• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8607-8612
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• 2014

Background: Breast cancer patients experience a variety of altered appearance - such as loss or disfigurement of breasts, discolored skin, and hair loss - which result in psychological distress that affect their quality of life. This study aims to evaluate the impact of socioeconomic status on the altered appearance distress, body image, and quality of life among Korean breast cancer patients. Materials and Methods: A cross-sectional survey was conducted at advocacy events held at 16 different hospitals in Korea. Subjects were eligible to participate if they were 18 years of age or older, had a histologically confirmed diagnosis of breast cancer, had no evidence of recurrence or metastasis, and had no psychological problems at the time of the survey. Employment status, marital status, education, and income were assessed for patient socioeconomic status. Altered appearance distress was measured using the NCI's cancer treatment side effects scale; body image and quality of life were measured by the EORTC QLC-C30 and BR23. Means and standard deviations of each outcome were compared by socioeconomic status and multivariate linear regression models for evaluating the association between socioeconomic status and altered appearance distress, body image, and quality of life. Results: A total of 126 breast cancer patients participated in the study; the mean age of participants was 47.7 (SD=8.4). Of the total, 83.2% were married, 85.6% received more than high school education, 35.2% were employed, and 41% had more than $3000 in monthly household income. About 46% had mastectomy, and over 30% were receiving either chemotherapy or radiation therapy at the time of the survey. With fully adjusted models, the employed patients had significantly higher altered appearance distress (1.80 vs 1.48; p<0.05) and poorer body image (36.63 vs 51.69; p<0.05) compared to the patients who were unemployed. Higher education (10.58, standard error (SE)=7.63) and family income (12.88, SE=5.08) was positively associated with better body image after adjusting for age, disease stage at diagnosis, current treatment status, and breast surgery type. Similarly, patients who were married and who had higher education had better quality of life were statistically significant in the multivariate models. Conclusions: Socioeconomic status is significantly associated with altered appearance distress, body image, and quality of life in Korean women with breast cancer. Patients who suffer from altered appearance distress or lower body image are much more likely to experience psychosocial, physical, and functional problems than women who do not, therefore health care providers should be aware of the changes and distresses that these breast cancer patients go through and provide specific information and psychosocial support to socioeconomically more vulnerable patients.

• Journal of Preventive Medicine and Public Health
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• 제35권4호
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• pp.287-294
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• 2002

Objectives : To examine whether cumulative chronic stress influences the immune status, and to verify the effect of social support on the relationship between these two dimensions in male manufacturing workers. Methods : A total of 39 workers were recruited for this study. A structured-questionnaire was used to assess general characteristics, job characteristics (work demand and decision latitude), psychosocial distress, and social support. The serum levels of CD4 and CD8 were measured as immune markers, and were collected between 8:00 and 10:00am in order to standardize the markers. Nonparametric statistics were used to estimate the differences between job characteristics and the immune markers. Results : General characteristics, and health-related behaviors, were not associated with CD4, CD8 or CD4/CD8. No relationships were found between job characteristics and the mean levels of immune reactivity. These results were consistent, even after controlling for social support. Social support failed to modify the relationship toward work demand, decision latitude or psychosocial distress to CD4, CD8, and CD4/CD8. Conclusion : Cumulative chronic life stress might not influence the immune status, and the effects of social support on the immune function under chronic stress, may not play a crucial role in modifying the relationships. This implication supports that the effect of stress on the immune function may be determined by the characteristics of that stress. further research should effectively considers the type, magnitude and timing of a stress event, and modifiable factors, such as personality traits, coping style, and hormone excretion levels, on the alteration of immune status.

