장애인 가족 돌봄부담의 우울과 자살생각의 관계 연구-돌봄지원의 조절매개효과를 중심으로
Care burdens, depression and suicidal ideation among family caregivers of persons with disabilities– a focus on the moderated mediation effects of care services
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본 연구는 첫째, 장애인 돌봄가족원의 객관적인 돌봄 현황과 주관적으로 인지하는 돌봄부담이 어느 정도인지를 알아보고, 둘째 이러한 돌봄부담이 가족원의 정신건강에 영향을 주는지, 곧 우울에 영향을 주며 우울을 매개로 자살생각에 영향을 주는가를 알아보고, 마지막으로 장애에 대한 사회적 지원이 돌봄가족원의 돌봄부담으로 인한 영향을 완화시키는가를 실증적으로 검증하고자 하였다. 이를 위해 서울‧경기 지역의 복지기관, 장애인 자립생활센터의 이용자, 특수학교 재학‧졸업생 중 지체장애, 뇌병변장애가 있는 만18세 이상 성인장애인의 돌봄가족원을 대상으로 조사를 실시하여 총 174부의 조사표를 분석하여 결과를 제시하였다. 연구 결과 주관적 돌봄부담이 높은 경우 돌봄가족원의 우울이 높아지고 그러한 경우 극단적으로 자살생각까지 이어지는 돌봄부담의 부정적 영향 이 검증되었다. 사회적 지원 중 돌봄지원 및 방문의료지원의 만족스러운 경험은 돌봄부담이 가족원의 우울을 매개로 자살생각에 미치는 영향을 완화시키는 것으로 나타났다. 이러한 결과를 바탕으로 장애인 돌봄가족원의 정신 건강을 지원하는 프로그램의 개발과 확대를 제안하였고, 장애인과 가족이 선택할 수 있는 대안 확대가 필요하며 이를 위한 단기 돌봄서비스 도입 등을 제안하였다. 아울러 성인장애인의 자립생활을 위한 사회적 지원 확대와 환경 구축이 필요함을 제안하였다.
Abstract
The purpose of this study is to examine the relationship between care burdens, depression, and suicidal ideation among family caregivers taking care of adults with physical disabilities, and to identify the moderated mediation effects of support services for persons with disabilities on the relationships between care burdens, depression and suicidal ideation among family caregivers. According to survey results, the mediation effects of depression are verified by the relationship between care burdens and suicidal ideation. Furthermore, care services for persons with disabilities have moderated mediation effects on the relationships between care burdens, depression, and suicidal ideation among family caregivers. The negative effects of care burdens are verified by the significant positive relationships between care burdens, depression and suicidal ideation. And the buffering effects of care services for persons with disabilities on the relationships between care burdens, depression, and suicidal ideation are also verified. Based on the results, the practical and policy implications of supporting persons with disabilities and family caregivers are discussed, and developing mental health programs for family caregivers and increasing support services for persons with disabilities and respite services for family caregivers are also suggested.
참고문헌 (46)
- 강우진, "시각장애인과 주부양자 특성이 부양부담에 미치는 영향", 임상사회사업연구, 8(1), pp.1~30 (2011)
- 김고은, "성인 지적장애인을 돌보는 노년기 어머니의 우울 : 가족관계 만족의 중재효과", 정신건강과 사회복지, (38), pp.237~259 (2011), 한국정신건강사회복지학회
- 김교연, "지적 장애인의 생애주기에 따른 어머니의 돌봄 부담감(Subjective Caregiving Burden) 차이", 지적장애연구, 12(2), pp.285~307 (2010), 한국지적장애교육학회
- 김재엽, "암환자 주부양자의 부양부담이 자녀와의 역기능적 의사소통에 미치는 영향에서 가족간 TSL 태도의 조절효과:청장년층과 중장년층의 비교연구", 한국가족복지학, (54), pp.77~106 (2016), 한국가족사회복지학회[DOI]
- 김형수, "한국노인의 자살생각과 관련요인 연구", 한국노년학, 22(1), pp.159~172 (2002), 한국노년학회
- 변보기, "“장애아동 부모의 양육 스트레스 및 가족지원에 관한 연구-자폐아동부모를 중심으로", 교육의 이론과 실천, 11(2), pp.77~88 (2006)
- 어용숙, "일상생활의존도와 가족 대처자원이 장애아동 부모의 양육스트레스에 미치는 영향", 특수교육재활과학연구, 47(2), pp.167~183 (2008), 특수교육재활과학연구소
- 윤현숙, "뇌졸중 노인 부양가족의 부양부담과 우울에 미치는 영향요인에관한 연구", 한국노년학, 20(2), pp.137~153 (2000)
- 이민홍, "한국형 부양자반응척도(Caregiver Reaction Assessment)의 구성타당화 연구", 한국노년학, 29(2), pp.407~424 (2009), 한국노년학회
- 최해경, "성인 발달장애인을 돌보는 부모의 보호부담과 사회적 지지가 우울에 미치는 영향", 사회과학연구, 21(2), pp.243~263 (2010), 사회과학연구소
- Anderson, C, "A population-based assessment of the impact and burden of caregiving for long-term stroke survivors", Stroke, 26(5), pp.843~849 (1995)
- Anderson, D, "The personal costs of caring for a child with a disability: A review of the literature", Public Health Reports, 122(1), pp.3~16 (2007)
- Armstrong, I. M, "Pathways between social support, family well being, quality of parenting, and child resillience: What we know", Journal of Child and Family Studies, 14(2), pp.269~281 (2005)
- Barns, C, "Rethinking care from the perspective of disabled people" (2001), Cornell University ILR school
- Bass, M. D, "The moderating influence of service use on negative caregiving consequences", Journal of Gerontology, 51B(3), pp.S121~S131 (1996)
- Borsay, A, "Disability and attitudes to family care in Britain: towards a sociological perspective", Disability, Handicap & Society, 5(2), pp.107~122 (1990)
- Braithwaite, V, "Caregiving burden: Making the concept scientifically useful and policy relevant", Research on Aging, 14(1), pp.3~27 (1992)
