혈액투석 환자의 희망, 우울 및 자아존중감이 극복력에 미치는 영향 = The Effects of Hope, Depression, and Self-Esteem on Resilience of Hemodialysis Patients

다국어 초록 (Multilingual Abstract)

This study evaluated the degree of resilience and interrelationship among the variables of the descriptive correlation studies, focusing on the perceived levels of hope, depression, and self esteem in the hemodialysis patients. Hemodialysis patients’ resilience to disease can developed with a positive adaptation process, which may lead to the conviction of recovery. This study aimed to identify the impact of the resilience factors, hope, depression, and self esteem, on the hemodialysis patients, as affecting the patient's treatment and recovery in the hemodialysis nursing practice and nursing interventions. This study was carried out in the City of Daejeon University Hospital, with the regular blood dialysis patients who visited the artificial kidney room two to three times per week. The study involved 110 patients, and the data collection protocol was approved by the K University Hospital Institutional Review Board (IRB File No. 12-31). The data collection period was between June 1 , 2012 and July 31, 2012. In order to measure the resilience of the hemodialysis patients, we used the resilience measuring device which was adjusted by Song(2004), as based on the resilience scale by Wagnild and Young(1993). As a measuring instrument for the level of hope, we used the device which was adjusted by Lee(1992), based on the hope measuring instrument by Miller & Powers(1988). As a measuring instrument for the level of depression, we used the device which was adjusted by Lee ＆ Song(1991), based on the depression measuring instrument by Beck(1967). As a measuring instrument for the level of self-esteem, we used the device which was adjusted by Jeon(1965), based on the self-esteem measuring instrument by Rosenberg(1965). The collected materials were analyzed by the frequency, ratio, average, standard deviation, t-test, ANOVA, Pearson's Correlation Coefficient, and Multiple Regression.

1) The hemodialysis patient's level of hope was close to the mean score at 2.71 ± 0.42 points(range:1∼4), above the middle. The level of depression was near the mean score at 0.64 ± 0.59 points(range:0∼3), as comparable with mild depression. The self-esteem level was close to the mean score at 2.56 ± 0.54 points(range:1∼5), in the medium self-esteem range. The resilience level was close to the mean score at 4.01 ± 1.16 points(range:1∼7), in the medium resilience.
2) With the characteristics of the relevant disease and patient’s degree of hope, there was a statistically significant difference in the following: the hope of the hemodialysis family (t=-3.018, p=.003), especially in the help people(F=2.810, p=.043); blood dialysis duration(F=3.074, p=.031); and current perception of the health status(F=6.501, p<.001). The depressed patients with hemodialysis associated the following with a statistically significant difference: the marital status (F=8.869, p<.001); economic status(F=5.424, p=.010); insurance(t=2.119, p=.043); family(t=3.470, p=.006), mainly the help people(F=5.760, p=.005); and current perception of health status(F=6.403, p<.001). Based on the degree of resilience of patients with hemodialysis, the marital status (F=3.576, p=.016) and current perception of health status(F=5.539, p=.001) showed a statistically significant difference.
3) Resilience had a statistically significant positive correlation with hope(r=.818, p<.001) and self-esteem(r=.824, p<.001); and a statistically significant negative correlation with depression(r=-.743, p<.001).In other words, the higher resilience patients showed a higher level of hope and self esteem; and the lower resilience patients showed a higher level of depression.
4) In the multiple regression analysis calculating resilience (F = 161.177, p<.001), the impact factors were self-esteem and hope, with 75.1% prediction. The results are as follows: self esteem(β=.472, p<.001); and hope (β=.443, p<.001).

This study of the hemodialysis patient's resilience showed the relationship with the level of hope, depression, and self-esteem in the patients. There was a relationship between the Hemodialysis patient's resilience and the level of hope and self-esteem. As such, it is recommended that the hemodialysis patients require nursing interventions to promote resilience.

국문 초록 (Abstract)

본 연구는 혈액투석 환자의 희망, 우울, 자아존중감 및 극복력의 정도를 파악하고 제 변수간의 상관성을 규명하기 위한 서술적 상관관계 연구이다.
본 연구 대상자는 D시에 위치한 K대 대학병원 인공신장실에서 혈액투석을 받고 있는 환자 중에서 혈액투석을 시작한 지 3개월 이상 되었고 주 2∼3회 혈액투석을 받고 있으며 환자로 연구 목적과 자료 수집 과정을 설명하고 동의한 환자를 대상으로 해당 K대 병원 연구 윤리 위원회(IRB)의 승인(IRB File No. 12-31)을 받은 후 연구를 진행하였다. 연구의 자료 수집 기간은 2012년 6월 1일부터 7월 31일까지였다. 총 115부의 설문지를 배부하였으나, 응답이 미비한 자료 5부를 제외하고 110부(회수율: 95.6%)로 자료를 분석하였다.