• 종양간호연구
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• 제11권3호
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• pp.237-246
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• 2011

Purpose: The aim of this study was to investigate the relationships between stigma, distress, and quality of life (QOL) in patients with lung cancer. Methods: The subjects of the study were 123 lung cancer patients who visited the outpatient department of S hospital in Seoul from July 21st to August 29th, 2011. To measure stigma, distress, and QOL, Cataldo Lung Cancer Stigma Scale, Hospital Anxiety and Depression Scale (HADS), and EORTC QLQ-C30 (Quality of Life Questionnaire, Core 30) were used in this study. The collected data were analyzed using frequency, average, t-test, ANOVA, and Pearson correlation with SPSS WIN 19.0. Results: Stigma showed positive correlations with anxiety, depression, and symptom (r=.37, p<.001; r=.44, p<.001; r=.23 p=.012), while it showed negative correlations with global QOL and function (r=-.26, p=.003; r=-.40, p<.001). Anxiety and depression also positively correlated with symptoms (r=.43, p<.001; r=.58, p<.001) while anxiety and depression negatively correlated with global QOL (r=-.40, p<.001; r=-.56, p<.001) and function (r=-.64, p<.001; r=-.66, p<.001). Conclusion: The findings of the study demonstrated that lung cancer patients experienced stigma and distress that had a negative influence on the subjects' QOL. Thus the study's findings can be useful in developing psychosocial nursing strategies to improve QOL of lung cancer patients in the future.

• 한국콘텐츠학회논문지
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• 제17권8호
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• pp.586-596
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• 2017

간호사는 대상자에게 양질의 간호를 제공하기 위해 수준 높은 간호 지식과 탁월한 업무수행능력이 요구된다. 특히 업무 특성상 여러 전문적 종사자들, 환자 보호자들과 상호작용 속에서 다른 어떤 직종보다 언어폭력에 노출될 수밖에 없는 실정이다. 언어폭력은 환자 간호에도 부정적인 영향을 미칠 뿐 만 아니라 스트레스 또한 높으며 간호업무성과와도 관계가 있다. 이에 본 연구는 일반 간호사의 언어폭력 경험, 사회 심리적 스트레스, 간호업무성과와의 정도를 확인하고, 이들 간의 관계를 파악하기 위한 서술적 상관관계연구이다. 연구결과는 다음과 같다. 일반 간호사의 언어폭력 경험과 사회 심리적 스트레스와 간호업무성과 정도를 분석한 결과 언어폭력 경험과 간호업무성과(r=-.099, p=.146)는 관계가 없었고, 언어폭력 경험과 사회 심리적 스트레스(r=.234, p<.001)는 양의 상관관계를 보였고, 사회 심리적 스트레스와 간호업무성과(r=-.254, p<.001)는 음의 상관관계가 있는 것으로 나타났다. 본 연구 결과에 기초하여 일반 간호사의 간호업무성과와 언어폭력 경험과의 관계를 확인하는 추후 연구가 필요하고, 간호업무성과를 증진시키기 위해서 사회 심리적 스트레스를 줄이는 프로그램의 개발과 검증하는 연구가 필요하다.

• 한국산학기술학회논문지
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• 제15권6호
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• pp.3685-3695
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• 2014

본 연구는 중학생들의 절망감, 사회심리적 스트레스 및 우울수준과 자살생각 간의 관련성을 파악하며, 또한 자살생각에 유의하게 영향을 미치는 요인들을 규명하고자 시도하였다. 조사대상은 경인 지역의 4개 중학교에서 임의로 선정된 재학생 975명으로 하였으며, 자료 수집은 2013년 5월 1일부터 2013년 6월 30일까지의 조사기간 동안에 구조화된 무기명 자기기입식 설문지(self-administrated questionnaire)를 통해 이루어졌다. 연구결과, 자살생각과 관련 요인들 간의 상관관계를 보면, 자살생각은 절망감, 사회심리적 스트레스 및 우울수준과 유의한 양의 상관관계를 보였다. 다중회귀분석결과, 조사대상자의 자살생각에 관련된 요인으로는 성별, 음주경험여부, 취미 및 여가의 충분성, 주관적 건강상태, 학년, 학교폭력 경험, 절망감의 수준, 사회심리적 스트레스의 수준, 우울수준이 유의한 변수로 선정되었다. 공분산 구조분석 결과, 절망감은 사회심리적 스트레스나 우울수준보다는 자살생각에 더 큰 영향을 미쳤으며, 사회심리적 스트레스, 우울수준 및 절망감이 높아질수록 자살생각을 증가시키는 효과가 있는 것으로 나타났다.

