Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Relationship between depression and resilience in adolescents with congenital heart disease

선천성심질환 청소년의 우울과 극복력의 관계분석

  • Moon, Ju Ryoung (Grown-Up Congenital Heart(GUCH) Clinic, Cardiac & Vascular Center, Samsung Medical Center, Sungkyunkwan University, College of Medicine) ;
  • Jung, Yoen Yi (Grown-Up Congenital Heart(GUCH) Clinic, Cardiac & Vascular Center, Samsung Medical Center, Sungkyunkwan University, College of Medicine) ;
  • Huh, June (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University,College of Medicine) ;
  • Kang, I-Seok (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University,College of Medicine) ;
  • Park, Seung Woo (Division of Cardiology, Samsung Medical Center, Sungkyunkwan University,College of Medicine) ;
  • Yang, Ji-Hyuk (Department of Thoracic & Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University, College of Medicine) ;
  • Jun, Tae-Gook (Department of Thoracic & Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University, College of Medicine) ;
  • Kim, Myung Ja (College of Nursing, Catholic University) ;
  • Lee, Heung Jae (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University,College of Medicine)
  • 문주령 (성균관대학교 의과대학 삼성서울병원 심장혈관센터, 청소년 및 성인선천성심질환 클리닉) ;
  • 정연이 (성균관대학교 의과대학 삼성서울병원 심장혈관센터, 청소년 및 성인선천성심질환 클리닉) ;
  • 허준 (성균관대학교 의과대학 삼성서울병원 소아과) ;
  • 강이석 (성균관대학교 의과대학 삼성서울병원 소아과) ;
  • 박승우 (성균관대학교 의과대학 삼성서울병원 순환기내과) ;
  • 양지혁 (성균관대학교 의과대학 삼성서울병원 흉부외과) ;
  • 전태국 (성균관대학교 의과대학 삼성서울병원 흉부외과) ;
  • 김명자 (가톨릭대학교 간호대학) ;
  • 이흥재 (성균관대학교 의과대학 삼성서울병원 소아과)
  • Received : 2005.11.18
  • Accepted : 2006.01.12
  • Published : 2006.05.15
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Abstract

Purpose : The purpose of this study was to investigate the relationship between depression and resilience in adolescents with congenital heart disease(CHD) and to identify the variables associated with depression. Methods : The Resilience Scale(cronbach's ${\alpha}=0.92$), Children's Depression Inventory(cronbach's ${\alpha}=0.72$) and Maternal Behavior Research Instrument(cronbach's ${\alpha}=0.88$) were applied and analyzed to assess depression and resilience among 231 adolescents after surgery for CHD from three major cardiac centers in Korea. This group consist of 114 males and 117 females. The mean age was 15.8 years(range : 13-18 years). The clinical severity of illness was rated by CHD functional index and NYHA functional class. Results : The mean score for depression and resilience was 16.74(range : 0-49) and 115.84(range : 70-132) respectively. Depression was significantly related to age(r=0.25, P<0.001) and NYHA functional class(r=0.35, P<0.001), as well as being negatively correlated with oxygen saturation(r=-0.39, P<0.001), academic achievement(r=-0.41, P<0.001), parental attitude(r=-0.49, P<0.001) and resilience (r=-0.59, P<0.001). The results of multiple regression analysis showed that parental attitude(${\beta}=-0.48$, P<0.01) and resilience(${\beta}=-0.62$, P<0.01) were related to depression. Conclusion : This study demonstrated that adolescents with CHD had a higher resilience and were less depressed with an affectionate parent. With respect to medical and nursing intervention programs, it is essential to identify strengths of adolescents with CHD in order to increase their resilience. Additionally, it is also important that parenting and counseling programs be implemented for the parents of adolescents with CHD.

목 적 : 선천성심질환 청소년의 우울정도와 극복력의 상관관계를 파악하고 우울과 관련된 변수를 확인하고자 하였다. 방 법 : 선천성심질환으로 수술을 받고 2개 대학병원 및 심장전문병원에 등록되어 추적관찰 중인 만 13-18세 청소년 231명을 대상으로 하였다. 연구 도구는 만성질환아를 대상으로 개발한 극복력 도구와 Beck의 우울척도를 8-18세에 맞게 변형시킨 Kovasc의 CDI를 사용하였다. 결 과 : 선천성심질환 청소년의 우울정도는 0-54점 가능 점수에서 평균 16.74점이었고, 극복력은 70-160점 가능 점수에서 115.84점이었다. 극복력에 따른 우울정도는 극복력과 우울은 유의한 역상관관계(r=-0.59, P<0.01)를 나타났다. 또한, 극복력의 하부 개념인 개인내적요인(r=-0.69, P<0.01), 대처양상(r=-0.39, P<0.05), 대인관계(r=-0.59, P<0.01)도 우울정도와 통계적으로 유의한 역상관관계를 보였다. 다중회귀분석 결과 선천성심질환 청소년의 우울과 관련된 유의한 변수는 부모의 양육태도(${\beta}=-0.48$, P<0.01) 및 극복력(${\beta}=-0.62$, P<0.01)으로 나타났다. 결 론 : 선천성심질환 청소년에서 청소년 자신의 극복력이 높을수록 부모가 긍정적인 양육태도를 가질수록 우울정도가 낮음을 알 수 있었다. 따라서 환자 자신의 극복력을 파악하고 증진할 수 시킬 수 있는 심층 연구와 선천성심질환 청소년과 같이 만성질환을 가진 자녀의 부모에게 양육태도의 중요성을 가질 수 있도록 돕는 중재개발이 필요하다.

Keywords

Acknowledgement

Supported by : (재)인성의과학연구재단

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