본 연구에서는 유방암 환자의 신체기능 및 신체증상 등 건강관련 삶의 질이 우울증상에 미치는 영향력을 규명하였다. 384명의 유방암 환자가 연구에 참여하여 한국판 유방암 환자의 삶의 질 척도(EORTC QLQ-BR23)로 건강관련 삶의 질을 평가하였고 우울증상 역학조사 척도(CES-D)로 우울증상을 평가하였다. 그 결과 신체상, 성적 기능, 성적 흥미, 미래 전망 등 4가지 기능 수준과 팔증상, 가슴증상, 치료 부작용, 모발 손실로 인한 괴로움 등 4가지 증상 수준 등 건강관련 삶의 질은 우울증상 총점과 우울정서, 긍정적 정서 부족, 대인관계 문제 및 신체적 저하를 유의하게 예측하였다. 하위요인별로 보면 신체상과 미래전망이 부정적일수록, 가슴증상과 치료부작용이 심할수록 우울증상 총점이 증가하였다. 미래전망이 부정적일수록, 가슴증상과 치료 부작용이 심할수록 우울정서가 심하였고, 신체상이 부정적일수록 긍정적 정서가 부족하였다. 또한 신체상과 미래전망이 부정적일수록, 가슴증상과 치료 부작용이 심할수록 대인관계 문제가 심하였다. 미래전망이 부정적일수록, 가슴증상과 치료부작용이 심할수록 신체적 저하가 심하였다. 이와 같은 결과를 통해 유방암 환자의 우울증상에 미치는 건강 관련 삶의 질의 중요성을 확인하였고 우울증상에 대한 심리학적 개입의 중요성과 방향에 대해 논의하였다.
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.
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