녹내장 환자의 불안과 우울, 삶의 질에 대한 조사연구
Anxiety, Depression, Quality of Life in Glaucoma Patients
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
녹내장은 후천적 실명을 일으키는 대표적 질환의 하나로 정신·심리적으로 미치는 영향 또한 크다. 이 연구에서는 삶의 질에 영향을 미치는 요인을 평가하여 녹내장의 치료 효과 개선을 위한 정서적 지지의 중요성을 강조하고자 하였다. 연구대상은 부산광역시 P대학병원 안과에 정기적으로 방문하는 환자 중 녹내장군 81명과 정상대조군 88명을 대상으로 2013년 9월부터 11월까지였으며, 조사 방법은 자기기입식 및 직접면담 설문조사였다. 연구도구는 병원 불안·우울 척도(Hospital Anxiety-Depression Scale, HADS), 삶의 질 척도(Korean version of WHO QOL-BREF)을 측정하여 MedCalc (ver 13.1.0, Mariakerke, Belgium)를 이용 녹내장군과 정상대조군의 삶의 질을 비교 분석하였다. 녹내장 환자군과 정상대조군 전체에 대한 평균 수준 비교에서는 불안 녹내장군 6.7점, 정상대조군 5.8점(P=0.143), 우울 녹내장군 4.2점, 정상대조군 4.6점(P=0.496), 삶의 질 녹내장군 83.4점, 정상대조군 89.6점으로(P=0.005) 녹내장군에서 불안은 높았고, 삶의 질은 낮았다. 진단경과기간별로는 불안은 2년 미만(P=0.011)에서 높았고, 삶의 질은 3년 이상(P=0.002)에서 낮았다. 다중회귀분석 결과에서도 성, 교육, 직업, 배우자 유무를 보정한 상태에서 불안·우울, 삶의 질에 중요하게 영향을 미치는 요인은 녹내장 동반과 시력이었다. 따라서 녹내장 환자 치료 및 관리 개선을 위해서는 질병 자체나 증상 치료뿐만 아니라 이러한 정신·심리적 측면까지도 적절히 평가하고 지지 할 수 있는 통합적인 관리 중재 지침 개발과 적용이 필요하다.
Abstract
Glaucoma is one of typical diseases to cause acquired blindness, and its mental and psychological influences are quite great. The purpose of this study was to examine influential factors for the quality of life in an effort to stress the importance of emotional support for the improvement of glaucoma treatment effects. The subjects in this study were 169 patients who paid regular visits to the department of ophthalmology at a university hospital in the city of Busan. Out of them, 81 patients of the experimental group suffered from glaucoma, and 88 patients that were selected as a control group didn't. Self-administered and interview surveys were conducted from September to November, 2013, and the instruments used in this study were a Hospital Anxiety-Depression Scale (HADS) and a Korean version of WHO QOL-BREF. The collected data were analyzed by MedCalc 13.1.0(Mariakerke, Belgium) to make a comparative analysis of the quality of life between the experimental and control groups. When the averages of the two groups were compared, the experimental group got a mean of 6.7 in anxiety, and the control group got 5.8(P=0.143). The former got 4.2 in depression, and the latter got 4.6(P+0.496). The former got 83.4 in the quality of life, and the latter got 89.6(P=0.005). Concerning the period of time after diagnosis, the patients who were diagnosed less than two years ago scored higher in anxiety (P=0.011), and the respondents who were diagnosed three or more years ago scored lower in the quality of life(P=0.002). When a multiple regression analysis was made, suffering from glaucoma and another disease at the same time and vision were identified as the factors to have a crucial impact on anxiety, depression and the quality of life when gender, education, occupation and presence or absence of the spouse were adjusted. In order to ensure successful treatment and management for glaucoma patients, integrated management and intervention guidelines should be prepared not only to treat the disease itself or its symptoms but to properly assess and support mental and psychological aspects.
참고문헌 (21)
- Bradley R. Straatsma, "Principles and Practice of Ophthalmology", Archives of Ophthalmology, 112(9), pp.1153~ (1994), American Medical Association (AMA)[DOI]
- Gutierrez P1, "Influence of glaucomatous visual field loss on health-related quality of life", Arch Ophthalmol, 115(6), pp.777~784 (1997)
- Luini LP, "Investigating spatial behaviour : an application of space analysis to criminal investigations", Cogn Process, 10(2), pp.247~249 (2009)
- Uriel Ticho, "Laser Trabeculoplasty in Glaucoma", Archives of Ophthalmology, 107(6), pp.844~ (1989), American Medical Association (AMA)[DOI]
- Wilson MR., "Epidemiological features of glaucoma", Int Ophthalmol Clin, 30, pp.153~160 (1990)
- Lee BL, "Health-related Quality of Life in Patients With Cataract and Glaucoma", Journal of Glaucoma, 9(1), pp.87~94 (2000)
- Lim SJ, "Clinical Assessment of Quality of Life in Glaucoma Patients", The Korean Ophthalmological Society, 36(4), pp.124~128 (1995)
- 하명숙, "녹내장 환자의 불안과 우울상태에 대한 고찰", 대한안과학회지, 43(2), pp.8~289 (2002), 대한안과학회
- 윤길중, "녹내장이 삶의 질에 미치는 영향에 관한 연구", 대한안과학회지, 44(2), pp.30~484 (2003), 대한안과학회
- 이주연, "녹내장환자에서 양안 이스터만 시야검사 결과와삶의 질과의 연관성", 대한안과학회지, 54(10), pp.1567~1572 (2013), 대한안과학회
- 풍계현, "녹내장 환자의 삶의 질에 관한 연구", 대한안과학회지, 55(12), pp.1868~1877 (2014), 대한안과학회
- Zigmond AS, "The hospital anxiety and depressionscale", Acta Psychiatrica Scandinavica, 67, pp.361~370 (1983)[DOI]
- Oh SM, "A Comparison of Normal, Depressed and Anxious Groups = A Study on the Standardization of the Hospital Anxiety and Depressed Scale for Koreans", THE KOREAN NEUROPSYCHIATRIC ASSOCIATION, 38(2), pp.289~296 (1999)
- Min SK, "Development of Korean Version of WHO Quality of Life Scale Abbreviated Version(WHOQOL-BREF)", THE KOREAN NEUROPSYCHIATRIC ASSOCIATION, 37(3), pp.571~579 (2000)
- Kim YN., "A study on the quality of life of the patients with Crohn's disease", Mater’s, pp.2010
- Lee JY, "Impact of physical and emotional state on quality oflife in hemodialysis patients : tageting ESRD patients", Mater’s, pp.2013
- 김지인, "대장암 환자의 회복탄력성에 영향을 미치는 요인", Asian Oncology Nursing, 13(4), pp.256~264 (2013), 대한종양간호학회
- Ferrans CE, "Psychometric assessment of the Quality of Life Index", Research in Nursing and Health, 15(1), pp.29~38 (1992)
- Chuandi Z, "Anxiety and depression in Chinese patients with glaucoma : Sociodemographic, clinical, and self-reported correlates", Journal of Psychosomatic Research, 15(1), pp.75~82 (2013)