the outpatient clinic. Validity and reliability analyses included item analysis, exploratory and confirmatory factor analysis, convergent validity, known-group validity, and internal consistency of the scale. Results: The final scale consisted of 17 items and 3 factors. The three distinct factors were 'self-deprecation, worry about future health, and withdrawal from society' and this structure was validated using a confirmatory factor analysis. Convergent validity was supported by comparison with the Center for Epidemiologic Studies Depression Scale (r = .54, p < .001) and Brief Illness Perception Questionnaire (r = .67, p < .001). Known-groups validity was verified by dividing groups according to 'duration since diagnosis' (t = 2.65, p = .009), 'presence of sequela' (t = 10.16, p < .001), and 'awareness of distress' (t = 12.09, p < .001). The internal consistency of the scale using Cronbach's α for the total items was .93. Conclusion: The Ischemic Stroke Distress Scale is a valid and reliable tool that reflects stroke distress effectively. It is expected to be used as a basic tool to develop various intervention strategies to reduce distress in ischemic stroke patients.

유방암 환자에 대한 심리교육 집단개입의 효과 (A Pychoeducational Group Intervention for Women with Primary Breast Carcinoma)

  • 황숙연;이인수;박병우
    • 한국사회복지학
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    • 제51권
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    • pp.93-118
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    • 2002
  • 우리나라에서 유방암은 여성암 중 두 번째를 차지하고 있고, 점차 증가하고 있으며 이들의 심리사회적 적응에 대한 욕구와 관심이 증대되고 있음에도 불구하고 아직 우리나라에서 유방암 환자들의 심리사회적 후유증을 감소시키기 위한 개입은 이루어지지 못하고 있다. 본 연구는 유방암 환자를 대상으로 서구에서 주로 실시되어 왔던 심리교육 집단개입이 우리나라에서도 심리적 디스트레스를 감소시키고 대처를 증진시킴으로써 심리사회적 후유증을 감소시키는데 효과가 있는지를 평가하고 이에 대한 합의를 논하는데 목적을 두었다. 유방암 수술을 받은 지 1년이 경과하지 않은 환자들 중 유방암 병기가 3기 B이상이거나 70세 이상의 환자, 거동이 불편한 환자, 지리적으로 참석이 불가능한 환자 등을 제외한 80명의 환자 중 연구에 참여를 희망하는 환자 70명을 실험집단, 대기자 통제집단 및 대기자 집단으로 무작위 할당하였다. 실험집단과 통제집단의 수는 각각 24명이었으며 최종 분석에 포함된 환자 수는 실험집단 22명, 통제집단 13명이었다. 이들에 대해 매 주 특정주제를 중심으로 8주간의 구주화된 집단개입을 실시하였으며, 프로그램은 교육과 심리적 지지를 결합한 심리교육적 전략을 사용하였다. 대상자들은 심리적 디스트레스와 대처에 대해 Beck Depression Inventory와 Ways of Coping Checklist-Revised(WCCL-R)를 실시하여 집단개입 전과 8주 후에 각각 평가하였다. 분석결과 실험집단은 통제집단에 비해 집단 개입 이후 BDI상에 나타난 우울에 대해서는 유의미하게 낮은 점수를 보였지만(p<.05). 대처에 대해서는 총점에서나 하위척도 상으로 유의미한 차이를 보이지 않았다. 연구결과와 관련하여 집단의 크기, 프로그램의 내용, 수술 후 경가 시기 등이 논의되었다. 몇 가지 한계에도 불구하고 본 연구는 우리나라에서도 단기 심리교육 집단개입이 유방암 환자들의 수술 후 심리사회적 후유증을 줄이고 삶의 질을 증진시키는 중요한 방법으로 활용될 수 있는 가능성을 보여주었다고 할 수 있다.

