치매 환자 어머니를 부양하는 기독 여성의 심리적 갈등연구

국문 초록 (Abstract)

현대 사회는 의학과 과학기술 발달 및 질병 예방에 대한 사회적 인식변화와 생활환경의 변화로 수명연장이 늘어나고 있다. 우리나라에서도 고령화와 함께 치매유병률도 급증하고 있는 가운데 부양자들은 부양 부담과 심리적 어려움을 내포하고
있다. 이를 위해 본 연구에서는 치매 환자 어머니를 부양하는 기독 여성이 겪는 갈등과 어려움은 어떠한가, 치매 환자 어머니를 부양하면서 기독 여성이 겪는 갈등과 어려움의 극복 요인은 무엇인가, 두 가지 연구질문을 중심으로 기독 여성이 치매를 겪고 있
는 어머니를 부양하면서 겪는 어려움을 살펴보고자 한다. 더욱이 치매 환자를 부양하면서 신앙의 모습에서 나타나는 어머니와의 감정의 갈등이 무엇인지와 하나님 안에서 어떻게 견디었는지 딸의 갈등 극복 과정을 살펴보고 기독 상담적 활용 방안을제시하고자 하였다.

본 연구자는 치매 환자인 어머니를 부양하면서 딸이 겪는 심리적 어려움과 그어려움을 극복해 나가는 요인에 대해 구성주의 근거이론으로 연구하였고 근거이론방법론은 차마즈의 연구방법을 이용하였다.연구 참여자는 서울, 경기 지역에 거주하는 기독 여성으로 치매 환자인 어머니
를 부양하는 딸 20명으로 구성하였다. 자료 수집은 2021년 8월부터 2022년 6월까지 연구 참여자의 개인정보보호를 위한 약속과 함께 연구 참여 동의서를 작성한 후30-40분 정도 대면 면접을 하였다. 코로나 상황에서 대면 면접의 어려움으로 2차,3차는 전화 면접을 하였다. 이를 바탕으로 차마즈의 근거이론 방법을 적용하여 연구 참여자들의 경험에 관한 결과를 도출하였다. 또, 기독(목회) 상담적 입장에서 거킨의 이야기 해석학적 견해를 적용해 보았다.

본 연구룰 통해 도출된 연구 결과를 요약하면 76개의 개념과 23개의 하위범주,6개의 범주로 분류되었다. 구체적으로 기독교인 딸이 치매 환자인 어머니를 부양하면서 겪는 어려움은 ‘물질의 어려움’, ‘내 생활이 없음’, ‘몸이 힘듦’, ‘형제들의 비난’이었고, 치매 어머니를 돌보면서 느끼는 감정으로는 ‘서운한 마음’, ‘양가감정’,‘억울함’, ‘죄책감’으로, 신앙때문에 겪는 어려움은 ‘내 신앙 지키지 어려움’, ‘가족들에게 본이 되어야 한다는 마음’과 ‘보여줘야 한다는 생각’, ‘하나님 앞에서 가식적인모습’ 등과 같은 심리적 어려움을 경험하고 있었다. 이런 어려움의 극복 요인으로는누구의 도움 없이 스스로 견디며 이겨내고, 신앙의 힘으로 이겨내기도 하며, 지인들과 함께하면서 극복해 나가고 있는 것을 발견하였다.

위와 같이 기독 여성 부양자들은 치매 환자인 어머니를 부양하면서 겪은 어려움들을 신앙의 힘으로 이겨나가고 있었다. 시간에 쫓기며 힘든 가운데 틈틈이 교회에서 기도하고 말씀과 찬양으로 예배드리면서 하나님의 함께하심과 채워주심을 경험하면서 하나님 안에서 극복해 나가고 있음을 알 수 있었다.

또한 기독 여성 부양자들은 치매 어머니를 부양하는 경험 속에서 어머니를 향한 죄책감과 억울함, 그리고 서운한 감정들에 강하게 사로잡혔으나, 이 모든 어려움을 통과하면서 하나님 앞에 올곧이 서게 됨으로서 자신의 존재이유와 가치를 새롭게 발견하게 되고, 기독교인으로써 삶의 우선순위를 다시 정립하며, 하나님께 더 힘있게 나아가게 되는 은혜이자 성숙의 기회가 되었다.

결론적으로 교회 공동체는 치매 환자를 부양하는 가족들에게 말씀 가운데 서로위로하고 격려하며, 하나님을 더욱 의지하며 나갈 수 있도록 다양한 물질적, 정서적, 사회적, 영적인 자원을 제공할 수 있다. 뿐만 아니라 돌봄이 필요한 가족구성원에게 돌봄을 제공하고 있는 부양자 역시 그들도 누군가의 돌봄이 필요한 자라는 문제의식을 공유하고 신앙공동체 안에서 따뜻한 위로와 기쁨과 격려를 누릴 수 있는장을 제공할 수 있으며, 기독(목회) 상담자는 동일한 어려움을 가진 이들에게 치매가족을 돌보며 생기는 어려움을 토로하고 지지받고 이해받을 수 있는 지지적 집단상담과 치매 환자를 부양하면서 경험한 죄책감이나 양가감정으로부터 벗어나는 치료적 집단상담을 제공하고, 다양한 돌봄 프로그램을 활용하여 치매 가족의 성장을지원할 수 있다. 이를 통해 기독 상담자는 치매 환자를 돌보는 부양자와 그 가족들이 교회 공동체를 통한 회복을 경험하도록 실제적인 도움을 줄 수 있다.

