치매 환자 돌봄 가족의 돌봄 스트레스와 우울감의 관계: 대처방식과 돌봄 죄책감의 다중병렬 매개효과 검증
The Relationship between Caregiving Stress and Depression in the Family Caregivers of Dementia Patients: a Parallel Multiple Mediating Effect of Coping Styles and Caregiver Guilt
2
조회
0
다운로드
5
인용
0
참고문헌
키워드
초록
연구목적: 본 연구의 목적은 치매 환자 돌봄 가족들의 돌봄 스트레스가 우울감에 영향을 미치는 과정에서 돌봄 가족의 돌봄 스트레스, 대처방식, 돌봄 죄책감, 우울감의 관계를 살펴보고, 대처방식과 돌봄 죄책감의 다중병렬 매개효과를 알아보는 것이다. 연구방법: 치매 환자 돌봄 가족 204명이 돌봄 스트레스, 우울감, 대처방식, 돌봄 죄책감에 대한 온라인 설문에 참여했고 이 중에서 중복참여와 미완성 설문지를 제외하고 123명의 자료를 SPSS 프로그램을 사용하여 Hayes (2018) PROCESS macro의 다중병렬 매개모형으로 분석하였다. 연구 결과: 돌봄 스트레스는 우울감에 직접적인 영향을 주었다. 또한 돌봄 스트레스가 높을수록 우울감, 대처방식 중 정서중심 대처와 소망적 사고, 그리고 돌봄 죄책감의 수준이 높아졌다. 대처방식과 돌봄 죄책감의 다중병렬 매개효과를 검증한 결과 돌봄 죄책감만이 매개효과를 나타내었다. 결론: 치매 돌봄 가족의 우울감 예방을 위해서 돌봄 죄책감의 관리가 필요하며 대처방식의 효과를 규명하기 위해서는 추후 연구가 필요하다.
Abstract
Objective: This study examines the relationship between caregiving stress, coping styles, caregiver guilt, and depression for family caregivers of dementia patients. Also the parallel multiple mediating effects of coping styles and caregiver guilt in the caregiving stress process were investigated. Methods: Total 204 family members caring for dementia patients participated in an online survey on caregiving stress, depression, coping styles, and caring guilt. Among them, excluding multiple participation and incomplete questionnaires, data from 123 people were analyzed using the SPSS program as a multiple parallel mediating model of Hayes (2018) PROCESS macro. Results: First, caring stress was closely related to caregiver guilt, emotion-focused coping style, wishful thinking and depression. Second, the level of depression of the caring family was ‘very severe’, and the stress of caring had a direct effect on the depression. Third, the level of caring guilt of family caregivers was also very high, and there was a significant positive correlation with caring stress and depression. Fourth, as a result of examining the parallel multiple mediating effects of coping styles and caregiver guilt, only caregiver guilt showed mediating effects. Conclusions: In order to prevent depression in family caregivers of dementia patients, it is recommended to control the caregiver guilt. Also further studies are needed to examine the the effectiveness of different coping styles.
참고문헌 (61)
- 권정화, "치매 환자 주 돌봄제공자의 자기돌봄과 소진", 석사, pp.2019
- 김석범, "중증치매노인보호자의 돌봄스트레스와 내외통제성이 우울에 미치는 영향", 대한지역사회작업치료학회지, 10(1), pp.63~72 (2020), 대한지역사회작업치료학회[DOI]
- 김스미, "치매 노인 부양 가족의 스트레스에 대한 자원의 조절효과와 매개효과", 박사, 공중보건학, pp.2004
- 金貞姬, "知覺된 스트레스,認知세트 및 對處方式의 憂鬱에 대한 作用: 대학신입생의 스트레스 경험을 중심으로", 박사, 심리학, pp.1987
- 김재엽, "치매노인 가족의 부양부담이 우울에 미치는 영향: 지각된 공식적지지의 조절효과를 중심으로", 노인복지연구, 73(2), pp.171~191 (2018), 한국노인복지학회[DOI]
- 김태현, "가족보호자의 간병 부담감, 우울 및 신체증상에 치매환자의 내현화 문제행동이 미치는 영향", 한국심리학회지: 건강, 21(1), pp.65~89 (2016), 한국건강심리학회[DOI]
- 남가영, "치매 노인의 인지 및 일상활동능력이 부양자의 스트레스에 영향을 미치는 과정에서 대처방식과 비합리적 신념의 조절효과", Korean Journal of Clinical Psychology, 36(3), pp.301~314 (2017), 한국임상심리학회[DOI]
- 대한노인정신의학회, "한국형 치매 평가검사", pp.258~259 (2003), 학지사
- 서화숙, "기독교인 치매 환자 돌봄 제공자의 심리적 갈등 경험 연구", 박사, pp.2020
- 유선영, "요양시설에 입소한 노인 가족의 부양죄책감과 우울", 노인간호학회지, 16(3), pp.276~287 (2014), 한국노인간호학회[DOI]
- 윤경아, "치매노인 가족부양자의 부양부담이 부양자의 성장과 가족의 삶의 질에 미치는 영향: 대처전략의 조절효과를 중심으로", 노인복지연구, 72(1), pp.257~282 (2017), 한국노인복지학회[DOI]
- 윤은경, "요보호노인에 대한 부양부담이 부양자의 죄책감에 미치는 영향 : 재가노인과 시설생활노인의 비교를 중심으로", 노인복지연구, (47), pp.289~308 (2010), 한국노인복지학회[DOI]
- 윤은경, "부양자의 죄책감이 수발도움 요청행위에 미치는 영향", 한국노년학, 28(4), pp.1249~1264 (2008), 한국노년학회
- 장윤화, "직무스트레스와 스트레스 대처방식이 심리적 탈진에 미치는 영향 : 소방공무원을 대상으로", 석사, 상담심리치료학과, pp.2012
- 정성희, "국내 치매노인 가족 부양자 중재에 대한 체계적 고찰", 한국간호교육학회지, 27(3), pp.306~320 (2021), 한국간호교육학회[DOI]
- 조맹제, "주요 우울증 환자 예비평가시 the center for epidemiological studies depression의 진단적 타당도에 대한 연구", 신경정신의학, 32, pp.381~399 (1993)[DOI]
- "대한민국 치매현황 2019" (2020)[URL]
- 한계수, "기독교인 치매환자가족의 죄책감 경험에 관한 내러티브 탐구", 박사, 신학과 상담학전공, pp.2013
- 한상순, "노인병원에 입원한 치매 노인가족의 부양죄책감, 효인식, 심리적 안녕감", 석사, pp.2019
