일차치료가 종료된 유방암 환자의 부부친밀도에 따른 정신건강과 삶의 질 = The Influence of Marital Intimacy on Mental Health and Quality of Life in Breast Cancer Survivors

다국어 초록 (Multilingual Abstract)

Background: This study investigated how marital intimacy affects mental health and quality of life among disease-free breast cancer patients who completed primary treatment.
Methods: The descriptive survey design was conducted using a convenient sample including 185 women who had completed primary breast cancer treatment. They completed surveys on marital intimacy, mental health,and quality of life. The data were analyzed using descriptive statistics, independent t-test, analysis of variance,and analysis of covariance.
Results: The high, moderate, and low marital intimacy groups consisted of 33.0%, 41.1%, and 25.9% of the subjects respectively. Differences in mental health and quality of life among the three groups were statistically significant. The high marital intimacy group scored lower in perceived anger (P=0.001), anxiety (P=0.003), confusion (P=0.010), and depression (P<0.001) than the low marital intimacy group. For total quality of life (P<0.001) and social well-being (P<0.001), the high marital intimacy group scored higher than the low marital group.
Conclusions: Marital intimacy plays a significant role in enriching mental health and quality of life in breast cancer survivors.

국문 초록 (Abstract)

연구배경: 유방암관련 일차치료가 종료된 유방암 환자를 대상으로 부부친밀도, 정신건강과 삶의 질을 파악하고 부부친밀도에 따른 정신건강과 삶의 질의 차이를 확인하기 위한 서술적 조사연구이다.
방법: 본 연구의 대상은 수도권 소재 일 대학병원과 일 여성전문병원의 유방클리닉을 방문하여 배우자가 있는 유방암 환자 총 185명으로, 자료수집기간은 2008년 3월부터2008년 12월까지이었다. 부부친밀도는 Waring23)이 개발한Marital Intimacy 질문지를 Kim24)이 번역, 수정한 도구를이용하였고, 삶의 질은 한국어판 FACT-B, 정신건강은Sutherland, Walker와 Till25)이 개발한 LASA Scale을 이용하여 측정하였다.
결과: 대상자의 부부친밀도 평균 점수는 20.36점이었으며 상위 25%인 높은 부부친밀도를 보인 대상자는 33.0%,중간 50%인 중간정도의 부부친밀도를 보인 대상자는41.1%, 하위 25%인 낮은 부부친밀도군은 25.9%이었다.
부부친밀도에 따른 정신건강과 삶의 질의 차이에서는 부부친밀도가 높은 대상자가 부부친밀도가 낮은 대상자보다분노, 불안, 혼돈 및 우울점수가 낮은 것으로 나타났다. 삶의 질에서도 부부친밀도가 높을수록 전체 삶의 질 점수도통계적으로 유의하게 높았으며, 하부영역에서는 사회적안녕에서 부부친밀도가 높은 대상자의 삶의 질 점수가 부부친밀도가 낮은 대상자보다 높은 것으로 나타났다.
결론: 부부친밀도는 일차치료가 종료된 유방암 환자의정신건강과 삶의 질에 영향을 주는 주요요인으로 유방암생존자의 정신건강과 삶의 질을 향상시키기 위한 중재 방안의 하나로 부부친밀도를 높이는 프로그램의 개발이 요구된다.

참고문헌 (Reference)

1 최연실, "중년기 기혼남녀의 부부의사소통과 부부친밀감이심리적 복지에 미치는 영향" 한국가정관리학회 25 (25): 1-23, 2007

2 구본진, "중년 여성의 극복력, 희망, 부부친밀감 및 가족지지가 삶의 질에 미치는 영향" 정신간호학회 17 (17): 421-430, 2008

3 조옥희, "유방암 환자의 수술 후 심리사회적 적응, 부부친밀도 및 가족지지" 대한종양간호학회 9 (9): 129-135, 2009

4 박진희, "유방암 생존자의 신체적 증상, 정서적 증상과 삶의 질" 한국간호과학회 39 (39): 613-621, 2009

5 황종귀, "암환자가 지각한 가족지지와 환자를 돌보는 가족의 부담감 및 신체적·심리적 건강" 한국가족관계학회 10 (10): 173-198, 2005

6 Waring EM, "The measurement of marital intimacy" 10 (10): 185-192, 1984

7 Falagas ME, "The effect of psychosocial factors on breast cancer outcome: a systematic review" 9 (9): R44-, 2007

8 Sutherland HJ, "The development of a method for determining oncology patients' emotional distress using linear analogue scales" 11 (11): 303-308, 1988

9 Yoo YS, "Spouse support, sexual satisfaction and marital intimacy of post-mastectomy patients" 15 (15): 145-156, 2001

10 Pelusi J, "Sexuality and body image" 106 : 32-38, 2006

11 Holmberg SK, "Relationship issues of wowen with breast cancer" 24 (24): 53-60, 2001

12 Kim Y, "Quality of life of couples dealing with cancer: dyadic and individual adjustment among breast and prostate cancer survivors and their spousal caregivers" 35 (35): 230-238, 2008

13 Dizon DS, "Quality of life after breast cancer: survivorship and sexuality" 15 (15): 500-504, 2009

14 Phillips KA, "Psychosocial factors and survival of young women with breast cancer: a population-based prospective cohort study" 26 (26): 4666-4671, 2008

15 Nezu AM, "Project Genesis: assessing the efficacy of problem-solving therapy for distressed adult cancer patients" 71 (71): 1036-1048, 2003

16 Manne S, "Partner unsupportive responses, avoidance and distress among women with early stage breast cancer: patient and partner perspectives" 24 (24): 635-641, 2005

17 Yang HC, "Marital quality and survivorship: slowed recovery for breast cancer patients in distressed relationships" 115 (115): 217-228, 2009

18 McNair DM, "Manual for the profile of mood states" Educational and Industrial Testing Service 1971

19 Manne S, "Intimacy and relationship processes in couples' psychosocial adaptation to cancer" 112 (112): 2541-2555, 2008

20 Wimberly SR, "Harris SD, Antoni MH. Perceived partner reactions to diagnosis and treatment of breast cancer: impact on psychosocial and psychosexual adjustment" 73 (73): 300-311, 2005

21 Waring EM, "Dimensions of intimacy in marriage" 44 (44): 169-175, 1981

22 Dorval M, "Couples who get closer after breast cancer: frequency and predictors in a prospective investigation" 23 (23): 3588-3596, 2005

23 Cappiello M, "Breast cancer survivors: information and support after treatment" 16 (16): 278-293, 2007

24 Paskett ED, "Breast cancer survivors' health-related quality of life: racial differences and comparisons with noncancer controls" 113 (113): 3222-3230, 2008

25 Ganz PA, "Breast cancer in younger women: reproductive and late health effects of treatment" 21 (21): 4184-4193, 2003

26 Korean Breast Cancer Society, "Breast cancer facts and figures 2006-2008"

27 Fobair P, "Body image and sexual problems in young women with breast cancer" 15 (15): 579-594, 2006

28 Pielage SB, "Adult attachment, intimacy and psychological distress in a clinical and community sample" 12 (12): 455-464, 2005

29 Rowland JH, "Addressing intimacy and partner communication after breast cancer: a randomized controlled group intervention" 118 (118): 99-111, 2009

30 Kim SN, "A structural model for quality of life in women having hysterectomies [disertation]" Yonsei University 1998

31 Mellon S, "A population-based study of the quality of life of cancer survivors and their family caregivers" 29 (29): 120-131, 2006