위암 생존자의 이차암 예방을 위한 건강행위 영향요인

Abstract

The purposes of this study were to investigate the degree of practice of health behaviors to prevent second primary cancer and to identify factors that affect the practice of health behaviors to prevent second primary cancer in stomach cancer survivors.

In this study, a structured questionnaire was used for 135 patients who survived less than 5 years after of stomach cancer patients visiting gastroenterology and surgical outpatients at Y University Hospital in D City. The collection of data and survey was conducted from December 2021 to March 2022, and the survey consisted of tools including general characteristics and related characteristics of disease, knowledge of the prevention of second primary cancer, perceived benefit, perceived barriers, anxiety, depression, social support, and health behaviors for the prevention of second primary cancer. The collected data was analyzed by frequency and percentage, mean and standard deviation, independent sample t-test, one-way analysis of variance, correlation analysis, and multiple regression analysis using the SPSS WIN 26.0 program.

The degree of practice of health behaviors to prevent second primary cancer in stomach cancer survivors was 2.20±0.43 points. Among subject’s characteristics, health behaviors for the prevention of second primary cancer showed statistically significant differences depending on the degree of education (F=3.81, p=.012), smoking (F=14.03, p<.001), and drinking (F=3.52, p=.033).

Health behaviors for the prevention of second primary cancer showed a positive correlation with knowledge of prevention of second primary cancer (r=.22, p=.012), perceived benefits (r=.26, p=.002), social support (r=.29, p=.001), and subjective health conditions (r=.31, p=<.001), and a negative correlation with perceived barriers (r=-.50, p=<.001) and depression (r=-.25, p=.003). Factors affecting the practice of health behaviors for the prevention of second primary cancer appeared in the order of perceived barriers (β=-.37, p<.001), smoking (β=-.33, p<.001), subjective health conditions (β=.20, p=.002), drinking (β=-.20, p=.016), recommendation for examination of second primary cancer (β=.15, p=.028), and knowledge of prevention of second primary cancer (β=.14, p=.035) and the explanatory power was 45.1%.

In conclusion, nurses should provide with nursing strategies to reduce the subject's perceived barriers, and educate on the risk of smoking and drinking in order to promote the practice of health behaviors to prevent second primary cancer in stomach cancer survivors. In addition, education on the prevention of second primary cancer and active surveillance examination on second primary cancer should be recommeded in stomach cancer survivors.

본 연구의 목적은 위암 생존자의 이차암 예방을 위한 건강행위 정도를 조사하고, 이차암 예방을 위한 건강행위에 영향요인을 파악하기 위해 시도하였다.

본 연구는 D시 Y대학교 병원 소화기내과와 외과 외래에 내원한 위암 환자로 진단 후 5년 이하인 환자 135명을 대상으로 구조화된 설문지를 이용하여 자료를 수집하였다. 자료 수집은 2021년 12월부터 2022년 3월까지 하였으며, 설문지는 일반적 및 질병관련 특성, 이차암 예방 지식, 지각된 유익성, 지각된 장애성, 불안, 우울, 사회적 지지, 이차암 예방 건강행위를 측정하는 도구로 구성되었다. 수집된 자료는 SPSS WIN 26.0 프로그램을 이용하여 빈도와 백분율, 평균과 표준편차, 독립표본 t-검정, 일원분산분석, 상관분석, 다중회귀분석 방법으로 분석하였다.

위암 생존자의 이차암 예방을 위한 건강행위 정도는 2.20±0.43점이었으며, 대상자 특성에 따른 이차암 예방 건강행위는 교육정도(F=3.81, p=.012), 흡연 여부(F=14.03, p<.001), 음주 여부(F=3.52, p=.033)에 따라 통계적으로 유의한 차이가 있었다. 이차암 예방을 위한 건강행위는 이차암 예방 지식(r=.22, p=.012), 지각된 유익성(r=.26, p=.002), 사회적 지지(r=.29, p=.001), 주관적 건강상태(r=.31, p=<.001)에 대해 양의 상관관계를 나타냈고, 지각된 장애성(r=-.50, p=<.001)과 우울(r=-.25, p=.003)에 대해 음의 상관관계를 나타냈다. 이차암 예방을 위한 건강행위에 영향을 미치는 요인은 지각된 장애성(β=-.37, p<.001), 흡연 여부(β=-.33, p<.001), 주관적 건강상태(β=.20, p=.002), 음주 여부(β=-.20, p=.016), 이차암 검진 권유(β=.15, p=.028), 이차암 예방 지식(β=.14, p=.035) 순으로 나타났고, 설명력은 45.1%이었다.

위암 생존자의 이차암 예방을 위한 건강행위를 증진시키기 위해서 간호사는 대상자의 지각된 장애성을 낮출 수 있도록 간호 전략을 마련하고, 흡연 및 음주 위험성을 교육하여야 한다. 또한 대상자에게 이차암 예방 교육을 제공하고, 이차암 검진을 적극적으로 권유할 필요가 있다.