바로가기메뉴

본문 바로가기 주메뉴 바로가기

logo

배우자 부양자의 심리적 요인이 부양부담과 우울에 미치는 영향

The Effect of Psychological Factors on Caregiver Burden and Depression of Spousal Caregivers

한국심리학회지 : 문화 및 사회문제 / Korean Psychological Journal of Culture and Social Issues, (P)1229-0661; (E)1229-0661
2012, v.18 no.3, pp.367-387
홍주연 (한국상담대학원대학교)
김민희 (한국상담대학원대학교)
방희정 (이화여자대학교)
  • 다운로드 수
  • 조회수

초록

본 연구는 고령화 사회에서 점점 증가하고 있는 배우자 부양자의 부양부담과 우울에 미치는 부양자의 심리적 요인의 영향을 확인하고자 하였다. 서울과 인천에 거주하고 있고 50세 이상의 배우자 부양자 142명(여자 89명, 남자 52명)을 대상으로 피부양자의 객관적인 요인, 부양자의 인구학적인 요인, 그리고 심리적 요인으로 부양자의 외향성, 신경증적 성향, 부양 전 부부관계 만족, 사회적 지지가 부양부담과 부양자 우울에 미치는 영향을 조사하고자 설문을 실시하였다. 부양부담과 우울에 대한 변인들의 영향력 검증을 위해 위계적 회귀분석을 실시한 결과, 부양부담에는 피부양자의 일상생활활동수준과 신경증적 성향이, 우울에는 부양자의 신경증적 성향과 부양 전 부부관계 만족이 영향을 주는 것으로 나타났다. 특히 피부양자의 객관적 요인이나 부양자의 인구학적 요인에 비해 부양자의 심리적 요인이 부양부담과 우울을 더 잘 예측함을 확인할 수 있었다. 연구결과를 바탕으로 부양자의 심리적 요인이 부양경험에 미치는 영향에 대해 논의했으며, 마지막으로 배우자 부양부담 완화를 위한 제언, 연구의 제한점, 그리고 미래 연구 방향에 대해 제안하였다.

keywords
spousal caregiving, caregiver burden, psychological factors, personality, marital satisfaction, 배우자 부양자, 부양부담, 우울, 심리적 요인, 성격, 부부관계 만족

Abstract

The purpose of the current study was to examine the effect of psychological factors on caregiver burden and depression among Korean spousal caregivers. 142 spousal caregivers (89 wives, 52 husbands) in Seoul and Incheon City were surveyed to determine the influence of objective factors of the care recipient, demographic of the caregiver, personality dimensions of extroversion and neuroticism of caregiver, social support, and pre-caregiving marital satisfaction on caregiver burden and depression of spousal caregivers. Hierarchical regression was used to determine the influence of the various factors on caregiver burden and depression. Finding suggest that care recipient’s activities of daily living(ADL) and caregiver neuroticism predicted caregiver burden, whereas pre-caregiving martial satisfaction and caregiver neuroticism predicted depression. In particular, psychological factors were better predictors of caregiver burden and depression compared with objective factors. Based on the results, the implications, interventions, limitations and future directions for research were discussed about the psychological factors on spousal caregiving.

keywords
spousal caregiving, caregiver burden, psychological factors, personality, marital satisfaction, 배우자 부양자, 부양부담, 우울, 심리적 요인, 성격, 부부관계 만족

참고문헌

1.

김민희, 홍주연 (2011). 배우자 부양 스트레스의 이해: 심리 통합 모델의 제안. 한국심리학회지: 일반, 29(2), 389-414.

2.

김수영, 김진선, 윤현숙 (2004). 치매노인을 돌보는 가족부양자의 우울과 삶의 만족 예측 요인. 한국노년학, 24(2), 111-128.

3.

김양이 (2006). 치매노인 주부양자를 위한 스트레스 관리 훈련의 효과. 서울여자대학교 박사학위 청구논문.

4.

김재민, 신일선, 윤진상, 이형영 (2001). 지역사회 거주노인의 인지기능에 따른 한국형 노인우울검사의 타당도. 정신병리학, 10(2), 126-131.

5.

