DOI QR코드

DOI QR Code

Posttraumatic Growth in Cancer Survivors: The Application of Double ABCX Family Stress Model

암 생존자의 외상 후 성장 영향요인: Double ABCX 가족스트레스 모델의 적용

  • Lim, Soo-Youb (Department of Nursing, Chungbuk Health & Science University) ;
  • Kim, Yeong-Hee (Department of Child Welfare, Chungbuk National University)
  • 임수업 (충북보건과학대학교 간호학과) ;
  • 김영희 (충북대학교 아동복지학과)
  • Received : 2020.08.20
  • Accepted : 2020.10.20
  • Published : 2020.10.28

Abstract

This study aimed to explore the effects of perceived family stress, supportive resources, intentional rumination, and coping behaviors on posttraumatic growth of cancer survivors based on the Double ABCX Family Stress Model. Data were collected from 200 cancer survivors currently living with their spouses and analyzed by path analysis using AMOS program. The results of this study were as follows. First, perceived family stress of cancer survivors had direct effects on supportive resources, intentional rumination, and coping behaviors, and had indirect effects on posttraumatic growth mediated by supportive resources, intentional rumination, and coping behaviors. Second, supportive resources, intentional rumination, and coping behaviors had direct effects on posttraumatic growth. Third, supportive resources and intentional rumination had direct effects on coping behaviors and had an indirect effect on posttraumatic growth mediated by coping behaviors. The current study supported the applicability of the Double ABCX Family Stress Model to the posttraumatic growth process of cancer survivors.

본 연구는 Double ABCX 가족스트레스 모델을 기반으로 암 생존자가 지각한 가족스트레스, 지지자원, 의도적 반추, 대처행동이 외상 후 성장에 어떠한 영향을 미치는지를 살펴보고자 하였다. 연구대상은 배우자와 함께 살고 있는 암 생존자 200명을 대상으로 설문조사를 실시하였고 응답한 자료는 AMOS 프로그램을 이용하여 경로분석을 실시하였다. 분석 결과 첫째, 암 생존자가 지각한 가족스트레스는 지지자원, 의도적 반추, 대처행동에 직접적인 영향을 미치고, 지지자원, 의도적 반추, 대처행동을 통해 외상 후 성장에 간접적인 영향을 미치는 것으로 나타났다. 둘째, 지지자원, 의도적 반추, 대처행동은 외상 후 성장에 직접적인 영향을 미치는 것으로 나타났다. 셋째, 지지자원과 의도적 반추는 대처행동에 직접적인 영향을 미칠 뿐 아니라 대처행동을 통해 외상 후 성장에 간접적인 영향을 미치는 것으로 나타났다. 본 연구의 결과는 암 생존자의 외상 후 성장을 예측하는데 Double ABCX 가족스트레스 모델이 적용될 수 있음을 입증해 주었다.

