유방암 환자의 회복탄력성과 외상후 스트레스장애가 삶의 질에 미치는 영향

다국어 초록 (Multilingual Abstract)

Purpose: The purpose of this study is to grasp
relationships of resilience, Post-Traumatic Stress Disorder(PTSD), and quality of life of breast cancer patients, and provide baseline data needed for nursing intervention that can enhance breast cancer patients’ quality of life by improving resilience and lowering PTSD.
Methods: Data collection period was August 16-October 16, 2013, and after gaining approval of Institutional Review Board of S University Hospital(2013-SCMC-32-00), it
targeted 129 breast cancer patients who had visited department of internal medicine, department of surgery, or department of rehabilitation medicine in S University Hospital or two Women's Hospitals located in C City, Gyeongsangnam-do. The patients were notified of the necessity and purpose of this study, benefits, data collection methods, time required, and secret security, and it was fully explained to the subjects that they could participate in this study, or stop or deny it according to their own decisions. And then only those who understood the purpose of this study and agreed on their voluntary participations were selected as subjects. Written consents were received from the subjects, and data was collected by distributing structuralized questionnaires to them.

For research tools, a tool that Yangsuk Song(2004) translated and modified Resilience Scale developed by Wagnild & Young(1993), Impact of Event Scale-Revised Korean Version that Hunjung Eun et al. (2005) standardized Impact of Event Scale-Revised(IES-R) produced by Weiss & Marmar(1997), and Functional Assessment of Cancer Therapy-Breast Cancer Version 4(FACT-B, Korean Version) developed by Brady, et al. (1997) were used after gaining approval.
The collected data was analyzed through frequency, percentage, average and standard deviation, t-test, ANOVA, Duncan multiple range test, Pearson correlation coefficient, and Multiple Stepweiss regression, by using the PASW 18.0 window program.

The study results can be summarized as below.

1) The resilience average score of the subjects was 89.27±14.95(range 25~125).
2) The PTSD average score of the subjects was 29.25±17.52(range 0~88). Here, 53.5% of the subjects was included in the PTSD high-risk group and 16.3% was in the PTSD risk group, indicating that 69.8% of the subjects had PTSD higher than a risk level.
3) The quality of life average score of the subjects was 93.34±19.34(range 0~148). For the average scores of sub-areas of quality of life, breast cancer area was 22.55±5.06(range 0~40), body area 19.51±6.51(range 0~28), function area 18.39±6.02(range 0~28), society/family area 16.61±6.18(range 0~28), and emotion area 16.27±4.69(range 0~24).
4) Resilience according to general characteristics of the subjects showed statistically significant differences on age(F=5.848, p=.017) and job(F=4.219, p=.042). PTSD according to general characteristics of the subjects showed statistically significant differences on age(F=5.240, p=.024). Quality of life according to general characteristics of the subjects showed statistically significant differences on religion(t=2.114, p=.033) and hobby(t=2.790, p=.006).
5) Resilience, PTSD, and quality of life according to disease-related characteristics of the subjects showed no significant difference.
6) Resilience and quality of life of the subjects had a positive correlation(r=.588, p<.001), and resilience and PTSD had a negative correlation(r=-.225, p=.010). PTSD and quality of life had a negative correlation(r=-.459, p<.001).
7) A factor that had a biggest effect on quality of life of the subjects turned out to be resilience. For the influence of resilience and PTSD on quality of life, resilience regression coefficient β=.511 and PTSD regression coefficient β=-.344, and explanatory power of resilience and PTSD on quality of life was 44.9%.

Conclusion: As above, it turned out that as resilience of breast cancer patients was higher and PTSD was lower, quality of life increased. Thus, based on this result, a study to develop and apply nursing intervention programs to improve resilience and relieve PTSD is proposed. And a long-term longitudinal study to examine factors related to changes of PTSD and quality of life of breast cancer patients depending on time elapsing is proposed.
Keywords: Resilience, Breast cancer patients, Post-Traumatic Stress Disorder(PTSD), Quality of life

목차 (Table of Contents)

• 목 차
• I. 서 론 1
• 1. 연구의 필요성 1
• 2. 연구의 목적 3
• 3. 용어의 정의 4
• 4. 연구의 제한점 5
• Ⅱ. 문헌고찰 6
• 1. 유방암 환자의 삶의 질 6
• 2. 유방암 환자의 회복탄력성 10
• 3. 유방암 환자의 외상후 스트레스장애 15
• 4. 유방암 환자의 회복탄력성과 외상후 스트레스장애가 삶의 질에 미치는 영향
• 20
• Ⅲ．연구방법 25
• 1. 연구 설계 25
• 2. 연구 대상 25
• 3. 연구 도구 26
• 4. 연구의 윤리적인 측면 27
• 5. 자료수집 방법 28
• 6. 자료 분석 29
• Ⅳ. 연구 결과 30
• 1. 대상자의 일반적 특성 및 질병관련 특성 30
• 2. 대상자의 회복탄력성, 외상후 스트레스장애, 삶의 질 34
• 1) 대상자의 회복탄력성 34
• 2) 대상자의 외상후 스트레스장애 34
• 3) 대상자의 삶의 질 35
• 3. 대상자의 일반적 특성에 따른 회복탄력성, 외상후 스트레스장애 및 삶의 질
• 36
• 4. 대상자의 질병관련 특성에 따른 회복탄력성, 외상후 스트레스장애 및 삶의 질
• 40
• 5. 대상자의 회복탄력성, 외상후 스트레스장애 및 삶의 질과의 관계 43
• 6. 대상자의 회복탄력성, 외상후 스트레스장애가 삶의 질에 미치는 영향 44
• Ⅴ. 논의 45
• 1. 대상자의 회복탄력성, 외상후 스트레스장애 및 삶의 질과의 관계 45
• 2. 대상자의 회복탄력성, 외상후 스트레스장애가 삶의 질에 미치는 영향 51
• Ⅵ. 결론 및 제언 53
• 1. 결론 53
• 2. 제언 55
• 참고문헌 56
• 부록 68
• 부록-1. 연구자 참여 동의서 68
• 부록-2. 일반적 특성 및 질병관련 특성 설문지 69
• 부록-3. 회복탄력성 설문지 70
• 부록-4. 외상후 스트레스장애 설문지 71
• 부록-5. 삶의 질 설문지 72