Journal of the Korean society of biological therapies in psychiatry (생물치료정신의학)

The Korean Society of Biological Therapies in Psychiatry (대한생물치료정신의학회)
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Factors Associated with Quality of Life of Family Caregivers in Terminally Ill Cancer Patients

말기암 환자 가족보호자의 삶의 질에 영향을 미치는 요인

  • Kim, Seon Young (Mental Health Clinic, Chonnam National University Hwasun Hospital) ;
  • Kim, Jae Min (Departments of Psychiatry, Chonnam National University Medical School) ;
  • Kim, Sung Wan (Departments of Psychiatry, Chonnam National University Medical School) ;
  • Kang, Hee Ju (Departments of Psychiatry, Chonnam National University Medical School) ;
  • Lee, Ju Yeon (Departments of Psychiatry, Chonnam National University Medical School) ;
  • Shin, Il Seon (Departments of Psychiatry, Chonnam National University Medical School) ;
  • Shim, Hyun Jeong (Department of Hemato-Oncology, Chonnam National University Medical School) ;
  • Yoon, Jin Sang (Departments of Psychiatry, Chonnam National University Medical School)
  • 김선영 (화순전남대학교병원 정신건강클리닉) ;
  • 김재민 (전남대학교 의과대학 정신건강의학교실) ;
  • 김성완 (전남대학교 의과대학 정신건강의학교실) ;
  • 강희주 (전남대학교 의과대학 정신건강의학교실) ;
  • 이주연 (전남대학교 의과대학 정신건강의학교실) ;
  • 신일선 (전남대학교 의과대학 정신건강의학교실) ;
  • 심현정 (전남대학교 의과대학 혈액종양내과학교실) ;
  • 윤진상 (전남대학교 의과대학 정신건강의학교실)
  • Received : 2014.09.03
  • Accepted : 2014.11.15
  • Published : 2014.12.31
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Abstract

Objectives:The primary purpose of the present study was to assess the factors associated with quality of life(QoL) of the family caregivers of terminally ill cancer patients. Methods:A broad range of factors related to the patient-family caregiver dyad was investigated in a palliative care setting using a cross-sectional design. Caregiver QoL was assessed by the EuroQoL-5 dimensions-visual analog scale (EQ-VAS). The independent variables included patient- and caregiver-related sociodemographic and psychological factors such as depressive symptoms, subjective burden, and coping style. The clinical data of the patients were also obtained from their medical charts or gathered using measurements on face-to face interview. Multivariate linear regression analyses were conducted to identify the influences of individual factors on caregiver QoL. Results:Of 304 analyzed dyads, multivariate analyses revealed that the psychological factors of the caregivers were significantly related to their QoL. Greater levels of depressive symptoms and subjective burden in the caregiver were significantly associated with a lower QoL, but an active coping style was associated with a higher QoL. Caregivers with a physical illness reported a lower QoL than those without an illness. However, patient-related factors were not related to caregiver QoL. Conclusions:Caregiver's psychological factors rather than patient's factors are significantly related with caregiver's QoL. Providing psychiatric screening and intervention for depression and caregiver support programs for burden and coping style are recommended for enhancing QoL in caregivers of terminally ill cancer patients.

목 적 : 본 연구는 국내의 말기 암 환자 보호자의 삶의 질에 영향을 미치는 요인을 파악하기 위해 시행되었다. 방 법 : 완화병동에 입원 중인 말기 암환자-가족보 호자 쌍을 대상으로 임상적, 사회인구학적, 정신의학적 요인 등 광범위한 요인을 단면적으로 조사 및 분석하였 다. 가족보호자의 삶의 질은 EuroQoL-5 dimensions-visual analog scale(EQ-VAS)로 조사되었다. 삶의 질에 영향을 미치는 독립변인은 환자와 가족의 사회 인구학 적 요인, 정신의학적 요인(우울증상, 부양부담, 대처방식 등)을 평가하였다. 환자의 임상적 요인은 의무기록을 통 해 조사하거나, 면대면 면담을 통해 측정되었다. 각 독립 변인이 가족보호자의 삶의 질에 미치는 영향을 평가하기 위해 다중회귀분석을 시행하였다. 결 과 : 최종적으로 환자-가족보호자 304쌍을 분석 하였다. 다중회귀분석 결과 가족보호자의 정신의학적 요인은 보호자의 삶의 질과 매우 유의한 상관관계를 보였다. 높은 우울증상과 부양부담은 가족보호자의 낮은 삶 의 질과 관련되었다. 반면, 가족보호자가 적극적 대처방 식을 많이 사용하는 경우 삶의 질은 증가하였다. 가족보 호자가 신체 질환을 가지고 있는 경우 그렇지 않은 경 우에 비해 삶의 질이 낮았다. 한편, 환자 관련 요인은 가 족보호자의 삶의 질과 유의하게 관련되지 않았다. 결 론 : 말기 암 환자 가족보호자의 삶의 질은 환자 요인보다는 가족보호자 자신의 정신의학적 요인과 강 력하게 연관되었다. 우울증상에 대한 정신의학적 평가 및 개입, 부양부담과 대처방식에 대한 보호자 지지 프로 그램의 제공이 말기 암 환자 가족보호자의 삶의 질 향 상에 도움 될 것으로 보인다.

Keywords

Acknowledgement

Supported by : 전남대학교병원

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