일회용 약물주입기로 가정에서 항암치료 중인 대장암 환자의 삶의 질
Quality of Life in Colorectal Cancer Patients at Home 5-Fluorouracil Chemotherapy with Disposable Elastomeric Infusion Pumps
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목적: 본 연구는 일회용 약물주입기를 이용하여 가정에서 항암치료 중인 대장암 환자의 삶의 질에 영향을 미치는 요인을 확인하기 위해 시행되었다. 방법: 2019년 9월부터 2021년 1월까지 총 179명 대장암 환자들을 대상으로 조사하였다. 일반적 자기효능감, 국립암센터 심리증상평가지, EORTC QLQ-C30를 사용하였고, 독립표본 t검정, 일원분산분석, 위계적 회귀분석을 실시하였다. 결과: 대장암 환자의 52.0%가 심리적 디스트레스를 경험하고 있는 것으로 나타났다. 본 연구 결과 심리적 디스트레스 유무(β=-.20, p=.005), 항암치료 차수(β=.19, p=.002), 식욕부진(β=-.20, p=.001), 피로(β=-.16, p=.035), 신체기능(β=-.16, p=.024) 및 정서기능(β=-.15, p=.025)이 대장암 환자의 삶의 질에 관련이 있으며, 설명력은 45.0%이었다. 결론: 가정에서 일회용 약물주입기로 처음 치료를 시작하거나, 항암치료 후 재발되어 약을 바꿔서 다시 항암치료를 시작하는 경우 가정에서 일상생활에 겪는 문제에 잘 적응할 수 있도록 심리적 디스트레스를 낮추고 신체 및 정서 기능을 증진시키도록 지지하는 개별화된 간호중재를 제공해야 할 것으로 생각된다. 임상적으로 의미 있는 절단점을 이용하여 고위험군을 조기 선별검사에 활용할 것을 기대하는 바이다.
Abstract
Purpose: The purpose of this study was to examine the psychological distress related to quality of life (QoL) of patients with colorectal cancer receiving 5-fluorouracil (5-FU) chemotherapy at home with disposableElastomeric infusion pumps. Methods: In this study, 179 colorectal outpatients were recruited between September 2019 and January 2021. National Cancer Center Psychological Symptom Inventory scores, generalself-efficacy, and the EORTC QLQ-C30 scores were measured. Data were analyzed using Independent t-test, One-way ANOVA with Bonferroni post hoc analysis, and hierarchical multiple linear regression with the SPSS/WIN 26.0 programs. Results: The overall prevalence of psychological distress was 52.0% in colorectal patients. In multiple regression, psychological distress (β=-.20, p=.005), appetite loss (β=-.20, p=.001), chemotherapy cycles (β= .19, p=.002), fatigue (β=-.16, p=.035), physical functioning (β=-.16, p=.024), and emotional functioning (β=-.15, p=.025) were significant factors of QoL, and the final model explained 45.0% of the total variance of QoL. Conclusion: Supporting patients toward decreased psychological distress and increased physical and emotional functioning, especially in the first or second cycle of chemotherapy, could be used to improve their QoL. To consider the thresholds for clinical importance, it is necessary to increase the interpretation of psychological distress in clinical practice and further research.
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