암 환자의 영적건강과 불안의 관계연구

Abstract

[한글]

본 연구는 암 환자를 대상으로 그들의 영적건강정도와 불안을 파악하고 영적건강과 불안의 관계를 규명하여 암 환자를 위한 영적 간호중재 프로그램 개발을 위한 기초 자료를 제공하고자 시도하였다.

연구대상자는 Y대학부속병원에서 20세 이상의 암 환자로 본 연구의 목적을 이해하고 참여에 수락한자, 국문해독이 가능하고 의사소통에 무리가 없는 자, 본인이 진단 명을 알고 있는 자로 179명을 무작위로 추출하였다. 자료수집기간은 2008년 5월 1일부터 5월 31일까지 한 달간이었다.

연구도구는 구조화된 설문지를 사용하였으며 설문지는 일반적 특성에 관한 문항과 영적건강과 불안을 측정하는 문항들로 총 78개 문항으로 구성하였다.

수집된 자료는 SPSS 12.0을 이용하여 빈도, 백분율, 평균, 표준편차, t-test, ANOVA, Pearson correlation으로 분석하였다.

연구의 결과를 요약하면 다음과 같다.

1. 대상자의 영적건강 정도는 평균 68.73± 14.57(최소 21점, 최대 100점) 평균평점 3.43±.74 나타났으며, 세부적으로 실존적 영적건강은 평균 35.89±10.18(평균평점 3.59±0.66), 종교적 영적건강은 32.8 ± 12 . 07(평균평점 3.28±0.92)로 나타났다.

2. 대상자의 특성별 영적건강 정도는 여성이 남성(t=-2.792, p=.006) 보다, 종교가 있는 군이 없는 군보다(t=-8.004, p=.000), 기독교군이 불교나 기타군보다(F=16.69, p=.000), 호전되었다고 지각한 군이 변화 없거나 나빠진 군보다(F=6.125, p=.000), 이전생활 회복기대군이 다른 군보다(F=7.429, p=.001), 지지가 매우 높은 군이 보통군보다(F=8.013, p= .000), 종교생활기간 20~30년이 다른 군보다(F=10.921, p= .000), 종교가 필요하다고 인정한 군이 부정한 군보다(F= 63.879, p=.000), 신앙적 도움이 있는 군이 없는 군보다(t=-3.083, p=.003), 신앙 도움에 만족 군이 보통군보다(t=7.769, p=.000), 종교 활동으로 말씀묵상(F=5.878, p=.000), 개인기도(F=7.040, p=.000), 찬송(F= 9.307, p= .000), 공부(F=3.542, p=.018), 예배(F=31.652, p=.000)는 매일하는 군이 다른 군 보다, 삶에 미치는 영향이 많은 군이 다른 군보다, 구원확신이 있는 군이 없는 군보다 (t=-3.842, p=.000) 높은 것으로 나타났다.

3. 대상자의 불안 정도는 상태불안 44.2±11.89 (최소 20점, 최대 79점), 기질불안 44.12±10.72(최소 20점, 최대 77점)로 약간 낮은 것으로 나타났다.

4. 대상자의 특성별 상태불안 정도는 종교가 있는 군이 없는 군보다(t=2.382, p=.018), 지각된 건강상태는 완쾌나 호전 군이 각각 변화 없거나 나빠진 군보다(F=5.148, p=.001), 인지된 지지가 매우 높은 군이 보통이나 낮은 군보다(F=8.013, p=.000), 종교생활기간은 20~30년 군이 다른 군보다(F=4.739, p=.003), 신앙도움에 만족 군이 보통 군보다(t=-3.644, p=.001), 말씀묵상은 매일하는 군이 다른 군보다(F=3.131, p=.029) 낮은 것으로 나타났다.

5. 대상자의 특성별 기질불안은 지각된 건강상태가 완쾌된 군이 다른 군보다, (F=5.865, p=.000), 인지된 지지는 매우 높은 군이 낮은 군보다(F=8.013, p=.000), 종교생활기간은 20~30년 군이 다른 군보다(F=4.681, p=.004), 종교가 꼭 필요한 군이 다른 군보다(F=3.918, p=.022), 도움 만족 군이 보통 군보다(t=-2.581, p=.011), 개인기도는 매일 하는 군이 가끔 하는 군보다(F=3.223, p=.026) 낮은 것으로 나타났다.

6. 대상자의 영적건강과 상태불안(r=-.550, p<.001), 기질불안(r=-.467, p<.001)의 상관관계는 각각 역 상관관계였고, 세부적으로는 실존적 영적 건강과 상태불안(r=-.649, p<.001), 기질불안(r=-.697, p<.001) 상관관계, 종교적 영적건강과 상태불안(r=-.401, p<.001), 기질불안( r=-.308, p<.001)상관관계는 각각 모두 역 상관관계를 보였다.

