산후 우울감을 예측하는 심리적 요인 연구:사회적지지, 자아존중감, 스트레스를 중심으로 = Psycho-social predicting factors Model of Postpartum Depression

다국어 초록 (Multilingual Abstract)

The purpose of this study was to propose and test a psycho-social predicting factors model of postpartum depression. This model posits that postpartum stress, postpartum support and self-esteem are predicting factors of postpartum depression and the predicting factors are correlated each other. Participants were 121 women who lives in Seoul and Gyounggi Provance and have gave birth to baby recently. Postpartum depression, postpartum stress, postpartum support and self-esteem were assessed with the 'Edinburgh Postnatal Depression Scale', 'Korean CES-D(Center of Epidemiological Studies Depression Scale)', 'Perceived Stress Scale', 'Childcare Stress Inventory', 'Postpartum Social Support Questionnaire', 'Postpartum Social Questionnaire' and 'Self-esteem Inventory'. Postpartum stress, postpartum support, self-esteem were all significantly correlated each other. Postpartum stress was a significant predicting factor of postpartum depress but postpartum support and self-esteem. Result of this study informed perinatal women to plan and solicit effective support from their social network and reduce possible stress. Result of this study can be applied to make group therapy programming as well. The peer group of which members have a similar experiences or the group of which women's husband are participating will be helpful for postpartum women to overcome the stress. The group programme to increase self-esteem would be helpful as well.

국문 초록 (Abstract)

본 연구 논문의 목적은 산후 우울감을 예측하는 심리적 요인을 검증하는 것이다. 산후 스트레스, 산후지지, 자아존중감 요인이 산후 우울을 예측하는 변인으로 가정되었고, 이들은 서로 상호작용하면서 모두 산후 우울감을 예측하리라고 가정되었다. 서울과 수도권에 거주하는 여성 121명을 대상으로 산후 우울(Edinburgh Postnatal Depression Scale : EPDS, 한국판 CES-D), 산후 스트레스(지각하는 스트레스, 양육 스트레스), 산후 지지(산후 사회적 지지, 산후 가족 지지), 자존감을 측정한 결과, 산후 스트레스, 산후 지지, 자아존중감은 모두 서로 유의미하게 상관이 있었고 산후 스트레스는 산후 우울을 유의미하게 예측하였다. 하지만, 산후 지지와 자아존중감은 산후 우울을 유의미하게 예측하지는 않았다. 이 결과는 산후 지지와 자존감이 산후 우울의 직접적인 원인은 아닌 것을 의미하며 산후 스트레스를 산후 우울의 예측 변인으로 고려할 수 있다는 것이다. 본 연구 결과는 출산을 준비하는 여성에게 가능한 스트레스를 줄이는 대처를 준비해야 하며, 스트레스와 상관이 있는 산후 지지와 자존감 증진 체계를 계획하는 것이 산후 우울 예방에 중요하다는 정보를 제공한다.

참고문헌 (Reference)

1 전겸구, "한국판 CES-D 개발 연구 Ⅰ" 437-445, 1992

2 이정균, "정신의학 제4판" 일조각 2001

3 김정규, "자아가치관 검사 실시요강" 한국 가이던스 2003

4 이경혜, "여성건강에 대한 개념분석 연구" 1 (1): 1995

5 하영수, "여성건강 간호학의 역사적 조명" 1994

6 송홍지, "여성 건강의 최신 연구 동향 및 과제" 24 (24): 2003

7 송대현, "심리학에서 본 자존심" 성원사 1993

8 권정혜, "심리사회적 요인이 산후우울에 미치는 영향: 산후우울에 대한 스트레스 취약성 모델 검증" 16 (16): 55-66, 1997

9 박시성, "산후우울증의 심리사회적 위험요인" 한국정신신체의학회 7 (7): 124-133, 1999

10 이태균, "산후우울증에 관한 문헌적 고찰.대한" 13 (13): 518-530, 2000

11 배정이, "산후 우울감 경험에 관한 연구, 근거 이론적 접근" 26 (26): 1996

12 전지아, "산후 스트레스와 사회적 관계망이 산후우울에 미치는 영향" 고려대학교 대학원 1990

13 조영숙, "산욕기 산모의 자아존중감과 산후우울과의 관계연구" 대한간호학회정신간호학회 1 (1): 1992

14 이동규, "부인과 외래의 산후우울증에 관한 보고. 동국대학교 한의과대학 부인과교실" 14 (14): 328-335, 2001

15 조영숙, "배우자지지행위가 산후우울 및 자아존중감에 미치는 영향에 관한 연구" 3 : 1992

16 김계수, "구조방정식 모형 분석: AMOS 4.0. 서울: SPSS 아카데미.김락형, 김수연, 권보형 (2000). 산후우울증에 대한 임상적 연구. 동의신경정신과 학회지, 11(2)" 2002

17 Watson,J.P., "sychiatric disorder in pregnancy and the first postnatal year" 144 : 453-462, 1984

18 Suin,L., "depressive symptoms in the late postpartum among low socio-economic status women" 26 (26): 157-163, 1999

19 House,J., "Work stress and social support" Addison-Wesley 1981

20 Whiffen,V.E., "Vulnerability to postpartum depression: A prospective, multivariate study" 97 : 467-474, 1988

21 Lluisa Garcia-Esteve, "Validation of the Edinburgh? 산후 우울 척도 in Spanish mothers" 1 : 2002

22 Harris,B., "The hormonal environment of postnatal depression" 154 : 660-667, 1989

23 Chich-Hsiu Hung, "The effects of postpartum stress and social support on postpartum women's health status. Issues and Innovation in Nursing Practice"

