Earticle

본 연구는 여성생식기 암 생존자들의 외상 후 성장과 관련한 영향요인을 파악하고자 시도되었다. 여성생 식기 암 환자들 가운데 치료가 성공적으로 종결되고 인터넷 카페 활동을 하는 암 환자 자조모임의 141명을 대상으 로 하였으며, 2016년 9월부터 10월까지 외상 후 성장, 질병으로 인한 영향, 대처, 가족응집력 그리고 사회적 지지를 이메일을 이용하여 측정한 후 일원변량분석, 피어슨 상관관계 그리고 다중회귀분석을 실시하였다. 외상 후 성장은 평균 84.13점 이었으며, 나이, 종교, 결혼상태에 따라 유의미한 차이를 보였고, 대처, 가족응집력, 사회적 지지와는 정적 상관관계를 나타냈다. 외상 후 성장에 영향을 미치는 주요 변수는 종교(ß=.127), 결혼상태(ß=.081), 대처 (ß=.232) 그리고 가족응집력(ß=.415)으로 설명력은 44.7%였다. 본 연구는 여성생식기 암 생존자의 외상 후 성장을 위하여 개인의 일반적인 특성에 대한 이해와 사회심리적 요인을 파악할 필요가 있음을 제시하고 있다. 나아가 여성 생식기 암 대상자의 외상 후 성장을 촉진할 수 있는 의료 및 지역사회 기관의 융합적인 접근이 필요함을 시사한다.

The purpose of the study was to investigate the convergence factors to posttraumatic growth(PTG) in survivors with female urogenital neoplasm survivors. A self-reported questionnaire was completed by 141 female urogenital neoplasm survivors via e-mail from September to October, 2016. The questionnaire consisted of PTG inventory, illness intrusiveness rating scale, cancer coping, family cohesion evaluation scale, and medical outcomes study social support survey. The data were analyzed by ANOVA, Pearson-correlation coefficient, and multiple regression analysis. Total score of PTG was 84.13points and statistically significant according to age, religion, marital status and positively associated with coping, family cohesion and social support. Results of the regression analysis showed religion(ß=.127), marital status(ß=.081), coping(ß=.232) and family cohesion(ß=.415), it were explained 44.7%. This study indicates that it is important to understand general characteristics of personal. And a convergent approach is needed to promote PTG by hospital and community.

Purpose To examine the psychometric properties of the Korean version of the adapted Illness Intrusiveness Rating Scale (a-IIRS). The a-IIRS is a modified version of the original IIRS that measures illnessdisruptions to daily life in patients with diverse diagnoses. While the psychometric properties of the original IIRS have been validated, no study has been conducted to validate the Korean version of a-IIRS. Methods After translation and back-translation processes, the Korean version of a-IIRS was developed. A pilot test was conducted with 10 patients with chronic diseases. A convenience sample of 380 patients with diabetes, hypertension, and/or arthritis was used. Exploratory and confirmatory factor analyses,known-group technique, hypothesized relationships, internal consistency, and item analysis were tested. Results Three factors were extracted from principal components analysis with varimax rotation:Relationships and Personal Development, Instrumental Life, and Intimacy. Confirmatory factor analysis corroborated the good fit of the three-factor model. Illness intrusiveness was significantly different among the study subjects categorized into three groups according to different health status: poor, fair and good. The instrument was positively correlated with the scales of fatigue and depression. The tool demonstrated high internal consistency with adequate item-total correlations. Conclusions The findings are consistent with previous study results on IIRS and support the reliability and validity of the Korean version of a-IIRS. The instrument is culturally relevant for Korean patients with chronic diseases. Health care professionals need to consider illness intrusiveness when caring for patients with chronic diseases and promote their quality of life. [Asian Nursing Research 2010;4(4):194?204]