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한국 유방암 생존자들의 디스트레스와 삶의 질 (Distress and Quality of Life in Breast Cancer Survivors in Korea)

  • 권은진;이명선
    • 종양간호연구
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    • 제12권4호
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    • pp.289-296
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    • 2012
  • Purpose: The purposes of this study were to find the levels of distress and quality of life of breast cancer survivors in Korea and to identify relationship between distress and quality of life. Methods: The data were collected from 122 breast cancer survivors in 2009. To measure the distress and quality of life, the 'Distress Thermometer and Problem List' and the 'Functional Assessment Cancer Therapy-Breast' were used respectively. Results: The mean score of distress was 4.77 (${\pm}2.35$) and 63.1% of the subjects reported a distress score of 4 or more, indicating a clinically significant level of distress. Among these, the most frequently reported problem area was emotion, followed by family. The mean score of the quality of life was 88.22 (${\pm}18.41$), signifying 6.13 out of 10. The levels of distress and the quality of life were negatively correlated (r=-.38, p<.001). Conclusion: The results of the study indicate that distress is prevalent in Korean breast cancer survivors and the distress is related negatively with their quality of life. Thus oncology professionals continuously need to assess distress of breast cancer survivors and to provide appropriate psychosocial interventions to improve their quality of life.

빈곤층 편모의 스트레스가 부모역할 수행에 미치는 영향 :심리적 디스트레스의 매개역할을 중심으로 (Stress and psychological Distress as Determinants of Parenting Practices among Poor Single Mothers)

  • 한경혜
    • 가정과삶의질연구
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    • 제14권4호
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    • pp.263-276
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    • 1996
  • The purpose of this study is to explore various environmental factors that explain parenting practices. Those factors considered are stress and characteristics of single-mother/child together with psychological distress experienced by the single mother. A total of 285 poor single mothers with a child attending elementary school or junior high school completed a structured questionaire. The relationships among the variables were analyzed by the path analysis. The results showed that poor single mothers rely on affectiv $e^portive involvement more frequently then punitive/inconsistent discipline. It is also confirmed that the enviromental factors such as financial stress living environmental stress and job status play important roles in determining the quality of parenting practices with the mediating role of psychological distress.ss.

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진단 직후 유방암환자의 디스트레스 관리를 위한 심리교육프로그램의 효과 (Psychoeducational Approach to Distress Management of Newly Diagnosed Patients with Breast Cancer)

  • 박진희;전미선;정용식;배선형;정영미
    • 대한간호학회지
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    • 제48권6호
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    • pp.669-678
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    • 2018
  • Purpose: The purpose of this study was to examine the effects of integrated psychoeducational program for distress management of newly diagnosed patients with breast cancer. Methods: A quasi-experimental trial was conducted. The participants consisted of 47 female patients with breast cancer assigned to an intervention group (n=25) and control group (n=22). The intervention group participated in integrated psychoeducational program, consisting of individual face-to-face education and telephone-delivered health-coaching sessions. Data were collected at three time points: pre-intervention (T1), post-intervention (T2), and 6-month follow-up (T3). Study instruments were Distress thermometer, Supportive Care Needs Survey Short Form 34 and Functional Assessment of Cancer Therapy-Breast. Results: Compared with the control group, breast cancer patients in the intervention group reported lower distress and supportive care needs than the control group. The intervention group reported higher quality of life (QOL) overall and higher emotional well-being than the control group. Conclusion: These findings indicate that the integrated psychoeducational program is an effective intervention for reducing distress and supportive care needs and increasing QOL of newly diagnosed patients with breast cancer. Oncology nurses need to provide psychoeducational intervention to support patients with breast cancer in managing their distress and helping them adjust to their life.

물리치료사의 사회적 지지가 환자의 심리적 디스트레스에 미치는 영향 : 환자의 조절초점을 중심으로 (The Effect of Patient's Psychological Distress on Social Support in Physical Therapists : Focused on patient's regulatory focus)

  • 김철용
    • 대한물리의학회지
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    • 제6권3호
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    • pp.331-339
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    • 2011
  • Purpose : The purpose of this study is to examine the impact of patient's psycological distress on social support in the view of patient's regulatory focus. Methods : For this study 300 questionnaires were distributed to medical institution, Busan from July 19 through August 4, 2010. The contents item divided the general characteristics, social support, psychological distress, and regulatory focus. The collected data were analyzed by t-test and multi-regression analysis. Results : The results show that patient's psychological distress is significantly influenced by physical therapist's emotional support and informational support. Also, there were difference with the effect of psychological distress on social supports in the physical therapists according to patient's regulatory focus. Conclusion : The instrumental support is more important to patient with promotion-focus than patient with prevention-focus. The implication of this research confirmed that physical therapist's social support plays important role in decreasing patient's psychological distress.