- P-ISSN1229-0661
- E-ISSN1229-0661
- KCI
치매환자 가족부양자의 부양부담과 건강 및 삶의 질에 대한 사회지원의 중재효과
The Moderate Effect of Social Support on Family Caregivers' Burdens and Health and Quality of Life with Demented Patients
천경임 (삼육대학교)
초록
본 연구의 목적은 한국사회가 고령화되고 있는 시점에서 치매환자 가족부양자의 부양부담과 사회지원이 건강 및 삶의 질과 어떤 관계가 있는지를 탐색하고, 부양자의 건강 및 삶의 질에 대한 부양부담과 사회지원의 상호작용을 검증하는 것이다. 본 연구의 참여자는 서울, 경기, 충청 지역에 거주하는 치매환자 가족부양자 207명(여: 106)이었으며, 그들의 평균 연령은 51.62(SD=9.25)세였다. 본 연구에서 사용된 심리검사는 다차원부양자부담설문지, 전겸구의 신체증상척도, 한덕웅과 장은영의 건강지각척도, 자기진술 부정정서질문지, Cambell의 주관안녕척도, MOS의 사회지원질문지, 권중돈의 치매노인 부적응문제척도이다. 분석 결과, 치매환자 가족부양자의 부양부담은 신체증상이나 우울과는 정적으로 건강지각이나 주관안녕과는 부적으로 관계하고 있었다. 사회지원은 치매환자 부양부담이 건강지각, 우울 및 주관안녕에 미치는 영향을 중재하는 것으로 나타났다. 이는 치매환자 부양에 따른 부정적 효과에 대해 완충작용을 할 수 있는 것을 의미한다. 부양부담이 가족부양자의 신체증상과 우울의 변량을 30～40% 가량이나 설명하고 있었기 때문에 결과를 부양자의 건강이나 삶의 질의 중재를 중심으로 논의하였다. 사회지원이 부양부담 수준에 따라 다르게 작용하는 것 외에도 치매증상이 더 심각할 경우 사회지원이 적은 것 등과 관련해서도 선행연구를 바탕으로 논의하였다.
- keywords
- 치매, 가족부양자, 신체건강, 정신건강, 삶의 질, dementia, family caregivers, physical health, mental health, quality of life
Abstract
As quickly becoming an ageing society in Korea, this study aims to investigate how family caregivers' burden with demented patients and social supports are related to their health and quality of life, and the interaction of caregiving burden and social supports on caregivers' health and quality of life. The participants were 207 family caregivers (106 females) of demented patients lived in Seoul, Kyunggi, and Chungcheong areas, whose average of age were 51.62 (SD=9.25). The psychological tests used in this research included the following: Multidimensional Caregiver Burden Inventory, Chon's Physical Symptom Questionnaire, Hahn & Jang's Perceived Health Inventory, Negative Affect Self-Statement Questionnaire, and the Korean Version of Cambell's Subjective Well-being Scale, Social Support Survey in Medical Outcomes Study, and Kwon's Questionnaire for Maladjusted Problems of Demented. Results indicated that caregivers' burden with demented patient related to physical symptoms and depression positively, and perceived health and subjective well-being negatively. Social supports showed moderate effects on influences of caregiving burden in perceived health, depression, and subjective well-being of family caregivers with demented patients. It was identified the possibility of their buffering effect on negative results of caregiving burden with demented patients. Since caregiving burden accounted for the 34% of the variances for family caregivers' physical symptoms and depression, researchers discussed the promotion and intervention of their health and quality of life. Beside of different effects of social supports with level of caregiving burden, with previous studies it was discussed some saliant findings such as family caregivers with patients who showed severe dementia symptoms were perceiving even less supports from others.
- keywords
- 치매, 가족부양자, 신체건강, 정신건강, 삶의 질, dementia, family caregivers, physical health, mental health, quality of life
참고문헌
권중돈 (1992). 치매노인의 현황과 과제. 서울: 한국노인문제연구소.
권중돈 (1995). 한국치매가족연구: 부양부담 사정도구 및 결정모형 개발. 서울: 홍익제.
김수영, 김진선, 윤현숙 (2004). 치매노인을 돌보는 가족부양자의 우울과 삶의 만족 예측요인. 한국노년학, 24, 111-128.
김윤정, 최혜경 (1993). 치매노인의 장애기간과 부양자의대처자원이 부양자의 부담 및 부양만족감에 미치는 영향. 한국노년학, 13, 63-83.
김의철, 홍천수, 이정권, 박영신 (2005). 건강과 삶의 질에 영향을 주는 요인에 대한 분석: 자기효능감, 사회적 지원 및 질병관리를 중심으로. 한국심리학회: 사회문제, 11, 143-181.
류준범 (2000). 분노의 다차원적 특성과 신체 건강간의 관계. 대구대학교 석사학위논문.
