호르몬요법을 받는 전립선암 환자의 안면홍조와 남성호르몬 저하 증상

Other Titles
Hot Flashes and Hypogonadism Symptoms in Patients with Prostate Cancer Receiving Hormone Therapy.
Authors
박현혜
Issue Date
2013-08
Awarded Date
2013
Abstract
This research investigated various factors related to frequency of hot flashes, and predictors of hot flashes and symptoms and factors related to hypogonadism targeting prostate cancer patients with hormone therapy. This is, thus, a descriptive study, which based on the results, providies base line data for nursing intervention with these patients. The data collection was made through targeting a total of 111 prostate cancer patients who were receiving hormone therapy in two university hospitals located in D city from June 2012 to December 2012. The measuring methods for this research were: 1) the measurement method used in a research by Jung and Kim (2008) which was modified and supplemented to measure the frequency of hot flashes, their degree and duration, and perspiration and palpitation accompanying the hot flashes. 2) an original AMS (Aging Male's Symptoms rating scales) devised by Heinemann et al. (1999) which was translated into Korean by Daig et al. (2003). The data analysis methods used were real number and percentage, average and standard deviation, t-test, ANOVA, Fisher’s exact test, logistic regression analysis and multiple regression analysis. The results of this research are as follows: 1. The percentage of patients who experienced hot flashes from all the prostate cancer patients receiving hormone therapy was 14.4%. The group which drank more than three cups of coffee (χ²=8.09, p=.013), the group which had promiscuous eating habits (χ²=6.92, p=.029) and the group which received luteinizing hormone releasing hormone agonist (χ²=0.68, p=.012) had more hot flashes symptoms. 2. The predictors for hot flashes were eating habits, frequency of drinking coffee and hormone preparation. The prediction probability of logistic regression analysis was 87.4%. The probability of experiencing hot flashes in people who had promiscuous eating habits was 11.95 times greater compared to people who had regular eating habits. People who drank more than 3 cups of coffee had an 8.89 times greater probability of experiencing hot flashes compared to people who drank less than 1 cup of coffee. Finally, people who received luteinizing hormone releasing hormone agonist had a 7.61 times greater probability of experiencing hot flashes compared to people who received anti-androgen. 3. The symptoms of hypogonadism found in prostate cancer patients with hormone therapy were sexual symptom (2.77 out of five-point scale), physical symptom (2.02 out of five-point scale), and psychological symptom (1.75 out of five-point scale). 4. The degree of hypogonadism was higher in the group where 5 years had passed since the first diagnosis, in the group which had irregular eating habits, and in the group with vegetarian eating habits. The related factors were less than 1 year (β=-0.38), less than 1-5 years (β=-0.25), and further for the common eating habit (β=-0.55) and regular (β=-0.78). The explanation ability was 23%. Through this research, we found that irregular eating habits were an important factor in hot flashes and hypogonadism. Therefore, nutrition education to promote regular eating habits is required. For patients who use luteinizing hormone releasing hormone agonist, the provision of detailed information about hot flashes is required.
본 연구는 호르몬요법을 받는 전립선암 환자를 대상으로 안면홍조의 발생 빈도 및 안면홍조 영향요인, 남성호르몬 저하 증상 및 영향요인에 대해 조사하여 전립선암 환자를 위한 간호중재의 기초자료를 제공하기 위한 서술적 조사연구이다. 자료수집은 D시 소재 2개의 대학병원에서 호르몬요법을 받고 있는 전립선암 환자 111명을 대상으로 2012년 7월부터 12월까지 진행하였다. 측정도구는 정수경과 김동일 (2008)의 연구에서 사용한 안면홍조 일지 도구를 수정 보완하여 안면홍조 정도, 빈도, 지속시간 및 안면홍조에 수반되는 발한현상과 두근거림에 대한 측정도구, Heinemann 등(1999)이 개발한 AMS 증상점수표를 Daig 등(2003)에 의해 한국어로 번역된 한국인 남성 갱년기증상 설문지(Aging Male’s Symptom: AMS)를 사용하였다. 자료분석은 실수와 백분율, 평균 및 표준편차, t-test, ANOVA, Fisher’s exact test, 로지스틱회귀분석, 다중회귀분석을 이용하였다. 본 연구의 결과는 다음과 같다. 1. 호르몬요법을 받는 전립선암 환자가 안면홍조를 경험하는 비율은 14.4% 였으며, 커피를 하루 평균 3잔 이상 마시는 군(χ²=8.09, p=.013), 불규칙한 식사습관 군(χ²=6.92, p=.029), 황체형성호르몬분비호르몬 촉진제 사용 군(χ²=0.68, p=.012)에서 안면홍조가 더 많이 나타났다. 2. 안면홍조를 일으키는 영향요인은 식사습관, 커피 섭취 정도와 호르몬 제제로 로지스틱회귀분석 모형의 예측확률은 87.4%이었다. 안면홍조를 경험할 확률은 식사를 불규칙적으로 하는 전립선암 환자가 규칙적으로 하는 환자보다 11.95배, 커피를 하루 평균 3잔 이상 마시는 환자가 1잔 이하 마시는 환자 보다 8.89배, 치료약으로 황체형성호르몬분비호르몬 촉진제를 사용하는 전립선암 환자가 항남성호르몬제를 사용하는 환자보다 7.61배 더 높은 것으로 나타났다. 3. 호르몬요법을 받는 전립선암 환자의 남성호르몬 저하 증상으로는 성적 증상 2.77점(5점 만점), 신체적 증상 2.02점(5점 만점), 정신적 증상 1.75점(5점 만점) 순으로 나타났다. 4. 남성호르몬 저하 증상 정도는 진단 받은 기간이 5년 이상인 군, 불규칙한 식사습관 군, 채식 섭취군에서 더 높게 나타났으며, 영향요인으로 진단 후 기간 1년 미만(β=-0.38), 1-5년 미만(β=-0.25)과 식사습관 보통(β=-0.55), 규칙적(β=-0.78)으로 확인되었으며, 설명력은 23%으로 나타났다. 본 연구결과를 통해 안면홍조와 남성호르몬 저하 증상에 불규칙한 식사습관이 증상 발현에 중요한 영향을 미치는 것으로 나타나 식사습관을 규칙적으로 할 수 있도록 영양교육을 체계적으로 실시할 필요가 있으며, 황체형성호르몬분비호르몬 촉진제를 사용하는 환자에게 안면홍조에 대한 정보 제공을 구체적으로 실시할 필요가 있다.
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/10968
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3. Thesis (학위논문) > 2. College of Nursing (간호대학) > 석사
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