본 연구 논문의 목적은 산후 우울감을 예측하는 심리적 요인을 검증하는 것이다. 산후 스트레스, 산후지지, 자아존중감 요인이 산후 우울을 예측하는 변인으로 가정되었고, 이들은 서로 상호작용하면서 모두 산후 우울감을 예측하리라고 가정되었다. 서울과 수도권에 거주하는 여성 121명을 대상으로 산후 우울(Edinburgh Postnatal Depression Scale : EPDS, 한국판 CES-D), 산후 스트레스(지각하는 스트레스, 양육 스트레스), 산후 지지(산후 사회적 지지, 산후 가족 지지), 자존감을 측정한 결과, 산후 스트레스, 산후 지지, 자아존중감은 모두 서로 유의미하게 상관이 있었고 산후 스트레스는 산후 우울을 유의미하게 예측하였다. 하지만, 산후 지지와 자아존중감은 산후 우울을 유의미하게 예측하지는 않았다. 이 결과는 산후 지지와 자존감이 산후 우울의 직접적인 원인은 아닌 것을 의미하며 산후 스트레스를 산후 우울의 예측 변인으로 고려할 수 있다는 것이다. 본 연구 결과는 출산을 준비하는 여성에게 가능한 스트레스를 줄이는 대처를 준비해야 하며, 스트레스와 상관이 있는 산후 지지와 자존감 증진 체계를 계획하는 것이 산후 우울 예방에 중요하다는 정보를 제공한다.
The purpose of this study was to propose and test a psycho-social predicting factors model of postpartum depression. This model posits that postpartum stress, postpartum support and self-esteem are predicting factors of postpartum depression and the predicting factors are correlated each other. Participants were 121 women who lives in Seoul and Gyounggi Provance and have gave birth to baby recently. Postpartum depression, postpartum stress, postpartum support and self-esteem were assessed with the 'Edinburgh Postnatal Depression Scale', 'Korean CES-D(Center of Epidemiological Studies Depression Scale)', 'Perceived Stress Scale', 'Childcare Stress Inventory', 'Postpartum Social Support Questionnaire', 'Postpartum Social Questionnaire' and 'Self-esteem Inventory'. Postpartum stress, postpartum support, self-esteem were all significantly correlated each other. Postpartum stress was a significant predicting factor of postpartum depress but postpartum support and self-esteem. Result of this study informed perinatal women to plan and solicit effective support from their social network and reduce possible stress. Result of this study can be applied to make group therapy programming as well. The peer group of which members have a similar experiences or the group of which women's husband are participating will be helpful for postpartum women to overcome the stress. The group programme to increase self-esteem would be helpful as well.
권정혜, (1997) 심리사회적 요인이 산후우울에 미치는 영향: 산후우울에 대한 스트레스 취약성 모델 검증, 한국심리학회지: 임상
김계수, (2002) 구조방정식 모형 분석: AMOS 4.0. 서울: SPSS 아카데미.김락형, 김수연, 권보형 (2000). 산후우울증에 대한 임상적 연구. 동의신경정신과 학회지, 11(2),
김정규, (2003) 자아가치관 검사 실시요강, 한국 가이던스
박시성 ; 한귀원, (1999) 산후우울증의 심리사회적 위험요인, 정신신체의학
배정이, (1996) 산후 우울감 경험에 관한 연구, 근거 이론적 접근, 대한간호학회지
송대현, (1993) 심리학에서 본 자존심, 성원사
송홍지, (2003) 여성 건강의 최신 연구 동향 및 과제, 가정의학회지
이경혜, (1995) 여성건강에 대한 개념분석 연구, 여성건강간호학회지
이동규, (2001) 부인과 외래의 산후우울증에 관한 보고. 동국대학교 한의과대학 부인과교실, 대한한방부인과학회지
이부영, (1998) ICD-10 정신 및 행태장애, 일조각
이정균, (2001) 정신의학 제4판, 일조각
이태균, (2000) 산후우울증에 관한 문헌적 고찰.대한, 한방부인과학회지
전겸구, (1992) 한국판 CES-D 개발 연구 Ⅰ, 한국심리학회 '92 연차대회 학술발표논문집
전지아, (1990) 산후 스트레스와 사회적 관계망이 산후우울에 미치는 영향,
조영숙, (1992) 배우자지지행위가 산후우울 및 자아존중감에 미치는 영향에 관한 연구, 간호과학
조영숙, (1992) 산욕기 산모의 자아존중감과 산후우울과의 관계연구, 정신간호학회지
하영수, (1994) 여성건강 간호학의 역사적 조명, 대한간호학회 여성건강간호학회 정기총회 및 학술대회
Ann,L.D., (1997) Evaluation and Treatment of Postpartum Emotional Disorders. Practitioner's resource series, Professional Resource Press
Appleby,L., (1994) Screening women for high risk of postnatal depression, Journal of Psychosomatic Research
Arizmedi,T.G., (1987) Stressful events related to pregnancy and postpartum, Journal of Psychosomatic Research
Battle,J., (1978) Rlationship between Self-esteem and Depression, Psychological Report
Brown,G.W., (1990) Self-esteem and depression Ⅲ. Aetiological issues, Social Psychiatry and Psychiatric Epidemiology
Chich-Hsiu Hung, (2001) The effects of postpartum stress and social support on postpartum women's health status. Issues and Innovation in Nursing Practice,
Cohen,S., (1983) Positive events and social support as buffers of life change stress, Journal of Applied Social Psychology
Cohen,S., (1985) Stress, social support, and the buffering hypothesis, Psychological Bulletin
Cowan,C.P., (1987) A preventive intervention for couples becoming parents in : Research on Support for Parents and Infants in the Postnatal Period, Ablex
Cox,J.L., (1987) Detection of postnatal depression: Development of the ten-item Edinburgh Postnatal Depression Scale, British Jouranl of Psychiatry
Cramer,B., (1993) Are postpartum depressions a mother-infant relationship disorder, Infant Mental Health Journal
