만성신부전 환자의 심리적 적응에서 사회비교 동기와 통제신념의 효과
The Effcts of Social Comparison Motive and Control on Psychological Adjustment of the Hemodialysis Patients
현명호 (중앙대학교)
김효창 (학지사 심리검사연구소)
초록
본 연구는 혈액투석중인 만성신부전 환자의 심리적 적응에 사회비교추구 성향과 통제감이 미치는 영향력을 탐색하여 만성신부전 환자의 적응을 위한 심리적 개입의 기초를 제공하고자 하였다. 서울과 경인, 부산 지역 소재 총 12개 인공 신장실 외래를 방문한 혈액투석 환자 131명을 대상으로 연구한 결과는 다음과 같다. 첫째, 상향비교를 추구하는 집단은 하향비교를 추구하는 집단보다 심리적 적응수준이 높은 경향성을 보였으나 통계적으로 유의하지는 않았다. 둘째, 통제감이 높은 집단은 통제감이 낮은 집단에 비해 심리적 적응수준이 높았다. 마지막으로, 심리적 적응수준에 대한 사회비교추구 성향과 통제감과의 상호작용 효과는 유의하였다. 즉 통제감이 높은 수준에서 상향 비교를 추구하는 집단이 하향비교를 추구하는 집단보다 심리적 적응수준이 더 높게 나타났다. 본 연구 결과를 통해, 완치에 대한 현실적인 기대를 갖지 못하는 만성신부전증 환자에게 적절한 심리적 개입을 함으로서 그들의 심리적 적응을 도울 수 있을 것으로 기대된다.
- keywords
- Hemodialysis, Psychological Adjustment, Social Comparison Motive, Control, 만성신부전, 사회비교추구, 통제감, 심리적 적응
Abstract
The purpose of this study is to investigate the effects of social comparison motive and control on psychological adjustment of hemodialysis patients with an end-stage renal disease and to provide basic data for effective psychological intervention to the psychological maladjustment in hemodialysis patients. In order to do this, Self- Control Schedule, Social Comparison Motive, and Psychosocial Adjustment to Illness Scale-Self Report are administered to 131 hemodialysis patients with ESRD at twelve hospitals in Seoul, Busan, and Kyung-in area. The results are as follows. Firstly, in the degree of psychological adjustment, the upward comparison group show no significant differences from the downward comparison group. Second, the high control group show higher levels of psychological adjustment than the low control group. Third, the interaction effect between social comparison motive and control on psychological adjustment show differences. That is, the upward comparison group in high control show higher levels of psychological adjustment than the downward comparison group. Thanks to the result of this study, the Psychological Adjustment of patients with an end-stage renal disease, who are in the situation under which it is impossible for them to have real expectation for perfect cures, can be dealt with more in death. Specifically speaking, through a proper psychological intervention, when we approach the patients, it can be used in a expansive cure for the patients
- keywords
- Hemodialysis, Psychological Adjustment, Social Comparison Motive, Control, 만성신부전, 사회비교추구, 통제감, 심리적 적응
참고문헌
고태연 (2002). 사회비교 정보와 심리적 특성이 수술 전환자의 정서에 미치는 영향. 아주대학교 석사학위 논문.
김영경 (1990). 만성신부전 환자의 스트레스와 적응간의 노정분석 연구. 이화여자대학교 박사학위 논문.
김희정 (2004). 상향 사회비교의 목표, 비교 대상의 선택의 자결성 및 결과가 수행에 미치는 영향.성균관 대학교 석사학위 논문.
대한신장학회 등록위원회 (2006). 우리나라 신대체 요법 현황. 대한신장학회지, 25(2), S425-S457.
서순림 (1996). 항암치료환자에게 시행한 자기간호 교육과 자원동원성 수준이 적극적 대처 행위에 미치는 효과. 서울대학교 박사학위 논문.
서창원 (1998). 심리적 통제감에 대한 소고. 충남대학교 사회과학연구, 9, 119-135.
소희영, 김종임, 김흥선 (1985). 혈액투석 환자의 우울에 관한 연구. 충남의대지, 12(1), 198-205.
