자살예방교육이 노인의 우울, 자아 존중감 및 삶의 질에 미치는 영향

Abstract

국문초록

본 연구는 노인자살예방을 목적으로 노인의 우울을 경감시키고 자아 존중감 및 삶의 질을 증진시키기 위한 자살예방교육의 중재효과를 알아보기 위한 단일집단 사전사후 실험연구이다. 2011년 3월 2일부터 3월 23일까지 대전광역시에 거주하는 D노인 복지관 내 자살예방교육에 참여한 노인을 대상으로 하였으며 ‵ 아름다운 소풍′이라는 제목으로 주 1회 60분씩 D복지관에서 3회 실시하였다. 연구 도구는 한국판 단축형 노인 우울 척도 단축형(GDSSF-K: G), Rosenberg의 자아 존중감 도구(Rosenberg Self-esteem Scale), 노인용 삶의 질 척도(Quality of Life Scale for the Elderly)를 이용하였고 수집된 자료는 SPSS Window 18.0 program을 이용하여 분석하였다. 대상자의 일반적 특성은 실수와 백분율, 자살예방교육의 전 후 우울, 자아 존중감 및 삶의 질의 차이는 paired t-test를 이용하여 분석하였다. 교육 전후에 따른 우울 군 간의 차이는 χ²를 이용하여 분석 하였다.

연구 결과는 다음과 같다. 첫째, 자살예방교육 전·후의 우울은 총점 15점에서 교육 전 평균 5.04점(±4.13)에서 교육 후 1.69점(±2.83)으로 중재 전에 비해 3.35점 감소하였고 유의한 차이가 있었다(t=5.15, p=.000).

둘째, 자살예방교육 전·후의 자아 존중감은 총점 40점에서 교육 전 27.28점(±3.25)에서 교육 후 29.04점(±2.69)으로 1.76점 증가하여 통계적으로 유의한 차이가 있었다(t=-3.63, p=.001).

셋째, 자살예방교육 전·후의 삶의 질은 교육 전 130.08점(±16.57)에서 교육 후 138.58점(±13.66)으로 중재 후 8.5점 증가하였으며 통계적으로 유의한 차이가 있었다(t=-3.98 p=.000).

넷째, 자살예방교육은 우울 개별 점수 차이에서 경증, 중증 우울에서 치료적 효과가 있었다. 교육 후 경증 우울에 해당하는 18명의 우울 점수를 비교한 결과 11명의 우울 점수가 정상으로 나왔고, 중증도 우울이었던 2명은 우울 점수가 0점으로 정상 범위로 나타났다(χ²=12.84, p=.002).

이상의 결과를 통해 자살예방교육은 자살에 직접적인 영향을 주며 자살변인에 가장 큰 위험요인으로 작용하는 지역사회노인의 우울을 조절하고 정신건강의 긍정적 측면인 자아 존중감과 삶의 질을 증진하여 노인자살을 예방할 수 있는 효과적인 교육임을 확인하였다.

이러한 결과에 입각하여 노인들을 대상으로 하는 자살예방교육의 확대와 실천적 활동을 위해 지역사회자원을 활용해야 함을 논의하였고 마지막으로 연구의 한계와 후속연구를 위한 제언을 하였다. | Effects of Suicide Prevention Education influencing toward Elderly depression, self-esteem and quality of life.

Park, Su Hee Dept. of Hospice & Palliative Special Nursing The Graduate School of Information in Clinical Nursing Hanyang University (Directed by Professor Kim, Boon Han)

This study is ‵ Before and After Experiment Study′ on a single group which aims at verifying the mediation effect of Suicide Prevention Education, of which the purpose is to prevent senior suicide by decreasing geriatric depression and increasing self-esteem and quality of life. The subject of this study was a single group of senior citizens from D Senior House in Daejeon who participated in In-house Suicide Prevention Education between March 2th and March 23th 2011. The study was named as ‘Beautiful Excursion’ and conducted 3 times at D Senior house, once a week, for 60 minutes at a time.

The instruments used for this study are Geriatric Depression Scale Short Form- Korea Version(GDSSF-K: G), Rosenberg Self-esteem Scale, and Quality of Life Scale for the Elderly; the collected data were analyzed by SPSS Window 18.0 Program. The general characteristics of the subjects were analyzed by real numbers and percentage, and the difference of depression, self-esteem, and quality of life before and after the Suicide Prevention Education, by paired t-test. Comparison of the depressed group before and after the education was analyzed by using χ².

The results of the study are as follows:

First, depression ‵ before and after the suicide prevention education′, scale of 15, indicated that the average was 5.04(±4.13) before, and 1.69(±2.83) after the education, concluding that depression was decreased by 3.35 points after the education with relevant differences(t=5.15, p=.000).

Second, self-esteem ‵ before and after the suicide prevention education′, scale of 40, indicated 27.28(±3.25) points before, and 29.04(±2.69) points after the education, concluding that self-esteem was increased by 1.76 points after the education with statistically relevant differences(t=3.63, p=.001).

Third, quality of life ‵ before and after the suicide prevention education′, indicated 130.08(±16.57) points before, and 138.58(±13.66) points after the education, concluding that quality of life measure was increased by 8.5 points with statistically relevant differences(t=3.98, p=.000).

Fourth, based on the differences of individual depression value, Suicide Prevention Education appeared to have therapeutic effect for slight and serious mental depression. Comparison of the depression value of 18 subjects with slight depression showed that 11 of them indicated normal depression value after the education. Two of the subjects with serious mental depression also showed normal depression value of 0 point after the education(χ²=12.84, p=.002).

Through the above results, Suicide Prevention Education Program was verified to be an effective education program which can prevent senior suicide by: first, controlling depression, the most influential and dangerous leading factor of suicide; second, promoting self-esteem and quality of life, positive aspects of mental health.

Based on these results, we made final discussion on the expansion and active practice of suicide prevention education and should be followed by the successive study, acknowledging the limitation of the original study.; Effects of Suicide Prevention Education influencing toward Elderly depression, self-esteem and quality of life.

Park, Su Hee Dept. of Hospice & Palliative Special Nursing The Graduate School of Information in Clinical Nursing Hanyang University (Directed by Professor Kim, Boon Han)

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