본 연구는 암 환자를 위한 국내외 심리사회적 개입에 관한 연구를 개관한 것이다. 암 환자들은 진단을 받는 순간에서 치료를 받는 동안, 또한 치료종결 이후에도 지속적인 심리적 문제를 경험한다. 암 환자들에게 일차적으로 의학적 치료가 중요하지만, 수술이나 항암요법, 방사선 치료만으로 충분히 이들을 돌볼 수가 없다. 최근에는 심리사회적 개입법들이 암 환자의 삶의 질 향상이나 정서적 고통 완화, 대처기술의 향상, 대인관계 증진과 같은 심리적 효과뿐만 아니라, 면역기능 향상, 스트레스 호르몬의 감소 등과 같은 긍정적인 생리적 효과를 낳는다는 연구결과가 발표되고 있어 더욱 심리사회적 개입법의 중요성이 인정되고 있는 상황이다. 이에 본 연구에서는 먼저 암 환자들의 심리적인 어려움을 간략히 기술한 후 이를 극복하도록 도와주기 위한 여러 심리사회적 개입법의 효과검증 연구들을 유형별로 개관하였다. 심리사회적 개입법의 대표적인 유형을 교육, 지지-표현(경험-실존) 치료, 인지-행동 치료, 통합 치료 등 4가지로 구분하였다. 교육적 개입에는 질병과 치료, 부작용 등에 대한 건강교육 및 증상관리기술, 스트레스 관리가 주요 내용으로 포함되며, 지지-표현 치료에서는 감정 표현 및 사회적 지지가 중요한 치료 요인으로 죽음과 삶의 의미, 책임감 등 실존적인 문제에 대한 직면이 포함된다. 인지-행동 치료에는 인지적 재구조화, 이완훈련, 문제해결훈련이 주요 치료요인으로 포함되며, 통합 치료는 이상의 여러 치료적 접근을 함께 적용한 경우를 일컫는다. 또한 예술치료를 포함하여 기타 접근을 추가로 고찰하였다. 마지막으로, 국내의 최근 연구 동향을 정리하였고 앞으로의 연구방향과 관련된 제언을 제시하였다.
The purpose of this study is to review research on the psychosocial interventions for cancer patients. Cancer patients experience continuing psychological problems from at the moment diagnosed, during medical treatment, and after termination of the treatment. Of course, medical treatment is the critical for them, but surgical operation, chemical therapy, and radiation therapy are not enough for caring cancer patients. Recent research indicates that psychosocial interventions for the cancer patients can not only improve the quality of life, decrease emotional distress, and enhance coping skills and interpersonal relationships, but also result in positive physiological effects such as improvement of immune functions and decrease of stress hormone. Now many researchers admit the importance of the psychosocial interventions for cancer patients. So, we described psychological disturbances of cancer patients at first, and then reviewed research for the validation of the efficacy of psychosocial intervention programs for cancer patients. We discriminated interventions according to the content and major therapeutic factors, and categorized them into 4 types such as education, supportive- expressive(experiential-existential) therapy, cognitive-behavioral therapy, and integrative therapy. Education approach involves health education(for disease, treatment, and side effect), symptom management, and stress management skill. Supportive-expressive therapy primarily encourages emotion expression and social support, and it also involves confrontation of existential problems such as death, dying, meaning of life, responsibility, and so on. Cognitive-behavioral therapy includes cognitive restructuring, relaxation training, and problem-solving training in general. Integrative therapy is labeled in the case of utilizing different therapeutic approaches together. And we also introduced other approaches for cancer patients including art therapy. Finally, we presented recent research accomplished in Korea and suggested some future research tasks.