- Chan, A, "Health impact of caregiving for older adults with functional limitations: Results from the Singapore survey on informal caregiving", Journal of Aging and Health, 25(6), pp.998~1012 (2013)
- Chan, B. J, "Does respite care reduce parental stress in families with developmentally disabled children", Child & Youth Care Forum, 30(5), pp.253~263 (2001)
- Clark, M. S, "The double ABCX model of family crisis as a representation of family functioning after rehabilitation from stroke", Psychology, Health & Medicine, 4(2), pp.203~220 (1999)
- Edwards, B, "The families caring for a person with a disability study and the social lives of carers", Family Matters, 76, pp.8~17 (2007)
- Eriksen, J, "Public payment for informal care of disabled children-Some dilemmas of the Norwegian welfare state", European Societies, 5(4), pp.445~463 (2003)
- Fairchild, J. A, "A general model for testing mediation and moderation effects", Prevention Science, 10(2), pp.87~99 (2009)
- Harlow, L. Lisa, "Depression, self-derogation, substance use, and suicide ideation: Lack of purpose in life as a mediational factor", Journal of Clinical Psychology, 42(1), pp.5~21 (1986)
- Haskin, J, "Introduction: Special issue on families and disabilities", Michigan Family Review, 17(1), pp.1~4 (2013)
- Hayes, A, "Beyond Baron and Kenny: Statistical mediation analysis in the new millennium", Communication Monographs, 76(4), pp.408~420 (2009)
- Hiroe, YŌDA, "New views on disabilities and the challenge to social welfare in Japan", Social Science Japan Journal, 5(1), pp.1~15 (2002)
- Lim, J. W, "Caring for family members with chronic physical illness: A critical review of caregiver literature", Health and quality of life outcomes, 50(2), pp.1~9 (2004)
- Magliano, L, "Burden, professional support, and social network in families of children and young adults with muscular dystrophies", Muscle & Nerve, 52, pp.13~21 (2015)
- McCubbin, I. H, "The family stress process", Marriage & Family Review, 6, pp.7~37 (1983)
- Montgomery, R. J. V, "Caregiving and the experience of subjective and objective burden", Family Relations, 34, pp.19~26 (1985)
- O'Dwyer, S, "Suicidal ideation in family carers of people with dementia: a pilot study", International Journal of Geriatric Psychiatry, 28, pp.1182~1188 (2013)
- O'Dwyer, S, "Suicidal ideation and resilience in family carers of people with dementia: A pilot qualitative study", Aging and Mental Health, 17(6), pp.753~760 (2013)
- Pearlin, L, "Caregiving and the stress process: An overview of concepts and their measures", The Gerontologist, 30(5), pp.583~594 (1990)
- Penning, M, "Cognitive impairment, caregiver burden, and the utilization of home health services", Journal of aging and health, 7(2), pp.233~253 (1995)
- Pinquart, M, "Differences between caregivers and noncaregivers in psychological health and physical health: A meta-analysis", Psychology and aging, 18(2), pp.250~267 (2003)
- Rosengard, C, "Suicidal ideation, bereavement, HIV serostatus and psychosocial variables in partners of men with AIDS", AIDS Care, 9(4), pp.373~384 (1997)
- Saloviita, T, "Explaining the parental stress of fathers and mothers caring for a child with intellectual disability: a Double ABCX model", Journal of Intellectual Disability Research, 4(4, pp.5) (2003), 300~312
- Saraceno, C, "Varieties of familialism: Comparing four southern European and East Asian welfare regimes", Journal of European social policy, 26(4), pp.314~326 (2016)
- Scharlach, A, "Cultural attitudes and caregiver service use: Lessons from focus groups with racially and ethnically diverse family caregivers", Journal of Gerontological Social Work, 47(1, pp.2) (2006), 133~156
- Stansfeld, S, "Stressors and common mental disorder in informal carers - An analysis of the English adult psychiatric morbidity survey 2007", Social Science & Medicine, 120, pp.190~198 (2014)
- Stoller, P. E, "Other roles of caregivers: Competing responsibilities or supportive resources", Journal of Gerontology, 44(6), pp.S231~S238 (1989)
- Tolkacheva, N, "The impact of informal care-giving networks on adult children's care-giver burden", Aging & Society, 31, pp.34~51 (2011)
- "사회조사-자살에 대한 충동 및 이유(13세 이상 인구)" (2014), 통계청[URL]
- "CES-D"[URL]
- "Aging and Disability resource center"[URL]
