항문괄약근 보존술을 받은 직장암 환자의 배변기능, 사회적 지지 및 삶의 질

Abstract

본 연구는 항문괄약근 보존술을 받은 직장암 환자의 배변기능, 사회적 지지 및 삶의 질을 파악하기 위해 시도된 서술적 상관관계 연구이다. 항문괄약근 보존술을 받은 직장암 환자 131명을 대상으로 하였으며, 수집된 자료의 분석은 SPSS 21.0 통계프로그램을 이용하여 기술통계, t-test, one-way ANOVA, Pearson's correlation coefficient, Multiple Regression 분석 방법을 사용하였다.

주요 연구 결과는 다음과 같다. 1. 대상자의 배변기능을 분석한 결과, 배변기능 점수는 최소 43점에서 최대 86점까지 분포하며, 평균 65.26±8.33점으로 나타났다. 배변기능 하부항목 에서의 평균점수는 빈변 24.38±4.97점, 긴박변/변실금 15.64±3.56점, 식이특성 13.48±3.06점, 배변특성 11.74±2.49점의 순으로 나타났다. 2. 대상자의 사회적 지지 점수는 최소 16점에서 최대 60점으로 분포하며 평균 43.09±9.72점으로 나타났다. 사회적 지지 하부영역에서의 평균점수는 가족지지 17.22±3.24점, 친구지지 14.93±4.17점, 의료인지지 10.93±5.45점의 순으로 나타났다. 3. 대상자의 삶의 질 점수는 최소 54점에서 최대 133점으로 분포하며 평균 98.80±19.64점으로 나타났다. 삶의 질 하부영역에서의 평균점수는 신체 영역 23.52±4.53점, 사회/가족 영역 17.06±7.58점, 정서 영역 18.91±3.83 점, 기능영역 19.76±6.39점, 대장암관련 영역 19.56±4.26점으로 나타났다. 4. 대상자의 특성에 따른 배변기능에서는 수술 방식(p=.001), 일시적 장루 경험유무(p=0.26)에 따라 통계적으로 유의한 차이가 있었으며, 사회적지지에서는 교육정도(p=.007)에 따라, 삶의 질에서는 교육정도(p=.033), 직업유무 p=.005), 항암제 사용유무(p=.043)에 따라 통계적으로 유의한 차이가 있었다. 5. 삶의 질은 배변기능(r=.308), 사회적 지지(r=.375)와 각각 유의한 양의 상관관계가 있는 것으로 나타났다(p<.001). 배변기능은 삶의 질 하부영역의 경우 신체 영역, 정서 영역, 기능 영역, 대장암관련 영역과 유의한 양의 상관관계를 나타냈고(p<.01), 사회적 지지는 신체 영역, 사회 가족 영역, 정서 영역, 기능 영역의 삶의 질과 유의한 양의 상관관계를 나타냈다(p<.05). 6. 삶의 질 영향요인을 확인하는 회귀분석 결과, 배변기능, 사회적 지지, 직업유무가 삶의 질에 영향을 미치는 독립적 예측 요인임이 확인되었다 (Adj R2=.285, p<.01). |Purpose: This study employed a descriptive correlational design aimed at determining bowel function, social support, and quality of life in rectal cancer patients who underwent sphincter saving resection. The study participants consisted of 131 rectal cancer patients who underwent spincter saving resection. Student t-test, one-way ANOVA, Pearson’s correlation coefficient, and Multiple Regression were conducted on collected data using SPSS program version 21. Results: The defecation score ranged from 43 to 86 with the average score of 65.26±8.33. Among sub-items for bowel function, frequent defecation had the highest average score(24.38±4.97), followed by urgent defecation and fecal incontinence (15.64±3.56), dietary characteristics (13.48±3.06), and characteristics on defecation (11.74±2.49). The score for social support ranged from 16 to 60 with the average score of 43.09±9.72. Among sub-items for social support, family support had the highest average score(17.22±3.24), followed by friend support(14.93±4.17),and health-care provider support(10.93±5.45). The score for quality of life ranged from 54 to 133 with the average score of 98.80±19.64. Among sub-items for quality of life, physical state had the highest average score(23.52±4.53); social and family relationship(17.06±7.58); emotional state(18.91±3.83); functional state(19.76±6.39); and relatedness of colon cancer(19.56±4.26). Also statistically significant differences were found in bowel function according to operative method(p=.001), temporary stom(p=0.26), found in social support according to educational attainment(p=.007)and found in quality of life according to educational attainment(p=.033),occupation(p=.005), types of surgery(p=.005), and the use or nonuse of anticancer drugs(p=.043) Quality of life was found to be positively correlated with bowel function(r=.308) and social support(p<.05), respectively; bowel function was found to be positively correlated with physical, emotional, functional state, and relatedness of colon cancer(p<.01),respectively; and social support was found to be positively correlated with physical, social and family relationship, emotional state, and functional state, respectively(p<.05). The regression analysis on the factors affecting quality of life demonstrated that bowel function, social support, and occupational status were found as independent predictors for quality of life. The three sets accounted for 28.5% of the variance in overall qulaity of life(p<.01).; Purpose: This study employed a descriptive correlational design aimed at determining bowel function, social support, and quality of life in rectal cancer patients who underwent sphincter saving resection. The study participants consisted of 131 rectal cancer patients who underwent spincter saving resection. Student t-test, one-way ANOVA, Pearson’s correlation coefficient, and Multiple Regression were conducted on collected data using SPSS program version 21. Results: The defecation score ranged from 43 to 86 with the average score of 65.26±8.33. Among sub-items for bowel function, frequent defecation had the highest average score(24.38±4.97), followed by urgent defecation and fecal incontinence (15.64±3.56), dietary characteristics (13.48±3.06), and characteristics on defecation (11.74±2.49). The score for social support ranged from 16 to 60 with the average score of 43.09±9.72. Among sub-items for social support, family support had the highest average score(17.22±3.24), followed by friend support(14.93±4.17),and health-care provider support(10.93±5.45). The score for quality of life ranged from 54 to 133 with the average score of 98.80±19.64. Among sub-items for quality of life, physical state had the highest average score(23.52±4.53)