감성희, (2003) 자기효능증진 프로그램이 암환자의 자기효능,자가간호,불안에 미치는 영향,
김영순, (2006) I 치료에 대한 정보제공 프로그램이 갑상선암 환자의 불안과 면역기능에 미치는 효과, 종양간호학회지
김조자 ; 허혜경 ; 강덕희 ; 김보환, (2004) 유방암 환자의 스트레스 대응 능력 증진을 위한 심리사회적 중재 개발 및 효과: 예비연구, Journal of Korean Academy of Nursing
김조자, (2007) 유방암 환자의 스트레스 대응 능력 증진을 위한 심리사회적 중재 효과, 대한간호학회지
권정혜 ; 김종남, (2006) 유방암 환자를 위한 통합적 집단치료가삶의 질과 면역기능에 미치는 효과, 한국심리학회지 임상
박영미, (2005) 유방암 환자의 삶의 질 구조 모형,
박호란 ; 박선남 ; 정경희 ; 김혜자, (2001) 암 환아 어머니의 희망, 부담감과 가족기능, Child Health Nursing Research
서순 림.이원기, (2003) 재가 암 환자의 증상관리를 위한 심리교육 중재효과*, Asian Oncology Nursing
서연옥, (2007) 유방암 환자의 삶의 질 영향요인, Journal of Korean Academy of Nursing
암정복추진기획단, (2007) 암 환자의 정신적 고통, 어떻게 도울 것인가, 제 9회 암정복포럼 자료집
이명아, (2007) 소아암 완치자와 주보호자의 장기적인 심리적 적응에 대한 예비연구, 2007년 제 4차 건강심리학회 학술발표대회 및 워크샵 자료집
이원희 ; 황애란, (2003) 암으로 자녀와 사별한 어머니의 슬픔단계와 반응, Journal of Korean Academy of Nursing
이정섭, (1994) 암으로 자녀를 잃은 가족의 경험에 대한 질적 연구, 대한간호학회지
이태현, (1992) 35세 이하 여성의 유방암, 대한암학회지
정영호, (2002) 암 사망으로 인한 손실소득액 추계, 보건복지포럼
태영숙 ; 윤수정, (2006) 용서간호중재 프로그램이 여성 암환자의 희망과 삶의 질에 미치는 영향* , Asian Oncology Nursing
통계청, (2007) 통계청 (2007). 2006년 사망원인통계결과 (http://www. nso.go.kr),
한국중앙암등록본부, (2003) 한국중앙암등록본부 (2003). 암발생률-생존률 통계(보도자료-세부통계자료) (http://www.ncc.re.kr),
황숙연, (2000) 유방암 환자를 위한 심리교육 프로그램에 고한한 기초연구, 사회복지연구
Aldridge,D., (1996) A walk through Paris , The development of melodic expression in music therapy with a breast-cancer patient, Arts in Psychotherapy
Ali, N. S., (1989) Effect of psychoeducational intervention on anxiety among Egyptian bladder cancer patients, Cancer Nursing
Ana,P., (2004) The efficacy of art therapy to enhance emotional expression, spirituality and psychological well-being of newly diagnosed stage I and stage II breast cancer patients, Dissertation presented to the graduate school of the University of Flori
Anderson,B.L., (1992) Psychological interventions for cancer patients to enhance the quality of life, Journal of Consulting and Clinical Psychology
Antoni, M. H., (2006) How stress management improves quality of life after treatment for breast cancer, Journal of Consulting and Clinical Psych
Avis, N. E., (2004) Psychosocial problems among younger women with breast cancer, Psycho-Oncology
Bakke, A. C., (2002) The effect of hypnotic-guided imagery on psychological well-being and immune function in patients with prior breast cancer, Journal of Psychosomatic Research
Bloom, J. R., (1984) The relationship of two dimensions of social support to the psychological well-being and social functioning of women with advanced breast cancer, Social Science and Medicine
Boesen,E.H., (2007) Survival after a psychoeducational intervention for patients with cutaneous malignant melanoma: A replication study, Journal o
Boesen, E. H., (2005) Psychoeducational intervention for patients with cutaneous malignant melanoma: A replication study, Journal of Clinical Onco
Cain, E. N., (1986) Psychosocial benefits of a cancer support group, Cancer
Cameron, J. I., (2004) A brief problem-solving intervention for family caregivers to individuals with advanced cancer, Journal of Psychosomatic Research
Cameron, L. D., (2007) Changes in emotion regulation and psychological adjustment following use of a group psychosocial support program for women recently diagnosed with breast cancer, Psycho-On
Carlson, L. E., (2007) One year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction(MBSR) in breast and prostate cancer outpatients, Br
Classen, C., (2001) Supportive-expressive group psychotherapy and distress in patients with meatastatic breast cancer, Archiv
Compas, B. E., (1998) Sampling of empirically supported psychological treatments from health psychology: Smoking, chronic pain, cancer, and bulimia nervosa, Journal of Consulting and Clinic
