만성신부전환자의 우울성향과 가족기능 평가

Abstract

Background : As if is known to us that a family is a primary social factor affected in its health and is more influenced on patients and its function in chronic diseases, this research has been done to help medical treatment comparing the degree of chronic renal failure patient's depression and the family function with healthy peoples.

Methods : This research has been done by means of questionnaire reports to translate Beck Depression inventory(BDI) on the part of depression and the Family Adaptability and Cohesion Evaluation Scales III(FACESIII) in the part of family funcion, in which 138 chronic renal failure patient treated in hemodialysis and 142 people of health screen transferred into family physician have taken part at renal center in the Dong-San Medical Center from April to August in 1994.

Results : 1. The study group had average BDI's score of 25.05±12.76, which was higher than control group with BDI's score of 11.63±8.83. Thus, in patient group, depression degree were higher than control group. 2. In FACESIII cohesion of the patient group, there were 90 people(65.2%) in "Disengaged" and 26 people(18.8%) in "Separated" and 17 people(12.4%) in "Connected" and 5 people(3.6%) in "Enmeshed". In that of the contrast group. 53 people(37.3%) in "Disengaged" and 45 people(31.7%) in "Seperated" and 41 people(28.9%) in "Connected"and 3 people(2.8%) in "Enmeshed". 3. In FACESIII adaptability of the patient group. there were 36 people(26.1%) in "Rigid" and 43 people(31.2%) in "Structured" and27 people(19.6%) in "Flexible" and 32 people(23.2%) in "Chaotic". In that of the control group. 15 people(10.6%) in "Rigid" and 56 people(39.4%) in "Structured" and 49 people(34.5%) in "Flexible" and 22 people(15.5%) in "Chaotic". 4. In FACESIII family types of the patient groups, there were 47 people(34.1%) of "Extreme" and 69 people(50.0%) of "Mid-Range" and 22 people(15.9%) of "Balanced" type. In those of the contrast group, there were 73 people(51.4) of "Balanced" and 114 people(40.7%) of "Mid-Range" and 24 people(16.9%) of "Extreme" type.

Conclusion : This study suggested that depression and family dysfunction should be considered in the management of the chronic renal failure patients.

연구배경 ：가족은건강에 영향을미치는중요한사회적 요인이며 만성질환은환자개인과 가족기능에 미치는 영향이 더 큰 것으로 알려져 왔기에 본 연구는 만성신부전환자의 우울정도와 가족기능을 정상인과 비교하여 환자진료시 도움이 되고자 실시하였다.

방법 ： 본 연구는 1994년 4월 1일부터 1994년 8월 31일까지 대구 동산의료원 신장실에서 혈액투석실시 중인 만성신부전환자 138명과 가정의학과 외래를 내원한 종합건강검진자 중 질환이 없는 142명에 대하여 우울증은 자기평가 우울척도 (Beck Depression Inventory), 가족기능은 가족적응력 결속력 평가지수 질문표(Family Adaptability and CohesionEvaluation scalesⅢ)를 번역한 설문지법에 의하여 조사하였다.

결과:만성신부전 환자의 우울점수(BDI)의 평균은 25.02±12.76으로 대조군 11.63±8.83보다 우울성향이 높았고 가족기능 평가에서 가족결속력의 평균은 32.07±7.06으로 대조군보다 낮고, 가족적응력의 평균은 25.05±12.7로 대조군의 11.63±8.83보다 높아 만성신부전 환자의 가족결속력은 대조군보다 떨어지나 가족적응력은 더 좋은 것으로 나타났고, 가족 유형중 극단형이 34.1%로 대조군의 16.9%보다 많아 가족기능 장애가 더 많은 결과를 보였다.

결론:만성신부전 환자 진료시 우울성향과 가족기능 저하에 대한 고려가 필요한 것으로 사료된다.(가정의학회지 1996 ； 17 ： 143 ~ 151)

중심단어 ： 만성신부전, 우울척도, 가족적응력 결속력 평가지수 질문표