만성 질병에 처한 가족의 대응도 및 반응단계에 관련된 요인

Abstract

Background : The experience of chronic illness affects families in profound ways and how well the family adapts to chronic illness can influence the course of the illness. The purpose of this study is to analyze the factors correlated with the family's coping and the reaction phase to chronic illness, and then to suggest the basis of model for the family-oriented family medicine.

Methods : Total 211 patients and their family was reviewed to investigate the correlating factors between the family's coping, the reaction phase and the chronic illness by the questionnares on which the followings were included : the score of a family's coping with chronic illness, family APGAR, family stress(by Holmes's SRRS), the reaction phase, the duration of chief complaints, demographic factors, etc. The results were analyzed by the descriptive, comparative and multiple regression statistics with DBSTAT and SPSS/PC+4.0 computer program.

Results : The completed subjects was 203 cases of which the mean age was 47.6±15.8 years old. The mean of the duration of chief complaints was 4.3±2.7 years. The mean score of family's coping was 11.3±2.9 points, and the above 11 points was 67.0%, 5 to 10 points was 28.6%, the below 4 points was 4.4%. The distribution of families on the each reaction phase to chronic illness was followings : 1) Denial phase : 3.5%, 2) Fear phase : 17.7%, 3) Guilty phase : 7.9%, 4) Anger phase : 9.3%, 5) Depression phase : 22.7%, 6) Acceptance phase : 38.9%. The factors correlated with the score of family's coping to chronic illness was family APGAR and family stress(r=0.26). Other associated factors was followings : religion, education, economy, reaction phase, the family's coping experience of past ilness(P<0.05). The factors correlated with the family's reaction phase to chronic illness was patient'sage and the duration of chief complaints (r=0.15). And the other associated factors was the number of admission, the score of family's coping and stress, the family's experience to past illness(P<0.05). For only all of the 1st admission patients, their families on denial and fear phase was 80.0%, 83.4% within 2 years. Depression phase was 76.9% within 5 years. Acceptance phase was 75.0% within 7 years(P<0.05)

Conclusion : The score of family's coping with chronic illness was correlated with the family's APGAR and family's stress. The family's reaction phase to chronic illness was correlated with the pamily's stress. The family's reaction phase to chronic illness was correlated with the patient's age and the duration of chief complaints. Further study of the factors and reaching times of family's reaction phase to chronic illness were needed.