본 연구에서 암환자 가족의 돌봄 부담을 측정하는 도구는 한국형 돌봄 경험평가도구(Caregiver Reaction Assessment-Korean Version: CRA-K)로 이는 Given 등[71]이 신체적, 정신적 질환을 앓고 있는 환자를 돌보는 돌봄 제공자의 돌봄 경험을 평가하기 위해 개발한 척도로 Lee[5]가 번안한 도구를 사용하였다. 가족탄력성을 측정하는 도구는 Kim[15], Jung[26], Wang[27]의 연구에서 수정·보완한 가족탄력성 도구를 Park[28]의 연구에서 사용한 도구를 암환자 가족에 맞게 수정·보완하였으며, 간호학 교수 2인과 암 병동에 근무하는 간호사 3인으로부터 내용타당도를 확인하였다. 자료 분석은 SPSS WIN 24.0 통계프로그램을 이용하여 빈도와 백분율, 평균과 표준편차, Independent t-test, One-way ANOVA, Scheffé-test, Pearson’s correlation coefficient로 하였다. 

연구결과는 다음과 같다. 

1. 대상자의 연령은 평균 50.5세이었고, 40세 이하 35명(30.4%), 61세 이 상 33명(28.7%), 51∼60세 26명(22.6%) 순이었으며, 성별은 남자 39명 (33.9%), 여자 76명(66.1%)이었다. 종교는 있음 91명(79.1%), 없음 24명(20.9%)이었고, 환자와의 관계는 자녀 63명(54.8%), 배우자 44명(38.2%) 순이었다. 간병인수는 평균 2.37명으로 2명 36명(31.3%), 3명 34명(29.6%), 1명이 29명(25.2%) 순이었고, 의료비 부담자는 환자본인 41명(35.7%), 자녀 39명(33.9%), 배우자 32명(27.8%) 순으로 나타났다.

2. 대상자의 돌봄 부담 정도는 5점 만점에 평균은 2.67점이었고 하위영역별로 살펴보면 생활패턴의 변화 3.18점, 신체적 부담 2.72점, 경제적부담 2.59점, 가족협조부족 2.17점이었다. 

3. 대상자의 가족탄력성 정도는 5점 만점에 평점은 3.60점이었고 하위영역별로 살펴보면 가족응집력 3.79점, 가족강점 3.75점, 의사소통 3.74점, 대처전략 3.56점, 사회적지지 3.55점, 가족자원 3.26점이었다.

4. 대상자의 일반적 특성에 따른 돌봄 부담의 차이는 간병인수(F=6.24 p=.001)에 따라 통계적으로 유의한 차이가 있는 것으로 나타났다. 

5. 대상자의 일반적 특성에 따른 가족탄력성의 차이는 간병인수(F=5.71, p=.001), 월 평균 의료비(F=3.09, p=.011)에 따라 통계적으로 유의한 차이가 있는 것으로 나타났다.

6. 대상자의 돌봄 부담, 가족탄력성간의 관계는 음의 상관관계를 보였다(r=-0.65, p<.001).

이상의 결과를 종합해 볼 때, 암환자 가족의 가족탄력성은 돌봄 부담에 관련성이 있음을 확인할 수 있었고, 실제 임상에서 암환자가족의 돌봄 부담을 완화시키기 위해 가족탄력성의 사정과 중재방안에 대한 고려가 필요함을 알 수 있었다.

This study aimed to investigate the level of care burden and family resilience and examine the relationship between related variables among family caregivers of patients with cancer. The participants were 120 family caregivers of patients with cancer, including the family caregivers of outpatients with cancer who visited the hemato-oncology outpatient clinics of two general hospitals located in P Metropolitan City, South Korea and the family caregivers of hospitalized patients with cancer in internal medicine wards at the same hospitals. The participants were surveyed using a questionnaire from November 29 to December 10, 2018. Data from 115 participants were finally analyzed. 

In this study, care burden among family caregivers of patients with cancer was measured using the Caregiver Reaction Assessment (CRA-K). This tool was originally developed by Given et al. [71] with the aim of assessing the care experience of care providers of patients with physical and mental illness and was translated into Korean by Lee [5]. Family resilience was measured using a tool for quantifying family resilience that was modified and supplemented in studies by Kim [15], Jung [26] and Wang [27]; used in a study by Park [28]; and modified and supplemented to fit family caregivers of patients with cancer for use in this study. Its content validity was verified by two nursing professors and three nurses working in cancer wards. Data were analyzed by frequency and percentage, mean and standard deviation, independent t-test, one-way ANOVA, Scheffé-test, and Pearson’s correlation coefficient using SPSS WIN 24.0. 

The results of this study were as follows. 

1. The mean age of the participants was 50.5 years, with participants 40 years or younger being the most common (n=35, 30.4%), followed by those aged 61 years or older (n=33, 28.7%), and those aged 51-60 years (n=26, 22.6%). By gender, there were 39 men (33.9%) and 76 women (66.1%). In terms of religion, 91 (79.1%) had a religion and 24(20.9%) had no religion. Concerning the relationship with patients, the majority of the participants 63 (54.8%) were patients’ children, followed by patients’ spouses (n=44,38.2%). The average number of caregivers was 2.37, followed by 2 caregivers (n=36, 31.3%), 3 caregivers (n=34, 29.6%) and 1 caregiver (n=29, 25.2%). In terms of health expenditure, patients most frequently reported bearing these expenses (41, 35.7%), followed by children (n=39, 33.9%), and spouses (n=32, 27.8%).

2. The mean score for the level of caregiver burden was 2.67 out of 5 points. By subdomain, the scores for change in life pattern, physical burden, economic burden, and lack of family cooperation were 3.18, 2.72, 2.59, and 2.17 points, respectively.

3. The mean score for the level of family resilience was 3.60 out of 5 points. By subdomain, the scores for family cohesion, family strengths, communication, coping strategies, social support, and family resources were 3.79, 3.75, 3.74, 3.56,3.55, and 3.26 points, respectively.

4. In terms of the difference in care burden according to the participants’ general characteristics, there was a statistically significant difference in care burden according to the number of caregivers (F=6.24 p=.001). 

5. There was a statistically significant difference in family resilience according to the number of caregivers (F=5.71, p=.001) and average monthly medical expenses (F=3.09, p=.011).

6. There was a negative correlation between care burden and family resilience among the participants (r=-0.65, p<.001).

In conclusion, the results of this study found that family resilience among family caregivers of patients with cancer was related to care burden. Further, in order to alleviate care burden among family caregivers of patients with cancer in clinical settings, it is necessary to assess their level of family resilience and consider related interventions for them.

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