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비만 책임 귀인과 낙인 대처 커뮤니케이션: 비만 상담의도와 건강행동의도에 대한 영향을 중심으로

Obesity responsibility attribution and stigma coping communication: effects on obesity counseling intention, and health behavior intention

임유진|유선욱|김수진
한국헬스커뮤니케이션학회 (Korea Health Communication Association)|2023.04|헬스커뮤니케이션연구 (Health Communication Research)|제22권 제1호|pp. 43-101|DOI 10.24172/hcr.2023.22.1.43

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참고문헌

키워드

doctor-patient communication비만 낙인의사-환자 커뮤니케이션비만 책임 귀인낙인 대처 커뮤니케이션상담의도Obesity responsibility attributionobesity stigmastigma coping communicationcounseling intention

초록

세계보건기구에서 비만은 질병이라고 선포한 지 20년이 지났다. 하지만 비만은 질병으로 인식되기 보다는 게으르고 자기관리에 충실하지 못한 개인의 책임으로 인한 것이라는 인식이 만연하다. 이에 본 연구에서는 비만의 책임 귀인과 비만 낙인에 대한 반응으로서 비만 낙인 대처 커뮤니케이션이 어떻게 나타나며, 이것이 비만인의 비만 상담의도와 건강행동의도에 어떤 영향을 미치는지 알아보고자 5개의 연구문제를 설정했다. 온라인 서베이를 실시한 결과, 1,100명 중 비만인이 417명, 비비만인 응답자가 683명으로 나타났다. 연구문제 분석 결과, 비만 책임귀인에 대한 비만인과 비비만인 집단의 차이가 나타났는데, 사회 귀인은 비만인 집단에서 더 높고 기업 귀인은 비비만인 집단에서 더 높았다. 비만 낙인에 대한 비만인의 대처 커뮤니케이션은 도전, 수용, 초월, 부정의 4가지 전략으로 구분되었고, 비만인의 비만 책임 귀인에 따라 낙인 대처 커뮤니케이션도 다르게 나타났다. 비만인의 낙인 대처 커뮤니케이션과 상담의도의 관련성을 검토한 결과, 부정적 낙인 대처를 하는 비만인의 경우, 운동치료 상담의도가 높아지고, 도전적 대처가 커질수록 약물치료 상담의도가 감소하는 것으로 나타났다. 반면 수용적 대처를 하는 비만인의 경우에는 약물치료 상담의도가 증가하고 초월적 낙인 대처를 하는 비만인일수록 운동치료와 약물치료, 수술치료 상담의도가 모두 높아지는 것으로 나타났다. 또한 건강행동의도에 대한 비만인의 낙인 대처 커뮤니케이션의 영향도 다르게 나타났는데, 초월, 수용적 낙인 대처를 하는 비만인일수록 적극적인 체중조절을 위한 노력을 하고, 부정적 낙인 대처는 더 이상 비만해지지 않기 위한 예방 노력과 관련이 있는 것으로 나타났다. 수용적 낙인 관리는 건강관리를 하고자 하는 노력을 감소시키는 것으로 나타났다. 본 연구는 비만 낙인을 사회적 문제로 바라보고 커뮤니케이션학과 의학의 융합적 접근을 통해 비만 문제해결을 위한 해답을 제공하고자 한 학제간 연구라는데 의미가 있다. 또한, 비만인의 건강행동과 의사-환자 커뮤니케이션에 영향을 주는 비만인의 낙인 대처 커뮤니케이션에 대한 실무적 함의를 제시하였다.

Abstract

Twenty years have passed since the World Health Organization declared obesity a disease. However, there is a widespread perception that obesity is due to the responsibility of individuals who are lazy and not faithful to self-management rather than being recognized as a disease. Therefore, in this study, five research questions were set to find out how obesity stigma coping communication appears as a response to obesity attribution and obesity stigma, and how it affects obesity counseling intention and health behavior intention of obese people. An online survey was conducted on obese and non-obese people, and out of 1,100 respondents, 417 were obese and 683 were non-obese. As a result of the analysis, difference between the obese and the non-obese groups were found for the cause of obesity. The social attribution was higher in the obese group and the corporate attribution was higher in the non-obese. The obesity stigma coping communication of the obese were divided into four strategies: challenge, acceptance, transcendence, and denial, and the stigma coping communication was also different depending on the attribution of the cause of obesity in the obese. As a result of examining the relationship between stigma coping communication and counseling intention of obese people, exercise therapy counseling intention was higher for obese people who dealt with negative stigma, and drug treatment counseling intention was lower for obese people who showed challenging coping response and higher for those who showed acceptance coping response. It was found that the more obese people cope with transcendent stigma, the higher the intention to consult both exercise treatment and drug treatment. In addition, the impact of obese people’s stigma coping communication on health behavioral intentions was different, and it was found that obese people who transcend and accept stigma tried to actively control weight, and negative stigma coping was related to prevention behavior intention. Acceptance strategy of stigma coping communication was found to reduce efforts to manage health. This study has academic significance as an interdisciplinary study to view obesity stigma as a social problem and to provide answers to obesity problems through the convergence of communication and medicine. Through the stigma coping communication of obese people, practical implications for doctor-patient communication to solve obesity problems were suggested.

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