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The Korean Journal of Woman Psychology

The Influence of Health Related Quality of Life on Depressive Symptoms of Breast Cancer Patients


The purpose of this study was to examine the influence of health related quality of life on depressive symptoms in breast cancer patients. The 374 breast cancer patients were recruited and they were assessed on cancer related variables, sociodemographic variables, EORTC QLQ-BR23 and CES-D. The results showed as follows. First, there were significant correlations among depressive symptoms and all variables of health related quality of life including physical functioning and physical symptoms. Second, multiple regression analysis showed that all variables of the health related quality of life including body image, sexual functioning, sexual enjoyment, future perspective, arm symptoms, breast symptoms, side effects of systemic therapy, and upset by hair loss significantly predicted the increasing of depressive symptoms. Third, future perspective, breast symptoms, and side effects of systemic therapy significantly predicted of depressive mood, and body image significantly predicted loss of positive mood. Body image, future perspective, breast symptoms, and side effects of systemic therapy showed significant effects on interpersonal relationship. And future perspective, breast symptoms, and side effects of systemic therapy were significant predictors of physical deterioration. Finally it was discussed the important influences of the health related quality of life on the depressive symptoms in breast cancer patients and the future directions of psychological intervention for the breast cancer patients.

breast cancer, depressive symptom, body image, future perspective, breast symptoms, 유방암, 우울증상, 건강관련 삶의 질, 신체상, 미래전망, 가슴증상



김수현, 전은영, 이원희 (2006). 유방암 환자의 우울에 영향을 미치는 요인. 종양간호학회지, 6(2), 133-142.


김은정, 오경자, 하은혜 (1999). 기혼여성의 우울증상에 대한 취약성: 스트레스 경험 및 대처과정을 중심으로. 한국심리학회지, 여성, 4(1), 1-14.


오경자, 김은정, 하은혜 (1999). 임상적 우울 집단과 준 임상 우울집단의 심리사회적 특성 비교. 한국심리학회지, 임상, 8(1), 95- 104.


김혜영, 소향숙, 채명정, 김경미 (2008). 유방암 생존자의 삶의 질, 성기능 및 우울: 성생활 집단과 비성생활 집단 간의 비교. 종양간호학회지, 8(2), 77-85.


박정윤, 이은옥 (2001). 유방암 생존자와 정상 여성의 성적 행동 비교. 종양간호학회지, 1(2), 180-190.


배정이 (2004). 여성의 성기능 장애와 결혼 적응도, 우울 및 위기감과의 관계 연구. 정신간호학회지, 13(4), 467-475.


신승철, 김만권, 윤관수, 김진학, 이명선, 문수재 등. (1991). 한국에서의 the Center for Epidemiological Studies Depression Scale (CES-D)의 사용. 신경정신의학, 30(4), 752- 767.


이은현 (2007). 한국 암특이형 삶의 질(CQOL) 개발 및 평가. 대한 간호학회지, 37(3), 324-333.


전겸구, 이민규 (1992). 한국판 CCES-D 개발연구 Ⅰ. 한국심리학회지, 임상, 1(1) 65-76.


채영란 (2005). 유방암 절제술을 받은 여성의 지각된 건강상태, 우울 및 삶의 질의 관계. 성인간호학회지, 17(1), 119-127.


최배정, 박재홍, 최병무, 한성호, 김성환 (2011). 유방암 수술 환자의 불안, 우울에 영향을 미치는 인자. 생물치료정신의학, 17(1), 87- 95.


하은혜, 이선희, 유은승, 김종흔, 강한석, 노정실, 이근석 (2011). 유방암 환자의 화병과 우울증상의 관계. 한국심리학회지, 여성, 16(1), 115-133.


하은혜, 서주은, 정 준, 양정현, 남석진, 이정언, 백혜진 (2008). 유방암 환자의 우울장애 예측변인. 한국심리학회지, 임상, 27(4), 961-976.


한국보건사회연구원 (2006). 보건복지동향.


황숙연. (2009). 유방암 생존자의 삶의 질과 영향요인. 정신보건과 사회사업. 33, 257-287.


American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders. 4th rev ed(text revision). Washington, DC: American Psychiatric Association Inc.


Andritsch, E., Dietmaier, G., Hofmann, G., Zloklikovits, S., & Samonigg, H. (2007). Global quality of life and its potential predictors in breast cancer patients: an exploratory study. Supportive Care in Cancer. 15(1), 21-30.


Bardwell, W. A., Natarajan, L., Dimsdale, J. E., Rock, C. L., Mortimer, J. E., Hollenbach, K., et al. (2006). Objective cancer-related variables are associated with depressive symptoms in women treated for early-stage breast cancer. Journal of Clinical Oncology, 24, 2420-2427.


Barraclough, J., Pinder, P., Cruddas, M., Osmond, C., Taylor, I., & Perry, M. (1992). Life events and breast cancer prognosis. British Medical Journal, 304, 1078-1081.


Bodurka-Bevers, D., Basen-Enquist, K., Carmack, C. L., Fitzgerald, M. A.,Wolf, J. K., de Moor, C. & Gershenson, D. M.(2000). Depression, anxiety and quality of life in patients with epithelial ovarian cancer. Gynecolgic Oncology, 8, 302-308.


Burgess, C., Cornelius, V., Love, S., Graham J., Richard, M., & Ramirez, A. (2005). Depression and anxiety in women with early breast cancer: five year observational cohort study. British Medical Journal, 330, 702-705.


