open access
메뉴E-ISSN : 2733-4538
The purposes of this study were 1) to identify the effects of attitude toward recovery on quality of life among persons with psychiatric disabilities, and 2) to test whether the individual effects of relevant variables (i.e., psychological symptoms, psychological functions, social support, and economic status) on quality of life variable are mediated by attitude toward recovery. Results from a stepwise regression analysis (N = 520 persons with psychiatric disabilities) with quality of life as a dependent variable showed that attitude toward recovery explained 43% of the total variance in quality of life. Economic status, psychological functions and social support explained 8%, 8%, and 2% of the total variance, respectively. Psychological symptoms were not a significant predictor. Based on previous studies and these results, a hypothetical model (Attitude toward recovery mediating effects model) was developed. This model predicted that the effects of psychological symptoms, psychological functions, social support, and economic status on quality of life would be mediated by paticipants' attitude toward recovery. A covariance structural analysis produced favorable goodness of fit indexes (GFI = .915, AGFI = .905, NFI = .921, NNFI = .934, CFI = .940) except for the chi-square value (χ2 = 900.95, p<.001). Analysis of the path coefficients in this model showed that each direct effect of attitude toward recovery, psychological functions, and social support on quality of life was positively significant, but the direct effect of psychological symptoms on quality of life was not significant. Also, the results showed that each indirect effects of psychological symptoms, psychological functions and social support on quality of life were significant when mediated by attitude toward recovery. However, the indirect effect of economic status, when mediated by attitude toward recovery, was not significant. In conclusion, the proposed attitude toward recovery mediating effects model was supported by the results of the current study. Implications of the study and applicability of the results were discussed.
국승희 (2001). 정신분열병 환자의 삶의 질 모델개발. 전북대학교 박사학위논문.
김나라 (2004). 만성 정신분열병의 회복에 관한연구. 고려대학교 석사학위논문.
김이영 (2004). 통합 정신재활 서비스와 재활성과 및 삶의 질에 관한 연구. 계명대학교 박사학위논문.
김지영 (2003). 정신분열병 환자의 회복경험: ‘삶의 재구성’ 과정. 이화여자대학교 박사학위논문.
김희정 (1992). 퇴원한 정신질환자가 지각한 사회적 지지와 정신건강상태와의 관계. 이화여자대학교 석사학위논문.
노은선 (2000). 정신분열병환자의 삶의 질 모형개발. 중앙대학교 박사학위논문.
노춘희 (2002). 직업재활 프로그램에 참여하는만성 정신질환자의 회복경험. 정신간호학회지, 11(1), 5-18.
박지원 (1985). 사회적 지지척도 개발을 위한 일연구. 연세대학교 박사학위논문.
배정규 (2005). 정신장애인의 재기태도와 삶의질: 척도개발과 모형검증을 중심으로. 계명대학교 박사학위논문.
손명자 (1996). 기능평가: 재활정신의학의 진단. 한국심리학회지: 임상, 15(1), 235-254.
손명자, 박동건, 최영희, 이선희, 배정규 (2001).정신장애인 기능평가도구 개발연구. 한국심리학회지: 임상, 20(4), 731-749.
윤창영 (2001). 기혼직장여성의 주관적 삶의 질에 대한 연구: 직장-가정 갈등모형과 영역별 삶의 질 모형의 통합. 성균관대학교 박사학위논문.
장혜경, 박경애, 김오남 (2004). 정신분열병을가진 개인들의 회복, 가능한가? 회복 패러다임을 중심으로. 지역사회정신보건, 6,207 -237.
한글학회 (1992). 우리말 큰사전. 서울: 어문각.
Anthony, W. A. (1990). Toward a vision of recovery.Boston, MA: Boston University, Center for Psychiatric Rehabilitation.
Anthony, W. A. (1993). Recovery from mental illness: The guiding vision of the mental health services system in the 1990s. Psychosocial Rehabilitation Journal, 16(4), 11-23.
Awad, A. G., Voruganti, L. N. P., & Heslegrave, R. J. (1997). A conceptual model of quality of life in schizophrenia: Description and preliminary clinical validation. Quality of Life Research, 6, 21-26.
Bengtsson-Tops, A., & Hansson, L. (1999). Subjective quality of life in schizophrenic patients living in the community: Relationship to clinical and social characteristics. European Psychiatry, 14, 256-263.
Bobes, J., & González, M. P. (1997). Quality of life in schizophrenia. In H. Katschnig, H. Freeman, & N. Sartorius (Eds.), Quality of life in mental disorders (pp.165-178). New York: John Wiley & Sons.
