가족구성원의 가족환경에 대한 지각불일치와 가족건강상태와의 관계에 대한 연구

Abstract

[한글]

본 연구는 가족환경에 대한 지각불일치와 가족건강상태와의 관계를 규명하기 위한 상관 관계연구이다.

본 연구의 목적은 가족구성원들이 가족환경을 서로 다르게 지각하고 있는 정도 즉, 가족환경에 대한 지각불일치 및 가족상태를 파악하므로써 가족환경에 대한 지각불일치와 가족건강상태와의 관계를 규명하여, 가족건강상태를 예측할 수 있고 가족환경과 가족건강에

관한 보다 진전된 연구가 수행될 수 있는 기초자료를 제공하는 것이다.

본 연구는 질병체제이론을 이론적 기틀로 하여 가족과 가족환경, 가족건강에 관한 문헌을 고찰하였다.

연구대상은 "S"고등학교 2학년 2개반을 편의에 의해 표집한 후, 핵가족으로, 가족구성원이 모두 함께 살며 서울에 거주하고 있고, 가족구성원의 연령이 10세이상이며, 가족구성원수가 5명이하인 54가족을 선정하였으나, 자료분석이 곤란한 대상을 제외하여 실제자

료분석에 사용된 대상은 40가족이었다.

연구도구로는 구조화된 질문지를 사용하였다. 가족건강상태를 측정하기위하여 Brodman과 그의 동료들에 의해 개발된 건강조사표(C-ornell Medical Index )를 한국의 남호창이 간이화한 간이형 건강조사표를 사용하였다. 간이형 건강조사표는 57개의 문항으로 되어있으며 각 문항은 "예", "아니오"로 답하게 되어있다. "예"는 해당문항의 증상이 대상자에게 있음을 의미한다. 가족환경에 대한 지각불일치를 측정하기 위하여 Rudolf Moos와 그의 동료들에 의해 개발된 가족환경척도(Family Environment Scale)중 Form R을 사용하였다.

가족환경척도는 90개의 문항으로 되어있으며 각 문항은 "예", "아니오"로 답하게 되어있다. 가족환경에 대한 지각불일치점수는 가족환경척도 계산법에 의해 산출된다.

자료수집기간은 1984년 10월 9일부터 10월 28일까지 총 20일간이었다. 자료수집방법으로는 질문지법과 가정방문을 통한 직접면접 방법을 이용하였다.

자료분석은 가족의 일반적 특성은 각 문항에 대하여 빈도 및 백분율을 구하였다. 가족건강상태, 신체건강상태, 정신건강상태는 평균과 표준편차를 구하였고, 가족구성원의 가족환경에 대한 지각불일치도 평균과 표준편차로 파악하였다. 일반적 특성과 가족건강상태, 신체건강상태, 정신건강상태 및 가족환경에 대한 지각불일치와의 관계를 검토하기 위해 Pearson Correlation Coefficient를 산출하였다. 가족구성원의 가족환경에 대한 지각불

일치가 가족건강상태, 신체건강상태, 정신건강상태를 얼마나 예측할 수 있는지 파악하기 위하여 회귀분석을 하였다.

본 연구의 결과는 아래와 같다.

1. 가족건강상태 점수는 최저 0점에서 최고 57점까지의 분포를 보일 수 있는데 점수가 높을수록 가족건강상태가 좋지 않다는 것을 의미한다. 본 연구대상의 가족건강상태 점수는 8 - 24점 사이의 분포를 보였고 그 평균은 16.1937점으로 나타났다. 즉, 연구대상가족

의 건강상태는 비교적 좋은 편이라 할 수 있겠다. 가족신체건강상태 점수는 최저 0점에서 최고 37점까지의 분포를 보일 수 있는데 점수가 높을수록 가족신체건강상태가 좋지 않다는 것을 의미한다. 본 연구대상의 가족신체건강상태 점수는 1 - 13점 사이의 분포를 보였

고 그 평균은 8.1812점으로 나타났다. 즉, 연구대상가족의 신체건강상태는 비교적 좋은 편이라 할 수 있겠다. 가족정신건강상태 점수는 최저 0점에서 최고 22점까지의 분포를 보일 수 있는데 점수가 높을수록 가족정신건강상태가 좋지 않다는 것을 의미한다. 본 연구

대상의 가족정신건강상태 점수는 4 - 12점사이의 분포를 보였고 그 평균은 7.7875점으로 나타났다. 즉 연구대상가족의 정신건강상태는 비교적 좋은 편이라 할 수 있겠다.

2. 가족환경에 대한 지각불일치 점수가 높다는 것은 가족구성원이 가족환경을 서로 다르게 지각하는 정도가 높다는 것을 의미한다. 본 연구대상의 가족환경에 대한 지각불일치 점수는 10 - 20점사이의 분포를 보였으며 그 평균은 14.7945점으로 나타났다.

3. 연구대상 가족의 일반적 특성과 가족건강상태, 신체건강상태, 정신건강상태 및 가족환경에 대한 지각불일치와의 관계는 통계적으로 유의하지 않은 것으로 나타났다.