- Alzheimer’s Association, "2019 Alzheimer's disease facts and figures", Alzheimer's & Dementia, 15(3), pp.321~387 (2019), Wiley[DOI]
- Henry Brodaty, "Family caregivers of people with dementia", Dialogues in Clinical Neuroscience, 11(2), pp.217~228 (2009), Informa UK Limited[DOI]
- Sheung-Tak Cheng, "Dementia Caregiver Burden: a Research Update and Critical Analysis", Current Psychiatry Reports, 19(9) (2017), Springer Science and Business Media LLC[DOI]
- Claudia Cooper, "A systematic review of the prevalence and covariates of anxiety in caregivers of people with dementia", International Psychogeriatrics, 19(02), pp.175~ (2006), Cambridge University Press (CUP)[DOI]
- C. Cooper, "The determinants of family carers' abusive behaviour to people with dementia: Results of the CARD study", Journal of Affective Disorders, 121(1-2), pp.136~142 (2010), Elsevier BV[DOI]
- Jennifer Duncan Davis, "Guilt after placement questionnaire: a new instrument to assess caregiver emotional functioning following nursing home placement", Aging & Mental Health, 23(3), pp.352~356 (2018), Informa UK Limited[DOI]
- Alexandra Feast, "The contribution of caregiver psychosocial factors to distress associated with behavioural and psychological symptoms in dementia", International Journal of Geriatric Psychiatry, 32(1), pp.76~85 (2016), Wiley[DOI]
- Susan Folkman, "Coping: Pitfalls and Promise", Annual Review of Psychology, 55(1), pp.745~774 (2004), Annual Reviews[DOI]
- Damien Gallagher, "Self-efficacy for managing dementia may protect against burden and depression in Alzheimer's caregivers", Aging & Mental Health, 15(6), pp.663~670 (2011), Informa UK Limited[DOI]
- Laura Gallego-Alberto, "“I Feel Guilty”. Exploring Guilt-Related Dynamics in Family Caregivers of People with Dementia", Clinical Gerontologist, 45(5), pp.1294~1303 (2020), Informa UK Limited[DOI]
- Judith G. Gonyea, "Adult daughters and aging mothers: The role of guilt in the experience of caregiver burden", Aging & Mental Health, 12(5), pp.559~567 (2008), Informa UK Limited[DOI]
- B. H. Gottlieb, "Coping with family caregiving to persons with dementia: A critical review", Aging & Mental Health, 6(4), pp.325~342 (2002), Informa UK Limited[DOI]
- K. J. Gilhooly, "A meta-review of stress, coping and interventions in dementia and dementia caregiving", BMC Geriatrics, 16(1) (2016), Springer Science and Business Media LLC[DOI]
- Haley, W. E., "Stress, appraisal, coping, and social support as predictors of adaptational outcome among dementia caregivers", Psychology and Aging, 2(4), pp.323~330 (1987)[DOI]
- Hayes, A. F., "Introduction to mediation, moderation, and conditional process analysis" (2018), The Guilford Press
- Daniel I. Kaufer, "Validation of the NPI-Q, a Brief Clinical Form of the Neuropsychiatric Inventory", The Journal of Neuropsychiatry and Clinical Neurosciences, 12(2), pp.233~239 (2000), American Psychiatric Association Publishing[DOI]
- Ian I. Kneebone, "Coping and caregivers of people with dementia", British Journal of Health Psychology, 8(1), pp.1~17 (2003), Wiley[DOI]
- B. G. Knight, "Cultural Values and Caregiving: The Updated Sociocultural Stress and Coping Model", The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 65B(1), pp.5~13 (2009), Oxford University Press (OUP)[DOI]
- Karen Kugler, "On conceptualizing and assessing guilt", Journal of Personality and Social Psychology, 62(2), pp.318~327 (1992), American Psychological Association (APA)[DOI]
- Jennifer Lawlor, "Suspicious and fraudulent online survey participation: Introducing the REAL framework", Methodological Innovations, 14(3), pp.205979912110504~ (2021), SAGE Publications[DOI]
- Lazarus, R. S., "The handbook of behavioral medicine", pp.282~325 (1984), Guilford Press
- Ryan Li, "Coping strategies and psychological morbidity in family carers of people with dementia: A systematic review and meta-analysis", Journal of Affective Disorders, 139(1), pp.1~11 (2012), Elsevier BV[DOI]
