Journal of Digital Convergence (디지털융복합연구)

The Society of Digital Policy and Management (한국디지털정책학회)
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The relationship between of Uncertainty, Depression, Physiologic Index and Basic Psychological Need of Hemodialysis Patients

혈액투석환자의 질병 불확실성, 우울, 생리지표와 기본심리욕구와의 관계

  • 조영문 (동신대학교 한의과 대학 간호학과) ;
  • 윤경순 (동신대학교 한의과 대학 간호학과)
  • Received : 2017.07.13
  • Accepted : 2017.10.20
  • Published : 2017.10.28
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Abstract

This purpose of study was to identify variables predicting basic psychological need in hemodialysis patients. The participants were 134 patients from two major general hospitals and two dialysis center located in J city. Data were collected using self-report questionnaires and physiological index. Data analysis was done by using SPSS WIN 18.0 program for one-way ANOVA, independent t-test, Pearson correlation coefficients, and multiple regression. This study showed a negative correlation between basic psychological need and uncertainty(r=--.464, p<.001), depression(r=-.422, p<.001). In addition, relationships and physiological index were Positively correlated. The uncertainty(${\beta}=-.345$), depression(${\beta}=-.279$), physiological index(${\beta}=-.117$) have a 29% explanatory power for the basic psychological need in hemodialysis patients. Physiological index, uncertainty and depression in turn influenced the basic psychological needs of hemodialysis patients. It is necessary to develop nursing strategies and programs to reduce disease uncertainty and depression in order to increase self-deterministic health behavior through autonomy, competence and relationship satisfaction.

본 연구는 혈액투석환자의 질병 불확실성, 우울, 생리적 지표와 기본심리욕구 와의 관계성을 파악하기 위한 연구로 연구대상자는 J도에 위치한 2 개의 대학부속병원과 2곳의 병원 투석센터에서 160명을 편의 추출하였다. 자료 수집은 구조화된 질문지를 이용한 일대일 설문조사와 의무기록 자료를 통한 생리지표를 이용하여 수집하였다. 자료 분석은 SPSS/WIN 18.0프로그램으로 t-test와 ANOVA, 다중회귀분석 방법을 이용하였다. 연구결과 기본심리욕구는 불확실성 (r=-.464, p<.001)과 우울증 (r=-422, p<.001) 사이에 음의 상관관계가, 기본심리욕구의 하위 요인인 관계성은 질병불확실성, 우울, 생리지표와 음의 상관관계가 있었다. 또한 혈액투석환자의 기본심리욕구에 대하여 질병 불확실성(${\beta}=-.345$)과 우울(${\beta}=-.279$), 생리지표(${\beta}=-.117$)는 29%의 설명력을 보였다. 생리지표, 질병 불확실성 및 우울증은 혈액 투석 환자의 기본심리욕구에 영향을 주었습니다. 따라서 혈액투석환자의 불확실성을 인생관에 긍정적으로 통합시켜 삶을 재설정하고자 하는 심리적 지지와 자율성, 유능감, 관계성의 기본심리욕구 증진을 위한 간호전략과 프로그램 개발이 필요하다.