김혜경 (2004). 일본 재가 요보호노인과 부양자간의 관계의 질과 부양자의 정신건강. 한국 노년학, 24(2), 129-144.

6.

배경열 (2006). 노인의 인지기능에 따른 부양자의 부양부담. 전남대학교 의과대학교 석사학위 청구논문.

7.

백주희 (2007). 부양 전 부부관계의 질과 결혼기간이 치매노인 부양자의 스트레스 평가, 복지감, 삶의 질에 미치는 영향. 한국노년학, 27(1), 255-272.

8.

서경현, 김정호, 유제민 (2009). 성격과 주관적 웰빙 간의 관계: Big 5 성격요인과 BAS/ BIS를 중심으로. 한국심리학회지: 사회문제, 15(1), 169-186.

9.

서경현, 천경임 (2009). 치매환자 가족부양자의 부양부담과 건강 및 삶의 질에 대한 사회지원의 중재효과. 한국심리학회지: 사회문제, 15(3), 339-357.

10.

송미영, 최경구 (2007). 치매노인 주부양자의 부양부담에 영향을 미치는 요인. 노인복지연구, 37(1), 131-160.

11.

신송재, 이재신 (2011). 인지행동치료가 치매환자의 배회행동과 보호자 부담감에 미치는 영향. 치매작업치료학회지, 5(1), 33-45.

12.

심리척도핸드북 (1998). 고려대학교 행동과학연구소.

13.

유태용, 김명언, 이도형 (1997). 5요인 성격검사의 개발 및 타당화 연구. 한국심리학회지: 산업 및 조직, 10(1), 85-102.

14.

윤현숙, 류삼희 (2007). 장기요양보호노인 가족수발자의 수발부담에 영향을 미치는 요인-배우자와 자녀 비교. 한국노년학, 27(1), 195-211.

15.

윤현숙, 차흥봉, 조양순 (2000). 뇌졸중 노인 부양가족의 부양부담과 우울에 미치는 영향요인에 관한 연구. 한국노년학, 20(2), 137-153.

16.

이가옥, 이미진 (2000). 장기요양보호노인 가족수발자의 정서적 부양부담에 관한 연구.한국노년학, 20(2), 215-228.

17.

이미애 (2006). 주부양제공자의 하위집단별 부양부담 및 특정수발항목에 대한 부담도-성별, 거주 지역별, 노인과의 관계별 변이. 노인복지연구, 33, 279-300.

18.

이은희, 김소형, 윤가현 (2004). 치매노인부양자의 부양부담감소를 위한 인지-행동개입. 한국노년학, 13(1), 23-36.

19.

이인정 (2006). 기능손상노인의 아내 수발자와 며느리 수발자의 부담요인의 차이에 관한 연구. 사회복지연구, 31(1), 329-349.

20.

이현주 (2005). 치매를 앓는 부인을 돌보는 남편의 부양경험과 적응과정-노인부부가구를 중심으로. 한국노년학, 26(1), 45-62.

21.

장혜경, 홍승아, 이상원, 김영란, 강은화, 김고은 (2006). 가족 내 돌봄 노동에 대한 사회적 지원방안연구. 한국여성정책연구원.

22.

한경혜, 이서연 (2009). 배우자 부양자의 부양동기, 사회적 지지와 부양부담: 성별 차이를 중심으로. 한국노년학, 29(2), 683-699.

23.

한국개발원구원 (2010). 가구유형 변화에 대한 대응방안’ 보고서.

24.

통계청 (2010). 2009 고령자통계.

25.

Antonucci, T., & Israel, B. (1986). Veridicality of social support: A comparison of principal and network members' responses. Journal of Consulting and Clinical Psychology, 54(4), 432- 437.

26.

Barber, C., & Pasley, B. (1994). Family care of Alzheimer's patients: The role of gender and generational relationship on caregiver outcomes. Journal of Applied Gerontology, 14(2). 172-192 .

27.

Biegel, D., Sales, E., Schulz, R., & Rau, M. (1991). Careving in Stroke: Family Caregiving in Chronic Illness, CA: Sage.

28.

Bookwala, J., & Schulz, R. (1998). The role of neuroticism and mastery in spousal caregivers' assessment of and response to a contextual stressor. Journal of Gerontology: Psychological Sciences, 53B(3), 155-164.