- Li, R., "Do changes in coping mediate the effects of a psychological intervention on psychological morbidity in carers of people with dementia?", Doctor, pp.2014
- Andrés Losada, "Development and validation of the Caregiver Guilt Questionnaire", International Psychogeriatrics, 22(4), pp.650~660 (2010), Cambridge University Press (CUP)[DOI]
- Andrés Losada, "Leisure and distress in caregivers for elderly patients", Archives of Gerontology and Geriatrics, 50(3), pp.347~350 (2010), Elsevier BV[DOI]
- Brent T. Mausbach, "Avoidant Coping Partially Mediates the Relationship Between Patient Problem Behaviors and Depressive Symptoms in Spousal Alzheimer Caregivers", The American Journal of Geriatric Psychiatry, 14(4), pp.299~306 (2006), Elsevier BV[DOI]
- Alexandre Magno Frota Monteiro, "Coping strategies among caregivers of people with Alzheimer disease: a systematic review", Trends in Psychiatry and Psychotherapy, 40(3), pp.258~268 (2018), FapUNIFESP (SciELO)[DOI]
- C. L. Morano, "Appraisal and coping: Moderators or mediators of stress in Alzheimer's disease caregivers?", Social Work Research, 27(2), pp.116~128 (2003), Oxford University Press (OUP)[DOI]
- M. G. Ory, "Prevalence and Impact of Caregiving: A Detailed Comparison Between Dementia and Nondementia Caregivers", The Gerontologist, 39(2), pp.177~186 (1999), Oxford University Press (OUP)[DOI]
- L. I. Pearlin, "Caregiving and the Stress Process: An Overview of Concepts and Their Measures", The Gerontologist, 30(5), pp.583~594 (1990), Oxford University Press (OUP)[DOI]
- K. W. Piercy, "Predictors of Dementia Caregiver Depressive Symptoms in a Population: The Cache County Dementia Progression Study", The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 68(6), pp.921~926 (2012), Oxford University Press (OUP)[DOI]
- Martin Pinquart, "Associations of Stressors and Uplifts of Caregiving With Caregiver Burden and Depressive Mood: A Meta-Analysis", The Journals of Gerontology: Series B, 58(2), pp.P112~P128 (2003), Oxford University Press (OUP)[DOI]
- Rachel A. Pruchno, "Mental health of caregiving spouses: Coping as mediator, moderator, or main effect?", Psychology and Aging, 4(4), pp.454~463 (1989), American Psychological Association (APA)[DOI]
- Lenore Sawyer Radloff, "The CES-D scale: A self-report depression scale for research in the general population", Applied Psychological Measurement, 1(3), pp.385~401 (1977), SAGE Publications[DOI]
- Louise Roach, "Validation of the Caregiver Guilt Questionnaire (CGQ) in a sample of British dementia caregivers", International Psychogeriatrics, 25(12), pp.2001~2010 (2013), Cambridge University Press (CUP)[DOI]
- Lauren Roche, DClinPsy, "The Role of Coping Strategies in Psychological Outcomes for Frontotemporal Dementia Caregivers", Journal of Geriatric Psychiatry and Neurology, 28(3), pp.218~228 (2015), SAGE Publications[DOI]
- R. Romero-Moreno, "Leisure, Gender, and Kinship in Dementia Caregiving: Psychological Vulnerability of Caregiving Daughters With Feelings of Guilt", The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 69(4), pp.502~513 (2013), Oxford University Press (OUP)[DOI]
- E. Rosa, "Needs of caregivers of the patients with dementia", Archives of Gerontology and Geriatrics, 51(1), pp.54~58 (2010), Elsevier BV[DOI]
- Patrick E. Shrout, "Mediation in experimental and nonexperimental studies: New procedures and recommendations", Psychological Methods, 7(4), pp.422~445 (2002), American Psychological Association (APA)[DOI]
- Christine M. Snyder, "Dementia caregivers’ coping strategies and their relationship to health and well-being: the Cache County Study", Aging & Mental Health, 19(5), pp.390~399 (2014), Informa UK Limited[DOI]
- "Dementia" (2021)[URL]
- Qi Yuan, "Coping Patterns Among Primary Informal Dementia Caregivers in Singapore and Its Impact on Caregivers—Implications of a Latent Class Analysis", The Gerontologist, 61(5), pp.680~692 (2020), Oxford University Press (OUP)[DOI]
