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암환자 보호자의 정신병리와 삶의 질

Psychopathology and Quality of Life in Family Caregivers of Patients with Cancer

이철순|박철수|김봉조|차보석|이다원|손진욱|김승남
대한생물치료정신의학회 (Korean Society Of Biological Therapies In Psychiatry)|2010.12|생물치료정신의학 (Journal of the Korean Society of Biological Therapies in Psychiatry)|제16권 제2호|pp. 102-111

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암·보호자·삶의 질·정신병리.Cancer · Caregivers · Psychopathology · Quality of life
주제분류정신과학

초록

연구목적암은 환자뿐만 아니라 그들의 보호자들에게 있어 심리적 건강과 삶의 질에 영향을 미친다. 본 연구는 암 환자 보호자들의 정신병리와 삶의 질을 평가하고 두 사이의 관계를 알아 보고자 하였다. 방 법경상대학교 병원 암 센터를 방문한 72명의 암 환자 보호자를 대상으로 MINI 정신건강평가로 정신병리를 평가하고 한국판 세계보건기구 삶의 질 척도 단축형을 사용하여 삶의 질을 평가하였다. 결 과72명의 보호자 중 18명(25%)이 정신병리가 있는 것으로 나타났으며, 우울증 15명(20.8%), 범불안장애 2명(2.8%), 공황장애 1명(1.4%)이였다. 정신병리가 있는 군(n=18)의 삶의 질은 정신병리가 없는 군(n=54)에 비하여 WHOQOL-BREF 척도의 전반적인 삶의 질및 일반적 건강항목(4.9±1.9 vs. 7.1±1.1, p=0.000),신체적 건강영역(10.0±0.6 vs. 14.6±0.4, p=0.000),심리적 영역(11.3±0.5 vs. 13.4±0.4, p=0.006), 사회적 관계영역(11.6±0.3 vs. 13.4±0.3, p=0.001), 환경영역(11.5±0.5 vs. 13.1±0.3, p=0.017)에서 낮은결과를 보였으며, 보호자의 정신병리 점수와 WHOQOLBREF 척도의 전반적인 삶의 질 및 일반적 건강항목(r=-0.555, p=0.000), 신체적 건강영역(r=-0.642, p=0.000), 심리적 영역(r=-0.445, p=0.000), 사회적 관계영역(r=-0.403, p=0.000), 환경영역(r=-0.345,p=0.003)은 음의 상관관계를 보였다. 결 론암 환자 보호자들은 정신병의 비율, 특히 우울증의 비율이 일반인구에 비해 높고 정신병리 점수가 높을수록삶의 질이 낮아지는 것으로 나타났다. 그러므로 암환자뿐만 아니라 암환자 보호자에 대한 정신적 건강 및 삶의질에 대한 평가와 적절한 개입이 필요할 것으로 보인다.

Abstract

Objectives：Cancer affects the psychological health and quality of life not only of individuals with the disease,but also, it affects their family caregivers. The aim of this study was to investigate the prevalence of psychiatric disorders and quality of life in family caregivers of patients with cancer. Materials and Methods：We enrolled 72 caregivers of patients with cancer from the Gyeongsang National University Hospital Cancer Center and obtained demographic information. The quality of life and psychopathology of caregivers was estimated using the Korean version of an abbreviated version of the World Health Organization Quality of Life assessment(WHOQOL-BREF) and the Mini International Neuropsychiatric Interview patient health survey (MINI patient health survey). Results：According to the MINI patient health survey, 18 caregivers(25%) had a psychiatric disorder：15(20.8%)had depression；2(2.8%) generalized anxiety disorder；1(1.4%) panic disorder. Caregivers with a psychiatric disorder had a lower quality of life compared to those without a psychiatric disorder(n=54) in all domains of the WHOQOLBREF{Overall QOL and general health(4.9±1.9 vs. 7.1±1.1, p=0.000), Physical health domain(10.0±0.6 vs. 14.6±0.4, p=0.000), Psychological domain(11.3±0.5 vs. 13.4±0.4, p=0.006), Social relationships domain(11.6±0.3vs. 13.4±0.3, p=0.001), Environmental domain(11.5±0.5 vs. 13.1±0.3, p=0.017)}. Psychopathology scores were negatively correlated with all domains of the WHOQOL-BREF score {Overall QOL and general health (Spearman’s rho=-0.555, p=0.000), Physical health domain(Spearman’s rho=-0.642, p=0.000), Psychological domain(Spearman’s rho=-0.445, p=0.000), Social relationships domain(Spearman’s rho=-0.403, p=0.000), Environmental domain(Spearman’s rho=-0.345, p=0.003)}. Conclusion：Our results show that the prevalence of depression in family caregivers of patients with cancer is higher than in the general population and that quality of life is lower. Therefore, healthcare professionals should pay more attention to psychological and emotional aspects of caregivers who take care of patients with cancer, and develop comprehensive management strategies both for the cancer patients and for their caregivers..

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