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관상동맥우회술 대상자의 건강관련 삶의 질 영향요인

Factors Influencing Health-related Quality of Life in Patients with Coronary Artery Bypass Graft

  • 김지영 (이화여자대학교 간호대학)
  • 투고 : 2016.03.07
  • 심사 : 2016.05.12
  • 발행 : 2016.05.31

초록

본 논문은 관상동맥우회술 대상자의 사회적지지, 우울, 건강관련 삶의 질의 관계를 규명하고자 하였다. 서울시 S 상급종합병원에서 관상동맥우회술을 받고 외래에 내원한 환자 134명을 대상으로 설문지를 이용하여 자료 수집하였고, SPSS WIN 21을 이용하여 통계 분석하였다. 신체적 건강관련 삶의 질은 연령(F=4.616, p=.004), 성별(t=3.657, p<.001), 교육정도(F=7.688, p=.001), 직업(t=-4.363, p<.001), 배우자(t=-3.065, p=.003), 기저질환(F=3.078, p=.030)에 따라 유의한 차이를 보였다. 정신적 건강관련 삶의 질은 성별(t=2.243, p=.027), 월수입(F=2.821, p=.041)에 따라 유의한 차이를 보였다. 사회적지지는 우울(r=-.415, p<001)과 통계적으로 유의한 부적 상관관계가 있었으며, 정신적 건강관련 삶의 질(r=.261, p=.002)과 유의한 정적 상관관계가 있는 것으로 나타났다. 우울은 신체적 건강관련 삶의 질(r=-.459, p<.001), 정신적 건강관련 삶의 질(r=-.554, p<.001)과 각각 통계적으로 유의한 부적 상관관계가 있었다. 관상동맥질환자의 신체적 건강관련 삶의 질 영향요인은 우울, 기저질환이었고, 설명력은 36.7%이었으며, 정신적 건강관련 삶의 질 영향요인은 우울이었고, 설명력은 34.1%이었다. 관상동맥우회술 후 최적의 건강관련 삶의 질을 위해 우울을 주요 요인으로 하는 표준화된 간호 중재를 개발할 필요가 있다.

The purpose of this study was to determine the relationships among the social support, depression, and health-related quality of life and the factors affecting the health-related quality of life in patients with coronary artery bypass graft (CABG). The subjects consisted of 134 patients who had received CABG from S general hospitals in Seoul, Korea, and the results were analyzed using the SPSS Win 21.0 program. The physical component summary (PCS) was significantly different depending on the age (F=4.616, p=.004), gender (t=3.657, p<.001), education (F=7.688, p=.001), current job (t=-4.363, p<.001), spouse (t=-3.065, p=.003), and underlying disease (F=3.078, p=.030) of the subjects. There were differences in the scores for the mental component summary (MCS) according to their gender (t=2.243, p=.027) and monthly income (F=2.821, p=.041). A significant negative correlation was found between social support and depression (r=-.415, p<.001). Social support had a statistically significant positive correlation with the MCS (r=.261, p=.002). Significant negative correlations were found between depression and the PCS (r=-.459, p<.001) and MCS (r=-.554, p<.001). The depression and underlying disease accounted for 36.7% of the variance in the PCS. The depression accounted for 34.1% of the variance in the MCS. Based on these results, nurses should develop nursing intervention programs for patients who have undergone CABG which take into consideration their depression.