29.

Braun, M., Scholz, U., Bailey, B., Perren, S., Hornung, R., & Martin, M.(2009). Dementia caregiving in spousal relationships: A dyadic perspective. Aging and Mental Health, 13(3). 426-436.

30.

Butler, L. Field, N., Busch, A., Seplaki1, J., Hastings, T., & Spiegel, D. (2005). Anticipating loss and other temporal stressors predict traumatic stress symptoms among partners of metastatic/recurrent breast cancer patients. Psycho-Oncology, 14(6), 492-502.

31.

Campbell, P., Wright, J., Oyebode, J., Job, D.,. Crome, P., Bentham, P., et al. (2008). Determinants of burden in those who care for someone with dementia. International Journal of Geriatric Psychiatry, 23(10). 1078-1085.

32.

Cantor, M. (1983). Strain among caregivers: A study of experience in the U. S. The Gerontologist, 23(6), 597-624.

33.

Carver, C., & Connor-Smith, J. (2010). Personality and coping. Annual Review of Psychology, 61(1), 679-704.

34.

Cohen, C., Colantonio, A., & Vernich, L. (2002). Positive aspects of caregiving: Rounding out the caregiver experience. International Journal of Geriatric Psychiatry, 17(2), 184-188.

35.

Cohen, C., Gold, D., Shulman, K., & Zucchero, C. (1994). Positive aspects in caregiving: An overlooked variable in research. Canadian Journal on Aging, 13(3). 378-391.

36.

Costa, P., & McCrae, R. (2003). Personality in Adulthood: A Five-Factor Theory Perspective. New York: Guilford Press.

37.

Duberstein, P., Sörensen, S., Lyness, J., King, D., Conwell, Y., Seidlitz, L., et al. (2003). Personality is associated with perceived health and functional status in older primary care patients. Psychology and Aging, 18(1), 25-37.

38.

Eloniemi-Sulkava, U., Notkola, I., Hämäläinen, K., Rahkonen, T., Viramo, P., Hentinen, M., et al. (2002). Spouse caregivers' perceptions of influence of dementia on marriage, International Psychogeriatric Association, 14(1), 47-58.

39.

Fowers, B., & Olson, D. (1993). ENRICH Marital Satisfaction Scale: A brief research and clinical tool. Journal of Family Psychology, 7(2), 176- 185.

40.

George, L. & Gwyther, L. (1986). Caregiver well- being: A multi-dimensional examination of family caregivers of demented adults. The Gerontologist, 26(3), 253-259.

41.

Given, B., Kozachik, G., Collins, C., Devoss, P., & Given, A. (2001). Burden and depression among caregivers of patients with cancer at the end of life. Oncology Nursing Forum, 31(6), 1105-1117.

42.

Goldberg, L. (1992). The development of markers for the Big-Five factor structure. Psychological Assessment, 4(1), 26-42.

43.

Hagedoorn, M., Buunk, B., Kuijer, R., Wobbes, T., DeJong, G., & Sanderman, R. (2000). Marital satisfaction in patients with cancer: Does support from intimate partners benefit those who need it most? Health Psychology, 19(3), 274-282.

44.

Harwood, D., Barker, W., Ownby, R., Bravo, M., Aguero, H., & Duara, R. (2008). Depressive symptoms in Alzheimer's disease: An examination among community-dwelling Cuban American patients. American Journal of Geriatric Psychiatry, 8(1), 84-91.

45.

Hazan, C., & Shaver, P. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52(3), 511-524.

46.

Heru, A., Ryan, C., & Iqbal, A. (2004). Family functioning in the caregivers of patients with dementia. International Journal of Geriatric Psychology, 19(6), 533-537.

47.

Hollis-Sawyer, L. (2003). Mother-daughter eldercare and changing relationships: A path-analytic investigation of factors underlying positive, adaptive Relationships. Journal of Adult Development, 10(1), 41-52.

48.

Holmberg, S., Scott, L., Alexy, W., & Fife, B. (2001). Relationship issues of women with breast cancer. Cancer Nursing, 24(1), 53-60.

