암 환자를 돌보는 가족수발자의 우울에 대한 낙관성과 가족지지의 조절 효과
Moderating Effects of Optimismand Family Support on the Depression of Family Caregivers of Cancer Patients
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연구배경: 본 연구는 Weitzner 등13) 의 스트레스과정모델을 적용하여 암 환자를 돌보는 가족수발자가 지각하는 환자의 기능상태와 돌봄스트레스로 인한 우울에 이르는 과정에서 낙관성과 가족지지의 조절 효과를 검증하였다. 방법: 본 연구는 50세 이상의 암 환자를 돌보는 가족수발자 359명을 서울과 경기지역의 3개 대학병원에서 조사하였다. 탐색적 요인을 통해 척도의 구조적 유효성을 확인하였다. 우울에 영향을 미치는 스트레스 요인 및 조절 효과를검증하기 위해 변수에 대해 평균중심화(mean centering)를실시한 후 위계적 중다회귀분석을 실시하였다. 결과:Weitzner 등13)의 스트레스과정모델을 적용하여 가족수발자의 암 환자를 돌봄으로 인한 스트레스와 그 결과인 우울에 영향을 미치는 요인은 수발자의 교육수준, 경제적 상태, 환자의 정서기능과 역할과중이었다. 그리고 환자의 정서기능과 역할과중으로 인해 우울에 이르는 과정에서중재 요인인 수발자의 낙관성과 가족지지가 수발자의 우울을 조절하고 있었다. 결론: 배우자 가족수발자의 우울에 더 많은 관심이 요구된다. 따라서 환자와 가족수발자의 정서적 상태를 파악하고 "holding environments" 조성을 통한 전문적 치료접근이 고려되어야 함을 시사한다.
Abstract
Background:This study examined moderating effects of optimism and family support on the depression of family caregivers of cancer patients aged 55 and over by adopting stress process model. Methods:359 family caregivers who accompanied with cancer patients to out-patient clinics were recruited and completed questionnaire at three university hospitals located in Seoul and Gyeonggi province. Exploratory factor analysis was applied to test validity of the construction of the scale. Hierarchical multiple regression analysis was used to determine moderating effects of optimism and family support on depression after making mean centering of each variable. Results:Results showed that spouse caregivers have more depression than do adult children as the nursing period gets longer. Education and income status were significant variables affecting depression of family caregivers. Optimism and family support for family caregivers have moderating effects on the association between stressors (emotional functioning of cancer patients and role overload of family caregivers) and depression of family caregivers. Conclusions:The findings suggest that more attentions are needed to the depression of spouse caregivers. Interventions are strongly recommended for health professionals to provide cancer patients and their family caregivers with "holding environments" caring for emotions and facilitating adjustment.
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