Effects of Foot Massage and Supportive Communication by Hospice Volunteers on Depression, Anxiety, and Mood of Cancer Patients Who Undergo Intravenous Chemotherapy at Out-patient Department

호스피스 자원봉사자의 발마사지와 지지적 의사소통이 외래 항암화학요법 환자의 우울, 불안 및 기분에 미치는 효과

  • Hur, Hea-Kung (Department of Nursing, Wonju College of Medicine, Yonsei University) ;
  • Song, Hee-Young (Department of Nursing, Wonju College of Medicine, Yonsei University)
  • 허혜경 (연세대학교 원주의과대학 간호학과) ;
  • 송희영 (연세대학교 원주의과대학 간호학과)
  • Received : 2010.08.16
  • Accepted : 2010.10.19
  • Published : 2010.12.01

Abstract

Purpose: This study was done to investigate effects of foot massage and supportive communication provided by hospice volunteers on depression, anxiety, and mood of cancer patients who are going under intravenous chemotherapy at out patient department (OPD). Methods: A non-equivalent control group non-synchronized design was used. Sixty-four participants were recruited from out-patients setting in a university hospital by a convenient sampling. Two trained- hospice volunteers first provided regular hospice volunteer service to 34 patients in the control group. Subsequently, foot massage and supportive communication were provided to 30 participants in the experimental group. After the intervention, all participants answered the structured questionnaire with visual analog scales on depression, anxiety, and mood including general characteristics. Data were analyzed using descriptive statistics, two sample t-test, and paired t-test by PASW 17. Results: After the intervention, changes in negative moods, i.e. strain and powerlessness in the experimental group were significantly different from those in control group; strain and powerlessness in the experimental group were significantly decreased by foot massage and supportive communication provided by hospice volunteers. Conclusion: The current findings provide an empirical evidence of a brief and efficacious intervention for cancer patients. Further studies are warranted with larger sample size to validate the effectiveness of foot massage and supportive communication as a solid intervention for cancer patients who are undergoing intravenous chemotherapy at OPD.

목적: 종합병원 외래 주사실에서 항암화학요법을 받는 암환자를 대상으로 발마사지와 지지적 의사소통 제공 후 우울, 불안, 긍정적 및 부정적 기분의 변화를 확인하기 위함이다. 방법: 비동등대조군 전후 시차 유사 실험설계로 연구의 대상은 원주시의 일 3차 종합병원 외래 주사실에 항암화학요법을 받는 암환자를 편의표집하여 대조군 34명 실험군 30명 총 64명이었다. 연구도구는 일반적 특성과 질병특성, 최근에 경험하는 신체적 증상 측정 문항, 그리고 각각 10 cm 시각상사척도를 이용하여 우울, 불안, 활기, 의욕, 희망, 긴장 및 무기력을 측정하였다. 결과: 제 1 가설인 '발마사지와 지지적 의사소통을 받은 실험군은 대조군보다 처치 후에 우울과 불안이 더 많이 감소될 것이다'는 처치 후 실험군에서 우울(t=5.26, P<0.001)과 불안(t=5.07, P<0.001)이 유의하게 감소되어 지지되었다. 제 2 가설인 '실험군은 대조군 보다 처치 후에 활기, 의욕 및 희망이 더 증가될 것이다'는 두 군에서 활기, 의욕 및 희망의 처치 전후의 변화를 비교한 결과 실험군에서 유의한 변화가 없어 기각되었다. 제 3 가설인 '실험군은 대조군보다 처치 후에 긴장과 무기력이 더 감소될 것이다'는 처치 후 두 군 모두에서 긴장과 무기력이 유의한 감소를 나타냈으므로, 중재 전후 변화의 정도에 차이가 있는지를 확인하기 위해 두 변수의 중재 전과 후의 차이값의 평균을 비교하였다. 검정결과 대조군에 비해 실험군에서 긴장(t=5.64, P<0.001)과 무기력(t=5.38, P<0.001)이 더 큰 감소를 보여 제 3 가설은 지지되었다. 결론: 본 연구의 결과는 외래 주사실에서 항암화학요법을 받는 동안 호스피스 자원봉사자가 제공한 발마사지와 지지적 의사소통이 암환자의 우울, 불안, 긴장, 무기력을 감소에 유용함을 제시하였다. 연구 결과의 타당성을 높이기 위해 대상자 수를 확대하고 좀 더 정련화된 중재의 개발과 효과검증을 위한 추후 연구가 필요하다.