• 기본간호학회지
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• 제15권4호
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• pp.495-503
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• 2008

Purpose: To date most research related to patients with breast cancer has discriminately investigated the status within or after the treatment although the patients demand holistic nursing care from the time of diagnosis. Thus, the purpose of this study was to investigate the trajectory of breast cancer diagnosis and patients' experiences in the pre-treatment period. Method: This qualitative study used qualitative thematic analysis. Nineteen Korean women who were diagnosed with breast cancer within the last 6 month participated in the study. Individualized interviews were conducted with each participant in a cancer center in K city. The interviews were tape-recorded, transcribed, and analyzed using the thematic analysis process. Results: The overriding theme was "the scattered life in an unforeseen swirl", which illustrates the participants' unexpected crisis with confusion and emotional distress. Two subthemes included "falling into an unavoidable journey", and "staggering in a muddle with urgency". The categories were "unexpected probability", "nagging nodularity", "ominous presentiment", "emotional upheaval", "bad thought intrusion", and "a sense of urgency". Conclusion: Patients in the pre-treatment period encountered utter emotional distress and a sense of urgency after being diagnosed breast cancer. Strategies to develop nursing care for patients in this period and nursing implications are discussed.

• 정신신체의학
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• 제2권1호
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• pp.88-97
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• 1994

GARS스트레스지각척도 및 BDI우울척도를 이용하여 위암환자들과 위염환자들 간의 스트레스지각 및 우울의 정도를 비교하였다. 위암환자들의 50%, 위염환자들의 38%가 BDI우울척도에서 우울에 해당되었다. 위암환자군과 위염환자군 간에 스트레스지각점수는 유의한 차이가 없었다. 한편 BDI우울척도점수에 있어서는 통계적으로 유의한 차이가 없었으나 위암환자군이 위염환자군보다 더 높은 경향을 보였다. 위암환자들에서는 정신적 고통의 정도와 우울의 정도가 유의하게 양상관성을 보인 반면 위염환자들에서는 신체증상의 심한 정도와 우울의 정도가 유의하게 양상관성을 보였다. 즉 위암환자들의 우울은 신체증상의 정도보다는 정신적 고통의 정도와 더 밀접하게 관련되는 것으로 나타났다. 양군에서 각각 여자환자들은 남자환자들보다 스트레스지각이 유의하게 더 높았고, 연령은 스트레스지각과 유의하게 음상관성을 보였다. 결론적으로 동일한 장기의 기질적인 병리의 심한 정도가 스트레스지각 및 우울의 정도와 관련되지 않은 것은 위암환자들의 부정이 관련될 가능성이 있다. 따라서 위암환자들의 치료에서 정신사회적 접근 특히 정신과 자문조정활동의 필요성이 강조된다.

• 한국사회복지학
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• 제51권
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• pp.93-118
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• 2002

우리나라에서 유방암은 여성암 중 두 번째를 차지하고 있고, 점차 증가하고 있으며 이들의 심리사회적 적응에 대한 욕구와 관심이 증대되고 있음에도 불구하고 아직 우리나라에서 유방암 환자들의 심리사회적 후유증을 감소시키기 위한 개입은 이루어지지 못하고 있다. 본 연구는 유방암 환자를 대상으로 서구에서 주로 실시되어 왔던 심리교육 집단개입이 우리나라에서도 심리적 디스트레스를 감소시키고 대처를 증진시킴으로써 심리사회적 후유증을 감소시키는데 효과가 있는지를 평가하고 이에 대한 합의를 논하는데 목적을 두었다. 유방암 수술을 받은 지 1년이 경과하지 않은 환자들 중 유방암 병기가 3기 B이상이거나 70세 이상의 환자, 거동이 불편한 환자, 지리적으로 참석이 불가능한 환자 등을 제외한 80명의 환자 중 연구에 참여를 희망하는 환자 70명을 실험집단, 대기자 통제집단 및 대기자 집단으로 무작위 할당하였다. 실험집단과 통제집단의 수는 각각 24명이었으며 최종 분석에 포함된 환자 수는 실험집단 22명, 통제집단 13명이었다. 이들에 대해 매 주 특정주제를 중심으로 8주간의 구주화된 집단개입을 실시하였으며, 프로그램은 교육과 심리적 지지를 결합한 심리교육적 전략을 사용하였다. 대상자들은 심리적 디스트레스와 대처에 대해 Beck Depression Inventory와 Ways of Coping Checklist-Revised(WCCL-R)를 실시하여 집단개입 전과 8주 후에 각각 평가하였다. 분석결과 실험집단은 통제집단에 비해 집단 개입 이후 BDI상에 나타난 우울에 대해서는 유의미하게 낮은 점수를 보였지만(p<.05). 대처에 대해서는 총점에서나 하위척도 상으로 유의미한 차이를 보이지 않았다. 연구결과와 관련하여 집단의 크기, 프로그램의 내용, 수술 후 경가 시기 등이 논의되었다. 몇 가지 한계에도 불구하고 본 연구는 우리나라에서도 단기 심리교육 집단개입이 유방암 환자들의 수술 후 심리사회적 후유증을 줄이고 삶의 질을 증진시키는 중요한 방법으로 활용될 수 있는 가능성을 보여주었다고 할 수 있다.

