암생존자의 재활에 대한 예측요인 탐색 연구
Predictors of Rehabilitation in Cancer Survivors
0
조회
0
다운로드
7
인용
0
참고문헌
키워드
초록
조기 진단기술과 치료 방법의 발달로 암의 생존율은 점차 증대되고 있다. 암 관리에 있어 급성적 치료를 통해 완치에 치중하던 관점에서 벗어나 지속적인 추후 관리와 생존자의 삶의 질 증대에 대한 노력으로 관심이 전환되고 있다. 특히 암생존자의 일상으로의 복귀와 적응을 위한 재활의 필요성이 강조되고 있다. 하지만 국내의 경우 암생존자의 재활에 대한 사회적 관심과 관련 기초 자료가 매우 부족한 상황이다. 이에 본 연구는 암생존자의 재활에 영향을 미치는 요인을 실증적으로 검증하여 사회복지적 정책과 서비스 마련을 위한 토대를 제공하고자 수행되었다. 이러한 목적을 바탕으로 치료가 종결된 암생존자 303명을 대상으로 설문 조사하였으며, 문헌 고찰을 통해 암생존자의 재활에 대해 인구사회학적 요인, 질병관련 요인, 심리적 요인(외상 후 스트레스증상), 사회적 요인(사회적 지지, 사회적 배제)으로 영향요인을 구성하였고, 이를 위계적 회귀분석을 통해 검증하였다. 그 결과 종교가 있는 경우가 그렇지 않는 집단에 비해 재활 수준이 높았으며, 일상생활 수행 기능 정도가 좋을수록 재활 수준이 높았다. 심리적 요인으로 외상 후 스트레스 증상 중 하위 요인인 침습(intrusion) 정도는 재활 수준에 유의한 부적 영향을 미치고 있었으며, 사회적 지지의 하위요인 중 정서적, 정보적 상호작용은 재활 수준에 유의한 정적 영향을 미치고 있었다. 또한 사회적 배제는 암생존자의 재활에 대해 가장 강력한 영향을 미치고 있었는데 하위요인인 사회적 교류에서의 배제, 경제소비에서의 배제는 재활에 대해 유의한 부적 영향을 미치는 것으로 나타났다. 이러한 결과를 토대로 후속연구와 사회복지적 개입에 대한 제언을 제시하였다.
Abstract
Rate of cancer survival are gradually increasing as the treatment methods and early diagnosis techniques advances. The attention is being shifted to the continuous aftercare and increase in quality of life from the previous focus on acute treatment and full recovery. Importance of rehabilitation as the cancer survivor returns to normal life for better adaptation. However, society's attention regarding psycho-social rehabilitation for cancer survivors and basic research materials are quite lacking in South Korea. Thus, this research had been carried out in order to set up the basis that provides social welfare policies and services that affects cancer survivor's psycho-social rehabilitation. The research was conducted with 303 cancer survivors that had completed the treatment for this purpose. Through study of the literature, influential factor for cancer survivor's rehabilitation such as demographic sociology as the variable, disease related factors, psychological factor such as post traumatic stress, social factor such as social support and exclusion; all verified by multiple hierarchy regression analysis. As the result, group that had religion had better quality of rehabilitation than the group that didn't have any. Rehabilitation was lower as they had more side effects and better when they functioned better in daily life activities. Intrusion of posttraumatic symptom had a significant negative effect. Emotional and informational mutual interaction is found to have a positive effect in the quality of rehabilitation. Moreover, the social exclusion is found out to have the strongest influence in rehabilitation of cancer survivor's rehabilitation. It was found that the lower factor of the social exchange which is exclusion, more specifically the exclusion from spending in economic setting had found to be a significant negative effect for rehabilitation. Advice for social welfare's intervention and further research had been provided based on the result.