Carnon, J., Tempier, R., Mercier, C., & Leouffre, P. (1998). Components of social support and quality of life in severely mentally ill, low income individuals and a general population group. Community Mental Health Journal, 34(5), 459-475.
Deegan, P. E. (1988). Recovery: The lived experience of rehabilitation. In W. Anthony, & L. Spanial (Eds.), Readings in Psychiatric Rehabilitation (pp.149-161). Boston, MA: Boston University, Center for Psychiatric Rehabilitation.
Diener, E. (1984). Subjective well-being. Psychological Bulletin, 95, 542-575.
Frese, F. J., Stanley, J., Kress, K., & Vogel- Scibilia, S. (2001). Integrating evidence-based practices and the recovery model. Psychiatric Services, 52(11), 1462-1468.
Green, C. A., Polen, M. R., Janoff, L., Castleton, D. K., Wisdom, J. P., Vuckovic, N., Perrin,N. A., Paulson, R. I., & Oken, S. (2008). Understanding how clinician-patient relationships and relational continuity of care affect recovery from serious mental illness: STARS study results. Psychiatric Rehabilitation Journal, 32(1), 9-22.
Jacobson, N., & Curtis, L. (2000). Recovery as policy in mental health services: Strategies emerging from the states. Psychiatric Rehabilitation Journal, 23(4), 333-341.
Kay, S. R., Fiszbein, A., & Opler, L. A. (1991). 양성 및 음성 증상척도 평가지침서[The Positive and Negative Syndrome Scale(PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261-276]. (한국얀센 역). 서울: (주)한국얀 센 메디칼부. (원전은 1987년에 출판).
Lehman, A. F., Rachuba, L. T., & Postrado, L. T. (1995). Demographic influences on quality of life among persons with chronic mental illnesses. Evaluation and Program Planning,18(2), 155-164.
Liberman, J. A., Drake, R. E., Sederer, L. I.,Belger, A., Keefe, R., Perkins, D., Stroup, S.(2008). Science and recovery in schizophrenia. Psychiatric Services, 59(5), 487-496.
Mancini, M. (2003). Theories of recovery elicited from individuals diagnosed with psychiatric disabilities.Unpublished doctorial dissertation. State University of New York, New York.
McLean, A. (1995). Empower and the psychiatric consumer/ex-patient movement in the US: Contradictions, crisis, and change. Social Science & Medicine, 40, 1053-1071.
Noordsy, D., Torrey, W., Mueser, K., Mead, S.,O'Keefe, C., & Fox, L. (2002). Recovery from severe mental illness: An intrapersonal and functional outcome definition. International Review of Psychiatry, 14, 318-326.
Ochocka, J., Nelson, G., & Jansen, R. (2005). Moving forward: Negotiating self and external circumstances in recovery. Psychiatric Rehabilitation Journal, 28(4), 315-322.
Onken, S. J., Craig, C. M., Ridgway, P., Ralph, R., & Cook, J. A. (2007). An analysis of the definitions and elements of recovery: A review of literature. Psychiatric Rehabilitation Journal, 31(1), 9-21.
Preyer, H. (2001). What is recovery? Acommentary. Psychiatric Services, 52, 486-487.
Prince, P. N., & Prince, C. R. (2001). Subjective quality of life in the evaluation of programs for people with serious and persistent mental illness. Clinical Psychology Review, 21(7), 1005-1036.
Resnick, S. G., Rosenheck, R. A., & Lehman, A.F. (2004). An exploratory analysis of correlates of recovery. Psychiatric Services, 55(5), 540-547.
Snyder, C. R., Harris, C., Anderson, J. R., Holleran, S. A., Irving, L. M., Sigmon, S. T., Yoshinobu, L., Gibb, J., Langelle, C., & Harney, P. (1991). The will and the ways: Development and validation of an individual-differences measure of hope. Journal of Personality and Social Psychology, 60(4), 570-585.
Spilker, B. (1996). Introduction. In B. Spilker(Ed.), Quality of life and pharmacoeconomics in clinical trials, 2nd ed. (pp.2-10). Philadelphia: Lippincott-Raven.
Sullivan, G., Wells K. B., Leake, B. (1992).Clinical factors associated with better quality of life in a seriously mentally ill population. Hospital and Community Psychiatry, 43, 794-798.
Warner, R., Huxley, P. (1993). Psychopathology and quality of life among mentally ill patients in the community: British and US samples compared. British Journal of Psychiatry, 163,505-509.