혈액암환자의 영적건강과 우울과의 관계연구

Abstract

[한글]본 연구는 혈액암환자를 대상으로 그들의 우울상태와 영적건강간의 상관관계를 규명하기 위해 시도 되었다. 연구결과들은 영적건강 관리와 우울완화 및 예방의 중요성을 제시하는데 활용되어 질 것이다.연구 대상자는 서울시내 혈액암을 전문으로 치료하는 1개 종합병원에서20세 이상의 혈액암환자로 본 연구의 목적을 이해하고 참여에 수락한 자, 국문해독이 가능하고 의사소통에 무리가 없는 자, 전문의로부터 혈액암을 진단받고 본인의 진단명을 알고 있는 자로 100명을 무작위 추출하였다. 자료수집기간은 2006년 4월 19일 ~ 6월 9일까지 50일간이었다. 대상자 제외기준은 호스피스 대상자와 혈액암 이외 다른 암 병반자로 하였다.영적건강을 측정하기 위한 도구는 Highfield가 개발하고 이원희등이 수정한 31문항의 영적건강측정도구(SHI)이다. 우울측정은 Derogatis가 개발한 SCL-90-R을 김광일등이 한국어로 번안한 13문항 설문지이다.자료분석은 SPSS 12.0 프로그램을 사용하여 영적건강과 우울간의 상관관계를 피어슨 상관관계수와 다중회귀분석을 통해 분석하였다. 일반적 및 주간호자 특성, 신앙적 특성, 건강치료관련 특성과 영적건강 및 우울과의 차이는 t-test와 ANOVA로 분석하였다.연구결과는 다음과 같다.1.혈액암환자의 영적건강 점수는 31점에서 155점 범위에서 111. 62점(문항별평균:3.53+-1.349)이었으며 우울은 13점에서 65점 범위에서 29.78점(문항별 평균: 2.19+-1.082)이었다2.혈액암환자의 제 특성에 따른 영적건강과 우울의 평균비교 분석에서 영적건강은 신앙의 정도에 크게 영향을 받으며(F=19.65,p=0.000) 우울의 경우 나이(F=4.561, p=0.002) 와 영적상태(F=4.843, p=0.004)에 따른 영향이 크게 나타났다.3.영적건강과 우울은 중등도의 역 상관관계를 나타내었다 (r=-.681, p=.000).이상의 연구결과를 종합하여 볼 때 혈액암환자의 영적건강과 우울은 중등도의 역 상관관계를 가지므로 혈액암 환자들에게 관찰되는 우울을 관리하기 위해서 간호사들은 선행 요인으로 작용하는 영적건강을 관리함으로써 우울을 완화시키고 예방하여 혈액암 환자의 삶의 질과 간호의 질을 향상시키는데 기여해야 할 것이다.

[영문]This study was done to identify the relationship between spiritual health and depression in patients with hematological malignancies who were in isolation rooms. The results will be applied to develop spiritual health care, to mitigate the depression, and to suggest the importance of prevention of these problems, which is exactly what is required by patients with hematological malignancies.Participants in this study were 100 patients sampled randomly who were hospitalized at a general hospital in Seoul where professionals work to cure patients with hematological malignancies. All of the participants were 20 years of age or older. The selected participants satisfied the following requirements; Agreed to participate in the research, understood the research purpose, had reading comprehension of Korean, were diagnosed by a doctor as having a hematological malignancy and were aware of their disease. The data collection took about 50 days from April 19 to June 9, 2006. Other cancer patients and patients in hospice care were excluded from the present research.The instrument used to measure spiritual health was the Spiritual Health Inventory Scale (SHI) with 31 questions developed by Highfield and then modified by Lee. Depression was measured with the SCL-90-R which has 13 questions. It was originally developed by Derogatis and into Korean by Kim.Pearson correlation coefficients was used to analyze the data for relationships between spiritual health and depression T-test and ANOVA were calculated to examine differences in spiritual health and depression according to demographic characteristics, primary caregiver, faith and heath treatment. SPSS 12.0 was used to assist analysis. The results are as follows:1. The mean score for spiritual health of patients with hematological malignancies in isolation rooms was 111.62 (3.53+-1.389) with a range from 31 to 155. The score indicates that the patients perceived their state of spiritual health as greater than moderate. The mean score for depression was 29.78 (2.19+-1.082) with a range from 13 to 65. This score indicates that they perceived a low level of depression, below a moderate level.2. ANOVA and t-test were performed to test significant differences for spiritual health and depression according to the demographic characteristics of primary caregiver, faith and heath treatment. In spiritual health, the largest significant differences was in the field of faith (F=19.65, p=0.000). In depression, there were significant differences in the field of year (F=4.561, p=0.002) and spiritual state (F=4.843, p=0.004).3. A moderate negative correlation between spiritual health and depression was found (r=-.681, p=.000).Spiritual health was found to be negatively related to depression in these patients; therefore, spiritual care for spiritual health is required to prevent depression. From the above results, oncology nurses should manage spiritual health so as to improve the life of patients with hematological malignancies and also the quality of nursing care.Key words : Hematological Malignancies patients, Spiritual health, depression