참고문헌 (71)
- 김재엽, "가정내 자녀학대경험이 청소년의 자살생각에 미치는 영향 및 사회적 지지관계의 조절효과", 한국사회복지조사연구, 21, pp.119~144 (2009), 사회복지연구소
- 김윤선, "유방암 생존자의 삶의 질 영향요인", Asian Oncology Nursing, 11(3), pp.221~228 (2011), 대한종양간호학회
- 남기철, "사회적 배제의 개념과 사회복지실천의 딜레마", 상황과 복지, 19, pp.55~83 (2004)
- 남춘호, "노동 빈곤층의 사회적 배제와 빈곤화 유형 분석: 전주시 사례에 대한 생애사 분석을 중심으로", 산업노동연구, 12(1), pp.259~304 (2006), 한국산업노동학회
- 박미성, "암 생존자의 생활경험", Asian Oncology Nursing, 8(2), pp.93~104 (2008), 대한종양간호학회
- 박은옥, "제주지역 성인의 사회적 지지와 우울", 농촌의학.지역보건, 36(1), pp.25~35 (2011), 한국농촌의학.지역보건학회
- 국가암관리사업 이론과 실제, "박은철", 국립암센터, ~ (2010)
- 오경옥, "원예요법프로그램이 여성 암생존자의 상태불안과 피로 및 삶의 질에 미치는 효과", Asian Oncology Nursing, 12(2), pp.125~131 (2012), 대한종양간호학회[DOI]
- 윤미라, "유방암 생존자의 질병 극복 경험", 서울대학교 간호과학연구 논문집, 10(1), pp.41~51 (2013)
- 은헌정, "한국판 사건충격척도 수정판의 신뢰도 및 타당도 연구", 신경정신의학, 44(3), pp.303~310 (2005), 대한신경정신의학회
- 이영선, "암환자 가족의 삶의 질에 관한 연구 : 돌봄 부담감과 내적 성장의 매개효과 중심으로", 박사, 사회복지학, pp.2009
- 임정원, "한국 여성 유방암 생존자의 건강신념과 건강행위에 대한 질적 연구", 한국사회복지학, 63(4), pp.155~181 (2011), 한국사회복지학회
- 임정원, "유방암 및 부인과 암 생존자의 삶의 질에 대한 생존단계별 비교 연구", 한국사회복지학, 60(1), pp.5~27 (2008), 한국사회복지학회
- 장희경, "암 생존자의 암 재활에 대한 개념분석", 간호학의 지평, 8(1), pp.1~9 (2011)
- 전소선, "항암화학요법을 받는 종양 환자의 영적 안녕, 희망이 피로에 미치는 영향", 성인간호학회지, 24(6), pp.557~568 (2012), 성인간호학회
- 최권호, "소아암 생존자의 사회적 배제에 영향을 미치는 요인에 관한 연구", 석사, 사회복지학, pp.2008
- 허은경, "유방암 생존자의 직장복귀 경험", 한국모자보건학회지, 15(1), pp.92~102 (2011), 한국모자보건학회
- 황숙연, "유방암 생존자의 삶의 질과 영향요인", 정신보건과 사회사업, 33(33), pp.257~287 (2009), 한국정신보건사회복지학회
- Aguado Loi, C. X., "Risk factors associated with increased depressive symptoms among Latinas diagnosed with breast cancer within 5 years of survivorship. Psycho-Oncology, Epub ahead of print", ~ (2013)
- Amir, M., "Post-traumatic symptoms, emotional distress and quality of life in long-term survivors of breast cancer : a preliminary research", Journal of Anxiety Disorders, 16(2), pp.191~206 (2002)
- Baili, P., "Cancer rehabilitation indicators for Europe", European Journal of Cancer, 49(6), pp.1356~1364 (2013)
- Bender, C. M., "Symptom clusters in adults with chronic health problems and cancer as a comorbidity", Oncology Nursing Forum, 35(1), pp.1~11 (2008)
- Bloom, J. R., "Multi-dimensional quality of life among long-term(5+years)adult cancer survivors", Psycho-Oncology, 16(8), pp.691~706 (2007)
- The impact of low income on child health: evidence from a birth cohort study, "Burgess, S.", London School of Economics, ~, pp.CASE paper 85 (2004)
- Campbell, M. K., "Adult cancer survivorship care : experiences from the LIVESTRONG centers of excellence network", Journal of Cancer Survivorship, 5, pp.271~282 (2011)
- 정복례, "Developing a Rehabilitation Model of Bteast Cancer Patients Through Literature Review and Hospital Rehabilitation Programs", Asian Nursing Research, 2(1), pp.55~67 (2008), 한국간호과학회
- Corr, P. J., "Social exclusion and hierarchical defense System: comment on McDonald and Leary", Psychological Bulletin, 131, pp.231~236 (2005)
- Courneya, K. S., "The group psychotherapy and home-based physical exercise(group-hope)trial in cancer survivors : physical fitness and quality of life outcome", Psycho-Oncology, 12(4), pp.357~374 (2003)
