디지털융복합연구 (Journal of Digital Convergence)

  • 제13권2호
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  • Pages.237-244
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  • 2015
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  • 2713-6434(pISSN)
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  • 2713-6442(eISSN)
한국디지털정책학회 (The Society of Digital Policy and Management)
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뇌졸중 후 정신건강이 삶의 질에 미치는 영향

The Effects of Mental Health on the Quality of Life After Stroke

  • 김형민 (대구대학교 대학원 재활과학과 작업치료 전공) ;
  • 심민규 (대구대학교 대학원 재활과학과 작업치료 전공)
  • Kim, Hyeong-Min (Dept. of Rehabilitation Science, The Graduate School of Daegu University) ;
  • Shim, Min-Kyu (Dept. of Rehabilitation Science, The Graduate School of Daegu University)
  • 투고 : 2014.11.20
  • 심사 : 2015.02.20
  • 발행 : 2015.02.28
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초록

본 연구는 뇌졸중 환자의 정신건강과 삶의 질 간의 상관성을 파악하고 정신건강이 삶의 질에 미치는 영향을 알아보고자 하였다. 뇌졸중으로 진단받은 224명을 대상으로 삶의 질의 측정을 위해 뇌졸중 환자 삶의 질 평가도구(Stroke Specific Quality of Life: SS-QOL), 정신건강은 간이정신진단검사(Symptom Check-List-90-Revised: SCL-90-R)를 사용하였다. 정신건강과 삶의 질 간의 상관성을 알아보기 위해 피어슨 상관관계를 이용하였고, 정신건강이 삶의 질에 미치는 영향을 확인하기 위해 단순 회기분석과 하위 요인들을 알아보기 위해 단계적 다중 회귀분석을 실시하였다. 정신건강과 삶의 질은 통계적으로 유의한 상관성을 보였으며, 정신건강이 삶의 질 변화에 영향을 미치는 유의한 요인으로 $R^2$ 0.28로 28%의 설명력을 보였으며, 하위영역 중 우울은 $R^2$ 0.42로 42%의 설명력을 보였다. 뇌졸중 환자에서 우울이 낮을수록 환자의 삶의 질이 높아지는 것을 알 수 있었다. 그러므로 뇌졸중 환자의 삶의 질을 향상시키기 위해 재활 초기부터 정신건강 요인을 포함한 전인적 접근과 중재에 초점을 두어야 할 것이다.

The purposes of this study are to examine the correlations among mental health and quality of life in stroke patients and find the factors affecting quality of life. The participants were 224 inpatients diagnosed with stroke. The Stroke Specific Quality of Life(SS-QOL) was used for measuring Quality of life and the Symptom Check-List-90-Revised(SCL-90-R) was utilized to measure mental health. The relationships among the variables were examined with Pearson correlation coefficients. And the simple regression analysis and stepwise multiple regression analysis were performed to identify the predictive variables that explain changes of quality of life. There were statistically significant correlations between quality of life and mental health. Mental health was identified as a factor that explains 28% of change in quality of life. And depression was identified as a factor that explains 42% of change in quality of life. The quality of life in stroke patients, the depression was negatively related with it. When working with a stroke patient, an occupational therapist needs to address mental health aspects from the beginning of the rehabilitation process for a holistic approach and optimal outcome.