키워드

참고문헌

  1. Health Insurance Review & Assessment Service, "Acute myocardial infarction evaluation results", [cited 2015, January 2]. Available from: http://www.hira.or.kr/dummy.do?pgmid=HIRAA020041000000&cmsurl/cms/notice/02/1322009_24959.html
  2. D. Mozaffarian, E. J. Benjamin, A. S. Go, D. K. Arnett, M. J. Blaha, M. Cushman, et al. "Heart disease and stroke statistics-2016 update: A report from the American heart association", Circulation, Vol. 131, No. 4, pp. e29-e322, 2015. DOI: http://dx.doi.org/10.1161/CIR.0000000000000152
  3. L. H. McKenzie, J. Simpson, M. Stewart, "A systematic review of pre-operative predictors of post-operative depression and anxiety in individuals who have undergone coronary artery bypass graft surgery", Psychology, Health & Medicine, Vol. 15, No. 1, pp. 74-93, 2010. DOI: http://dx.doi.org/10.1080/13548500903483486
  4. D. J. Treat-Jacobson, R. Lindquist, "Exercise, quality of life, and symptoms in men and women five to six years after coronary artery bypass graft surgery", Heart & Lung, Vol. 36, No. 6, p. 387-397, 2007. DOI: http://dx.doi.org/10.1016/j.hrtlng.2007.01.002
  5. Korea Heart Foundation, "Cardiovascular surgery 2014", [cited 2015, November 12]. Available from: http://www.heart.or.kr/
  6. J. E. Ware, M. Kosinski, S. D. Keller, "A 12-item short form health survey: Construction of scales and preliminary tests of reliability and validity", Medical Care, Vol. 34, No. 3, pp. 220-233, 1996. DOI: http://dx.doi.org/10.1097/00005650-199603000-00003
  7. A. D. Auerbach, J. F. Hilton, J. Maselli, P. S. Pekow, M. B. Rothberg, P. K. Lindenauer, "Shop for quality or volume? volume, quality, and outcomes of coronary artery bypass surgery", Annals of Internal Medicine, Vol. 150, No. 10, pp. 696-704, 2009. DOI: http://dx.doi.org/10.7326/0003-4819-150-10-200905190-00007
  8. H. H. Tung, A. Hunter, J. Wei, "Coping, anxiety and quality of life after coronary artery bypass graft surgery", Journal of Advanced Nursing, Vol. 62, No. 2, pp. 651-663, 2008. DOI: http://dx.doi.org/10.1111/j.1365-2648.2007.04557.x
  9. L. J. Krzych, A. Woznica, A. Pawlak, J. Skarysz, Z. Eysymontt, B. Chromanska-Matera, et al. "Quality of life in young, professionally active men undergoing on-pump coronary artery bypass grafting-short-term follow-up results", Kardiologia Polska, Vol. 67, No. 10, pp. 1078-1085, 2009. DOI: http://dx.doi.org/10.1016/S0924-977X(09)70506-1
  10. Y. S. Song, J. S. Lee, "A comparison of quality of life between patients with 12 months after coronary artery bypass graft surgery and general population", Journal of Korean Clinical Nursing Research, Vol. 14, No. 1, pp. 25-32, 2008.
  11. L. C. Gallo, M. J. Malek, A. D. Gilbertson, J. L. Moore, "Perceived cognitive function and emotional distress following coronary artery bypass surgery", Journal of Behavioral Medicine, Vol. 28, No. 5, pp. 433-442, 2005. DOI: http://dx.doi.org/10.1007/s10865-005-9010-y
  12. W. Wang, Y. Lau, A. Chow, D. R. Thompson, H. G. He, "Health-related quality of life and social support among Chinese patients with coronary heart disease in mainland China", European Journal of Cardiovascular Nursing, Vol. 13, No.1, pp. 48-54, 2014. DOI: http://dx.doi.org/10.1177/1474515113476995
  13. E. C. Leifheit-Limson, K. J. Reid, S. V. Kasl, H. Lin, P. G. Jones, D. M. Buchanan, et al. "The role of social support in health status and depressive symptoms after acute myocardial infarction evidence for a stronger relationship among women", Circulation, Vol. 3, No. 2, pp. 143-150, 2010. DOI: http://dx.doi.org/10.1161/circoutcomes.109.899815
  14. G. A. Lee, "Determinants of quality of life five years after coronary artery bypass graft surgery", Heart & Lung, Vol. 38, No. 2, pp. 91-99, 2009. DOI: http://dx.doi.org/10.1016/j.hrtlng.2008.04.003
  15. I. I. Failde, M. M. Soto, "Changes in health related quality of life 3 months after an acute coronary syndrome", BMC Public Health, Vol. 6, pp. 18-22, 2006. DOI: http://dx.doi.org/10.1186/1471-2458-6-18
  16. M. Staniute, J. Brozaitiene, "Changes in health-related quality of life among patients with coronary artery disease: A 2-year follow-up", Medicina (Kaunas, Lithuania), Vol. 46, No. 12, pp. 843-850, 2010. DOI: http://dx.doi.org/10.1007/s11482-010-9130-6
