만성 신부전 환자의 정신병리, 가족지지체계 및 삶의 질

• Published in: Kidney research and clinical practice Vol. 23; no. 3; pp. 476 - 483
• Main Authors: 양종철, Yang Jong Cheol, 임소연, Im So Yeon, 최기철, Choe Gi Cheol
• Format: Journal Article
• Language: Korean
• Published: 대한신장학회 30.05.2004
• Subjects: Chronic renal failure; Family support system; Psychopathology; Quality of life; 내과학
• ISSN: 2211-9132; 2211-9140

목적 : 본 연구의 목적은 만성 신부전 환자들의 정신병리, 가족지지체계 및 삶의 질을 조사하고, 각 변인들 간의 상호 연관성을 알아봄으로써 만성 신부전 환자들의 정신건강 및 삶의 질 향상을 위한 기초 자료를 제공함에 있다. 방법 : 전남대학교병원에서 혈액투석군 43명, 복막투석군 53명, 신이식군 34명을 대상으로 하였다. 환자들의 사회 인구학적 자료를 조사하였고, 정신병리는 Symptom Checklist-90-Revised외 Beak Depression Inventory를 통해 평가하였으며, 가족지지체계는 Family Adhesion Scale와 Family Adaptability and Cohesion Evaluation Scale, 삶의 질은 World Health Organization Quality of Life Assessment Instrument를 통해 비교 분석한 후, 각 변인들 간의 상관관계를 조사하였다. 결과 : 혈액투석, 복막투석을 받는 환자는 신이식 환자에 비해 우울감이 유의하게 높았고, 가족지지체계와 삶의 질은 세 군간에 유의한 차이가 없었다. 상관관계 조사에서 가족적응력과 가족결속력은 우울과 가족응집력과 가족결속력은 적대감과 부적상관관계가 있었다. 삶의 질은 신체화, 강박증, 대인 민감성, 우울, 불안, 공포 불안, 정신증 등과 부적 상관관계를 나타냈다. 결론 : 만성 신부전 환자들의 장기적인 치료에 있어서 내과적 치료뿐만 아니라 정신병리와 가족 지지체계를 포함한 심리적 치료가 병행되어야 환자들의 총체적인 삶의 질 개선에 효과가 있을 것으로 평가되었다. Purpose : The purpose of this study is to evaluate the relationship among psychopathology, family support system and quality of life in patients treated with hemodialysis, peritoneal dialysis and kidney transplantation and provide useful information for therapeutic approach to patients with chronic renal failure. Methods : The subjects of the present study are 43 patients who have been treated with hemodialysis, 53 patients treated with peritoneal dialysis and 34 patients treated by renal transplantation. Beck Depression Inventory (BDI), Symptom Checklist-90- Revised (SCL-90-R) for psychopathology, Family Adhesion Scale, Family Adaptability and Cohesion Evaluation Scale Ⅱ (FACES Ⅱ) for family support system, and World Health Organization Quality of Life Assessment Instrument for quality of life were administered to subjects. To examine these, ANOVAs and Pearson correlation analysis were conducted. Results : The patients who have been treated with hemodialysis or peritoneal dialysis showed higher scores of depression in BDI and SCL-90-R than patients treated with renal transplantation. Depression correlated with family cohesion & adaptability, negatively. Hostility correlated with family adhesion & cohesion, negatively. Somatization, obsessive-compulsive, interpersonal sensitivity, anxiety, phobic anxiety and psychoticism correlated with quality of life, negatively. Conclusion : The main findings of this study indicate that psychopathology significantly related with family support system and quality `of life of the patients with chronic renal failure. These results suggest that the psychosocial intervention are necessary to promote the mental health, strengthen the family support system, and improve the quality of life in the patients with chronic renal failure. (Korean J Nephrol ZOO4;23(3):476-483)