DOI QR코드

DOI QR Code

The Impact of Socioeconomic Status on Quality of Life among Breast Cancer Survivors : Focusing on Breast Cancer Survivors in Their 40s

유방암 생존자의 사회경제적 지위가 삶의 질에 미치는 영향 : 40대 유방암 생존자를 대상으로

  • Received : 2015.12.04
  • Accepted : 2015.12.31
  • Published : 2016.02.28

Abstract

The purpose of this study was to examine the impact of socioeconomic status on quality of life(QOL) among breast cancer survivors. The data were from breast cancer survivors in their forties, among whom the prevalence in terms of age was the highest in Korea. A total of 607 cases were analyzed and the mean scores of QOL measured by FACT-B were 93.75(SD=21.50). After controlling for the other socio-demographic and medical variables, QOL was significantly correlated to income and job type, which confirms the association between high socioeconomic status and better QOL. Specifically, groups with higher income($${\geq_-}4$$ million won/month, ${\beta}=0.11$, p= .03) and groups with self-employed(${\beta}=0.10$, p= .01) or professional/managerial(${\beta}=0.17$, p< .001) job type showed significantly better QOL. The need for more attention and support, including formal and informal resources, for breast cancer survivors with low socio-economic status and the implication for practice were discussed.

본 연구의 목적은 유방암 생존자의 사회경제적 지위가 삶의 질에 미치는 영향을 검토하는 것으로, 자료수집은 우리나라에서 유방암 발생률이 가장 높은 40대 유방암 생존자들을 대상으로 이루어졌다. 총 607사례가 분석에 포함되었으며, FACT-B로 측정된 대상자의 삶의 질 총점평균은 93.75(SD=21.50)이었다. 다른 인구사회학적 변수와 의료적 변수를 통제하였을 때, 삶의 질은 소득 및 직업유형과 유의미한 관계가 있는 것으로 나타나 높은 수준의 사회경제적 지위와 높은 삶의 질 간의 관계를 확인해주었다. 구체적으로 자영업이나(${\beta}=0.10$, p= .01) 전문/사무직에 종사할수록(${\beta}=0.17$, p< .001), 또한 소득수준이 400만 원 이상일수록(${\beta}=0.11$, p= .03) 유의미하게 삶의 질이 높은 것으로 나타났다. 공적 사적 자원을 포함하여 사회경제적 지위가 낮은 유방암 생존자에 대한 관심과 지원의 필요성과 실천상의 함의가 논의되었다.