49.

Hooker, K., Monahan, D., Bowman, S., Frazier, L., & Shifren, K. (1998). Personality counts for a lot: Predictors of mental and physical health of spouse caregivers in two disease groups. Journal of Gerontology, Series B: Psychological Sciences and Social Sciences, 53B(2): 73-85.

50.

Hong, G., & Kim, H. (2008). Family caregiver burden by relationship to care recipient with dementia in Korea. Geriatric Nursing, 29(4), 267-274.

51.

Jang, Y., Clay, O., Roth, D., Haley, W., & Mittelman, M. (2004). Neuroticism and longitudinal change in caregiver depression: Impact of a spouse-caregiver intervention program. The Gerontologist, 44(3), 311-317.

52.

Jenkins, K., Kabeto, M., & Langa, K. (2009). Does caring for your spouse harm one's health? Evidence from a United States nationally-representative sample of older adults. Ageing and Society, 29(2), 277-293.

53.

Jepson, C., McCorkle, R., Adler, D., Nuamah, I. & Lusk, E. (1999). Effects of home care on caregivers' psychosocial status. Journal of Nursing Scholarship, 31(2), 115-120.

54.

Katz, S. (1983). Assessing self-maintenance: Activities of daily living, mobility, instrumental activities of daily living, Journal of the American Geriatrics Society, 31(12), 721-726.

55.

Koerner, S., Kenyon, D., & Shirai, Y. (2009). Caregiving for elder relatives: Which caregivers experience personal benefits/gains? Archives of Gerontology and Geriatrics, 48(2), 238-245.

56.

Knight, B., Silverstein, M., McCallum, T., Fox, L. (2000). A sociocultural stress and coping model for mental health outcomes among African American caregivers in Southern California. Journal of Gerontology, Series B: Psychological Sciences and Social Sciences, 55B(3), 142-150.

57.

Koerner, S., Kenyon, D., & Shirai, Y. (2009). Caregiving for elder relatives: Which caregivers experience personal benefits/gains? Archives of Gerontology and Geriatrics, 48(2), 238-245.

58.

Kramer, B. (2000). Husbands caring for wives with Dementia: A longitudinal study of continuity and change. Health Social Work, 25(2), 97-107.

59.

Lima, J., Allen, S., Goldscheider, F., & Intrator, O. (2008). Spousal caregiving in late midlife versus older ages: Implication of work and family obligations. Journal of Gerontoogy Series B: Psychoogical Sciences and Social Sciences, 63B(4), 229-238.

60.

Löckenhoff, C., Duberstein, P., Friedman, B., & Costa, P. (2011). Five-factor personality traits and subjective health among caregivers: The role of caregiver strain and self-efficacy. Psychology and Aging, 26(3), 592-604.

61.

Manne, S., Ostroff, J., Rini, C., Fox, K., Goldstein, L., & Generosa, G. (2004). The interpersonal process model of intimacy: The role of self-disclosure, partner disclosure, and partner responsiveness in interactions between breast cancer patients and their Partners. Journal of Family Psychology, 18(4), 589-599.

62.

Majerovitz, S. (1995). Role of family adaptability in the psychological adjustment of spouse caregivers to patients with dementia. Psychology and Aging, 10(3), 447-457.

63.

Melo, G., Maroco, J., & de Mendonç, A. (2011). Influence of personality on caregiver's burden, depression and distress related to the BPSD. International Journal of Geriatric Psychiatry, 26(12), 1275-1282.

64.

Miller, B. & Guo, S. (2000). Social support for spouse caregivers of persons with dementia. Journal of Gerontoogy Series B: Psychoogical Sciences and Social Sciences, 55B(3), 163-172

65.

Mittleman, M.. Roth, D., Clay, O., & Haley, W. (2007). Preserving health of Alzheimer's caregivers: Impact of a spouse caregiver intervention. Amerian Journal of Geriatric Psychiatry, 15(9), 780-789.

66.

Mittelman, M., Roth D., Haley, W., & Zarit, S. (2004). Effects of a caregiver intervention on negative caregiver appraisals of behavior problems in patients with Alzheimer's disease: Results of a randomized trial. Journal of Gerontoogy Series B: Psychoogical Sciences and Social Sciences, 59B(1), 27-34.