Keywords

References

  1. Deci, E. L., Ryan, R. M., "Self-determination theory: A macrotheory of human motivation development and health", Canadian Psychology, Vol. 49, No. 3, pp. 182-185, 2008. http://dx.doi.org/10.1037/a0012801.
  2. Fortier M. S., Williams, G. C., Sweet, S. N., Patrick, H., "Self-determination theory: Process models for health behavior change". in DiClemente, R. J., Crosby, R. A., Kegler, M. C., editors., "Emerging theories in health promotion practice and research", San Francisco, CA, Jossey-Bass., pp. 157-183, 2009.
  3. Russell, K. L., Bray, S. R., "Promoting self-determined motivation for exercise in cardiac rehabilitation: The role of autonomy support", Rehabilitation Psychology, Vol. 55, No. 1, pp. 74-84, 2010. http://dx.doi.org/10.1037/a0018416.
  4. Y. M. Seo, W. H. Choi, "A predictive model on self care behavior for patients with type 2 diabetes: Based on self-determination theory", Journal of Korean Academic of Nursing, Vol. 41, No. 4, pp. 491-499, 2011. http://dx.doi.org/10.4040/j.kan.2011.41.4.491.
  5. Zoffmann, V., Lauritzen, T., "Guided self-determination improves life skills with type 1 diabetes and AIC in randomized controlled trial", Patient Education and Counseling, Vol. 64, pp. 78-86, 2006. http://dx.doi.org/10.1016/j.pec.2005.11.017.
  6. Y. H. Seo, S. O. Lim, E. H. Hyeon, H. W. Kim, M. R. Eom, "Factors influencing medication adherence in hemodialysis patients: focusing on primary and secondary medical care", Perspectives in Nursing Science, Vol. 12, No. 1, pp. 60-70, 2015. http://dx.doi.org/10.16952/pns.2015.12.1.60.
  7. Kennedy, S., Goggin, K., Nollen, N., "Adherence to HIV medications: utility of the theory of selfdetermination", Cognitive Therapy and Research, Vol. 28, pp. 611-628, 2004. http://dx.doi.org/10.1023/B:COTR.0000045568.95219.e2
  8. Y. J. Kim, H. J. Choi, "The influence of uncertainty and social support on general well-being among hemodialysis patients", Korean Academic Society of Rehabilitation Nursing, Vol. 15, No. 1, pp. 20-29, 2012. http://dx.doi.org/10.7587/kjrehn.2012.20.
  9. Y. M. Cho, "A structural analysis for psycho-social variables related to sick role behavioral compliance in hemodialysis patients", Korean Journal of Adult Nursing, Vol. 28, No. 4, pp. 415-423, 2016. http://dx.doi.org/10.7475/kjan.2016.28.4.415.
  10. The Korean Society of Nephrology, "ESRD Registry Committee, Korean Society of Nephrology, Retrieved from: http://www.ksn.or.kr/rang_board/list.html?code=sinchart. (2016. Octobe. 15.)
  11. National Kidney Foundation, "K/DOQI clinical practice guideline for vhronic kidney disease: Evaluation classification, and stratification", American Journal of Kidney Diseases, Vol. 39, No. 2, pp. 261-266, 2002.
  12. J. Hur, "The development of hemodiafiltration treatment compliance indicators and discriminant standards, development of hemodiafiltration treatment compliance measurement-convergent form(HDFTCM-CF): Focused on online hemodiafiltration", Journal of Digital Convergence, Vol. 13, No. 7, pp. 269-282, 2015. http://dx.doi.org/10.14400/JDC.2015.13.7.269.
  13. Young-Su Jung, "The relationships among basic psychological needs, sensation seeking, flow, and exercise addiction of leisure sports participants", PhD. dissertation, Sungkyunkwan University, 2010.
  14. Ryan, R. M., Deci, E. L. "Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being", American Psychologist, Vol. 55, pp. 68-78, 2000. https://doi.org/10.1037/0003-066X.55.1.68
  15. Y. M. Cho, K. W. Sung, "The association of compliance with sick role behavior with satisfaction of basic psychological needs among hemodialysis patients", Korean Journal of Health Promotion, Vol. 12, No. 1, pp. 58-65, 2012.
  16. Mishe, M. H., "The measurement of uncertainty in illness", Nursing Reserach, Vol. 30, No. 5, pp. 258-263, 1981.