Keywords

References

  1. The Central Cancer Registration Office of the Ministry for Health, Welfare, and Family Affairs. Annual report of national cancer registration: cancer rates in 2007, prevalence rate in 2007, cancer survival rates between 1993 and 2007. Seoul:The Central Cancer Registration Office of the Ministry for Health, Welfare, and Family Affairs;2009.
  2. Chung BY, Yu X, Lee EH. Symptom experience, mood disturbances, & social support in breast cancer patients undergoing radiotherapy. J Korean Oncol Nurs 2006;6:172-80.
  3. Park JS, Oh YJ. An analysis of cancer symptoms, perceived health status, and given nursing services for community dwelling cancer patients who are registered in a public health center. J Korean Oncol Nurs 2010;10:48-58.
  4. Hur HK, Lee EH, Lee WH, So HS, Chung BY, Kang ES. Symptom occurrence related to disease characteristics of adult patients with cancer. J Korean Acad Adult Nurs 2002;14(3): 411-7.
  5. Kim MY. Transition of symptoms and quality of life in cancer patients on chemotherapy. J Korean Acad Nurs 2009;39(3):433-45. https://doi.org/10.4040/jkan.2009.39.3.433
  6. Lee PS, Sohn JN, Lee YM, Park EY, Park JS. A correlational study among perceived stress, anger expression, and depression in cancer patients. J Korean Acad Nurs 2005;35(1):195-205. https://doi.org/10.4040/jkan.2005.35.1.195
  7. Kim HK, Ko SH. A study on the spiritual well-being, family support, and depression of hospitalized cancer patients. J Korean Acad Adult Nurs 2005;17(5):822-30.
  8. Massie MJ. Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr 2004;(32):57-71.
  9. Greer S. Psychological intervention. The gap between research and practice. Acta Oncol 2002;41(3):238-43. https://doi.org/10.1080/02841860260088773
  10. Oh PJ. The effects of spirituality/hope promoting programs on fighting spirit, helpless, anxiety, and self-care in people with cancer. J Korean Acad Adult Nurs 2008;20(1):65-76.
  11. Yi MS, Kim JH, Park EY, Kim JN, Yu ES. Focus group study on psychosocial distress of cancer patients. J Korean Acad Adults Nurs 2010;22(1):19-30.
  12. So HS, Lee JJ, Ahn SH, Lee SJ, Shim JY, Kim AS, et al. Effects of foot massage on the degree of nausea & vomiting, anxiety, sleep and fatigue of cancer patients undergoing chemotherapy. J Korean Oncol Nurs 2004;4(1):38-48.
  13. Hur HK, Song HY. Comparison of effects of perceived stress and coping patterns on depression between cancer patients and healthy adults. Korean J Hosp Palliat Care 2008;11(2):91-8.
  14. Won JS, Jeong IS, Kim JS, Kim KS. Effect of foot reflexology on vital signs, fatigue and mood in cancer patients receiving chemotherapy. J Korean Acad Fundam Nurs 2002;9(1):16-26.
  15. Sutherland JA, Reakes J, Bridges C. Foot acupressure and massage for patients with Alzheimer's disease and related dementias. J Nurs Scholarsh 1999;31(4):347-8. https://doi.org/10.1111/j.1547-5069.1999.tb00516.x
  16. Snyder M, Egan EC, Burns KR. Efficacy of hand massage in decreasing agitation behaviors associated with care activities in persons with dementia. Geriatr Nurs 1995;16(2):60-3. https://doi.org/10.1016/S0197-4572(05)80005-9