신영수, 김용익, 이상일, 윤성철, 조인호(1988). 우리나라 만성신부전 환자 중 혈액투석 이용 환자수 예측에 관한 연구. 대한신장학회지, 7(2), 359-364.
안재현 (1996). 혈액투석 환자의 신체상과 자아존중감에 관한 연구. 이화여자대학교 석사학위논문.
이숙자 (1993). 지지적 간호행위가 혈액투석 환자의 대처방식에 따라 우울과 삶의 질에 미치는 영향. 연세대학교 박사학위 논문.
장은영, 한덕웅 (1998). 비교대상의 선택에서 환류유형,비교속성 및 통제감의 효과. 한국 심리학회 연차학술대회 발표 논문집, 461-476
장은영 (2003). 사회비교동기와 충족 수준이 비교대상의 선택과 정서에 미치는 영향. 성균관 대학교 박사학위 청구논문.
조금순 (1997). 자원동원성과 건강통제소재가 심리적 적응에 미치는 영향. 연세대학교 석사학위 논문.
Affleck G., & Tennen, H. (1991). Social comparison and coping with major medical problems. In J. Suls & T. A. Wills(Eds.). Social Comparison: Contemporary Theory and Research(pp.369-394). Hillsdale, NJ: Erlbaum.
Aspinwall, L. G., & Taylor, S. E. (1993). Effects of social comparison direction, threat, and selfesteem on affects, self-evaluation, and expected success. Journal of Personality and Social Psychology, 64, 708-722.
Bogart L. M., & Hwlgeson, V. S. (2000). Social comparison among woman with breast cancer: A longitudinal investigation. Journal of Applied Social Psychology, 30(3), 547-575.
Brickman, P., & Bullman, R. J. (1997). Pleasure and pain in social comparison. In J. M. Suls & R. L. Miller (Eds.) Social Comparison Processes; Theoretical and Empirical Perspectives. Washington, D. C. Hemisphere.
Burckhardt, C. S. (1987). Coping strategies of chronically ill. Nursing Clinics of North America, 22(3), 543-550.
Buunk, B. P., Collins, R. L., Taylor, S. E., VanYperen, W., & Dakof, G. A.(1990). The affective consequences of social comparison: Either direction has its ups and downs. Journal of Personality and Social Psychology, 59, 1238-1249.
Buunk, B. P. (1995). Comparison direction and comparison dimension among disabled individual: Toward a refined conceptualization of social comparison under stress. Personality and Social Psychology Bulletin, 21, 316-331.
Buunk, B. P., & Gibbons, F. X. (1997). Health, Coping and well-being: Perspective Form Social Comparison Theory. Mahwah, NJ. Erlbaum.
Buunk, B. P., & Yberma, J. F. (1997). Social comparison and occupational stress: The identification-contrast model. In B. P. Buunk & F. X. Gibbons (Eds.). Health, Coping and well-being: Perspective From Social Comparison Theory (pp.359-388). Mahwah, NJ. Erlbaum.
Buunk, B. P., Oldersma. F. L., & Dreu, C. K. W. (2001). Enhancing satisfaction through downward comparison: The role of relation discontent and individual difference in social conparison orientation. Journal of Experimental Social Psychology, 37, 452-467.
Christman, N. J. (1990). Uncertainty and adjustment during radiotherapy. Nursing Research, 39, 17-20.
Collins, R. L. (1996). For better of for worse: The impact of upward social comparisons on selfevaluations. Psychological Bulletin, 119, 51-69.
Derogatis, L. R. (1983). The Psychosocial Adjustment to Illness Scale (PAIS & PAIS-SR) Administration, Scoring and Procedures Manual-1. Baltimore, MD : Johns Hopkins University School of Medicine.
Ferrans, C. E., & Powers, M. J. (1985). The employment potential of hemodialysis patients. Nursing Research, 43, 273-277.
Festinger, L. A. (1954). Threat as determinant of downward comparison. Journal of Experimental Social Psychology, 2, 32-39.
Fitzgerald, T. E., Tennen, H., Affleck, G., & Pransky, G. S. (1993). The relative importance of dispositional optimism and control appraisals in quality of life after coronary bypass surgery. Journal of Behavioral Medicine, 16, 25-43.