키워드

참고문헌

  1. WHOQOL. Study protocol for the world health organization project to develop a quality of life assessment instrument. quality of life research, Vol. 2, pp. 153-159, 1993. https://doi.org/10.1007/BF00435734
  2. S. Y. Han, Quality of Life and Intrinsic Motivation. Korean Journal of Psychology, Vol. 2, No.1, pp. 95-111, 1995.
  3. R. Dubos, The State of Health and The Quality of life. The Western Journal of Medicine, Vol. 125, No.1, pp. 8-9, 1976.
  4. H. S. Kim, Y. O. Hwang, J. H. Yu, J. H. Jung, H. S. Woo, H. S. Jung, The Correlation Between Depression, Motivation for Rehabilitation, Activities of Daily Living, and Quality of Life in Stroke Patients. The Journal of Korean Society of Occupational Therapy, Vol. 17, No. 3, 2009.
  5. C. S. Kwon, Factors Related to the Activities of Daily Living and Pain, Depression and Quality of Life of Patients With Chronic Stroke. Kor J Neural Rehabil, Vol. 4, No. 1, pp. 21-29, 2014.
  6. Jung-In Moon, A study on the factors affecting stroke quality of life; using the stroke-specific quality of life(SS-QOL). master's. dissertation, Daegu University. 2003.
  7. J. Adamson, A Beswick, S. Ebrahim, Is stroke the most common cause of disability. Journal of Stroke and Cerebrovascular Disease, Vol. 13, No. 4, pp. 171-177, 2004. https://doi.org/10.1016/j.jstrokecerebrovasdis.2004.06.003
  8. M. V. Radomski, C. A. Trombly-Latham, Occupational therapy for physical dysfunction. PA: Lippincott Williams & Wilkins, 2007.
  9. Y. M. Soung, J. H. Lee, Factors in Post Stroke Depression of Stroke Patients Hospitalized in University Medical Centers. J Korean Gerontol Nurs, Vol. 15, No. 2, pp. 85-94, 2013.
  10. E. M. Oh, G. R. Hong, Factors Predicting Quality of Life among Older Adults in Rehabilitation Hospitals after Stroke. J Korean Gerontol Nurs, Vol. 16, No. 2, pp. 107-117, 2014. https://doi.org/10.17079/jkgn.2014.16.2.107
  11. A. S. Darlington, D. W. Dippel, G. M. Ribbers, R. Balen, J. Passchier, J. J. Busschbach, Coping strategies as determinants of quality of life in stroke patients: A longitudinal study. Cerebrovascular Diseases, Vol. 23, No. 5-6, pp. 401-407, 2007. https://doi.org/10.1159/000101463
  12. J. Y. Park, The Effect of Aerobic and Resistance Training on Self-esteem and Mental Health in Chronic Stroke Patients. The Korea Journal of Sports Science, Vol. 16, no. 3. pp. 205-217, 2007.
  13. A. Beattie, M. Gott, L. Jones, M. Sidell, Health and wellbeing: a reader. Macmillan, Basingstoke. 1993.
  14. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, D.C.: Author. 1994.
  15. www.kostsat.go.kr. 2011.
  16. M. L. Niemi, R. Laaksonen, M. Kotila, O. Waltimo, Quality of life four years after stroke. Stroke, Vol. 19, pp. 1101-1107, 1988. https://doi.org/10.1161/01.STR.19.9.1101
  17. UK700 Group, Predictors of quality of life in people with severe mental illness. British Journal of Psychiatry, Vol. 175, pp. 426-432, 1999. https://doi.org/10.1192/bjp.175.5.426
  18. Y. D. Kwon, H. Chang, Y. J. Choi, S. S. Yoon, Nationwide trends in stroke hospitalization over the past decade. Journal of the Korean Medical Association, Vol. 55, No. 10, pp. 1014-1025, 2012. https://doi.org/10.5124/jkma.2012.55.10.1014
  19. Jung-Bin Yang, A Study on the disease-related, psyvhosocial and evironmental factors affecting health-related quality of life of elderly stroke survivors. Ph.D. dissertation, Sungkyunkwan University. 2009.
  20. M. Astrom, R, Adolfsson, K. Asplund, Major depression in stroke patients: A 3-year longitudinal study. Stroke, Vol. 24, pp. 976-982, 1993. https://doi.org/10.1161/01.STR.24.7.976
  21. F. Khan, Poststroke depression. Clinical Practice, Vol. 33, No. 10, pp. 831-834, 2004.