Purpose: Illness intrusiveness (illness induced lifestyle disruption) by symptoms was investigated in 439 patients with rheumatoid arthritis. Method: The cross-sectional and retrospective survey design was used. Fatigue, disability, pain, and depression were considered as symptoms of rheumatoid arthritis. Result: Patients were reported to perceive more illness intrusiveness than other chronic disease patients such as end stage renal disease, bipolar disorder, and peritoneal dialysis patients. They were especially intrusive into work, health, and active recreation domains. Stepwise regression analysis identified four variables counting for 26% of illness intrusiveness variances: fatigue, disability, marital status, and depression. All of the symptoms except pain were found to significantly predict illness intrusiveness. Fatigue explained 16% of illness intrusiveness variances. Conclusion: Fatigue and depression usually overlooked by health professionals must be carefully assessed and managed to reduce perceived illness for rheumatoid arthritis patients.

Chronic disease such as rheumatoid arthritis is believed to induce a significant psychosocial stressors. The concept of illness intrusiveness-illness induced life style disruptions-was hypothesized to affect psychosocial status. And demographic, socioeconomic, disease and social characteristics were hypotehsized to affect illness intrusiveness. Hierarchial multiple regression analyses were used. As a result, among the demographic factors gender was identified as contributor to directly increase the psychosocial stress and education level was identified to affect the psychosocial stress through illness intrusiveness. Among socioeconomic factors, the burden about the cost of medical treatment was found to indirectly affect the psychosocial stress through the illness intrusiveness. Also income and job were found to affect directly the psychosocial status. Among the disease characteristics, only the pain level was identified to increase the psychosocial stress through the illness intrusiveness. Among the social characteristics, perceived social support is identified to increase the psychosocial stress through the illness intrusiveness. Based upon these results, some suggestions were made for minimizing illness intrusiveness in rheumatoid arthritis and future research.

Purpose: Illness intrusiveness (illness induced lifestyle disruption) by symptoms was investigated in 439 patients with rheumatoid arthritis. Method: The cross-sectional and retrospective survey design was used. Fatigue, disability, pain, and depression were considered as symptoms of rheumatoid arthritis. Result: Patients were reported to perceive more illness intrusiveness than other chronic disease patients such as end stage renal disease, bipolar disorder, and peritoneal dialysis patients. They were especially intrusive into work, health, and active recreation domains. Stepwise regression analysis identified four variables counting for 26% of illness intrusiveness variances: fatigue, disability, marital status, and depression. All of the symptoms except pain were found to significantly predict illness intrusiveness. Fatigue explained 16% of illness intrusiveness variances. Conclusion: Fatigue and depression usually overlooked by health professionals must be carefully assessed and managed to reduce perceived illness for rheumatoid arthritis patients.

Purpose: This study was performed to identify the illness intrusiveness, quality of life, and their relationships in patients with chronic liver disease. Method: Data was collected using scales of illness intrusiveness developed by Devins et al and Korean health related quality of life (KoQoLS) developed by Shim et al to measure the illness intrusiveness and quality of life from 141 chronic liver disease patients. Result: The total mean score of illness intrusiveness was $38.85{\pm}18.45$. The domain of illness intrusiveness which showed the highest mean score was health ($4.60{\pm}2.02$), and the lowest mean score domain was relationship with spouse ($20.4{\pm}1.69$). The subcategory of KoQoLS which showed the highest mean score was bodily pain ($6.96{\pm}2.98$), and the lowest mean score subcategory was vitality ($2.75{\pm}1.20$). There were negative relationships between illness intrusiveness and KoQoLS in all subcategories. Abovel all, Illness intrusiveness had the strongest negative relationship with role limitation (r=-0.641) among the KoQoLS subcategories. Conclusion: Because the illness intrusiveness had negative influence on the quality of life in patients with chronic liver disease, further research will need to specify detailed illness intrusiveness and to explore influencing factors on quality of life in them.

