성인환자가 지각한 사회적 지지와 불안의 관계에 관한 분석적 연구

Abstract

본 연구는 입원한 성인 환자가 지각한 사회적 지지 정도를 기능적 지지와 구조적 지지 측면에서 파악함과 동시에 사회적 지지와 상태 불안의 관계를 규명하고자 시도 되었다. 연구 목적을 달성하기 위하여, i) 연구대상자인 성인 환자가 지각한 사회적 지지의 기능적인 측면을 중심으로 한 기능적 지지 정도가 높을수록 상태 불안정도는 낮을 것이다 와 ii ) 사회적 지지체를 중심으로 한 구조적 지지 정도가 높을수록 상태 불안 정도는 낮을 것이라는 두개의 주 가설을 설정하였다. 이러한 주 가설을 검정함에 있어서 사회적 지지의 제기능인 1)경청 2)정서지지 3)정서 도전 4)사회현실 분담인 기능적인 측면에 대해 사회적지지 점수가 높을수록 상태 불안 정도는 낮을 것이라는 네개의 부 가설을 설정하였다. 연구 방법은 병실 방문을 통한 직접 면접 방법을 사용하였고 자료 수집은 저자와 훈련을 받은 연구조원 7명에 의해 수집되었으며 면접한 환자의 수는 405명이었으나 실제분석에 사용된 대상은 351명이었다. 연구 대상인 환자는 1984년 5월부터 9월 초까지 서울 시내에 소재한 3개 대학병원 내과에 입원한 순환기계, 호흡기계, 소화기계, 내분비계, 비뇨기계의 성인환자였다. 연구 도구는 Spielberqer에 의해 만들어진 S.T.A.I로 한국 표준화를 설정한 김 정택의「상태불안검사」를 사용하고 사회적 지지를 측정하기 위한 도구는 Pines가 개발한 것을 한국 실정에 맞도록 문헌 고찰을 통하여 저자가 수정 보완한 것으로 연구의 타당성과 적절성을 검정하기 위해 사전 조사와 Gronbach’s alpha를 이용하여 신뢰도를 검증한 도구를 이용하였다. 수집된 자료에서 연구 대상자가 지각하고 있는 사회적 지지와 불안 정도는 산술평균 및 표준편차를 연구 대상자의 일반적 특성과 사회적 지지 및 불안의 유의한 차이는 t-검증과 F-검증을, 연구 대상자가 지각한 사회적 지지와 불안간의 상관관계는 Pearson-correlation coefficient로 산출하였다. 본 연구의 결과는 다음과 같다. 가설(가) ; 「입원 전·후별 대상자가 지각한 기능면 사회적 지지 총점이 높을수록 상태 불안 정도는 낮을 것이다」에서 입원전 결과는 지지되지 않았고 입원 후는 지지 되었다. (입원전;r=-0.0451, p>.05, 입원후;r=-0.1871, p<.05). (1)「입원 전·후별 대상자가 지각한 경청면 사회적 지지 점수가 높을수록 상태 불안 정도는 낮을 것이다」는 지지 되었다. (입원전;r=-0.1584, p<.05, 입원후;r=-0.2498, p<.01). (2)「입원 전·후별 대상자가 지각한 정서 지지면 사회적 지지 점수가 높을수록 상태 불안정도는 낮을 것이다」에서 입원 전 결과는 지지되지 않았고 입원후는 지지 되었다. (입원전;r=-0.1104, p>.05, 입원후:r=-0.2629, p<.05). (3)「입원 전·후별 대상자가 지각한 정서 도전면 사회적 지지점수가 높을수록 상태 불안정도는 낮을 것이다」는 지지되지 않았다. (입원전:r+-0.0078, p>.05, 입원후;r=-0.0916, p>.05). (4)「입원 전·후별 대상자가 지각한 사회 현실 분담면 사회적 지지 점수가 높을수록 상태 불안 정도는 낮을 것이다」에서 입원전 결과는 지지되지 않았고, 입원후는 지지 되었다. (입원전;r=-0.0512, p>.05, 입원후;r=-0.1479, p<.05). 가설(나) ; 「입원 전·후별 대상자가 지각한 구조면 지지체를 중심으로한 지지 정도가 높을수록 상태 불안 정도는 낮을 것이다」에서 입원 전에서 배우자·부모·자녀가 지지 되었고(p<.05) 형제·기타 가족 및 친척·친구·간호원 및 의료인·동료 상사 및 성직자는 지지되지 않았다(p>.05). 입원 후에는 배우자·자녀·부모·형제·친구는 지지되었고 (P<.05) 기타 가족 및 친척·간호원 및 의료인·동료 상사 및 성직자는 지지되지 않았다(p>.05). 본 연구의 결과를 기초로 하여 다음의 제언을 하고자 한다. 1) 사회적지지와 불안의 관계를 일반화하기 위한 계속적인 반복연구가 필요하다. 2) 간호원의 기능적 지지 효과에 대한 실험연구가 필요하다. 3) 간호실무에서 사정할 수 있는 사회적지지와 불안에 대한 단순한 척도개발이 필요하다. ; The purpose of this study was to examine the relationship between the social support and the anxiety which adult patients perceive by means of the analysis of the relationship between the social support and the anxiety which are perceived by adult patients who are hospitalized. To achieve the purpose of this study, the hypothesis was set up that there is the correlation of the social support and the anxiety which the subject of study perceives, and concequently the correlation of the social support and the anxiety is different before and after the hospitalization. And then the correlation of the anxiety and the social support which is Listening, Emotional Support, Emotional Challenge, and Sharing Social Reality as the functional supports was analyzed, on the basis of the structural supporting frame of the social support the relevancy of the social supporting degree and an anxiety was certificated, and the quality of the support was investigated. The personal interview through sickroom visiting was used as method of study, data were collected by the present researcher and 7 research-assistants, and patients who was interviewed were 405 persons but the subject of study which was used in practical analysis was 351 persons. Patients as the subject of study were patients who were hospitalized because of the digestive trouble, or the respiratory trouble, or the circulatory trouble, or the meurosurgical disorders, or the endocine disorders, or urinary diseases in medical wards of the S. Univ. Hospital, E. Univ. Hospital, K. Univ.Hospital for three months or so from May to the beginning of September 1983. S.T.A.I. which was devised by Spierberger and Test for the anxiety of a state and a Trait which was used in Preliminary study for Korean Standardization by Kim, Jeong-Taeg were used as implements for this study. The implement, which was made through referential documents by the present researcher and was inspected and verified toward to the dependable degree of the analysis of items in advance, was used as the implement for the purpose of measuring the social support. With collected data, the social support and the degree of the anxiety which the subject of study perceives were compared by the arithmatical mean and the standard deviation, the efficient difference of the social support and the anxiety according to the