  17. J. Kim, "A comparison of social support, depression, and qualify of life in adults and elders who have undergone coronary artery bypass surgery", Journal of Korean Gerontological Nursing, Vol. 16, No. 3, pp. 210-219, 2014. DOI: http://dx.doi.org/10.17079/jkgn.2014.16.3.210
  18. The ENRICHD Investigators, "Enhancing recovery in coronary heart disease patients (ENRICHD): Study design and methods", American Heart Journal, Vol. 139, No. 1, pp. 1-9, 2000. DOI: http://dx.doi.org/10.1067/mhj.2000.101778
  19. N. Y. Shin, "The relationships among health locus of control and resilience, social support and health promoting behavior in patients with coronary artery disease", Unpublished master's thesis, Ewha Womans University, 2011.
  20. L. S. Radloff, "The CES-D scale: A self-report depression scale for research in the general population", Applied Psychological Measurement, Vol. 1, No. 3, pp. 385-401, 1977. DOI: http://dx.doi.org/10.1177/014662167700100306
  21. K. K. Chon, M. K. Rhee, "Preliminary development of Korean version of CES-D", Korean Journal of Clinical Psychology, Vol. 11, No. 1, pp. 65-76, 1992.
  22. S. Sendelbach, R. Lindquist, S. Watanuki, K. Savik, "Correlates of neurocognitive function of patients after off-pump coronary artery bypass surgery", American Journal of Critical Care, Vol. 15, No. 3, pp. 290-298, 2006.
  23. C. Kaiser, R. Jeger, S. Wyrsch, L. Schoeb, G. M. Kuster, P. Buser, et al. "Selection bias of elderly patients with chronic angina referred for catheterization", International Journal of Cardiology, Vol. 110, No. 1, pp. 80-85, 2006. DOI: http://dx.doi.org/10.1016/j.ijcard.2005.07.024
  24. C. Harries, D. Forrest, N. Harvey, A. McClelland, A. Bowling, "Which doctors are influenced by a patient's age? A multi-method study of angina treatment in general practice, cardiology and gerontology", Quality and Safety in Health Care, Vol. 16, No. 1, pp. 23-27, 2007. DOI: http://dx.doi.org/10.1136/qshc.2006.018036
  25. M. M. Burg, J. Barefoot, L. Berkman, D. J. Catellier, S.Czajkowski, P. Saab, et al. "Low perceived socialsupport and post-myocardial infarction prognosis in theenhancing recovery in coronary heart disease clinicaltrial: the effects of treatment", Psychosomatic Medicine,Vol. 67, No. 6, pp. 879-888, 2005. DOI: http://dx.doi.org/10.1097/01.psy.0000188480.61949.8c
  26. E. Okkonen, H. Vanhanen, "Family support, livingalone, and subjective health of a patient in connectionwith a coronary artery bypass surgery", Heart &Lung:The Journal of Acute and Critical Care, Vol. 35, No. 4,pp. 234-244, 2006. DOI: http://dx.doi.org/10.1016/j.hrtlng.2005.11.002
  27. S. J. Shin, "Health locus of control and compliance oftreatment in acute coronary syndrome patients afterpercutaneous coronary intervention", Korean Journal ofAdult Nursing, Vol. 20, No. 6, pp. 829-838, 2008.
  28. P. J. Bradshaw, K. D. Jamrozik, I. S. Gilfillan, P. L.Thompson, "Asymptomatic long-term survivors ofcoronary artery bypass surgery enjoy a quality of lifeequal to the general population", American HeartJournal, Vol. 151, No. 2, pp. 537-544, 2006.DOI: http://dx.doi.org/10.1016/j.ahj.2005.04.007
  29. B. L. Rollman, B. H. Belnap, M. S. LeMenager, S.Mazumdar, H. C. Schulberg, C. F. Reynolds, "TheBypassing the Blues Treatment protocol: Steppedcollaborative care for treating post-CABG depression",Psychosomatic Medicine, Vol. 71, No. 2, pp. 217-230,2009.DOI: http://dx.doi.org/10.1097/PSY.0b013e3181970c1c
  30. S. W. Park, K. Y. Bae, S. Y. Kim, J. A. Yoo, S. J.Yang, S. W. Kim, et al. "Predictors of depression afteracute coronary artery syndrome", Journal of the KoreanSociety of Biological Therapies in Psychiatry, Vol. 15,No. 2, 155-173, 2009.
  31. G. Khoueiry, M. Flory, N. A. Rafeh, M. H. Zgheib, M.Goldman, T. Abdallah, et al. "Depression, disability, andquality of life after off-pump coronary artery bypassgrafting: A prospective 9-month follow-up study", Heart& Lung, Vol. 40, No. 3, pp. 217-225, 2011.DOI: http://dx.doi.org/10.1016/j.hrtlng.2010.03.001