Keywords

References

  1. 한국유방암학회, 2014 유방암 백서, 한국유방암학회, 2014.
  2. 중앙암등록본부, 국가암등록사업 연례보고서(2011년 암등록통계), 보건복지부, 2013.
  3. 이인정, "저소득층 유방암환자의 투병경험에 대한 근거이론적 접근-이혼한 한부모 여성가장을 중심으로," 사회복지연구, 제45권, 제1호, pp.103-140, 2014.
  4. F. Baker, M. Denniston, T. Smith, and M. M. West, "Adult cancer survivors: How are they faring?," Cancer, Vol.104, No.11, pp.2565-2576, 2005. https://doi.org/10.1002/cncr.21488
  5. F. Mols, A. J. Vingerhoets, J. W. Coebergh, and L. V. Van de Poll-Franse, "Quality of life among long-term breast cancer survivors: A systematic reviews," European Journal of Cancer, Vol.41, No.17, pp.2613-2619, 2005. https://doi.org/10.1016/j.ejca.2005.05.017
  6. K. T. Ashing-Giwa and J. W. Lim, "Examining impact of socioeconmomic status and socioecologic stress on physical and mental health quality of life among breast cancer survivors," Oncology Nursing Forum, Vol.36, No.1, 2009.
  7. K. Ell, B. Xie, A. Wells, F. Nedjat-Haiem, P. J. Lee, and B. Vourlekis, "Economic stress among low-income women with cancer: Effects on quality of life," Cancer, Vol.112, No.3, 2008.
  8. P. A. Ganz, K. A. Desmond, B. Leedham, J. H. Rowland, B. E. Meyerowitz, and T. R. Belin, "Quality of life in long term disease-free survivors of breast cancer: a follow-up study," Journal of National Cancer Institute, Vol.94, pp.1660-1668, 2002. https://doi.org/10.1093/jnci/94.22.1660
  9. C. L. Shapiro and A. Recht, "Side effects of adjuvant treatment of breast cancer," New England Journal of Medicine, Vol.344, pp.1997-2008, 2001. https://doi.org/10.1056/NEJM200106283442607
  10. P. A. Parker, W. F. Baile, C. de Moor, and L. Cohen, "Psychosocial and demographic predictors of quality of life in a large sample of cancer patients," Psycho-Oncology, Vol.12, pp.183-193, 2003. https://doi.org/10.1002/pon.635
  11. V. S. Mor, Allen, and M. Malin, "The psychosocial impact of cancer on older versus younger patients and their families," Cancer, Vol.74, pp.2118-2127, 1994. https://doi.org/10.1002/1097-0142(19941001)74:7+<2118::AID-CNCR2820741720>3.0.CO;2-N
  12. 이정화, 변혜선, 김경덕, "유방암 생존자의 기분상태가 삶의 질에 미치는 영향," 한국콘텐츠학회논문지, 제14권, 제7호, pp.356-366, 2014.
  13. K. Kobayashi, S. Morita, M. Shimonagayoshi, M. Kobayashi, Y. Fujiki, Y. Uchida, and K. Yamaguchi, "Effects of socioeconomic factors and cancer survivors' worries on their quality of life(QOL) in Japan," Psycho-Oncology, Vol.17, pp.606-611, 2008. https://doi.org/10.1002/pon.1278
  14. K. T. Ashing-Giwa, and J. W. Lim, "Predicting health-related quality of life: Testing the Contextual Model using structural equation modeling," Applied Research in Quality of Life, Vol.3, No.3, pp.215-130, 2008. https://doi.org/10.1007/s11482-009-9057-y
  15. L. B. Wenzel, D. L. Fairclough, M. J. Brady, D. Cella, K. M. Garrett, B. C. Kluhsman, L. A. Crane, and A. C. Marcus, "Age-related differences in the quality of life of breast carcinoma patients after treatment," Cancer, Vol.86, pp.1768-1774, 1999. https://doi.org/10.1002/(SICI)1097-0142(19991101)86:9<1768::AID-CNCR19>3.0.CO;2-O
  16. N. E. Avis, S. Crawford, and J. Manuel, "Quality of life among younger women with breast cancer," Journal of Clinical Oncology, Vol.23, No.15, pp.3322-3330, 2005. https://doi.org/10.1200/JCO.2005.05.130
  17. 김혜영, 고은, "젊은 유방암 생존자와 나이든 유방암 생존자의 심리사회적 적응," 종양간호연구, 제12권, 제4호, pp.280-288, 2012.
  18. C. E. Mosher and S. Danoff-Burg, "A review of age differences in psychological adjustment to breast cancer," J Psychosocial Oncology, Vol.23, pp.101-114, 2005.
