암질병에 따른 암환자의 불편감과 고통에 관한 연구

Abstract

Purpose: The study was to furnish basic raw materials that evaluate the efficacy of meatal care according to the form and the relative importance of symptom distress which most of cancer sufferers have been experienced. For that, an investigation of five diverse major cancer symptom distress made a comparison between symptom distress and degree of suffering. Method: Study subjects were 138 inpatients with stomach cancer, lung cancer, hepatocellular carcinoma(HCC), large intestine cancer and breast cancer, except those in the terminal-stage, in 'H' university hospital in Seoul and 'K' center in Ilsan gathered from November 20, 2002 to February 20, 2003. * Hanyang University Medical Canter ** Professor, Department of Nursing, College of Medicine, Hanyang UniversityTo measure the correlation between feeling of discomfort and agony caused by cancer, 5 point scale (from zero to four), stood on the basis of Symptom Distress Scale (SDS, Rodes & Watson, 1987), was used for this study and the Cronbach's coefficient alpha was 0.95. Accumulated data was analyzed with SPSS 10.0 for window, also used by ANOVA and Duncan's Multiple Range Test, Pearson's Correlation Analysis. Results: 1. Symptom distress of cancer patients was noted and defined in their severity-fatigue, anorexia, pain, depression, dyspepsia, changing appearance and nausea. The degree of symptom distress was fatigue, dyspepsia, depression, anorexia, pain, changing appearance and the degree of suffering was nausea, pain, anorexia, dyspepsia, vomiting, breathing difficulty, changing appearance and fatigue. 2. Examining the difference of degree of symptom distress in each cancer cases, it takes the precedence of them. First, in case of stomach cancer, depression, pain, vomiting and nausea were shown in sequence. In case of lung cancer depression, pain, sleeping problem, anxiety, changing appearance, inattentiveness and vomiting were showed in sequence, depression, changing appearance, sleeping problem, pain in case of HCC, depression, pain in case of large intestine cancer and lastly in case of breast cancer changing appearance, depression, pain and anxiety were shown in sequence. The category of the degree of symptom distress that has a signifiant difference was anorexia, activity discomfort, fatigue, constipation or diarrhea, breathing difficulty, dyspepsia, caughing, fever or chillness, scotoma and urinary disorder. Verifying the highest degree of symptom distress in each cancer cases, anorexia was 1.94(F=4.00, p<.01) in stomach cancer, activity discomfort was 0.97(F=3.08, p<.01) in lung cancer and HCC, fatigue was 2.32(F=4.64, p<.01) in HCC, constipation or diarrhea was 1.83(F=22.31, p<.001) in large intestine cancer, breathing difficulty was 1.83(F=4.00, p<.01) in lung cancer, dyspepsia was 2.69(F=9.98, p<.001) in stomach cancer, coughing was 1.53(F=20.49, p<.001) in lung cancer, fever or chillness was 1.23(F=6.88, p<.001) in lung cancer, scotoma was 1.20(F=3.02, p<.05) in lung cancer and urinary disorder was 1.54(F=11.56, p<.001) in HCC. 3. Examining the difference degree of suffering on cancer cases, the result was as follows; depression of lung cancer was 1.17(F=3.76, p<.01), anorexia of stomach cancer was 1.61(F=3.89, p<.01), constipation or diarrhea of large intestine cancer was 1.42(F=10.43, p<.001), changing appearance of breast cancer was 1.65(F=5.43, p<.001), breathing difficulty of lung cancer was 2.27(F=18.57, p<.001), dyspepsia of stomach cancer was 1.97(F=13.56, p<.001), coughing of lung cancer was 1.70(F=22.07, p<.001), fever or chillness of lung cancer was 1.13(F=4.41, p<.01), scotoma of lung cancer was 0.87(F=3.34, p<.05), anxiety of lung cancer was 0.87(F=4.50, p<.001) and urinary disorder of HCC was 1.43(F=16.71, p<.001). 4. In consequence, comparing between symptom distress and degree of suffering on cancer patients undergoing chemotherapy, lung cancer patients showed the highest feeling of discomfort following stomach cancer, HCC, breast cancer and large intestine cancer(F=2.88, p<.05). On those undergoing radiotherapy, lung cancer, HCC, breast cancer, large intestine cancer was in sequence(F=3.78, p<.05) and those resisting radiotherapy, lung cancer, HCC, stomach cancer, large intestine cancer and breast cancer was in sequence(F=2.72, p<.05). 5. Correlation between symptom distress and degree of suffering on cancer patients was generally significant. Conclusion: this study not only defines a significant correlation between symptom distress and degree of suffering but also proffers basic data to evaluate the efficient meatal care depending upon diverse spectrums of symptom distress and degree of suffering.