  22. E. M. Whyte, B. H. Mulsant, Post stroke depression: Epidemiology, pathophysiology, and biological treatment. Biological Psychiatry, Vol. 52, pp. 253-264, 2002. https://doi.org/10.1016/S0006-3223(02)01424-5
  23. I. S. Park, D. Y. Kim, C. Y. Kang, The relationship of Dysfunctions Degree, Daily Living Activity, Depressiveness and Qualiry of Life among the Elderly Suffering from Stroke. The Korean Journal of Health Service Management, Vol. 5, No. 2, pp. 173-186, 2011. https://doi.org/10.12811/kshsm.2011.5.2.173
  24. J. H. Kim, H. S. Kang, W. O. Kim, M. J. Wang, C. M. Chang, Factors Affecting the Quality of Life Stroke Patient at Home. Korean J Rehabil Nurs, Vol. 9, No. 1, pp. 49-55, 2006.
  25. B. H. Cho, M. H. Ko, S. Y. Kim, A Study on stroke patient's ADL, depression, self-efficacy and quality of life. The Korean Journal of Rehabilitation Nursing, Vol. 6, No. 1, pp. 51-60, 2003.
  26. S. W. Linda, W. Morris, E. H. Lisa, O. C. Daniel, B. Jose, Development of a stroke-specific quality of life scale. Stroke, Vol. 30, pp. 1362-1369, 1999. https://doi.org/10.1161/01.STR.30.7.1362
  27. K. I. Kim, H. T. Won, J. H. Lee, K. Y. Kim, Standardization study of symptom check list-90 in korea. Journal of the Korean Neuropsychiatric Association, Vol. 17, No. 4, pp. 449-458, 1978.
  28. So-Yeon Jeon, A story of the SCL-90-R and the color preference on the Sasang physical constitution. master's. dissertation, Konkuk University. 2012.
  29. Sun-Ock Lim, A structural model for quality of life in stroke patients. Ph.D. dissertation, Kyung Hee University. 2002.
  30. World Health Organization, The world health organization quality of life assessment: position paper from the world health organization. Social Science & Medicine, Vol. 41 No.10, pp. 1403-1409, 1995. https://doi.org/10.1016/0277-9536(95)00112-K
  31. S. D. Yoo, M. H. Chun, S. B. Ryun, Relationship between the severity of poststroke depression(PSD) and cognitive function in the patients with stroke. Korean Academy of Rehabilitation Medicine, Vol. 33, pp. 527-532, 2009.
  32. Y. H. Han, A. J. Lim, S. R. Kim, J. Y. Kim, K. Y. Kam, The effect of changes in post-stroke depression on cognition and upper extremity recovery. The Journal of Korean Society of Occupational Therapy, Vol. 19, No. 2, pp. 39-51, 2011.
  33. R. B. King, Quality of life after stroke. Stroke, Vol. 27, 1467-1472, 1996. https://doi.org/10.1161/01.STR.27.9.1467
  34. K. Hafen, J. Jastrebow, R. Nubling, J. Bengel, Development a patient questionnaire for assessment a motivation for rehabilitation(PAREMO). Rehabilitation, Vol. 40, No. 1, pp. 3-11, 2001. https://doi.org/10.1055/s-2001-12136
  35. E. J. Chung, B. H. Lee, A Comparison of balance, activities of daily living and quality of life in stroke parients with depression and those without depression. Korean Journal of Exercise Rehabilitation, Vol. 8, No. 3, pp. 61-69, 2012.
  36. F. J. Carod-Artal, Determining quality of life in stroke survivors. Expert Review of Pharmacoeconomics & Outcomes Research, Vol. 12, No. 2, pp. 199-211, 2012. https://doi.org/10.1586/erp.11.104
  37. F. J. Carod-Artal, J. A. Egido, Quality of life after stroke : The importance of a good recovery. Cerebrovascular Diseases, Vol. 27, No. 1, pp. 204-214, 2009.
  38. Eun-Mi Oh, The relationship of perceived health status, daily living activities, depression and quality of life among elderly suffering from stroke. master's. dissertation, Hanyang University. 2010.

피인용 문헌

  1. A Study about the Quality of Life and QALYs of Stroke Patients according to the Medical Care Utilization Behavior: Findings from the 2009–2012 Korea Health Panel Data vol.37, pp.1, 2016, https://doi.org/10.13048/jkm.16005