67.

Nijboer, C., Triemstra, M., Tempelaar, R., Sandermann, R., & van den Bos, G. (1999). Determinants of caregiving experiences and mental health of partners of cancer patients. Cancer, 86(4), 577-588.

68.

O'Rourke, N., & Tuokko, H. (2003). Psychometric properties of an abridged version of the Zarit Burden Interview within a representative Canadian caregiver sample. The Gerontologist, 43(1), 121-127.

69.

Perren, S., Schmid, R., & Wettstein, A. (2006). Caregivers’ adaptation to change: The impact of increasing impairment of persons suffering from dementia on their caregivers’ subjective well-being. Aging & Mental Health, 10(5), 539 -548.

70.

Pinquart, M., & Sörensen, S. (2003). Differences between caregivers and noncaregivers in psychological health and physical health: A meta-analysis. Psychology and Aging, 18(2). 250- 267.

71.

Potter, J. (1993). Comprehensive geriatric assessment in the outpatient setting: Population characteristics and factors influencing outcome. Experimental Gerontology, 28(4), 447-457.

72.

Proctor, R., Martin, C., & Hewison, J. (2002). When a little knowledge is a dangerous thing: A study of carers' knowledge about dementia, preferred coping style and psychological distress. International Journal of Geriatric Psychiatry, 17(12), 1133-1139.

73.

Schulz, R., Tomkins, C., & Rau, M. (1988). A longitudinal study of the psychosocial impact of stroke on primary support persons. Psychology and Aging, 3(2), 131-141.

74.

Schulz, R., & Williamson, G. (1991). A 2-year longitudinal study of depression among Alzheimer's caregivers. Psychology and Aging, 6(4), 569-578.

75.

Sarason, I., Sarason, B., Shearin, E., & Pierce, G. (1985). A brief measure of social support: Practical and theoretical implications. Journal of Social and Personal Relationships, 4(4), 497-510.

76.

Savundranayagam, M., Montgomery, R., & Kosloski, K. (2011). A dimensional analysis of caregiver burden among spouses and adult children. The Gerontologist, 51(3), 321-331.

77.

Sheikh, J., & Yesavage, J. (1986). Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist: The Journal of Aging and Mental Health, 5(1-2), 165-173.

78.

Sherwood, P., Given, C., Given, B., & Von Eye, A. (2005). Caregiver burden and depressive symptoms: Analysis of common outcomes in caregivers of elderly patients, Journal of Aging and Health, 17(2), 125-147.

79.

Stoller, E. (1992). Gender differences in the experiences of caregiving spouses. In J. Swyer & R. Cosard(Eds.), Gender, Families, and Elder Care (pp.49-64). Newbury Park, CA: Sage.

80.

Tennstedt, S., Crawford, S., & McKinlay. J. (1993). Is Family Care on the Decline? A longitudinal investigation of the substitution of formal long-term care services for informal care. The Milbank Quarterly, 71(4), 601-24.

81.

Tennstedt S., McKnightly J., & Sullivan, L. (1989). Predictors of informal care for frail elders: The role of secondary caregivers. The Gerontologist, 29(5), 677-683.

82.

Yates, M., Tennstedt, S., & Chang, B. (1999). Contributors to and mediators of psychological well-being for informal caregivers. Journal of Gerontoogy Series B: Psychoogical Sciences and Social Sciences, 54B(1), 12-22.

83.

Young, R., & Kahana, E. (1989). Specifying caregiver outcomes: Gender and relationship aspects of caregiving strain. The Gerontologist, 29(5), 660-666.

84.

Wolff, J., & Kasper, J. (2006). Caregivers of frail elders: Updating a national profile. The Gerontologist, 46(3), 344-356.

85.

Zarit S., Orr N.., & Zarit J. (1985). Families under stress: Caring for the patient with Alzheimer's disease and related disorders. New York: University Press.

86.

Zhan, H. (2002). Chinese caregiving burden and the future burden of elder care in life-course perspective. The International Journal of Aging and Human Development, 54(4), 267-290.

한국심리학회지 : 문화 및 사회문제