general quality of the subject of study was compared by means of T-verification and F-verification, and the correlation of the social support and the anxiety which the subject of the study perceives was analyzed by Perarson-Correlation Coefficienty and ANOVA. The result of this study is as follows: The efficient difference of the social support according to the general quality of adult patients who are hospitalized was verified toward to the relevancy of the social support according to an age, a sex, a married life, a number of children members of a family who live in the same house, the physical system of a disease, an occupation, a way of an income, benefits of the medical cure insurance, the total monthly income, likes and dislikes in food and the habit of a repast, a state of sleep, an average sleeping hours, and way of the annulment of stress. The relevancy of the anxiety which is the response of the emotional inadaptability and the general quality of adult patients who were hospitalized was verified and comsequently the relevancy of the general quality and the anxiety of a state was verified in the relation with an age, a sex, a married life, a number of children, the power of a family, the period of contracting a disease, members of a family who live in the same house, a state of sleep, the experience that had been or had not been hospitalized beforehand, and a way of the annulment of stress. The relevancy of the general quality and the anxiety of trait was verified in the relation with the likes and dislikes in food and the habit of a repast, mumbers of a family who live in the same house and a state of sleep. The correlation of the social support and the anxiety which are perceived by adult patients who are hospitalized ? that main hypothesis in this study ? revealed the reverse correlation, and showed that the higher is the social supporting degree, the lower is the degree of the anxiety. In view of the results so far achieved the relevancy of the difference before and after the hospitalization was partly verified. The correlation of the degree of the social support which adult patients perceive showed the relevancy in the order named Listening, Emotional, and Sharing Social Reality in the social support. In the correlation of the anxiety and the social support by the structural supporting frame parents, brothers and sisters, spouse, the rest of a family and a relative, a nurse and a medicalman, a friend, a fellow officer and a higher officer, and a clergyman which are the structural supporting frame of the social support showed the special supporting degree of the item according to the supporting frame. Therefore the social support on the role of the supporting frame was examined. The social supporting degree of the structural supporting frame showed the high supporting degree in the order named parents, a spouse, and brothers and sisters, and the low supporting degree in the order named a nurse and a medical man, the rest of a family and a relative, and a fellow officer and a high officer. It is especially noticed that the supporting degree on a nurse and a medical man, who are expected as the important supporting frame of adult patients after the hospitalization, which adult patients perceives is low. By the result of this study, the present writer is to suggest as follows; Firstly, in the aspect of the study of nursing the many-sided and desirable study on the relation between the social support and the anxiety, and the study which a nurse can control and prevent the anxiety of adult patients by means of examining the measure and the cause of the social support on a patient must be accomplished. Secondly, in the aspect of the practical affairs of nursing the practical effort which puts emphasis on the whole personal nursing in the performance of the duty, and the institutional support in the nursing administration must be planned in order to increase the efficiency of the nursing service by promoting the whole-personal nursing role of a nurse. Thirdly, in the aspect of the nursing education the reason why a nurse choose the occupation of a nurse is the deep love and care for an human being which is whole-personal nursing in the performance of the nursing role, and it is the element that the social support has an distinct effect upon. For that reason a nurse is selected by grasping the motive for entering a school in order to increase the basic role of the whole-personal nursing.