본문 바로가기
KERD
논문KCI 등재

노인 암환자의 우울증에 대한 문제해결치료 프로그램 효과성

The Effectiveness of Problem-Solving Therapy Program Intervention in Reducing Depression of Older Cancer Patients

김여진|남일성|김운정|임연옥|최경원|함혜진|윤현숙
대한임상건강증진학회 (Korean Society For Health Promotion And Disease Prevention)|2018.03|Korean Journal of Health Promotion|제18권 제1호|pp. 60-70|DOI http://dx.doi.org/10.15384/kjhp.2018.18.1.60

0

조회

0

다운로드

7

인용

0

참고문헌

키워드

우울Depression노인 암환자문제해결치료 프로그램Older cancer patientsProblem-solving therapy
주제분류기타자연과학

초록

연구배경: 노인 암환자에게 우울증상이 나타나는 것은 일반적이라고 생각하기 때문에 적절한 개입이 이뤄지지 않고있다. 그러므로 본 연구는 암 진단을 받고 치료 중 또는 치료 종료 후 관찰 중인 65세 이상 노인 암환자 중 우울증상을 동반한 환자를 대상으로 우울수준 감소에 미치는 문제해결치료 프로그램의 효과를 검증하였다. 방법: 본 연구는 서울, 경기, 강원지역 5개 대학병원의 65세이상 노인 암환자 중 우울선별검사(PHQ-9) 점수가 10-19점에 해당하는 60명을 선정 후 참여 의사에 따라 각 30명을 실험군과 대조군으로 구성하였다. 문제해결치료 프로그램은6주간 실험군에 제공하였다. 문제해결치료 프로그램의 효과 검증을 위해 우울척도인 CES-D10와 사회적 문제해결력척도(SPSI-R)를 사용하였다. 결과: 실험군과 대조군의 사전 동질성 검정에서 두 집단이동질한 집단이었다. 노인 암환자의 우울수준과 부정적 문제수용태도가 유의한 정적 상관관계였다(r=0.663, P<0.001). 사회적 문제해결치료 프로그램의 효과성 검증에서 실험군에서 프로그램 개입 전·후로 우울수준(Z=-3.534, P<0.001)과사회적 문제해결력(Z=-2.908, P=0.003)에서 통계적으로 유의한 효과가 있었다. 결론: 문제해결치료 프로그램은 노인 암환자의 우울수준을 감소시키는 데 효과가 있으며 우울증 치료를 위한 의료적 대안으로 실행 가능함을 시사한다.

Abstract

Background:Appropriate intervention has not been developed and implemented because depression has been overlooked for older cancer patients. However, because depression is prevalent among this population, the need for the intervention is high. The objective of this study was to verify the effectiveness of the problem-solving therapy program in reducing depression level for older cancer patients. Methods: The experimental participants were recruited by social workers in five university hospitals in Seoul, Gyeonggi, and Gangwon. Using Patient Health Questionnaire-9 (PHQ-9), older cancer patients who scored between 10-19 points are selected. The subjects were assigned to the experimental group (30 patients) and the control group (30 patients) according to their will, and the experimental group participated in the problem solving therapy program for 6 weeks. The Center for Epidemiological Studies Depression 10 Scale and the Social Problem Solving Ability Scale were used to verify the effectiveness of the problem-solving program. Results:The group homogeneity test indicated that the experimental group and the control group are homogeneous. The results of this study showed that the depression of older cancer patients had a significant positive correlation with the negative attitude toward the problem. The effectiveness of the problem solving program was significantly reduced in the experimental group (Z=-3.534, P<0.001). And the social problem solving ability of experimental group was significantly improved (Z=-2.908, P=0.003). Conclusions:The problem-solving therapy program is effective for depression in geriatric cancer patients and this result suggests that it can be implemented as an alternative medical treatment.

참고문헌 (30)