  17. Uhm DC. Effects of foot reflexo-massage on blood velocity of lower extremities, physical status and mood of elderly patients with knee osteoarthritis [dissertation]. Seoul: Seoul National Univ.; 2003. Korean.
  18. Norman L, Cowan T. The reflexology handbook: a complete guide. London:Piatkus;1989.
  19. Byers DC. Better health with foot reflexology. Saint Petersburg, Fla., U.S.A.:Ingham Pub.;1983.
  20. Han HH, Lee YJ, Chae YJ, Eun JS, Lee HH, Park JW. The effectiveness of foot -reflexo-massage on the postoperative pain of gastrectomy patients. Korean J Crit Care Med 2005;20(2):136-43.
  21. Chung BY, Choi EH. Effect of foot massage on anxiety and pain in mastectomy patients. J Korean Oncol Nurs 2007;7(1):47-55.
  22. Hwang KH, Choi ES, Yoo YS. Effects of foot reflexzone massage on state-anxiety and discomfort in ovarian cancer patients receiving chemotherapy. Korean J Women Health Nurs 2005; 11(3):209-17.
  23. Kim CJ, Hur HK, Kang DH, Kim BH. The effects of psychosocial interventions to improve stress and coping in patients with breast cancer. J Korean Acad Nurs 2006;36(1):169-78.
  24. Towers R. Providing psychological support for patients with cancer. Nurs Stand 2007;22(12):50-7; quiz 58.
  25. Lim SH, Roh SH. The effects on the personal characteristic of hospice volunteer the participation level of volunteer activities and durability. Korean J Soc Welf Stud 2009;40(3):125-48. https://doi.org/10.16999/kasws.2009.40.3.125
  26. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, N.J.:L. Erlbaum Associates;1988.
  27. Polit DF, Beck CT. Nursing research: generating and assessing evidence for nursing practice. 8th ed. Philadelphia:Wolters Kluwer Health/lippincott Williams & Wilkins;2008.
  28. McDowell I. Measuring health: a guide to rating scales and questionnaires. 3rd ed. Oxford[u.a.]:Oxford Univ. Press;2006.
  29. Suh SR, Lee WK. The effect of psychoeducational intervention for symptom management of home cancer patient. J Korean Oncol Nurs 2003;3(1):56-65.
  30. Ernst E. Massage therapy for cancer palliation and supportive care: a systematic review of randomised clinical trials. Support Care Cancer 2009;17(4):333-7. https://doi.org/10.1007/s00520-008-0569-z
  31. Wilkinson S, Barnes K, Storey L. Massage for symptom relief in patients with cancer: systematic review. J Adv Nurs 2008;63(5): 430-9. https://doi.org/10.1111/j.1365-2648.2008.04712.x
  32. Kim GM. Effect of foot reflexology on fatigue in cancer patients receiving chemotherapy [master's thesis]. Seoul: Yonsei Univ.; 2003. Korean.
  33. Ham KH, Lee JB, Kim BH, Kang JS, Oh YJ, Kwon EJ. et al. The effects of foot reflexology on anxiety, nausea and vomiting in patients with hepatocellular carcinoma chemotherapy: in focus transarterial chemoembolization. J Korean Clinl Nurs Res 2002; 8(2):147-67.
  34. Choi JY, So HS, Cho IS. Nausea/vomiting and anxiety of hospitalized cancer patients. J Korean Acad Adult Nurs 2004;16(2):211-21.
  35. Grealish L, Lomasney A, Whiteman B. Foot massage. A nursing intervention to modify the distressing symptoms of pain and nausea in patients hospitalized with cancer. Cancer Nurs 2000;23(3):237-43. https://doi.org/10.1097/00002820-200006000-00012