Cunningham, A. J., (1989) A randomized trial of group psycho-educational therapy for cancer patients, Patient Education and Counseling
Davey, M., (2005) Adolescents coping with mom's breast cancer: Developing family intervention programs, Journal of Marital and Family Therapy
Davis,M., (2000) The healing way: A Journal for cancer survivors, Houghton Mifflin
Edelman, S., (1999) A group cognitive behaviour therapy program with metastatic breast cancer patients, Psycho-Oncology
Edmond, C. V. I., (1999) Psychological response to long term group therapy: A randomized trial with metastatic breast cancer patients, Psycho- Oncology
Epstein, D. R., (2007) Randomized trial of a cognitive-behavioral intervention for insomnia in breast cancer survivors, Oncology nursing forum
Ezer, H., (2006) Adaptation of wives to prostate cancer following diagnosis and 3 months after treatment: A test of family adaptation theory, International Journal of Nursing St
Fawzy, F. I., (1990) A structured psychiatric intervention for cancer patients: I. Changes over time in methods of coping and affective disturbance, Archives of General Psychiatry
Fawzy, F. I., (1995) Critical review of psychosocial interventions in cancer care, Archives of General Psychiatry
Fawzy, F. I., (1993) Malignant melanoma: Effects of an early structured psychiatric intervention, coping, and affective state on recurrence and survival 6 years later, Archi
Fawzy, F. I., (1990) A structured psychiatric intervention for cancer patients: II. Changes over time in immunological measures, Archives of General Psychiatry
Folkman,S., (1980) An analysis of coping in a middle-aged community sample, Journal of Health and Social Behavior
Ganz, P. A., (1998) Life after breast cancer: Understanding women's health-related quality of life and sexual functioning, Journal of Clinical Oncology
Garcia, H. B., (1989) Knowledge about cancer and use of health care services among Hispanic and Asian-American olden adults, Journal of Psychosocial Oncology
Goleman, D., (1993) Mind/Body Medicine: How to use your mind for better health, Consumer Reports Books, A Division of Consumers Union Yankers, New York
Gordon, W. A., (1980) Efficacy of psychosocial intervention with cancer patients, Journal of Consulting and Clinical Psychology
Grabsch, B., (2006) Psychological morbidity and quality of life in women with advanced breast cancer: A corss-sectional survey, Palliative Support Care
Greenstein, M., (2000) Cancer and the experience of meaning: A group psychotherapy program for people with cancer, American Journal of Psychotherapy
Greer,S., (2002) Psychological intervention the gap between research and practice, Acta Oncology
Greer, S., (1992) Adjuvant psychological therapy for patients with cancer: A prospective randomized trial, British Medical Journal
Gritz, E. R., (1990) Long-term effects of testicular cancer on marital relationships, Psychosomatics
Gruber, B. L., (1988) Immune system and psychological changes in metastatic cancer patients using relaxation and guided imagery: A pilot study, Scandinavian Journal of Behavior Therapy
Heinrich, R. L., (1985) Stress and activity management: Group treatment for cancer patients and their spouses, Journal of Consulting and Clinical Psychology
Hernandez-Reif, M., (2004) Breast cancer patients have improved immune and neuroendocrine functions following massage therapy, Jou
Hudson, P. L., (2005) A psycho-educational intervention for family caregivers of patients receiving palliative care: A randomized controlled trial, Journal of Pain and Symptom Management
Jacobs, C., (1983) Behavior of cancer patients: A randomized study of the effects of education and peer support groups, American Journal of Clinical Oncology