  1. 오창모, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2013", Cancer Research and Treatment, 48(2), pp.436~450 (2016), 대한암학회
  2. Kolva E, "Anxiety in terminally ill cancer patients", J Pain Symptom Manage, 42(5), pp.691~701 (2011)[DOI]
  3. Derogatis LR, "The prevalence of psychiatric disorders among cancer patients", JAMA, 249(6), pp.751~757 (1983)[DOI]
  4. de Jonge P, "Depressive symptoms in elderly patients predict poor adjustment after somatic events", Am J Geriatr Psychiatry, 12(1), pp.57~64 (2004)[DOI]
  5. Cho J, "Association between cancer stigma and depression among cancer survivors: a nationwide survey in Korea", Psychooncology, 22(10), pp.2372~2378 (2013)
  6. Yang YL, "The prevalence of depression and anxiety among Chinese adults with cancer: a systematic review and meta-analysis", BMC Cancer, 13, pp.393~ (2013)[DOI]
  7. Jorm AF, "History of depression as a risk factor for dementia: an updated review", Aust N Z J Psychiatry, 35(6), pp.776~781 (2001)[DOI]
  8. Ell K, "Economic stress among low-income women with cancer: effects on quality of life", Cancer, 112(3), pp.616~625 (2008)[DOI]
  9. 임연옥, "항암화학요법 치료 노인 암환자가 우울에 이르는 스트레스 과정: 영성, 낙관성, 가족 지지의 스트레스 중재요인을 중심으로", 한국노년학, 34(4), pp.821~842 (2014), 한국노년학회
  10. Park KS, "Problem-Solving Therapy: A Positive Approach to Clinical Intervention", pp.139~143 (2008), HAKJISA corp
  11. Zhang AY, "Recognition of depression and anxiety among elderly colorectal cancer patients", Nurs Res Pract, 2010, pp.693961~ (2010)
  12. Gellis ZD, "Problem solving therapy for subthreshold depression in home healthcare patients with cardiovascular disease", Am J Geriatr Psychiatry, 18(6), pp.464~474 (2010)[DOI]
  13. Arean PA, "Problem-solving therapy and supportive therapy in older adults with major depression and executive dysfunction", Am J Psychiatry, 167(11), pp.1391~1398 (2010)[DOI]
  14. Nezu AM, "Relevance of problem-solving therapy to psychosocial oncology", J Psychosoc Oncol, 16(3-4), pp.5~26 (1999)[DOI]
  15. Nezu AM, "Project Genesis: assessing the efficacy of problem-solving therapy for distressed adult cancer patients", J Consult Clin Psychol, 71(6), pp.1036~1048 (2003)[DOI]
  16. Hopko DR, "Brief behavioral activation and problem-solving therapy for depressed breast cancer patients: randomized trial", J Consult Clin Psychol, 79(6), pp.834~849 (2011)[DOI]
  17. Fann JR, "Improving primary care for older adults with cancer and depression", J Gen Intern Med, 24(Suppl 2), pp.S417~S424 (2009)[DOI]
  18. Malouff JM, "The efficacy of problem solving therapy in reducing mental and physical health problems: a meta-analysis", Clin Psychol Rev, 27(1), pp.46~57 (2007)[DOI]
  19. Bell AC, "Problem-solving therapy for depression: a meta-analysis", Clin Psychol Rev, 29(4), pp.348~353 (2009)[DOI]
  20. Nezu AM, "Problem-solving therapy : a positive approach to clinical intervention" (2006), Springer Publishing Company
  21. [URL]
  22. 윤현숙, "노인 우울증에 대한 문제해결치료(Problem-Solving Treatment)의 효과성 연구", 한국노년학, 30(3), pp.871~894 (2010), 한국노년학회
  23. Lee HK, "Handbook of Positive psychology" (2008), HAKJISA corp
  24. Irwin M, "Screening for depression in the older adult: criterion validity of the 10-item center for epidemiological studies depression scale (CES-D)", Arch Intern Med, 159(15), pp.1701~1704 (1999)[DOI]
  25. Kim HS, "Depressive symptoms, chronic medical illness, and health care utilization: findings from the Korean Longitudinal Study of Ageing (KLoSA)", Int Psychogeriatr, 23(8), pp.1285~1293 (2011)[DOI]
  26. D'Zurilla TJ, "Social problem-solving inventory Revised (SPSI-R): Technical manual" (2002), Multi-Health Systems
  27. Kim SY, "Statistical analysis based on experimental studies", Survey Research Spring Conference (2007), The Korean Association for Survey Research
  28. Baer RA, "Mindfulness training as a clinical intervention: a conceptual and empirical review", CLIN PSYCHOL-SCI PR, 10(2), pp.125~143 (2003)[DOI]
  29. Panza F, "Late-life depression, mild cognitive impairment, and dementia: possible continuum?", Am J Geriatr Psychiatry, 18(2), pp.98~116 (2010)[DOI]
  30. Richard E, "Late-life depression, mild cognitive impairment, and dementia", JAMA Neurol, 70(3), pp.374~382 (2013)[DOI]

이 간행물의 다른 논문 (7건)

흡연자에서 수면시간과 하루 평균 흡연량, 과다흡연의 연관성이근미, 유재건, 정승필, 김창곤pp. 1-6우리나라 암 경험자의 삶의 질과 관련 요인이정아, 박라영, 전승엽pp. 7-14종합병원 직원들의 건강증진 프로그램 참여 후의 건강지표들의 개선오범조, 이상형, 박재석, 이가혜, 박인혁pp. 15-22가정의 사회경제적 수준에 따른 한국 청소년의 체중상태 분포: 청소년건강행태온라인조사, 2016강재헌, 박현아, 김경우, 장진영, 허양임, 박기병, 조영규pp. 23-31불현성 갑상선기능저하증 환자의 우울에 대한 체계적 문헌고찰및 메타분석황은희, 신수진pp. 32-41
원문 보기