Purpose: The purpose of this study was to identify the influence of the type-D personality on quality of life and illness intrusiveness. Methods: This study was a cross-sectional study. Data were collected using self-reported questionnaire from 200 patients with coronary artery disease(CAD). Variables were measured with the Type-D Scale-14(DS14), Korean Health Related Quality of Life Scale(KoQoLS), and the Illness Intrusiveness Rating Scale(ILRS). Results: Of the patients, 38% were classified as type-D personality. Among the 10 subcategories of quality of life, the highest mean score was bodily pain($5.84{\pm}2.85$) and the lowest was role limitation($1.52{\pm}1.20$). Among 13 item of illness intrusiveness, the highest mean score was health($3.78{\pm}1.73$) and the lowest was family relationships($2.14{\pm}1.58$). There were significant differences in all the subcategories of quality of life between type-D and non type-D except for subcategories of bodily pain and role limitation. However, there were no significant differences in illness intrusiveness between type-D and non type-D. Conclusion: Type-D is an important factor in quality of life in patients with CAD, but no correlations between type-D and illness intrusiveness were found. These results can be used as basic data for developing cardiac rehabilitation programs to improve quality of life in type-D patients.

본 연구는 재가 뇌졸중 환자의 환경상태, 기능적 독립, 질병으로 인한 영향 정도를 파악하여 간호중재시의 기초자료로 활용하고자 K시와 그 인접지역에 거주하는 뇌졸중 환자 145명을 대상으로 수행된 조사연구이다. 수집된 자료는 SPSS 프로그램을 이용하여 분석하였으며 주요결과는 다음과 같다. 환경 및 안전 사정에서 주거지에 위험시설이 있다고 응답한 사람은 전체의 46.2%인 67명 이었고, 이들 중 위험시설을 계단이라고 응답한 사람은 58.2%로 가장 높았고, 그 외 가스/전기 시설을 위험지역으로 응답하였다. 현 거주지의 위생상 문제가 있다고 응답한 사람은 전체의 28.2%인 41명 이었다. 이 중 현 거주지의 위생상 문제로는 집밖에 오염된 화장실이 있는 경우와 정돈되지 않고 오염된 주거환경이 22.0%로 가장 높았고, 벌레나 쥐가 있는 경우, 부적당한 음식보관, 불규칙한 쓰레기수거, 부적절한 하수도 시설도 문제점으로 지적되었다. 대상자들의 기능적 독립(FIM : Function Independence Measure)은 총 126점 중 평균점수는 74.52, 총 7점 중 평균평점은 4.14 이었다. 이 중 운동영역에서 가장 낮은 것은 계단오르기(3.01)와 목욕하기(3.16)였으며, 인지영역에서 가장 낮은 것은 사회활동(3.66)이었다. 질병으로 인한 장애영향은 총 91점 중 평균점수는 58.86점, 총 7점 중 평균평점은 4.52이었다. 질병으로 인한 장애영향을 가장 높게 받는 항목은 건강(5.61), 일(5.68), 활동적인 여가활동(5.56), 경제적 측면(5.45)이었다. 기능적 독립(FIM)과 질병으로 인한 장애영향과는 유의한 음의 상관관계가 있었다(r=-0.66, p=0.00).

This study was conducted to examine the environmental status, FIM(Function Independence Measure), Illness intrusiveness of home stayed stroke patients. Data were collected on 145 patients living in K city and the neighborhood located in southern part of Korea. The data were analyzed by means of SPSS program. Results : In assessment of environmental safety, 46.2%(67) felt unsafe around their residential area. The most dangerous facilities in their residence was stairs(58.2%), gas/electric facilities(14.9%). For sanitary problems, 28.2%(41) felt they have problems at their home. The most important problems were outdoor polluted toilet(22.0%) and scattered and dirty residential circumstances(22.0%). The average FIM score was 74.52(4.14) of total score 126(7). In motor area FIM was lowest at stair walking(3.01) and bathing(3.16). In cognitive area FIM was lowest at social activities(3.36). The mean score of Illness intrusiveness was 58.86(4.52) of total score 91(7). The major area largely impacted by stroke were health(5.61), working(5.68), active leisure activities(5.56). There was significant reverse correlation between FIM and illness intrusiveness(r=-0.66, p=0.00). Conclusion : It was needed environmental improvement and rehabilitation program for stroke patients, and repeated follow up study.