Keywords

References

  1. J. Ahn et al. (2007). Adiposity, adult weight change, and postmenopausal breast cancer risk. Archives of Internal Medicine, 167(19), 2091-2102. DOI : 10.1001/archinte.167.19.2091
  2. G. Abbey, S. B. Thompson, T. Hickish & D. Heathcote. (2015). A metaanalysis of prevalence rates and moderating factors for cancer related post-traumatic stress disorder. Psycho-Oncology, 24(4), 371-381. DOI : 10.1002/pon.3654
  3. R. G. Tedeschi & L. G. Calhoun. (2004). Posttraumatic growth: conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1-18. DOI : 10.1207/s15327965pli1501_01
  4. C. Ochoa, A. Casellas-Grau, J. Vives, A. Font & J. M. Borras. (2017). Positive psychotherapy for distressed cancer survivors: posttraumatic growth facilitation reduces posttraumatic stress. International Journal of Clinical and Health Psychology, 17(1), 28-37. DOI : 10.1016/j.ijchp.2016.09.002
  5. J. Mangelsdorf, M. Eid & M. Luhmann. (2019). Does growth require suffering? a systematic review and meta-analysis on genuine posttraumatic and postecstatic growth. Psychological Bulletin, 145(3), 302-338. DOI : 10.1037/bul0000173
  6. H. I. McCubbin & J. M. Patterson. (1983). The family stress process: the double ABCX model of adjustment and adaptation. Marriage and Family Review, 6(1), 7-37. DOI : 10.1300/j002v06n01_02
  7. R. Hill. (1958). Generic features of families under stress. Social Casework, 39(2-3), 139-150. DOI : 10.1177/1044389458039002-318
  8. O. Bozo, E. Gundogdu & C. Buyukasik-Colak. (2009). The moderating role of different sources of perceived social support on the dispositional optimism-posttraumatic growth relationship in postoperative breast cancer patients. Journal of Health Psychology, 14(7), 1009-1020. DOI : 10.1177/1359105309342295
  9. H. R. Cho & N. W. Chung. (2017). The effect of intrusive rumination, deliberate rumination, and emotional clarity on posttraumatic growth. Korean Journal of Health Psychology, 22(2), 433-455. DOI : 10.17315/kjhp.2017.22.2.012
  10. E. S. Kim et al. (2007). Stress, social supports, and coping among the family members of the patients in ICU. Journal of Korean Clinical Nursing Research, 13(3), 123-134.
  11. R. S. Lazarus & S. Folkman. (2984). Stress, appraisal, and coping. Springer Publishing Company.
  12. S. Y. Yoo. (2019). The structural model between the disruption of core belief, coping, resilience, and posttraumatic growth in women with cancer. Master's Thesis. Konkuk University, Seoul.
  13. M. A. McCubbin & A. I. Thompson. (1987). Family stress theory and assessment. In H. I. McCubbin, & A. I. Thompson (Eds.), Family Assessment Inventories for Research and Practice (pp. 3-22). Madison, WI: University of Wisconsin-Madison.
  14. K. H. Yang, M. R. Song & E. K. Kim. (1998). The stress and adaptation in family caregiver of chemotherapy patients. The Seoul Journal of Nursing, 12(1), 118-132.
  15. G. G. Zimet, N. W. Dahlem, S. G. Zimet & G. K. Farley. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30-41. DOI : 10.1207/s15327752jpa5201_2
  16. J. S. Shin & Y. B. Lee. (1999). The effects of social supports on psychosocial well-being of the unemployed. Korean Journal of Social Welfare, 37(4), 241-269.
  17. A. Cann, L. G. Calhoun, R. G. Tedeschi, K. L. Triplett, T. Vishnevsky & C. M. Lindstorm. (2011). Assessing posttraumatic cognitive processes: The Event Related Rumination Inventory. Anxiety, Stress and Coping, 24(2), 137-156. DOI : 10.1080/10615806.2010.529901
  18. R. K. Yoo & E. J. Kim. (2016). Testing moderating effects of event-related deliberate rumination and coping strategies in the relationship between optimism and post-traumatic growth: for university students. The Korean Journal of Rehabilitation Psychology, 23(2), 417-437.
  19. R. S. Lazarus & S. Folkman. (1984). Stress, appraisal, and coping. Springer publishing company.
  20. J. S. Han & G. S. O. (1990). A study on the grief and coping pattern of mothers who have a chronically ill child. The Korean Nurse, 29(4), 73-87.
  21. R. G. Tedeschi & L. G. Calhoun. (1996). The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455-471. DOI : 10.1002/jts.2490090305
  22. S. H. Song, H. S. Lee, J. H. Park & K. H. Kim. (2009). Validity and reliability of the Korean version of the posttraumatic growth inventory. Korean Journal of Health Psychology, 14(1), 193-214. DOI : 10.17315/kjhp.2009.14.1.012
  23. J. P. Woo. (2012). Prof. Woo's concepts and understanding of structural equation modeling (Amos 4.0-20.0). Seoul: Hannarae Publishing.
  24. Y. H. Jeon, K. H. Lee & W. J. Kim. (2010). Influence of anxiety, stress and concern for recurrence on quality of life, and controlling effect of social support among cancer patients. Health and Welfare. 12, 115-137. https://doi.org/10.23948/kshw.2010.12.12.115
  25. S. Nolen-Hoeksema. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology, 100(4), 569-582. DOI : 10.1037/0021-843x.100.4.569
  26. S. Cohen & T. A. Wills. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310-357. DOI : 10.1037/0033-2909.98.2.310
  27. M. Seo, B. Y. Choi & H. I. Jo. (2006). The effect of life stress, stress coping, and social support on mental health. Korea Journal of Counseling, 7(2), 271-288.
  28. S. Y. Shin & N. W. Chung. (2012). The effect of meaning in life and social support on posttraumatic growth: Rumination as a mediating variable. Journal of Human Understanding and Counseling, 33(2), 217-235.
  29. Y. S. Rhee. (2009). A study of effect on quality of life of cancer patient's caregiver: focusing on the mediating effect of feeling of burden and growth. Korean Journal of Social Welfare, 61(2), 325-348. DOI : 10.20970/kasw.2009.61.2.013
  30. A. Wang, C. Chang, S. Chen, D. Chen & W. Hsu. (2014). Identification of posttraumatic growth trajectories in the first year after breast cancer surgery. Psycho-Oncology, 23, 1399-1405. DOI : 10.1002/pon.3577
  31. D. A. Kenny, D. A. Kashy & W. L. Cook. (2006). Dyadic data analysis. Guilford Press.
  32. J. G. Hwang & Y. H. Kim. (2005). Family support perceived by cancer patients, family caregivers' burden and physical & psychological health. Journal of Family Relations, 10(2), 173-198.