항암화학요법을 받는 유방암 환자의 면역기능, 수면장애, 우울, 가족지지가 자가간호수행에 미치는 영향 = Effects of Immune Function, Sleep Disturbance, Depression, and Family Support on Self-Care Performance in Breast Cancer Patients Undergoing Chemotherapy

다국어 초록 (Multilingual Abstract)

This study was conducted to identify the effects of immune function, sleep disturbance, depression, and family support on self-care performance among breast cancer patients receiving chemotherapy, and to provide foundational data for developing strategies to enhance self-care performance. The participants were 154 breast cancer patients undergoing chemotherapy in the outpatient clinic or during hospitalization at C University Hospital located in D metropolitan city. Data were collected from August 30 to October 25, 2025 using structured questionnaires and electronic medical records. The collected data were analyzed using IBM SPSS WIN 29.0 with descriptive statistics, the chi-square test, independent t-test, ANOVA with Scheffé post hoc test, Pearson’s correlation coefficient, and hierarchical multiple regression analysis.
The major findings of the study were as follows:
1. The mean age of participants was 55.4±9.89 years. The mean scores were as follows: immune function, 3.93±2.21; sleep disturbance, 7.34±3.43; depression, 18.78±11.24; family support, 48.34±5.26; and self-care performance, 64.64±7.10.
2. No significant differences in self-care performance were found according to general characteristics; however, significant differences were observed according to disease-related characteristics, including period after diagnosis (F=2.70, p=.048) and history of cancer diagnosis (t=−7.02, p<.001).
3. Correlation analyses revealed that self-care performance was significantly negatively correlated with sleep disturbance (r=−.54, p<.001) and depression (r=−.51, p<.001), and significantly positively correlated with family support (r=.46, p<.001). Immune function, however, showed no significant correlation with self-care performance.
4. In the hierarchical regression analysis, Model II explained 43.3% of the variance in self-care performance (F=16.24, p<.001). Sleep disturbance (β=−.34, p<.001), history of cancer diagnosis (β=.29, p<.001), depression (β=−.17, p=.048), the period after diagnosis of 12–36 months (β=−.17, p=.009), and family support (β=.15, p=.041) were identified as significant predictors of self-care performance.
These findings suggest that breast cancer patients who are 12–36 months post-diagnosis should be prioritized for targeted interventions in order to enhance self-care performance. Integrated nursing strategies to manage sleep disturbance, reduce depression, and improve family support are required. Moreover, individualized approaches that consider the patient’s experience of their cancer diagnosis and sleep-related symptoms are necessary when providing self-care education.

목차 (Table of Contents)

• 목 차 ⅰ
• 표 목 차 ⅲ
• 그림목차 ⅳ
• Ⅰ. 서 론 01
• 1. 연구 필요성 01
• 2. 연구 목적 05
• 3. 용어의 정의 06
• Ⅱ. 문헌 고찰 09
• 1. 유방암 환자의 자가간호수행 09
• 2. 유방암 환자의 자가간호수행 영향요인 11
• Ⅲ. 개념적 기틀 18
• Ⅳ. 연구 방법 20
• 1. 연구 설계 20
• 2. 연구 대상 20
• 3. 연구 도구 21
• 4. 자료 수집 방법 24
• 5. 자료 분석 방법 25
• 6. 윤리적 고려 26
• Ⅴ. 연구 결과 27
• 1. 대상자의 일반적 특성 27
• 2. 대상자의 질병 관련 특성 29
• 3. 대상자의 면역기능, 수면장애, 우울, 가족지지, 자가간호수행 수준 · 31
• 4. 일반적 특정에 따른 면역기능, 수면장애, 우울, 가족지지, 자가간호수행 차이 33
• 5. 질병 관련 특성에 따른 면역기능, 수면장애, 우울, 가족지지, 자가간호수행 차이 43
• 6. 면역기능, 수면장애, 우울, 가족지지와 자가간호수행 간의 상관관계 53
• 7. 자가간호수행에 영향을 미치는 요인 55
• Ⅵ. 논의 57
• Ⅶ. 결론 및 제언 67
• 참 고 문 헌 69
• 영 문 초 록 80
• 부 록 82
• 감 사 의 글 106