Folkman, S., Lazarus, R. S., Dunkel-Schetter, C., Delongis, A., & Gruen. R. J. (1986). Dynamics of stressful encounter: Cognitive appraisal, coping, and encounter outcomes. Journal of Personality and SocialPsychology, 50(5), 992-1003.
Gibbons, F. X. (1986). Social comparison and Depression: Company's effects on misery. Journal of Personality and Social Psychology, 51, 140-148.
Gibbons, F. X., Benbow, C. P., & Gerrard, M. (1994). From top dog to bottom half : Social comparison strategies in response to poor performance. Journal of Personality and Social Psychology, 67, 638-652.
Gibbons, F. X., Gerrard, M., Lando, H. A., & McGovern, P. G. (1991). Social comparison and smoking sensation: The role of the "typical smoker". Journal of Experimental Social Psychology, 27, 239-258.
Ginter, G. G., West, J. D., & Zarski, J. J. (1989). Learned Resourcefulness and situationspecific coping with stress. The Journal of Psychology, 123(3), 295-304.
Hakmiller, K. L. (1966). Threat as a determinant of downward comparison. Journal of Experimental Social Psychology, 2, 32-29.
Henner, T., Weisenberg, M., & Har-even, D. (1996). Supportive versus cognitive-behavioral intervention programs in achieving adjustment to home peritoneal kidney dialysis. Journal of Consulting and Clinical Psychology, 64(4), 731-741.
Karasek, R. A, Theorell, T. (1990). Healthy Work : Stress, Productivity and the Reconstruction of Working Life. New York : Basic Book.
Lazarus, R. (1976). Patterns of Adjustment (3rd ed.). New York: McGrawHill.
King, K. B., Clark, P. C., & Freidman, M. M. (1999). Social comparison and temporal comparison after coronary artery surgery. Heart & Lung, September/october, 316-325.
Kulik, J. A., Mahler, H. I. M., & Moore, P. J. (1996). Social comparison and affiliation under threat. of Personality and Social Psychology, 71(5), 969-979.
Lockwood, P. & Kunda, Z. (1997). Superstars and me : Predicting the impact of role. models on the self. Journal of Personality and Social Psychology, 73, 91-103.
Medvene, L. (1992). Self-help groups, peer counseling, and social comparison. In S. Spacapan & S. Oskamp (Eds.), Helping and Being Helped: Naturalistic Studies. London: Sage.
Nosanchuk, T. A., & Erickson, B. H. (1985). How high is up? Calibrating social comparison in the real world comparison. Journal of Personality and Social Psychology, 48, 624-634.
Pollock, S. E. (1989). The hardiness characteristic: A motivation factor in adaptation. Advance in Nursing Science, 11(2), 53-62.
Patricia, J. M. (2000). Behavioral and Affective Responses to Social Comparison Among Hemodialysis Patients : The Moderating Influence of Control Expectancies and Personality. The University of Iowa.
Radloff, R. (1966). Social comparison and ability evaluation. Journal of Experimental Social Psychology, Suppl. 1, 6-26.
Raps, C. S., Peterson, C., Jonas, M., & Seligman, M. E. P. (1982). Patients behavior in hospitals: Helplessness, reactance, or both? Journal of Personality and Social Psychology, 42, 1036-1041.
Reichsman, F., & Levy, N. B. (1972). Problems in adaptation to maintenance hemodialysis. Archives of Internal Medicine, 130, 859-965.
Rosenbaum, M. (1980). A schedule for assessing self-control behaviors.: Preliminary findings. Behavior Therapy, 11, 109-121.
Rosenbaum, M., & Ben-Ari, K. (1986). Cognitive and personality factor in the delay of ratification of hemodialysis patients. Journal of Personality and Social Psychology, 51, 357-364.
Rosenbaum, M., & Palmon, N. (1984). Helplessness and resourcefulness in coping with epilepsy. Journal of Consulting and Clinical Psychology, 52, 244-253.
Smith, T. W., Holman, J. M., & Gregory, M. C. (1991). Health locus of control and depression in end‑stage renal disease. Journal of Consulting and Clinical Psychology, 59, 419-424.
Smith, R. H. (2000). Assimilative and contrastive emotional reactions to upward and downward social comparison. In J. Suls & L. Wheeler (Eds.), Handbook of Social Comparison. Theory and Research Plenum (pp. 173-200), New York.