- Dow, K. H., "The meaning of quality of life in cancer survivorship", Oncology Nursing Forum, 26(3), pp.519~528 (1999)
- Foster, C., "Recovery and self-management support following primary cancer treatment", British Journal of Cancer, 105, pp.521~528 (2011)
- Ferrell, B., "The meaning of quality of life for bone marrow transplant survivors", Cancer Nursing, 15, pp.247~253 (1992)
- Ganz, P. A., "Survivorship : adult cancer survivors", Primary Care : Clinician Office Practice, 36, pp.721~741 (2009)
- Ganz, P. A., "Breast cancer survivors : Psychosocial concerns and quality of life", Breast Cancer Research and Treatment, 38(2), pp.183~199 (1996)
- Grant, M., "Educating health care professionals to provide institutional changes in cancer survivorship care", Journal of Cancer Education, 27(2), pp.226~232 (2012)
- Groarke, A., R., C., "Global stress predicts both positive and negative emotional adjustment at diagnosis and post-surgery in women with breast cancer", Psycho-Oncology, 22, pp.177~185 (2013)
- Hanssens, S., "Evaluation of a comprehensive rehabilitation program for post-treatment patients with cancer", Oncology Nursing Forum, 38(6), pp.418~424 (2011)
- Harrison, S. E., "Primary health and supportive care needs of long-term cancer survivors : a questionnaire survey", Journal of Clinical Oncology, 29(15), pp.2091~2098 (2011)
- Hodgkinson, K., "Assessing unmet supportive care needs in partners of cancer survivors : the development and evaluation of cancer survivors' partners unmet needs measure(CaSPUN)", Psycho-Oncology, 16, pp.805~813 (2007)
- Holm, L. V., "Social inequality in cancer rehabilitation : A population-based cohort study", Acta Oncologica, 52, pp.410~422 (2013)
- Holzner, B., "Quality of life in breast cancer patients-not enough attention for long-term survivors?", Psychosomatics, 42(2), pp.117~123 (2001)
- Horowitz M., "Impact of Event Scale : a measure of subjective stress", Psychosomatic Medicine, 41(3), pp.209~218 (1979)
- Hutchison, N. A., "Cancer rehabilitation", Minnesota Medicine, 93(10), pp.50~52 (2010)
- Johannessen-Henry, C. T., "Associations between faith, distress and mental adjustment-a Danish survivorship study", Acta Oncologica, 52(2), pp.364~371 (2012)
- Kangas, M., "Posttraumatic stress disorder following cancer. A conceptual and empirical review", Clinical Psychology Review, 22(4), pp.499~524 (2002)
- Kornblith, A. B., "Social support as a buffer to the psychological impact of stressful life events in women with breast cancer", Cancer, 91(2), pp.443~454 (2001)
- Lengerich, E. J., "Development of community plans to enhance survivorship from colorectal cancer : community-based participatory research in rural communities", Journal of Cancer Survivorship, 1, pp.205~211 (2007)
- Manne, S., "Posttraumatic growth after breast cancer : patient, partner, and couple perspectives", Psychosomatic Medicine, 66(3), pp.442~454 (2004)
- McDonough, M. H., "Predicting changes in posttraumatic growth and subjective well-being among breast cancer survivors: the role of social support and stress", Psycho-Oncology (2013)
- Meeske, K. A., "Posttraumatic stress, quality of life, and psychological distress in young adult survivors of childhood cancer", Oncology Nursing Forum, 28(3), pp.481~489 (2001)