Cronenwett,L.R., (1985) Network structure, social support, and psychological outcomes of pregnancy, Nursing Research
Cutrona,C.E., (1984) Social support and stress in the transition to parenthood, Journal of Abnormal Psychology
Cutrona C.E., (1986) Social Support, Infant Temperament and Parenting Self-Efficacy: A Mediational Model of Postpartum Depression, Child Development
Cynthia M., (2001) Psychosocial Predictors of Postpartum Depression in Diverse Groups of Women, Western Journal of Nursing Research
Demyttenaere,K., (1995) Individual coping style and psychological attitudes during pregnancy predict depression levels during pregnancy and during postpartum, Acta Psychiatric Scandinavica
Ding,L., (1995) Effects of Estimation Methods, Number of Indicators per Factor and Improper Solutions on Structrual Equation Modeling Fit Indices, Structural Equation Modeling
Feggetter,P., (1981) Nonpsychotic psychiatric disorders in women one year after childbirth, Journal of Psychosomatic Research
Fric Guay, (2000) Predicting Career Indecision: A Self-Determination Theory Perspective, Journal of Counseling Psychology
Gjerdingen,D.K., (1993) Changes in women's physical health during the first postpartum year, Archives of Family Medicine
Gotlib,I.H., (1991) Prospective investigation of postpartum depression: Factors involved in onset and recovery, Journal of Abnormal Psychology
Harris,B., (1989) The hormonal environment of postnatal depression, British Journal of Psychiatry
Hewston M., (1981) Psychological Change in Neurotic Depression: A repertory grid and personal construct theory approach, British Journal of Psychiatry
Hopkins,J., (1987) Role of infant-related stressors in postpartum depression, Journal of Abnormal Psychology
Hopkins,J., (1989) Postpartum depression and postpartum adaptation: overlapping constructs, Journal of Affective Disorders
House,J., (1981) Work stress and social support, Addison-Wesley
Hupcey,J.E., (1988) Clarifying the social support theory-research linkage, Journal of Advanced Nursing
Knops,G.G., (1993) Postpartum mood disorders: A startling contrast to the joy of birth, Postgraduate Medicine
Leung Sharron Shuk Kam, (2001) Postpartum depression: Perceived social support and stress among Hong Kong Chinese women,
Lluisa Garcia-Esteve, (2002) Validation of the Edinburgh? 산후 우울 척도 in Spanish mothers, Journal of Affective Disorders
Logsdon,M.C., (1989) Help after childbirth: Do women get what they expect and need, The Kentucky Nurse
Marsh,H., (1997) Organization of children's academic self-perceptions: Reanalysis and counterinterpretations of confirmatory factor analysis results, Journal of Educational Psychology
McGrath,J., (1970) A conceptual formulation for research on stress. In: Social and psychological factors in stress, Holt, Reinhart and Winston
O'Hara,M.W., (1982) Predicting depressive sympto- matology: Cognitive-behavioral models and postpartum depression, Journal of Abnormal Psychology
O'Hara,M.W., (1991) Controlled prospective study of postpartum mood disorders: Psychological, environmental, and hormonal variables, Journal of Abnormal Psychology
Paola Benvenuti, (1999) The Edinburgh Postnatal Depression Scale: validation for an Italian sample, Journal of Affective Disorders
Paykel,E.S., (1980) Life events and social support in puerperal depression, British Journal of Psychiatry
Rohde,A., (1993) Postpartum psychoses: Onset and long-term course, Psychopathology
Suin,L., (1999) depressive symptoms in the late postpartum among low socio-economic status women, British Journal of Psychology
Stuart,F.Q., (1984) Sleep disturbance in the eldery, Geriatrics
Taft,L.B., (1985) Self-esteem in later life: A Nursing perspectives, Advances in Nursing Science
Tentoni,Stuart C., (1980) Culturally Induced Postpartum Depression: Theoretical position, J.O.G.N. Nursing
Whiffen,V.E., (1988) Vulnerability to postpartum depression: A prospective, multivariate study, Journal of Abnormal Psychology
Whiffen,V.E., (1992) Is postpartum depression a distinct diagnosis, Clinical Psychology Review
Watson,J.P., (1984) sychiatric disorder in pregnancy and the first postnatal year, British Journal of Psychiatry