암환자의 죽음인식이 웰다잉과 영적 안녕에 미치는 영향에 관한 연구

• 영문명: Impact of Death Awareness on Well-Dying and Spiritual Wellbeing in Cancer Patients - the regulation effects of hospice care -
• 발행기관: 한국복지실천학회
• 저자명: 김석란(Kim Seak ran)
• 간행물 정보: 『한국복지실천학회지』제8권 제1호, 63~106쪽, 전체 44쪽
• 주제분류: 사회과학 > 사회복지학
• 파일형태: PDF
• 발행일자: 2017.11.30

국문 초록

암환자의 죽음인식에 따른 웰다잉과 영적안녕의 영향 관계를 파악하고 호스피스활동이 그 영향 관계를 조절하는 효과가 있는지 검증하여 사회복지 실천서비스로서 암환자를 위한 호스피스활동 개입의 필요성에 대한 기초자료를 제공하는데 목적을 두고 있다. 본 연구에서는 암환자를 대상으로 죽음인식을 독립변수로 하고 웰다잉과 영적안녕을 종속변수로, 호스피스활동을 조절변수로 하여 변수간의 영향을 검증하였다. 연구의 자료는 서울과 경기도지역의 호스피스 간호서비스를 제공받고 있는 암환자 350명을 대상으로 2016년 4월 1일부터 4월 28일 사이에 설문지를 사용하여 조사하였으며, 불성실한 응답 64부를 제외한 286부의 설문을 최종분석에 사용하였다. 본 연구의 결과는 다음과 같다. 첫째, 죽음인식이 웰다잉과 영적안녕에 미치는 영향력을 다중회귀분석을 확인한 결과, 암환자들은 죽음에 대한 긍정적 인식이 높을수록, 죽음에 대한 수용력이 높을수록, 평상시에 죽음에 대한 관심이 높을수록, 생명존중 인식이 높을수록 웰다잉에 대한 준비와 인식도가 더 높은 것으로 분석되었다. 또한 암환자들은 죽음에 대한 긍정적 인식이 높을수록, 죽음에 대한 불안이 적을수록, 평상시에 죽음에 대한 관심이 높을수록, 생명존중 인식이 높을수록 영적안녕에 대한 준비와 인식도가 더 높은 것으로 분석되었다. 둘째, 암환자가 인식하는 죽음인식은 호스피스활동에 영향관계를 갖고 있는 것으로 나타났다. 암환자는 죽음불안이 심할수록, 죽음수용이 강할수록, 생명존중 인식이 높을수록 호스피스활동에 긍정적인 것을 나타났으며, 암환자는 죽음불안이 심할수록, 죽음수용이 강할수록, 생명존중 인식이 높을수록 호스피스활동 중에서 상담, 사정, 사별관리, 퇴원계획, 지역사회 자원관리 등의 직접개입관련 활동에 보다 긍정적인 것으로 나타났다. 셋째, 암환자가 인지하는 죽음인식과 웰다잉의 사이 및 죽음인식과 영적안녕 사이에는 호스피스활동이 조절효과를 갖는 것으로 나타났다. 암환자의 웰다잉 및 영적안녕 각각은 암환자가 인지하는 죽음인식과의 사이에서 암환자가 인지하는 호스피스활동이 조절효과로 분석되어, 조절변수(호스피스활동)는 독립변수인 죽음인식과 종속변수인 웰다잉과 영적안녕의 관계를 각각 조절하는 역할을 하는 것으로 해석할 수 있다. 또한, 조절변수 상호작용 항의 베타 값이 플러스(+)로 나왔으므로 호스피스활동이 왕성할수록 암환자가 인식하는 죽음인식은 웰다잉 및 영적 안녕에 더 영향을 미치는 것을 확인하였다.

영문 초록

The purpose of this study was to examine the influential relationships of the death awareness of cancer patients to their well-dying and spiritual wellbeing and the mediating effects of hospice care on the influential relationship of the variables in an effort to provide some information on the necessity of hospice care intervention geared toward cancer patients as one of practical social welfare services. The death awareness of cancer patients was selected as an independent variable, and well-dying and spiritual wellbeing were selected as independent variables. The selected moderator variable was hospice care, and the mutual influences of the variables were analyzed. The subjects in this study were 350 selected cancer patients who were provided with hospice care in the metropolitan area. A survey was conducted from April 1 to 28, 2016, and the answer sheets from 286 respondents were analyzed except for 64 data that included unfaithful answers. The findings of the study were as follows: First, the general characteristics of the cancer patients had influential relationships with their well-dying and spiritual wellbeing. A more adaptive awareness of well-dying was found among the patients who were older, who were Christian, who were better educated, who lived with their spouses, whose financial status were more stable and were less burdened with medical expenses. In terms of spiritual wellbeing, there was a more compliant attitude in the respondents who were female, who were older, who were Christian, who were in the initial stage of cancer, who were in more stable financial condition, who were under less pressure about medical expenses and who were provided with more hours of hospice care a day. Second, the general characteristics of the cancer patients had influential relationships with their death awareness and hospice care. A more immersion in death ideation was found among the patients who were male, who were less educated, who had no spouses in terms of marital status, whose cancer was in worse conditions, who received treatment for a longer period of time and who were provided with more hours of hospice care a day. And the way of looking at hospice care was more positive among the respondents who were older, who were less educated, who had no spouses in terms of marital status, who received treatment for a longer period of time and who were offered more hours of hospice care a day. Third, multiple regression analysis was made to determine the influence of death awareness on well-dying and spiritual wellbeing. As a result, there were better preparations for well-dying and better awareness of it among the patients who took a more positive view of death, who were more receptive to it, who were usually more concerned about it and who had more respect for life. And the patients who took a more positive view of death, who felt less anxiety over it, who were usually more interested in it and who had more respect for life were better ready in terms of spiritual wellbeing and looked at spiritual wellbeing more favorably.

목차

국문초록

Ⅰ. 서론

Ⅱ. 이론적 배경

Ⅲ. 연구설계

Ⅳ. 연구결과 분석

Ⅴ. 요약

참고문헌

ABSTRACT

키워드

죽음인식 웰다잉 영적안녕 호스피스활동 death awareness well-dying spiritual wellbeing hospice care