서경현 (2006). 고령화 사회에서 한국인의 건강과 삶의 질. 한국심리학회지: 사회문제, 12, 133-147.
오은섭, 서경현 (2007). 치매환자 부양 스트레스와 스트레스 반응 및 신체건강. 대한임상건강증진학회지, 7, 253-260.
이강오 (2003). 치매환자가족의 삶의 질과 영향요인에 관한 연구. 정신간호학회지, 12, 15-26.
이애숙, 김한곤 (2003). 치매노인 부양자의 부양부담 실태 및 부양부담에 영향을 미치는 요인. 보건과 사회과학 13, 29-60.
이주영, 김지혜 (2002). 아동․청소년의 우울 및 불안과 관련된 부정적 자기진술: 한국판 부정적 자기진술 질문지(Negative Affect Self - Statement Questionnaire)의 타당화 연구. 한국심리학회지: 임상, 21, 871-889.
이해정, 김영숙, 김기련, 김주성, 서지민 (2003). 치매노인을 돌보는 가족간호제공자의 우울 예측 요인. 대한간호학회지, 33, 936- 944.
최혜경, 김윤정 (1997). 한국 치매노인 부양상황에서의 스트레스 과정. 한국노년학, 17, 35-50.
통계청 (2005). 장래인구추계결과. 통계청.
한덕웅, 장은영 (2003). 사회비교 동기와 강요된 사회비교가 주관안녕과 건강지각에 미치는 영향. 한국심리학회지: 건강, 8, 619- 644.
한덕웅, 표승연 (2002). 정서 경험에 따른 주관안녕, 건강지각 및 신체질병 예측. 한국심리학회지: 건강, 7, 403-427.
Almberg, G., Grafstrom, M., & Winblad, B. (1997). major strain and coping strategies as reported by family members who care for aged demented relatives. Journal of Advanced Nursing, 26, 683-691.
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders - IV. Washington D.C.: American Psychiatric Association.
Atienza, A. A., Collins, R., & King, A. C. (2001). The mediating effects of situational control on social support and mood following a stress: A prospective study of dementia caregivers in their natural environments. The Journals of Gerontology, 56B, S129-S139.
Barrera, M. (1986). Distinctions between social support concept, measure, and models, American Journal of Community Psychology, 14, 413-445.
Brannon, L., & Feist, J. (2000). Health psychology: An introduction to behavior and health. Belmont: Wordsworth.
Cambell, A. (1981). The sense of well-being in America. New York: McGraw-Hill.
Cattanach, L., & Tebes, J. K. (1991). The nature of elder impairment and its impact on family caregivers' health and psychological functioning. The Gerontologist, 31, 246-255.
Cohen, W., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310-357.
Covinsky, K. E., Newcomer, R., Fox, P., Wood, J., Sands, L., Dane, K., & Yaffe, K. (2003). Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. Journal of General and Internal Medicine, 18, 1006-1014.
De Jong, P., & Berg, I. K. (2002). Interviewing for solutions, 2nd Ed. Pacific Grove, CA: Brooks/Cole.
Dilworth-Anderson, P., William, I., & Gibson, B. (2002). Issues of race, ethnicity, and culture in caregiving research: A 20-year review (1980-2000). The Gerontologist, 42, 237-272.
Ducharme, F., Levessque, L., Lachance, L., Gangbe, M., Zarit, S. H., Vezina, J., & Caron, C. D. (2007). Older husbands as caregivers. Factors associated with health and the intention to end caregiving. Research on Aging, 29, 3-31.
Dunkel-Schetter, C., & Bennett, T. L. (1990). Differentiating the cognitive and behavioral aspects of social support. In B. R. Sarason & G. R. Pierce (Eds.), Social support: An interactional view. New York: Wiley.
Epstain-Lubow, G. (2009). Family caregiver health: What to do when a spouse or child needs help. Geriatrics for the Practicing Physician, 92, 106-107.
Furlini, L. (2001). The parent they knew and the “new” parent: Daughters' perception of dementia of the Alzheimer's type. Home Health Care Services Quarterly, 20, 21-38.
George. K., & Gwytheer, P. (1986). Caregiver well-being: A multidimensional examination of caregivers of demented adults. The Gerontologist 26, 253-259.
Gilliand, M P., & Bush, H. A. (2001). Social support for family caregivers: Toward a situation-specific theory. Journal of Theory, Construction, and Testing, 5, 53-62.
Haley, W. E., LaMonde, L. A., Han, B., Burton, A. M., & Schonwetter, R. (2003). Predictors of depression and life satisfaction among spousal caregivers in hospice: Application of a stress process model. Journal of Palliative Medicine, 6, 215-224.
Hobfoll, S., & Vaux, A.(1993). Social support: Resources and context. In L. Goldberger & S. Breznitz. (Eds.), Handbook stress: theoretical and clinical aspects. New York: Free Press. 685-705.