Stanton, A. L., Danoff-Burg, S., Cameron, C. L., Snider, P. R., & Kirk, S. B. (1999). Social comparison and adjustment to breast cancer: An experimental examination of upward affiliation and downward evaluation. Health Psychology. 18(2), 151-158.
Suls, J., Marco, C. A., & Tobin, S. (1991). The role of temporal comparison, social comparison, and direct appraisal in the edlerly's self-evaluations of health. Journal of Applied Social Psychology, 21, 1125-1144.
Sun, Y. C., & Croyle, R. T. (1995). Level of health threat as a moderator of social comparison preference. Journal of Applied Social Psychology, 25, 1937-1952.
Taylor, S. E., & Lobel, M. (1989). Social comparison activity under threat : Downward evaluating and upward contacts. Psychological Review,96, 569-575.
Taylor, S. E., Buunk. B. P., Collins, R. L., & Reed. G. M. (1992). Social comparison and affiliation under threat. In L. Montada, S. H. Filipp & M. J. Lerner (Eds.), Crises and Experiences of Loss in Adulthood(pp.213-228) Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.
Taylor, S. E., Wayment, H. A., & Carillo, M. (1993). Social comparison, self-regulation, and motivation. In R. M. Sorrentino & E. T. Higgins(Eds.). Motivation and Cognition. The Guilford Press.
Taylor, S. E., Aspinwall, L. G., Giuillford, T. L., Dakof, G. A., & Reardon, K. (1993). Storytelling, social comparison, and coping. Journal of Applied Social Psychology, 23, 1171-1195.
Tennen, H., & Affleck. G. (1997). Social comparison and subject well-being. In B. P. Buunk, & F. X. Gibbons (Eds.), Health, Coping, and Well-Being: Perspective from Social Comparison Theory. Hillsdale, NJ : Lawrence Erlbaum.
Testa, M., & Major, B. (1990). The impacts of social comparison after failure: The moderating effects of perceived control. Basic and Applied Social Psychology, 11, 205-218.
Thomson, S. C., & Spacapan. S. (1991). Perceptions of control in vulnerable populations. Journal of Social Issues, 47(4), 1-21.
Van der Zee, K. L., Buunk. B. P., & Sanderman. R. (1998). Neuroticism and reactions to social comparison information among cancer patients. Journal of Personality, 66(2), 175-194.
Wallston, B. S., Wallston, K. A., & Devills, R. (1978). Development of multidimensional health locus of control(MHLC) scale. Health Education Monographs, 6, 160-170.
Wallston, K. A., Wallston, B. S., & Smith, S., & Dobbins, C. J. (1987). Perceived Control and Health. Current Psychological Research and Reviews, 6, 5-25.
Wheeler, L., & Miyake, K. (1992). Social comparison in everyday life. Journal of Personality and Social Psychology, 62, 760-773.
Wills(1981). Downward comparison principles in social psychology. Psychological Bulletin, 90, 245-271.
Wills, T. A., & Suls, J. (1991). Commentary: Neo-social comparison theory and beyond. In J. Suls & T.A. Wills (Eds.), Social Comparison: Contemporary Theory and research(pp.395-411). Hillsdale, N.J: Erlbaum.
Wood, J. V., Taylor, S. E., & Lightman, R. R. (1985). Social comparison in adjustment to breast cancer. Journal of Personality and Social Psychology, 49, 1169-1183.
Wood, J. V., & Van der Zee, K. I. (1997). Social comparison among cancer patients: Under what conditions are comparison downward and upward? In B. P. Buunk & F. X. Gibbons (Eds.), Health, Coping and Well-being: Perspectives from Social Comparison Theory(pp.299-328). Mahwah, NJ.: Erlbaum.
Wright, R. G., Sand, D., & Livingston, G．(1966). Psychological stress during hemodialysis for chronic renal failure. Annals of Internal Medicine, 64, 611-621.
Ybema, J. F., & Buunk, B. P. (1995). Affective response to social comparison: A study among disabled individuals. British Journal of Social Psychology, 34, 279-292.
- 다운로드 수
- 조회수
- 0KCI 피인용수
- 0WOS 피인용수