Kabat-Zinn,J., (2003) Mindfulness-based interventions in context: Part, present, and future, American Psychological Association
Kiecolt-Glaser, J. K., (1992) Psychoimmunology: Can psychological interventions modulate immunity, Journal of Consulting and Clinical Psychology
Kissane, D. W., (1998) Family Grief therapy: A preliminary account of a new model to promote healthy family functioning during palliative care and bereavement, Psycho-Oncology
Kissane, D. W., (2003) Cognitive-existential group psychotherapy for women with primary breast cancer: A randomized controlled trial, Psycho-Oncology
Krupnick, J., (1993) Professionally-led support groups for cancer patients: An intervention in search of a model, Psychiatry in Medicine
Lee,C.S., (2001) The use of narrative in understanding how cancer affects development: The stories of one cancer survivor, Journal of Health Psychology
Lewis, F. M., (1992) Psychosocial adjustment of the family to breast cancer: A longitudinal analysis, Journal of the American Medical Women's Association
Linn, M. W., (1982) Effects of counseling for late stage cancer, Cancer
Malchiodi,C., (2003) Expressive arts therapy and multimodal approaches. In : The handbook of art therapy, Guilford
Manne, S. L., (2006) Are psychological interventions effective and accepted by cancer patients? II. Using empirically supported therapy guidelines to decide, Annuals of Behavioral Medicine
Marchioro, G., (1996) The impact of a psychological intervention on quality of life in non-metastatic breast cancer, European
Massie, M. J., (1988) Consultation and liaison issues in cancer care, Psychiatric Medicine
McGregor, B. A., (2004) Cognitive-behavioral stress management increases benefit finding and immune function among women with early-stage breast cancer, Journal of Psychosomatic R
Meyerowitz,B.E., (1983) Postmastectomy coping strategies and quality of life, Health Psychology
Moorey, S. Greer, (1998) A comparison of adjuvant psychological therapy and supportive counselling in patients with cancer, Psycho-Oncology
Mundy, E. A., (2003) The efficacy of behavioral interventions for cancer treatment-related side effects, Seminar of Clinical Neuropsychiatry
Nezu, A. M., (1997) Project Genesis: Application of problem-solving therapy to psychosocial oncology, The Behavior Therapist
Northouse, L., (2005) Effects of family intervention on the quality of life of women with recurrent breast cancer and their family caregivers, Psycho-Oncology
Nunes, D. F. T., (2007) Relaxation and guided imagery program in patients with breast cancer undergoing radiotherapy in not associated with neuroimmunomodulatory,
Osborn, R. L., (2006) Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: Meta-analysis, International Journal of Psychiatry Medicine
Penedo, F. J., (2006) A randomized clinical trial of group-based cognitive-behavioral stress management in localized prostate cancer, Development
Pompe, G., (1996) Adjustment to breast cancer: The psychological effects of psychosocial interventions, Patent Education and Counseling
Pompe, G., (1997) Effectiveness of a short-term group psychotherapy program on endocrine and immune function in breast cancer patients: An exploratory study, Journal of Psychosomatic Resea
Pruitt, B. T., (1993) An educational intervention for newly-diagnosed cancer patients undergoing radiotherapy, Psycho-Oncology
Rehse,B., (2003) Effects of psychosocail interventions on quality of life in adult cancer patients: Meta-analysis of 37 published controlled outcome studies, Patent Education and Counseling
Riessman,F., (1965) The "helper" therapy principle, Social Worker
Robert, C. S., (1997) Support group intervention to facilitate young adults' adjustment to cancer, Health and Social Work
