유방암 수술 후 자조집단 참여여부에 따른 건강증진행위에 관한 연구

Abstract

[한글]연구배경 및 목적

본 연구는 유방암 환자를 대상으로 자조집단 참여여부에 따른 건강증진행위를 비교하고 그 차이를 발견함으로써 유방암 환자의 질적인 삶을 증진시킬 수 있는 중재 방안으로 자조집단을 보다 활성화시키는 전략개발을 위한 기초 자료를 마련하고자 시도되었다.

연구방법

본 연구의 대상은 2008년 8월 1일부터 9월 30일까지 유방암 환자의 자조집단이 있는 서울 소재의 A병원에서 자조집단에 참여한 유방암 환자 100명과 자조집단에 참여하지 않은 유방암 환자 86명을 표본으로 하였다. 본 연구의 도구는 구조화된 질문지로서, 지각된 건강상태, 자아존중감, 자기효능감, 건강증진행위 그리고 일반적 특성 및 질병의 특성을 측정하였고, 자가보고법에 의해 자료 수집되었다. 수집된 자료는 기술통계, x²-test, t-test, ANOVA, Multiple regression analysis로 분석하였다.

연구 결과

자조집단 참여군과 비참여군의 건강증진행위와 관련된 요인의 분포와 동질성을 검증한 결과, 일반적 특성에서 연령을 제외하고, 질병관련 특성에서 수술 후 경과기간, 항암약물치료, 현재 월경상태를 제외하고 두 군간에 차이가 없었다.

자조집단 참여군과 비참여군 간의 지각된 건강상태를 비교해 본 결과, 각각 평균 7.92점(표준편차 1.90), 7.24점(1.99)으로 자조집단 참여군이 높았고, 통계적으로 유의성이 보였으며(p=0.0193), 자아 존중감 차이를 비교해 본 결과, 자조집단 참여군이 31.76점(4.58)으로 자조집단 비참여군의 30.45점(4.61)보다 높았으나 통계적으로 유의성은 없었다(p=0.0556). 자기 효능감 차이를 비교해 본 결과, 자조집단 참여군이 92.18점(19.62)으로 자조집단 비참여군의 90.21점(18.71)보다 높았으나 통계적으로 유의성은 없었고(p=0.4863), 건강증진행위를 비교해 본 결과, 자조집단 참여군이 123.25점(19.57)으로 자조집단 비참여군의 112.69점(20.27)보다 높았고 통계적으로 유의한 차이를 보였다(p=0.0004).

대상자들의 지각된 건강상태에 대한 요인분석 결과 조사 대상자의 자조집단 참여 여부, 수술 후 경과기간 60개월 이상, 직업에서 통계적으로 유의한 요인으로 확인되었고, 자아존중감에 대한 요인분석 결과 자조집단 참여여부, 직업에서 통계적으로 유의한 요인으로 확인되었으며, 건강증진행위에 대한 요인분석 결과 자조집단 참여여부에서 통계적으로 유의한 요인으로 확인되었다.

결론

본 연구에서 자조집단 참여여부에 따른 건강증진행위는 차이가 있었다. 본 연구는 자조집단과 건강증진행위를 관련 지어 설명 할 수 있는 근거자료를 제시했다는 점에서 의의가 있다고 하겠다. 점차로 증가하는 자조집단의 중재 효과를 알아보기 위해서는 자조집단과 건강증진행위와 전후관계를 명확하게 밝히고 객관적으로 그 효과를 측정하는 연구가 뒷받침되어야 한다.

[영문]The purpose of this study was to identify the influence of perceived health status, self-esteem, self-efficiency, and health promoting behavior in breast cancer patients who participated in self-help group. This study attempted to provide basic data for the development of strategies in order to activate the self-help groups and to develop well-founded interventions in order to improve the quality of life among breast cancer participants in the self-help group.

Data were collected by self-report questionnaires from August 1 to September 30, 2008. Breast cancer patients were recruited from one hospital in Seoul, Korea. The study included 100 patients attending the self-help group and 86 patients who did not participate in the self-help group. The questionnaire consisted of information on general characteristics, disease-related characteristics and perceived health status, self-esteem, self-efficiency, and health promoting behavior. The collected data were analyzed using the SAS program.

The results of this study were as follows;

1) There was no statistically significant difference in general characteristics, disease-related characteristics except for age, postoperative elapsed time, chemo therapy, menstruation state and health promoting behavior-related characteristics between the self-help group participants and the non self-help group participants.

2) There was a statistically significant difference in perceived health status between the two groups (p=0.0193).

3) There was no statistically significant difference in self-esteem between the two groups (p=0.0556).

4) There was no statistically significant difference in self-efficiency between the two groups (p=0.4863).

5) There was a statistically significant difference in health promoting behavior between the two groups (p=0.0004).

6) There were statistically significant differences in the general features and health promoting behavior between the two groups. The health promoting behavior scores were significantly higher in the patients in the self-help group, who are in their 40s and over 60's, a high school graduate, a christian, unemployed, and married than in the patients in the non self-help group.

7) There were statistically significant differences in the disease-related characteristics and health promoting behavior between the two groups. The health promoting behavior scores were significantly higher in the patients in the self-help group, who had 25 months to 60 months of postoperative elapsed time, had mastectomy, did not receive chemo therapy, received radiotherapy or did not receive radiotherapy, received hormone therapy, didn't have menopause for more than 1 year, had a family history of breast cancer or didn't have a family history of breast cancer than in the patients in the non self-help group.

8) In multi-regression analysis, the results of perception for health status showed positive correlation with the patients in the self-help group, the subjects who had more than 60 months of postoperative lapse duration and the subjects who were employed.

9) In multi-regression analysis, the results of self-esteem showed positive correlation with the patients in the self-help group and the subjects who are employed.

10) In multi-regression analysis, the results of health promoting behaviors showed positive correlation with the patients in the self-help group.

In conclusion, there was a significant difference in health promoting behavior between the self-help group participants and the non self-help group participants. This study provides basic data which can explain the relationship between self-help group participation and health promoting behavior. Therefore, more information and education by attending self-help participation would improve quality of life in breast cancer patients and to encourage their health promotion behavior.