  17. Y. S. Kim, Y. S. Tae, "The influencing factors on quality of life among breast cancer survivors", Journal of Korean Oncol Nurs, Vol. 11, No. 3, pp. 221-228, 2011. http://dx.doi.org/10.5388/jkon.2011.11.3.221.
  18. M. K. Ree, Y. H. Lee, S. H. Park, C. H. Sohn, Y. C. Chung, S. K. Hong, et al, "A standardization study of beck depression inventory I-korean version(K-BDI): Reliablity andfactor analysis", The Korean Society for Psychopathology and Psychiatric Classification, Vol. 4, No. 1, pp. 77-95, 1995.
  19. S. J. Kim, M. K. Jung, "The mediation role of basic psychological needs satisfaction between adult attachment and psychological distress of middle-aged women", Korean Journal of Educational Gerontology, Vol. 1, No. 2, pp. 83-104, 2015.
  20. M. Y. Chon, S. A. Kang, "The effect of uncertainty, family support and self-efficacy on health -related quality of life among patient with diabetic foot diseases at home", The Korean Society of Living Environmental System, Vol. 21, No. 2, pp. 260-271, 2014. https://doi.org/10.21086/ksles.2014.04.21.2.260
  21. J. A. Kim, M. K. Lee, "Mediating effect of basic psychological need satisfaction on the relationship between self concealment and maladaptive perfectionism and psychological health", Korean journal of health psychology, Vol. 19, No. 4, pp. 1063-1089, 2014. https://doi.org/10.17315/kjhp.2014.19.4.010
  22. Germino, B. B., Mishel, M. H., Crandell, J., Porter, L., Blyler, D., Jenerette, C., et al, "Outcomes of an uncertainty management intervention in younger african american and caucasian breast cancer survivors", Oncology Nursing Forum, Vol. 40, No. 1, pp. 82-92, 2013. http://dx.doi.org/10.1188/13.onf.82-92.
  23. Y. J. Kim, H, J. Choi, "The influence of uncertainty and social support on general well-being among hemodialysis patients", Korean Academic Society of Rehabilitation Nursing, Vol. 15, No. 1, pp. 20-29, 2012. http://dx.doi.org/10.7587/kjrehn.2012.20.
  24. S. J. Yun, Y. H. Lee, "Factors influencing uncertainty in dialysis patient by duration of dialysis", The Journal of Korean Academic Society of Adult Nursing, Vol. 24, No. 6, pp. 597-606, 2012. http://dx.doi.org/10.7475/kjan.2012.24.6.597.
  25. Zuroff, D. C., Koestner, D. S., Moskowiz, D. S., Mcbride, C., Marshall, M., Bagby, R. M., "Autonomous motivation for therapy: a new common factor in brief treatments for depression", Psychotberapy Research, Vol. 17, No. 2, pp. 137-147, 2007. http://dx.doi.org/10.1080/10503300600919380.
  26. S. S. Kim, "The structural relationship among basic psychological needs, life goals, psychological wellbeing, & depression", The Korean Journal of Educational Psychology, Vol. 29 No. 1, pp. 1-25, 2015. http://dx.doi.org/10.17286/KJEP.2015.29.1.01.
  27. H. W. Kim, J. H. Kim, D. J. Kim, D. S. Lee, "Depression of continuous ambulatory peritoneal dialysis patient: In relation with stress, hopelessness, negative coping", The Korean Journal of Clinical Psychology, Vol. 21 No. 3 pp. 581-593, 2002.
  28. Moon-Sum Ha, "The relationship between gender role conflict and aggression mediated by autonomy, relatedness and depression for young adolescent", PhD. dissertation, Hongik University, 2013.
  29. S. H. Cho, G. S. Jeon, "Uncertainty, self-care agency and physiological index in acute myocardial infarction patient who uneerwent primary percutaneous coronary intervention", The korean Journal of Health Service management, Vol. 9, No. 4, pp. 1705-1717, 2015. http://dx.doi.org/10.12811/kjshsm.2015.9.4.105.
  30. H. K. Kim, M. N. Choi, S. S. Kim, S. I. Kim, "Self-care, social support, and biological markers in liver transplant recipients", Korean Journal of Adult Nursing, Vol. 27, No. 2 pp. 170-179, 2015. http://dx.doi.org/10.7475/kjan.2015.27.2.170.
  31. Y. J. Kim, H. J. Choi, "The influence of uncertainty and social support on general well-being among hemodialysis patients", Korean Academic Society of Rehabilitation Nursing, Vol. 15, No. 1, pp. 20-29, 2012. http://dx.doi.org/ 10.7587/kjrehn.2012.20