Chae, Y. R., & Seo, K. (2010). Health-Related Quality of Life in Women With Breast Cancer in Korea: Do Sociodemographic Characteristics and Time Since Diagnosis Make a Difference? Oncology Nursing Forum, 37(4), 295-303.


Coyne, J. C., Palmer, S. C., Shapiro, P. J., Thompson, R., & DeMichele, A. (2004). Distress, psychiatric morbidity, and prescriptions for psychotropic medication in a breast cancer waiting room sample. General Hospital Psychiatry, 26(2), 121-128.


Dodd, M. J., Miaskowski, C., & Lee, K. A. (2004). Occurrence of symptom clusters. Journal of the National Cancer Institute Monographs, 32, 76-78.


Fann, J. R., Thomas-Rich, A. M., Katon, W. J., Cowley, D., Pepping, M., McGregor, B. A., et al. (2008). Major depression after breast cancer: a review of epidemiology and treatment. General Hospital Psychiatry, 30, 112 -126.


Fayers, P. M., Aaronson. N., Bjordal. K. (2001). EORTC-C30 Scoring Manual. 3rd ed. Brussels: EORTC.


Ferrell, B. R. Wisdom, C., & Wenzel, C. (1989). Quality of life as an outcome variable in the management of cancer pain. Cancer, 63(11), 2321-2327.


Figueiredo, M. I., Cullen, J., Hwang, Y. T., Rowland, J. H., Mandelblatt, J. S. (2004). Breast cancer treatment in older women: does getting what you want improve your long-term body image and mental health? Journal of Clinical Oncology. 22(19), 4009.


Green, B. l., Rowland, J. H., Krupnick, J. L., Epstein, S. A., Stockton, P., Stern, N. M., et al. (1998). Prevalence of posttraumatic stress disorder in woman with breast cancer. Psychosomatics, 39, 102-111.


Graham, J., Ramirez, A. J., Love, S., Richards, M., & Burgess, C. (2002). Stressful life experiences and risk of relapse of breast cancer: Observational cohort study. British Medical Journal, 324, 1420-1423.


Karekoyun-Celik, O., Gorken, I., Sahin, S., Orcin, E., Alanyali, H.,& Kinay, M. (2010). Depression and anxiety levels in woman under follow-up for breast cancer: relationship to coping with cancer and quality of life. Medical Oncology, 27, 108-113.


Leedham, B., & Ganz, P. A. (1999). Psychosocial concerns and quality of life in breast cancer survivors. Cancer Invest, 17, 342-348.


Lima A. F. B. S & Fleck M. P. A. (2011). Quality of life, diagnosis, and treatment of patients with major depression: a prospective cohort study in primary care. Revista Brasileira de Psiquiatria, 33(3), 245-251.


Miller, B. E., Pittman, B. & Strong, C. (2003). Gynecologic cancer patients' psychosocial needs and their views on the physician's role in meeting those needs. International Journal of Gynecologic Cancer, 13(2), 111-119.


Mystakidou, K., Tsilik,a E., Parpa, E., Katsouda, E., Galanos, A., & Vlahos, L. (2005). Assessment of anxiety and depression in advanced cancer patients and their relationship with quality of life. Quality of Life Research, 14, 1825-1833.


Pearman, T. (2003). Quality of life and psychosocial adjustment in gynecologic cancer survivors. Health and Quality of Life Outcomes, 1(33), 1-6.


Polinsky, M. L. (1994). Functional status of long term breast cancer survivors: Demonstrating chronicity. Health Social Work, 19, 165-173.


Ruiz, M. A., Garde, S., Ascunce, N., Del Moral (1998) A: Intervenci psicolica en pacientes con cancer de mama. An Sis San Navarra, 21, 119-124.


Schagen, S. B., van Dan, F. S., Muller, M. J., Boogerd, W., Lindeboom, J., & Bruning, P. F. (1999). Cognitive deficits after postoperative adjuvant chemotherapy for breast carcinoma. Cancer, 85, 640-650.


Scheier, M. F., & Helgeson, V. S. (2006). Really, disease doesn't matter A commentary on correlates of depressive symptoms in women treated for early-stage breast cancer. Journal of Clinical Oncology, 24, 2407-2408.


Somerset, W., Stout, S. C., Miller, A. H., & Musselman, D. (2004). Breast Cancer and Depression. Oncology, 18(8), 1021-1034.


Stanton, A. L., Danoff-Burg, S., & Huggins, M. E. (2002). The first year after breast cancer diagnosis: Hope and coping strategies a predictors of adjustment. Psychooncology, 11, 93- 102.


Ware, J., Koinski, M, & Dewy, J. E. (2000). How to Score Version Two of the SF-36Ⓡ Health Survey (Standard & Acute Forms). 3rd. Lincoln, RI: Quality Metric Incorporate.


Wenzel, L. B., Donnelly, J. P., Fowler, J. M., Habbal, R., Taylor, T. H., Aziz, N. & Cella, D (2002). Resilience, reflection, and residual stress in ovarian cancer survivorship: a gynecologic oncology group study. Psychooncology, 11(2), 142-153.


Yun, Y. H., Park, Y. S., Lee, E. S., Bang, S. M., Heo, D. S., Park, S. et al. (2004). Validation of the Korean version of the EORTC QLQ- C30. Quality of Life Research, 13, 863-868.

The Korean Journal of Woman Psychology