이상을 통해 암 환자의 영적건강과 불안은 중정도의 역상관관계로 영적건강 정도가 높을수록 불안정도가 낮은 것이 발견되었다.

따라서 연구결과를 종합하여 볼 때 병원에서 입원환자와 외래환자의 불안을 감소시키는 방안으로 영적건강을 높혀야 함이 설명되었으므로, 영적건강을 높이기 위한 방법으로 예배, 말씀, 기도 등의 종교 활동을 매일 정착화 시켜야할 근거가 제시되었다.

[영문]

The purpose of this study was to survey cancer patients for their state of spiritual health and anxiety and thereupon, analyze the relationship between their spiritual health and anxiety to provide for some basic data for development of a spiritual nursing intervention program.

For this purpose, the researcher randomly sampled 179 cancer patients aged 20 or older who had understood the purpose of this study and agreed to participate in the study; they could comprehend the Korean text and communicate with others, being well aware of the diseases diagnosed. The data were collected for a month from May 1 through May 31, 2008.

For the survey, a structured questionnaire was used. The questionnaire consisted of 78 items in total about subjects' demographic variables and their state of spiritual health and anxiety.

The collected data were processed using SPSS 12.0 for frequency, percentage, means, SD, T-test, ANOVA and Pearson correlation coefficients.

The results of this study can be summarized as follows;

1. Subjects' state of spiritual health scored 68.73± 14.57 on average (minimum 21 and maximum 100) or 3.43±.74 of means. In terms of sub-areas, their state of existential spiritual health scored 35.89±10.18 on average (means: 3.59±0.66), while their state of religious spiritual health scored 32.8 ± 12.07 on average (means: 3.28±0.92).

2. Subjects' state of spiritual health differed on their demographic variables; the state of spiritual health was higher in women than men (t=-2.792, p=.006), those who had faith than those who had not (t=-8.004, p=.000), Christians than Buddhists or other groups (F=16.69, p=.000), those who perceived that their health condition improved than those who perceived that their health condition remained same or worsened (F=6.125, p=.000), those who expected to return to their former life than other groups (F=7.429, p=.001), those supported high than those supported normally (F=8.013, p= .000), those who had lived a religious life for 20~30 years than other groups (F=10.921, p=.000), those who felt it necessary to have a faith than those who denied faith (F= 63.879, p=.000), those who were supported religiously than those who were not (t=-3.083, p=.003), those satisfied with a religious support than other normal groups (t=7.769, p=.000), those who were practicing meditation on Words (F=5.878, p=.000), personal praying (F=7.040, p=.000), praising (F= 9.307, p= .000), study (F=3.542, p=.018) or worship (F=31.652, p=.000) every day than other groups, those affected much by faith than other groups, and those convinced of salvation than those not convinced (t=-3.842, p=.000).

3. Subjects' state of anxiety scored a little lower or 44.2±11.89 (min. 20, max. 79) in terms of state anxiety and 44.12±10.72 (min. 20, max. 77) in terms of temperament anxiety.

4. Subjects' state anxiety differed depending on their demographic variables: their state anxiety was lower in those having a faith than those not having a faith (t=2.382, p=.018), those who perceived that their health condition improved than those who perceived that their health condition remained same or worsened (F=5.148, p=.001), those supported high than those supported normally or less (F=8.013, p=.000), those who had lived a religious life for 20~30 years than other groups (F=4.739, p=.003), those satisfied with the religious support than the normal group (t=-3.644, p=.001), and those who were practicing meditation on Words every day than other groups (F=3.131, p=.029).

5. Subjects' temperament anxiety differed depending on their demographic variables, too; it was lower in those who perceived that their health condition had been recovered completely than other groups (F=5.865, p=.000), those supported high than those supported low (F=8.013, p=.000), those who had lived a religious life for 20~30 years than other groups (F=4.681, p=.004), those who felt it necessary to have a faith than other groups (F=3.918, p=.022), those satisfied with the religious support than other groups (t=-2.581, p=.011), and those who were praying every day than those who were praying at times (F=3.223, p=.026).

6. Subjects' state of spiritual health was negatively correlated with their state anxiety (r=-.550, p<.001) and temperament anxiety (r=-.467, p<.001). In terms of sub-areas, their state of existential spiritual health was negatively correlated with their state anxiety (r=-.649, p<.001) and temperament anxiety (r=-.697, p<.001), and their religious spiritual health was negatively correlated, too, with their state anxiety (r=-.401, p<.001) and temperament anxiety (r=-.308, p<.001).

As discussed above, cancer patients' state of spiritual health and anxiety were negatively correlated more or less with their state of anxiety. Namely, the higher their state of spiritual health was, their state of anxiety was lower.

Summing up, since this study proved that cancer patients' (whether they were hospitalized outpatients) state of spiritual health should be enhanced in order to lower their state of anxiety, it may well have provided for a ground for worship, meditation on Words, praying and other religious activities which need to be practiced every day to enhance their spiritual health.