Ingersoll-Dayton, B., Starrels, M. E., & Dowler, D. (1996). Caregiving for parents and parents-in-law: Is gender important? The Gerontologist, 36, 483-491.
Motenko, A. K. (1988). Respite care and pride in caregiving: The experience of six older men caring for their disabled wives. In S. Reinharz & G. Rowles (Ed.), Qualitative Gerontology (pp. 104-127). New York: Springer.
Novak, M., & Guest, C. (1989). Application of a Multidimensional Caregiver Burden Inventory. The Gerontologist 29, 798-803.
O'Rourke, N., & Tuokko, H. (2000). Preserving personhood: (Re)membering the spouse with dementia. Family Relations, 51, 55-62.
OECD (2003). OECD Health Data, 3rd Ed. Paris.
Pearlin, L. I., Aneshensel, C. S., Mullan, J. T., & Whitlatch, C. J. (1995). Caregiving and its social support. In L. K. George & R. H. Binstock (Ed.). Handbook on aging and the social sciences (pp.283-302). New York: Academic Press.
Penning, M. J. (1995). Cognitive impairment, caregiver burden, and the utilization of home health services. Journal of Aging and Health, 7, 233-253.
Pinquart, M, & Sörensen, S. (2006). Gender differences in caregiver stressors, social resources, and health: An updated meta-analysis. The Journals of Gerontology, 61B, 33-45.
Pinquart, M., & Sorenson, S. (2007). Correlates of physical health of in formal caregivers: a meta-analysis. Journal of Gerontology: Psychological Science and Social Science, 62B, 126-137.
Ronan, K. R., Kendall, P. C., & Rowe, M. (1994). Negative affectivity in Children: Development and validation of a self-statement questionnaire. Cognitive Therapy and Research, 18, 509-529.
Sadock, B. J., & Sadock, V. A. (2000). Comprehensive Textbook of Psychiatry, 7th Ed. Philadelphia, PA: Lippincott Williams, & Wilkins.
Schulz, R., & Beach, S. R. (1999). Caregiving as a risk factor for mortality. Journal of the American Medical Association, 282, 2215-2219.
Schulz, R., O'Brien, A. T., Bookwala, J., & Fleissner, K. (1995). Psychiatric and physical morbidity effects of dementia caregiving: Prevalence, correlates, and causes. The Gerontologist, 35, 771-791.
Sherbourne, C, & Steward, A. (1991). The medical outcomes study social support survey. Social Science and Medicine, 32, 705-714.
Shurgot, G R., & Knight, B. G. (2005). Influence of neuroticism, ethnicity, familism, and social support on perceived burden in dementia caregivers: Pilot test of the Transactional Stress and Social Support Model. The Journals of Gerontology, 60B, 331-334.
Smith T. L., & Toseland, R. W. (2006). The effectiveness of a telephone support program for caregivers of frail older adults. The Gerontologist, 46, 620-629.
Stephens, M. A. P., Kinney, J. M., & Ogrocki, P. K. (1991). Stressors and Well-Being among Caregivers to Elder Adults with Dementia: The In-Home Nursing home Experience. The Gerontologist, 31, 217-223.
Stoller, E. P. (1990). Males as helpers: The role of sons, relatives, and friends. The Gerontologist, 30, 228-235.
Strawbridge, W. J., & Wallhagen, M. I. (1991). Impact of family conflict on adult child caregivers. The Gerontologist, 31, 770-777.
Strawn, B., Hester, S., & Brown, W. (1998). Telecare: A social support intervention for family caregivers of dementia victims. Clinical Gerontologist, 18, 66-69.
Sussman, T., & Regehr, C. (2009). The influence of community-based services on the burden of spouses caring for their partners with dementia. Health and Social Work, 31, 29-39.
Thoits, P. A. (1995). Stress, coping, and social support processes: Where are we? What next? Journal of Health and Social Behavior, 36, 53-79.
Vitaliano, P. P., Heather, M. Y., & Russo J. (1991). Burden: A review of measures used among caregivers individuals with dementia. The Gerontologist, 31, 67-75.
Ward-Griffin, C., & McKeever, P. (2000). Relationships between nurses and family caregivers: Partners in Care? Advances in Nursing Science, 22, 89-103.
Whitlatch, C., Zarit, S., & Von Eve, A. (1991). Efficacy of interventions with caregivers: A reanalysis. The Gerontologist, 31, 9-14.
Yee, J. L., & Schulz, R. (2000). Gender differences in psychiatric morbidity among family caregivers: A review and analysis. The Gerontologist, 40, 147-164.
Youn, G., Knight, B. G., Jeong, H. S., & Benton, D. (1999). Differences in familism values and caregiving outcomes among Korean, Korean American, and White American dementia caregivers. Psychology of Aging, 14, 355-364.
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