24 Paola Benvenuti, "The Edinburgh Postnatal Depression Scale: validation for an Italian sample" 53 : 137-141, 1999

25 Arizmedi,T.G., "Stressful events related to pregnancy and postpartum" 31 : 743-756, 1987

26 Cohen,S., "Stress, social support, and the buffering hypothesis" 98 (98): 310-357, 1985

27 Cutrona,C.E., "Social support and stress in the transition to parenthood" 93 : 378-390, 1984

28 Cutrona C.E., "Social Support, Infant Temperament and Parenting Self-Efficacy: A Mediational Model of Postpartum Depression" 57 : 1507-1518, 1986

29 Stuart,F.Q., "Sleep disturbance in the eldery" 39 (39): 42-47, 1984

30 Taft,L.B., "Self-esteem in later life: A Nursing perspectives" 8 (8): 77-84, 1985

31 Brown,G.W., "Self-esteem and depression Ⅲ. Aetiological issues" 25 : 235-243, 1990

32 Appleby,L., "Screening women for high risk of postnatal depression" 38 : 539-545, 1994

33 Hopkins,J., "Role of infant-related stressors in postpartum depression" 96 (96): 237-241, 1987

34 Battle,J., "Rlationship between Self-esteem and Depression" 42 : 745-746, 1978

35 Cynthia M., "Psychosocial Predictors of Postpartum Depression in Diverse Groups of Women" 23 (23): 563-574, 2001

36 Hewston M., "Psychological Change in Neurotic Depression: A repertory grid and personal construct theory approach" 139 : 47-51, 1981

37 Gotlib,I.H., "Prospective investigation of postpartum depression: Factors involved in onset and recovery" 100 : 122-132, 1991

38 O'Hara,M.W., "Predicting depressive sympto- matology: Cognitive-behavioral models and postpartum depression" 91 : 457-461, 1982

39 Fric Guay, "Predicting Career Indecision: A Self-Determination Theory Perspective" 50 (50): 165-177, 2000

40 Rohde,A., "Postpartum psychoses: Onset and long-term course" 26 : 203-209, 1993

41 Knops,G.G., "Postpartum mood disorders: A startling contrast to the joy of birth" 93 (93): 103-116, 1993

42 Leung Sharron Shuk Kam, "Postpartum depression: Perceived social support and stress among Hong Kong Chinese women" Hong Kong Polytechnic University 2001

43 Hopkins,J., "Postpartum depression and postpartum adaptation: overlapping constructs" 17 : 251-254, 1989

44 Cohen,S., "Positive events and social support as buffers of life change stress" 13 : 99-125, 1983

45 Marsh,H., "Organization of children's academic self-perceptions: Reanalysis and counterinterpretations of confirmatory factor analysis results" 89 : 752-759, 1997

46 Feggetter,P., "Nonpsychotic psychiatric disorders in women one year after childbirth" 25 : 369-372, 1981

47 Cronenwett,L.R., "Network structure, social support, and psychological outcomes of pregnancy" 34 (34): 93-99, 1985

48 Paykel,E.S., "Life events and social support in puerperal depression" 136 : 339-346, 1980

49 Whiffen,V.E., "Is postpartum depression a distinct diagnosis" 12 : 498-508, 1992

50 Demyttenaere,K., "Individual coping style and psychological attitudes during pregnancy predict depression levels during pregnancy and during postpartum" 91 : 95-102, 1995

51 이부영, "ICD-10 정신 및 행태장애" 일조각 1998

52 Logsdon,M.C., "Help after childbirth: Do women get what they expect and need" 37 (37): 14-15, 1989

53 Ann,L.D., "Evaluation and Treatment of Postpartum Emotional Disorders. Practitioner's resource series" Professional Resource Press 1997

54 Ding,L., "Effects of Estimation Methods, Number of Indicators per Factor and Improper Solutions on Structrual Equation Modeling Fit Indices" 2 : 199-143, 1995

55 Cox,J.L., "Detection of postnatal depression: Development of the ten-item Edinburgh Postnatal Depression Scale" 150 : 782-786, 1987

56 Tentoni,Stuart C., "Culturally Induced Postpartum Depression: Theoretical position" J.O.G.N. Nursing 1980

57 O'Hara,M.W., "Controlled prospective study of postpartum mood disorders: Psychological, environmental, and hormonal variables" 100 : 63-73, 1991

58 Hupcey,J.E., "Clarifying the social support theory-research linkage" 27 (27): 1231-1241, 1988

59 Gjerdingen,D.K., "Changes in women's physical health during the first postpartum year" 2 : 277-283, 1993

60 Cramer,B., "Are postpartum depressions a mother-infant relationship disorder" 14 : 283-297, 1993

61 Cowan,C.P., "A preventive intervention for couples becoming parents in : Research on Support for Parents and Infants in the Postnatal Period" Ablex 225-252, 1987

62 McGrath,J., "A conceptual formulation for research on stress. In: Social and psychological factors in stress" Holt, Reinhart and Winston 10-42, 1970