2. 뇌졸중 환자의 심리적 우울성향과 전체우울에 관련된 요인들은 교육정도, 치료형태, 훈련 정도, 치료 적응도, 약복용 및 기능회복이었다.
3. 뇌졸중 환자의 우울 정도는 보호자가 평가한 우울 정도보다 높게 나타났으며, 보호자가 환자의 우울 정도를 과소평가하고 있음을 보이고있었다.
4. 환자와의 관계에 따른 보호자의 평균점수 일치도에서는 배우자에서 보다 아들, 딸, 며느리가 포함된 자식에서 일치도가 더 높게 나왔다.
5. 보호자의 특성별 환자와의 평균점수 일치도에서 관련된 요인들은 보호자의 간호기간, 환자와의 동거관계, 뇌졸중 간호지식 및 건강상태였다.
6. 우울군과 비우울군의 특성 비교에서는 환자의 경우 마비부위, 용돈, 당뇨약 복용이 의의있게 차이가 있었으며, 보호자의 경우 결혼상태와 간호기간이 유의한 차이가 있었던 것 이외에 다른 차이는 없었다.
7. 뇌졸중 환자가 느끼는 우울증상의 발현 순서중 가장 점수가 높은 것은 심리적 우울성향인데 반해, 보호자가 보는 환자의 우울증 중 심하다고 느끼는 항목은 생리적 우울성향으로 환자와 보호자간에 차이가 있었다.
이러한 연구결과를 감안하여 볼 때 뇌졸중 환자의 재활치료에 임상적인 치료방법 뿐만 아니라 신경정신적인 후유증의 하나인 우울에 주는 영향을 감소할 수 있도록 가족 및 보호자의 지지체계 개념을 마련해 볼 만하다고 판단되며, 환자의 성공적 재활을 위한 적절한 치료적 중재가 있어야 하겠다.
이 연구의 제한점으로는 현재 재활치료를 받고 있는 뇌졸중 환자만을 연구대상으로 조사하였다는 점이다. 앞으로는 이 연구에서 고려하지 못한점과 제한점을 보완시키는 연구가 필요하다고 생각한다.
[영문]
The purpose of this study is to examine the differences between the degree of depression experienced by stroke patients and that of his/her caregivers. During the period from March 13 through April 13, 1995, 116 patients and caregivers were each presented with a questionnaire to determine the differences between the
patient's severity of depression and the degree of depression experienced by the caregivers as a result of their respective depression characteristics. Furthermore, in order to determine the states of depression and nondepression, characteristics
of depression were quantified by using a point system to classify the patients and their caregivers into two groups.
The results are as followed:
1. Amongst the 116 stroke patients surveyed, 43 patients (37%) fell under the category defined as depression, 38 patients (33%) were defined as mild to moderate depression and 5 patients (4%) as having moderate to severe depression. However, no patient fell under the category of severe depression.
2. Factors linking the psychological state of mind and the severity of depression were the patient's level of education, type of treatment, degree of home program training, adaptability to treatment, drug intake, and functional status.
3. The levels of depression recorded by the caregivers were much lower than those recorded by the patients. This was a result of the caregiver underestimating the patient's severity of depression.
4. The level of depression experienced by the patient's son(S),daughter(S), daughter-in-law(S) were higher than that recorded by the patient's spouse.
5. The variables affecting the caregiver's recorded degree of depression were the following: care period, living with the patient, knowledge about stroke care, and the caregiver's health status.
6. Based on the characteristics categorizing the nondepressed and depressed group, the patients were most affected by the area of paralysis, pocket money and the taking of diabetic drugs. On the other hand, the caregivers were most affected by marriage status and the period of care.
7. The highest points were given to the psychological disturbances of depression for the patients and physiological disturbances of depression for the caregivers.
As a result of this study, it may be concluded and recommended that stroke patients should, in addition to physical rehabilitation, be exposed to neuro-psychological treatment not only for minimizing the after-affects of stroke but also to maximize support from the caregiver and family. Thus, it is recommended that, for full and successful recovery of a stroke patient, a psychologist must be present to act as a mediator for the patient and their respective family members.