4. 가설검정결과

제 1 가설 "가족구성원의 가족환경에 대한 지각불일치가 클수록 가족건강상태는 좋지않을 것이다"는 지지되었다. (r=.8712, p<.001)

제 2 가설 " 가족구성원의 가족환경에 대한 지각불일치가 클수록 가족신체건강상태는 좋지 않을 것이다"(r=.7044, p<.001)

제 3 가설 "가족구성원의 가족환경에 대한 지각불일치가 클수록 가족정신건강상태는 좋지 않을 것이다"는 지지되었다. ( r=.8044, p<.001)

5. 가족구성원의 가족환경에 대한 지각불일치가 가족건강상태, 신체건강상태, 정신건강상태를 얼마나 예측할 수 있는 지 분석한 결과, 가족환경에 대한 지각불일치가 가족건강상태 75.3%, 가족신체건강상태 49 .6%, 가족정신건강상태 64.7%를 설명할 수 있는 것으로 나타났다. 그러므로 가족구성원의 가족환경에 대한 지각불일치를 파악하여 이것을 우선적으로 중재하므로써 가족건강상태를 증진시킬 수 있다. 또한 가족구성원의 가족환경에

대한 지각불일치의 중재는 가족신체건강상태보다는가족정신건강상태를 더욱 더 증진시킬 수 있다.

본 연구는 가족건강에 영향을 미치는 요소를 확인하고 가족구성원의 가족환경에 대한 지각불일치와 가족건강상태와의 관계를 파악하므로써, 가족환경에 대한 지각불일치가 가족단위의 건강상태에 대한 예측인자로 활용될 수 있으며, 가족환경과 가족건강에 관한 보

다 진전된 연구의 기초자료로 이용될 수 있다고 사려된다.

A STUDY ON THE RELATIONSHIP BETWEEN FAMILY INCONGRUENCE ABOUT FAMILY ENVIRONMENT

AND THE FAMILY HEALTH STATUS

Chung, Hyun Yong

Department of Nursing The Graduate School, Yonsei University

(Directed by Professor Chung, Hyun Sook)

This study was the correlational study of descriptive design to investigate the

relationship between family incongruence about family environment and the fami1y

health status.

The purpose of this study was to recognize the relationship between the degree of

family incongruence about family environment and the family health status in order

to provide possible predictor of family health status and the basic data for

further research about family environment and family health.

This study employed the systems theory of disease as its principal theoritical

framework and reviewed the related areas of family, family environment and family

health.

The criteria for sifting subjects of this study were as follows :

1. nuclear family

2. family whose members live all together in seoul

3. family whose members are less than 5

4. family whose members ale over 10 years of age

The samples of this study were chosen by convenient sampling. At first 54

families were chosen from "S" High school students comply to the criteria for

sifting the subjects but finally the data of 40 families were used after excluding

the useless data.

The research methods used were structured questionnares. Family health status was

measured using Cornell Medical Index designed by Brodman and modified by Nam, Ho

Chang. CMI is composed of 57 items which is followed by 'yes' and 'no'. A 'yes'

means a health problem is present. The family incongruence was measured using

Family Environment scale designed by Rudolf Moos. FES is composed of 90 items which

is followed by 'true' and 'false'. A family incongruence score can be obtained from

the FES.

Data for this study were collected over a period of 20 days from the 9th of

October to the 28th of that month 1984 using the interview and questionnare through

home visiting.

Incidence and percentage were used to analize the characteristics of family.

Means and standard deviation were used to analize the family health status and

family incongruence about family environment. ANOVA was used to analize the

diferrences in family incongruence score and family health score between groups

classified by the characteristics of family. Pearson correlation coefficient was

used to analize the relationship between family incongruence about family

environment and family health status. Regression was used to analize the

predictability of family incongruence about family environment for family health

status.

The results of this study were as followes :

1. The (total) health scores of family can range from 0 to 57. The higher the

health score of family there is, the worse the health status of family is. The

(total) health scores of family of subjects ranged from 8 to 24 and the mean score

was 16.1937. Therefore, the (total) health status of families was relatively good.

The physical health scores of family can range from 0 to 37. The higher the

physical health score of family there is, the worse the physical health status of

family is. The physical health scores of family of subjects ranged from 1 to 13 and

the mean score was 8.1812. Therefore, the physical health status of families was

relatively good. The emotional health scores of family can range from 0 to 22. The

higher the emotional health score of family there is. the worse the emotional

health status of family is. The emotional health scores of family of subjects

ranged from 4 to 12 and the mean score was 7.7875. Therefore, the emotional health

status of families was relatively good.

2. The higher the family incongruence score there is, the more the family members

perceive their family environment differently. The family incongruence scores of

subjects ranged from 10 to 20 and the mean score was 14.7975.

3. Differences in family's incongruence score and family health scores - the

total health score, the physical health score and the emotional health score of

family - between groups classified by the characteristics of family such as monthly

income of householder, state of residences father's occupation, mother's

occupation, father's degree of education and mother's degree of education were not

significant at the.05 level.