(2006) Rummans, T. A., Clark, M. M., Sloan, J. A., Frost, M. H., Bostwick, J. M., Artherton, P. J., Johnson, M. E., Gamble, G., Richardson, J., Brown, P., Martensen, J., Miller, J., Piderman, K., Huschka, M., Girardi, J., & Hanson, J. (2006). Impacting quality o,
(2005) Sahler, O. J., Fairclough, D. L., Phipps, S., Mulhern, R. K., Dolgin, M. J., Noll, R. B., Katz, E. R., Varni, J. W., Copeland, D. R., & Butler, R. W. (2005). Using problem-solving skills training to reduce negative affectivity in mothers of children with,
Savard, J., (2001) Prevalence, characteristics, and risk factors for insomnia in the context of breast cancer, Sleep
Shapiro, S. L., (2003) The efficacy of mindfulness-based stress reduction in the treatment of sleep disturbance in women with breast cancer: An exploratory study, Journal of Psychosomatic
Smedslund, G., (2004) Meta-analysis of the effects of psychosocial interventions on survival time in cancer patients, Journal of Psychosomatic Research
Speca, M., (2000) A randomized wait-list controlled trial: The effects of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients, Psychosomatic Medicine
Spiegel,D., (1993) Psychosocial intervention in cancer, Journal of the National Cancer Institute
Spiegel,D., (1999) Healing words: Emotional expression and disease outcome. (editorial; comment), The Journal of the American Medical Association
Spiegel, D., (1983) Group therapy and hypnosis reduce matastatic breast carcinoma pain, Psychosomatic Medicine
Spiegel, D., (1989) Effect of psychosocial treatment on survival of patients with metastatic breast cancer, Lancet
Spiegel, D., (1981) Group support for patients with metastatic cancer, Archives of General Psychiatry
Spiegel, D., (2007) Effects of supportive-expressive group therapy on survival of patients with metastatic breast cancer, A r
Spiegel,D., (2000) Group therapy for cancer patients, Basic behavioral sciences
Spiegel,D., (2002) Reduced emotional control as a mediator of decreasing distress among breast cancer patients in group therapy, International Congress Series
Spiegel, D., (1983) Effects of group confrontation with death and dying, International Journal of Group Psychotherapy
Spiegel,D., (1991) Supportive-expressive group therapy: A treatment manual of psychosocial intervention for women with recurrent breast cancer(unpublished), Psycosocial treatment laboratory; Stanford University School of Medicine
Spiegel, D., (1998) Complementary Medicine, The Western Journal of medicine
Spiegel, D., (1978) A support group for dying patients, International Journal of Group Psychotherapy
Stanton, A. L., (2000) Emotionally expressive coping predicts psychological and physical adjustment to breast cancer, Journal of Consulting and Cli
Tatrow, T., (2006) Cognitive behavioral therapy techniques for distress and pain in breast cancer patients: A meta-analysis, Journal of Behavioral Medicine
Telch, C. F., (1986) Group coping skills instruction and supportive group therapy for cancer patients: A comparison of strategies, Journal of Consulting and Clinical Psychology
Thewes, B., (2004) The psychosocial needs breast cancer survivors: A qualitative study of the shared and unique needs of yourger versus older survivors, Psycho-Oncology
Trijsburg, R. W., (1992) Effects of psychological treatment on cancer patients: A critical review, Psychosomatic Medicine
Wilkinson, S. M., (2007) Effectiveness of aromatherapy massage in the management of anxiety and depression in patinets with cancer, A multi
Yalom,I.D., (1995) The theory and practice of group psychotherapy, Basic Books
Yeo, W., (2004) Psychosocial impact of breast cancer surgeries in chinese patients and their spouses, Psycho-Oncology