• Journal of Preventive Medicine and Public Health
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• 제50권4호
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• pp.240-250
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• 2017

Objectives: Subjective life expectancy (SLE) has been found to show a significant association with mortality. In this study, we aimed to investigate the major factors affecting SLE. We also examined whether any differences existed between SLE and actuarial life expectancy (LE) in Korea. Methods: A cross-sectional survey of 1000 individuals in Korea aged 20-59 was conducted. Participants were asked about SLE via a self-reported questionnaire. LE from the National Health Insurance database in Korea was used to evaluate differences between SLE and actuarial LE. Age-adjusted least-squares means, correlations, and regression analyses were used to test the relationship of SLE with four categories of predictors: demographic factors, socioeconomic factors, health behaviors, and psychosocial factors. Results: Among the 1000 participants, women (mean SLE, 83.43 years; 95% confidence interval, 82.41 to 84.46 years; 48% of the total sample) had an expected LE 1.59 years longer than that of men. The socioeconomic factors of household income and housing arrangements were related to SLE. Among the health behaviors, smoking status, alcohol status, and physical activity were associated with SLE. Among the psychosocial factors, stress, self-rated health, and social connectedness were related to SLE. SLE had a positive correlation with actuarial estimates (r=0.61, p<0.001). Gender, household income, history of smoking, and distress were related to the presence of a gap between SLE and actuarial LE. Conclusions: Demographic factors, socioeconomic factors, health behaviors, and psychosocial factors showed significant associations with SLE, in the expected directions. Further studies are needed to determine the reasons for these results.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1225-1233
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• 2015

This study aims to clarify the psychosocial reactions of female patients with gynecological cancer undergoing chemotherapy and in the process of suffering from alopecia and to examine their nursing support. The target group comprised female patients who had received two or more cycles of chemotherapy, were suffering from alopecia, and were aged 30-65. Data were collected from semi-structured interviews, conducted from the time the patients were informed by their doctors that they might experience alopecia due to chemotherapy to the time they actually experienced alopecia and until they were able to accept the change. Inductive qualitative analysis was employed to close in on the subjective experiences of the cancer patients. The results showed the existence of six phases in the psychosocial reactions in the process of alopecia: phase one was the reaction after the doctor's explanation; phase two was the reaction when the hair starts to fall out; phase three was the reaction when the hair starts to intensely fall out; phase four was the reaction when the hair has completely fallen out; phase five was the reaction to behavior for coping with alopecia; and phase six was the reaction to change in interpersonal human relationships. The results also made it clear that there are five types of reaction patterns as follows: 1) treatment priority interpersonal relationship maintenance type; 2) alopecia agitated interpersonal relationship maintenance type; 3) alopecia agitated interpersonal relationship reduction type; 4) alopecia denial interpersonal relationship reduction type; and 5) alopecia denial treatment interruption type. It is important to find out which of the five types the patients belong to early during treatment and provide support so that nursing intervention that suits each individual can be practiced. The purpose of this study is to make clear the process in which patients receiving chemotherapy come to accept alopecia and to examine evidence-based nursing care on patients with strong mental distress from alopecia.