본 연구는 부양자 자기의 정체성에 대한 기독 상담적 자료가 될 뿐 아니라 점차 증가하고 있는 교회 안의 치매 가족을 위한 목회적 개입의 중요성을 피력하고구체적인 방안 마련을 위한 기초자료로 활용될 수 있다. 또 기독 상담적 입장에서부양자의 어려움을 어떻게 바라보아야 하는지에 대한 상담학적 방법과 방향을 제공했다는 점에서 그 의의가 있다고 할 수 있다.

핵심 단어: 기독여성, 치매 환자, 갈등, 죄책감, 심리적 어려움, 근거이론, 기독상담

목차 (Table of Contents)

• 목차
• 국문초록 ····················································································································· ⅰ
• Ⅰ. 서 론 ······················································································································ 1
• 1. 연구의 필요성과 목적 ······················································································· 1
• 2. 연구 문제 ············································································································· 5
• 3. 용어 정의 ············································································································· 5
• 1) 치매 ················································································································· 5
• 2) 부양 부담감 ····································································································· 6
• 3) 부양자 ··············································································································· 6
• 4) 기독 여성 ········································································································· 6
• 4. 선행연구 ··············································································································· 7
• Ⅱ. 이론적 배경 ········································································································· 11
• 1. 치매와 부양 부담의 이해 ··············································································· 11
• 1) 치매의 정의 ··································································································· 11
• 2) 치매의 증상 ··································································································· 12
• 3) 치매의 발달단계 ··························································································· 13
• 4) 부양 부담의 이해 ························································································· 14
• 5) 부양 부담의 내용 ························································································· 17
• 2. 한국인의 정(情), 한(恨), 효(孝)에 대한 이해 ·············································· 20
• 1) 정(情)의 개념 ································································································· 21
• 2) 한(恨)의 개념 ································································································· 23
• 3) 효(孝)의 개념 ································································································· 26
• 3. 애착이론에서 어머니에 대한 이해 ······························································· 29
• 1) 애착, 애착 행동, 애착 행동체계에 대한 개념 ······································· 29
• 2) 내적 작동모델 ······························································································· 30
• 3) 성인 애착 ······································································································· 31
• 4) 대상관계 이론과 애착 이론 ······································································· 32
• 4. 기독(목회) 상담학적 방법론 ··········································································· 34
• 1) 매카담스(Dan P. McAdams)의 이야기 심리학 ···································· 34
• 2) 찰스 거킨(Charles V. Gerkin)의 이야기 해석학에 대한 이해 ·········· 39
• 3) 이야기 해석학에서의 상담 ········································································· 44
• Ⅲ. 연구 방법과 절차 ······························································································ 48
• 1. 연구 방법 ··········································································································· 48
• 1) 근거이론 방법 ······························································································· 48
• 2) 자료 분석 ······································································································· 53
• 2. 연구 과정 ··········································································································· 57
• 1) 자료 수집 ······································································································· 57
• 2) 근거이론 연구 질문 ····················································································· 58
• 3) 연구의 윤리적 고려 ····················································································· 58
• 4) 연구 참여자 선정 ························································································· 59
• 5) 연구 참여자 소개 ························································································· 62
• Ⅳ. 연구 결과 ············································································································· 74
• 1. 1차 연구분석 결과 ··························································································· 74
• 1) 부양의 시작 (참여자의 부양 동기) ··························································· 76
• 2) 갈등의 시작 (치매 환자에게 나타나는 증상) ········································· 88
• 3) 모(母)에 대한 애증의 감정 (치매 환자에 대한 심리적 어려움) ··············· 101
• 4) 돌봄의 어려움 (부양하면서 오는 어려움) ············································ 121
• 5) 신앙의 어려움 ····························································································· 139
• 6) 어려움 극복 요인들 (어려움을 이겨내는 방법) ·································· 152
• 2. 범주들의 관계 분석 ······················································································· 167
• 1) 부양 동기와 부양하면서 치매어머니에게 느끼는 감정과의 관계 ········· 167
• 2) 부양하며 겪는 어려움과 신앙의 어려움과 극복 요인의 관계 ············· 168
• 3) 부양하면서 겪는 어려움과 어려움 극복 요인 ····································· 170
• 3. 이론적 코딩(Theoretical Coding) ······························································· 171
• 1) 어려움 극복 요인 분석의 이론적 통합 ················································· 172
• 2) 신앙적인 관점에서 논의 ··········································································· 175
• 3) 본 연구에 기반한 극복 요인 ··································································· 176
• Ⅴ. 논 의 ················································································································· 179
• 1. 치매 환자 어머니를 부양하는 기독 여성이 겪는 갈등과 어려움 요인 ·········· 179
• 2. 치매 환자 어머니를 부양하면서 겪는 갈등과 어려움의 극복 요인 ········· 182
• 3. 기독(목회) 상담론적 논의 ············································································· 183
• Ⅵ. 결론 및 제언 ····································································································· 188
• 1. 연구의 요약 및 의의 ····················································································· 188
• 1) 연구 요약 ··································································································· 188
• 2) 연구 의의 ····································································································· 191
• 2. 연구한계 및 제언 ························································································· 193
• 1) 연구의 한계점 ····························································································· 193
• 2) 연구의 제언 ································································································· 193
• 참고 문헌 ················································································································· 195
• ABSTRACT ················································································································ 209
• 부록1 ·························································································································· 212