Effect of Supportive Nursing Intervention on Hopelessness, Self-Esteem, Self-Concept of Operative Patient with Head and Neck Cancer

전인적 지지간호중재가 두경부암 수술환자의 절망감, 자아존중감 및 자아개념에 미치는 효과

Purpose: Despite the small incidence, head and neck cancer may cause a wide range of physical transformation by surgical operation, damage to active functions such as eating and speaking. It may provoke hopelessness, change self-esteem and self-concept after its operation, influencing the quality life of head and neck cancer patients. Thus nursing intervention should be developed to provide supportive nursing for head and neck cancer patients and play roles as competent supporters. Methods: This study was a nonequivalent, control group, pretest-posttest, non-synchronized quasi-experimental research designed to determine how supportive nursing intervention effects on hopelessness, self-esteem and self-concept of head and neck cancer patients. Subjects of the study included 40 adult inpatients of K University hospital in Pusan who were diagnosed as having head and neck cancer and operated. They were divided into experimental and comparison groups, each consisting of 20 members. The data were collected during the period from December 1, 1999 to April 11, 2000. Tools of the study included the protocol of supportive nursing intervention which was developed by researcher by means of reference, literal review and expert's advice. The measurement tool of hopelessness was translated by Won was the device of hopelessness self-evaluation from Beck, the tool for self-esteem measurement was developed by Rosenberg and translated by Kim, and the device of self-concept used by Lee et al, modified by Lee were used respectively. Data were analyzed using the SPSS/PC 9.0 program. The homogeneity of the subjects were tested using $x^2-test$ and t-test. 3 hypotheses were tested using t-test. Results: The results of the study can be summarized as follows. 1. The third hypothesis that the experimental group receiving supportive nursing intervention showed a little hopelessness than the control group not receiving supportive nursing intervention was supported (t=4.550, P=.000). 2. The third hypothesis that the experimental group receiving supportive nursing intervention showed more self-esteem than the control group not receiving supportive nursing intervention was supported (t=-6.40, p=.000). 3. The third hypothesis that the experimental group receiving supportive nursing intervention showed more self-concept than the control group not receiving supportive nursing intervention was supported (t=-6.065, P=.000). Conclusion: Supportive nursing intervention was effective nursing intervention strategy for reducing hopelessness and increasing self-esteem and self-concept of head and neck cancer patients. Then the quality of life of head and neck cancer patients can be enhanced by providing supportive nursing intervention in nursing practice.

목적: 본 연구는 전인적 지지간호중재가 수술한 두경부암 환자의 절망감, 자아존중감, 자아개념에 미치는 효과를 규명하기 위한 비동등성 대조군 전 후 시차 유사실험 설계연구이다. 방법: 연구대상은 P시에 소재한 K 대학교 부속 병원에서 두경부암으로 진단 후 수술을 받은 입원환자로써 대조군 20명, 실험군 20명으로 총 40명이었다. 자료수집 기간은 대조군이 1999년 12월 1일부터 2000년 2월 19일까지였고, 실험군은 2000년 2월 17일부터 4월 11일까지였다. 연구도구는 실험도구로서 전인적 지지간호중재 protocol은 연구자가 문헌고찰을 중심으로 전문가의 도움을 받아 제작한 것으로 신체적, 정서적, 정보적, 영적중재로 구성되어 있다. 측정도구는 절망감을 측정하기 위해 Beck(1974)의 절망감 측정도구를[15]이 번역한 척도를 사용하였다. 자아존중감에 대한 측정도구는 [29]가 개발하고 [41]가 번역한 도구를, 자아개념에 대한 측정도구는 [20] 등이 사용한 것을 [21]이 수정보완한 도구를 사용하였다. 자료처리는 SPSS/PC 9.0 프로그램을 이용하여 실수, 백분율, 평균, 평균평점, 표준편차, $x^2-test$, t-test로 분석하였다. 결과: 본 연구의 결과는 아래와 같았다. 1. 제 1가설 '전인적 지지간호중재를 받은 실험군은 받지 않은 대조군보다 절망감 정도가 낮을 것이다' 는 지지되었다(t=4.550, P=.000). 2. 제 2가설 '전인적 지지간호중재를 받은 실험군은 받지 않은 대조군보다 자아존중감 정도가 높을 것이다' 는 지지되었다(t=-6.442, P=.000). 3. 제 3가설 '전인적 지지간호중재를 받은 실험군은 받지 않은 대조군보다 자아개념 정도가 높을 것이다'는 지지되었다(t=-6.065, P=.000) 결론: 전인적 지지간호중재는 두경부암 수술환자의 절망감 감소와 자아존중감, 자아개념의 증진시키는데 효과가 있으므로, 두경부암 환자의 삶의 질을 위해 임상실무에 전인적 지지간호중재 프로토콜을 적용할 필요가 있으리라 사료된다.