한국형 돌봄 경험 평가도구(CRA-K)의 타당도 검증 : 암 환자 가족을 대상으로
Cross Cultural Validation of the Caregiver Reaction Assessment (CRA)for Cancer Patient’s Caregiver
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초록
연구배경 재원일수 감축, 핵가족화와 같은 사회적 상황은 의료전달체계에서 비공식적 돌봄 제공자인 가족의 역할과 부담을 크게 하고 있다. 특히 한국에서 사망원인 1위인 암의 경우 점차 만성질환이 되고 가족의 부담을 높이고 있으나, 환자가족의 돌봄 경험을 평가한 연구는 거의 없다. 이에 본 연구에서는 가족의 돌봄 경험을 평가하는 도구인 한국어판 Caregiver Reaction Assessment(CRA)의 타당도를 조사하여 암환자 가족에 대한 임상적 활용가능성을 검증하고자 한다. 방 법 엄격한 번역, 역번역 과정을 통하여 한국어판 CRA 설문지를 개발하였으며 국립암센터의 암환자 가족 248명을 대상으로 자기기입식으로 설문하였다. 구조분석을 위해 요인분석, 신뢰도 검증을 위해 Cronbach Alpha를 구하였고, 내용, 기준, 개념 타당도 검증을 위하여 전문가검토, 사회적 지지척도(SSS), 건강관련 삶의 질 척도(SF-36), 암 환자 가족 삶의 질 척도(CQOLC)와 상관관계를 분석하였다. 결 과 전체 문항의 신뢰도는 0.81이며, 5개의 하위척도의 신뢰도 계수는 0.52~0.80였다. 기준 타당도 검증결과 건강상태 및 사회적 지지와 상관관계가 통계적으로 유의하였으며, 구성 타당도 검증결과 이론적으로 관련이 있는 변수와는 높은 상관관계, 그렇지 않은 변수와는 상관관계가 없거나 낮게 나타나 타당한 도구임이 검증되었다. 결 론 한국어판 CRA는 암환자 가족의 전반적인 돌봄 경험을 평가하는 타당한 도구이며, 암환자 가족에 대한 이해 및 개입방안의 수립에 임상적으로 활용할 수 있을 것이다.
Abstract
Background The Caregiver Reaction Assessment Scale (CRA) is an instrument designed to assess special aspects of the caregiving situation, including both negative and positive dimensions of caregiving reactions: the impact of caregiving on disrupted schedule, financial problems, lack of family support, health problems and the impact of caregiving on caregiver's self-esteem. Methods This paper addresses the psychometric qualities of the CRA-K in a study among family caregivers of cancer patients (n=248). Results No problems in feasibility were observed. Reliability analyses showed that standardized Cronbach's alpha was 0.81 for the CRA-K, indicating sufficient internal consistencies. Content, criterion, construct validity were also supported. Conclusions The CRA-K proves to be a feasible, reliable and valid instrument for assessing both negative and positive reactions to caregiving among family caregivers of patients with cancer.
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