4. The first hypothesis, "The more family incongruence about family environment

there is, the worse the (total) health status of family is." was accepted (r=.8712,

p<.001). The second hypothesis, "The more family incongruence about family

environment there is, the worse the physical health status of family is." was

accepted (r=.7044, p<.001). The third hypothesis, "The more family incongruence

about family environment there is, the worse the emotional health status of family

is." was accepted (r=.8048, p<.001).

5. As a result of the test that how much the family incongruence about family

environment can predict the family health status. it was found that the family

incongruence about family environment predicted 75.9% of the varience of the

(total) health status of family, 49.6% of the varience of the physical health

status of family, and 64.7% of the emotional health status of family. Therefoer, it

can improve the family health status to recognize and intervene the family

incongruence about family environment. And the intervention of family incongruence

about family environment can improve the emotional health status of family more

than the physical health status of family.

It is concluded that this study may contribute to not only nursing practice by

providing the predictability of family incongruence about family environment for

family health status but also nursing research by providing the basic data for

further nursing research.

[영문]

This study was the correlational study of descriptive design to investigate the relationship between family incongruence about family environment and the fami1y health status.

The purpose of this study was to recognize the relationship between the degree of family incongruence about family environment and the family health status in order to provide possible predictor of family health status and the basic data for

further research about family environment and family health.

This study employed the systems theory of disease as its principal theoritical framework and reviewed the related areas of family, family environment and family health.

The criteria for sifting subjects of this study were as follows :

1. nuclear family

2. family whose members live all together in seoul

3. family whose members are less than 5

4. family whose members ale over 10 years of age

The samples of this study were chosen by convenient sampling. At first 54 families were chosen from "S" High school students comply to the criteria for sifting the subjects but finally the data of 40 families were used after excluding the useless data.

The research methods used were structured questionnares. Family health status was measured using Cornell Medical Index designed by Brodman and modified by Nam, Ho Chang. CMI is composed of 57 items which is followed by 'yes' and 'no'. A 'yes' means a health problem is present. The family incongruence was measured using

Family Environment scale designed by Rudolf Moos. FES is composed of 90 items which is followed by 'true' and 'false'. A family incongruence score can be obtained from the FES.

Data for this study were collected over a period of 20 days from the 9th of October to the 28th of that month 1984 using the interview and questionnare through home visiting.

Incidence and percentage were used to analize the characteristics of family.

Means and standard deviation were used to analize the family health status and family incongruence about family environment. ANOVA was used to analize the diferrences in family incongruence score and family health score between groups classified by the characteristics of family. Pearson correlation coefficient was

used to analize the relationship between family incongruence about family environment and family health status. Regression was used to analize the predictability of family incongruence about family environment for family health status.

The results of this study were as followes :

1. The (total) health scores of family can range from 0 to 57. The higher the health score of family there is, the worse the health status of family is. The (total) health scores of family of subjects ranged from 8 to 24 and the mean score was 16.1937. Therefore, the (total) health status of families was relatively good.

The physical health scores of family can range from 0 to 37. The higher the physical health score of family there is, the worse the physical health status of family is. The physical health scores of family of subjects ranged from 1 to 13 and the mean score was 8.1812. Therefore, the physical health status of families was relatively good. The emotional health scores of family can range from 0 to 22. The higher the emotional health score of family there is. the worse the emotional health status of family is. The emotional health scores of family of subjects

ranged from 4 to 12 and the mean score was 7.7875. Therefore, the emotional health status of families was relatively good.

2. The higher the family incongruence score there is, the more the family members perceive their family environment differently. The family incongruence scores of subjects ranged from 10 to 20 and the mean score was 14.7975.

3. Differences in family's incongruence score and family health scores - the total health score, the physical health score and the emotional health score of family - between groups classified by the characteristics of family such as monthly income of householder, state of residences father's occupation, mother's

occupation, father's degree of education and mother's degree of education were not significant at the.05 level.

4. The first hypothesis, "The more family incongruence about family environment there is, the worse the (total) health status of family is." was accepted (r=.8712, p<.001). The second hypothesis, "The more family incongruence about family

environment there is, the worse the physical health status of family is." was accepted (r=.7044, p<.001). The third hypothesis, "The more family incongruence about family environment there is, the worse the emotional health status of family is." was accepted (r=.8048, p<.001).

5. As a result of the test that how much the family incongruence about family environment can predict the family health status. it was found that the family incongruence about family environment predicted 75.9% of the varience of the (total) health status of family, 49.6% of the varience of the physical health status of family, and 64.7% of the emotional health status of family. Therefoer, it can improve the family health status to recognize and intervene the family incongruence about family environment. And the intervention of family incongruence

about family environment can improve the emotional health status of family more than the physical health status of family.

It is concluded that this study may contribute to not only nursing practice by providing the predictability of family incongruence about family environment for family health status but also nursing research by providing the basic data for

further nursing research.