  19. D. Axelrod, J. Smith, D. Kornreich, E. Grinstead, B. Singh, J. Cangiarella, and A. A. Guth, "Breast cancer in young women," Journal of American College of Surgery, Vol.206, No.11, pp.1193-1203, 2008. https://doi.org/10.1016/j.jamcollsurg.2007.12.026
  20. K. T. Ashing-Giwa and J. W. Lim, "Predicting physical quality of life among a multiethnic sample of breast cancer survivors," Quality of Life Research, Vol.19, pp789-802, 2010. https://doi.org/10.1007/s11136-010-9642-4
  21. S. Perry, T. L. Kowalski, and C. H. Chang, "Quality of life assessment in women with breast cancer: Benefits, acceptability and utilization," Health and Quality of Life Outcomes, Vol.5, pp.1-14, 2007. https://doi.org/10.1186/1477-7525-5-1
  22. P. A. Ganz, J. H. Rowland, K. Desmond, B. E. Meyerowitz, and G. E. Wyatt, "Life after breast cancer: understanding women's health-related quality of life and sexual functioning," J. of Clinical Oncology, Vol.16, pp.501-514, 1998. https://doi.org/10.1200/JCO.1998.16.2.501
  23. D. H. Baucom, L. S. Porterb, J. S. Kirbya, J. S. Gremora, and F. J. Keefeb, "Psychosocial issues confronting young women with breast cancer," Breast Disease, Vol.23, pp.103-113, 2006. https://doi.org/10.3233/BD-2006-23114
  24. P. Forbair, S. Stewart, S. Chang, C. D'Onofri, P. J. Banks, and J. R. Bloom, "Body image and sexual problems in young women with breast cancer," Psychooncology, Vol.15, pp.579-594, 2006. https://doi.org/10.1002/pon.991
  25. K. Shimozuma, P. A. Ganz, L. Petersen, and K. Kirhi, "Quality of life in the first year after breast cancer surgery: rehabilitation needs and patterns of recovery," Breast Cancer Research and Treatment, Vol.56, No.1, pp.45-57, 1999. https://doi.org/10.1023/A:1006214830854
  26. 서연옥, "유방암 환자의 삶의 질 영향요인," 대한간호학회지, 제37권, 제4호, pp.459-466, 2007.
  27. P. F. Short and E. L. Mallonee, "Income disparities in the quality of life of cancer survivor," Medical Care, Vol.44, No.1, pp.16-23, 2006. https://doi.org/10.1097/01.mlr.0000188986.84819.3a
  28. S. H. Kim, E. Y. Jun, and W. H. Lee, "The factors influencing depression in patients with breast cancer," J Korean Oncol Nurs, Vol.2, pp.133-142, 2002.
  29. J. Engel, J. Kerr, A. Schlesinger-Raab, R. Eckel, H. Sauer, and D. Holzel, "Predictors of quality of life of breast cancer patients," Acta Oncologica, Vol.42, No.7, pp.710-718, 2003. https://doi.org/10.1080/02841860310017658
  30. 황숙연, "40대 유방암 생존자의 우울.불안 위험 요인," 한국콘텐츠학회논문지, 제15권, 제2호, pp.313-323, 2015. https://doi.org/10.5392/JKCA.2015.15.02.313
  31. Y. H. Yun, T. R.. Mendoza, D. S. Heo, T. Yoo, B. Y. Heo, H. A Park, H. C. Shin, X. S. Wand, and C. S. Cleeland, "Development of a Cancer Pain Assessment in Korea: A Validation Study of a Korean Version of the Brief Pain Inventory," Oncology, Vol.66, No.6, pp.439-444, 2004. https://doi.org/10.1159/000079497
  32. H. J. Yoo, S. H. Ahn, S. Eremenco, H. Kim, W. K. Kim, S. B. Kim, and O. S. Han, "Korean translation and validation of the functional assessment of cancer therapy-breast(FACT-B) scale version 4," Quality of Life Research, Vol.14, pp.1627-1632, 2005. https://doi.org/10.1007/s11136-004-7712-1
  33. 백옥미, 임정원, "유방암 및 부인과 암 생존자의 사회적 지지: 암 병기 및 생존단계별 비교분석," 한국가족복지학, 제32호, pp.5-35, 2011.
  34. I. S. Bredal, N. A. Smeby, S. Ottesen, T. Warncke, and E. Schlichting, "Chronic Pain in Breast Cancer Survivors: Comparison of Psychosocial, Surgical, and Medical Characteristics Between Survivors With and Without Pain," Journal of Pain and Symptom Management, Vol.48, No.5, pp.852-862, 2014. https://doi.org/10.1016/j.jpainsymman.2013.12.239