- Mehnert, A., "Predictors of fear of recurrence in patients one year after cancer rehabilitation : a prospective study", Acta Oncologica, 52(6), pp.1102~1109 (2013)
- Meneses, K., "Does economic burden influence quality of life in breast cancer survivors?", Gynecologic Oncology, 124(3), pp.437~443 (2012)
- Mikkelsen, T. H., "Cancer rehabilitation: psychosocial rehabilitation needs after discharge from hospital?", Scandinavian Journal of Primary Health Care, 26, pp.216~221 (2008)
- Mullan, F., "Seasons of survival : reflections of physician with cancer", New England Journal of Medicine, 313, pp.270~273 (1985)
- Mystakidou, K., "Traumatic distress and positive changes in advanced cancer patients", The American Journal of Hospice & Palliative care, 24(4), pp.270~276 (2007)
- "National Cancer Institute"[URL]
- Nicholas, P. K., "Using the cancer rehabilitation. questionnaire in patients with colorectal cancer", Rehabilitation Nursing, 31(3), pp.106~113 (2006)
- Okamura, H., "Importance of rehabilitation in cancer treatment and palliative medicine", Japanese Journal Clinical Oncology, 41(6), pp.733~738 (2011)
- Paterson, C., "Exploring the relationship between coping, social support and health-related quality of life for prostate cancer survivors: A review of the literature", European Journal of Oncology Nursing (2013)
- Pryce, J., "Cancer survivorship and work : symptom, supervisor response, co-worker disclosure and work adjustment", The Journal of Occupational Rehabilitation, 17, pp.82~92 (2007)
- Sherbourne, C. D., "The MOS social support survey", Social Science & Medicine, 32, pp.713~714 (1991)
- Steel, J. L., "Measuring post-traumatic growth in people diagnosed with hepatobiliary cancer : directions for future research", Oncology Nursing Forum, 35(4), pp.643~650 (2008)
- Stein, K. D., "Physical and psychological long-term and late effects of cancer", Cancer, 112, pp.2577~2592 (2008)
- Thijs, K. M., "Rehabilitation using high-intensity physical training and long-term return-to-work in cancer survivors", Journal of Occupational Rehabilitation, 22, pp.220~229 (2011)
- Thornton, A. A., "Posttraumatic growth in prostate cancer survivors and their partners", Psycho-Oncology, 15(4), pp.285~296 (2006)
- Thorsen, L., "Cancer patients' needs for rehabilitation services", Acta Oncologica, 50, pp.212~222 (2011)
- van Weert, E., "A multidimensional cancer rehabilitation program for cancer survivors : Effectiveness on health-related quality of life", Journal of Psychosomatic Research, 58(6), pp.485~496 (2005)
- Velthuis, M. J., "Role of fear of movement in cancer survivors participating in a rehabilitation program : a longitudinal cohort study", Archives of Physical Medicine and Rehabilitation, 93(2), pp.332~338 (2012)
- Weiss, D. S., "The Impact of Event Scale - Revised, In Assessing psychological trauma and PTSD", pp.399~411 (1996), Guilford
- Wenzel, L., "Quality of life in long-term cervical cancer survivors", Gynecologic Oncology, 97, pp.310~317 (2005)
- Wyatt, G., "Long-term female cancer survivors : quality of life issues and clinical implications", Cancer Nursing, 19(1), pp.1~7 (1996)