위암 수술 환자의 외상 후 성장과 인지적 정서조절이 심리․사회 적응에 미치는 영향

Abstract

Purpose This study was intended to identify the factors affecting the psychosocial adjustment in patients who have had gastric cancer surgery. This study was a descriptive research study to understand correlation posttraumatic growth and cognitive emotion regulation on the psychosocial adjustment of patients with gastric cancer surgery.

Method The study employed a descriptive correlational design. Data were collected from 145 patients who had gastric cancer surgery and were treated at a cancer specialization hospital in Busan, South Korea. The researchers surveyed the participants with a structured self-report questionnaire from October 26, 2018 to March 31, 2019. Psychosocial adjustment was measured using the PAIS-SR (Psychosocial Adjustment to Illness Scale-Self Report) questionnaire developed by Derogatis and Derogatis (1983) and Posttraumatic growth was measured using the K-PTGI (Korea version of Posttraumatic Growth Inventory) questionnaire developed by Tedeschi and Calhoun (1996) and later converted and rationalized by Song, Kim, Lee & Park (2009). Cognitive emotion regulation was measured through the K-CERQ (Korean Cognitive Emotion Regulation Questionnaire) developed by Garnefski, Kraaij & Spinhven (2001) and translated by Kim (2008) and rationalized by Ahn, Lee & Joo (2013). The collected data were analyzed by frequency, percentage, mean and standard deviation, independent t-test, one-way ANOVA, Pearson's correlation coefficients, and multiple regression with SPSS/WIN 24.0 Program.

Results 1. The average Posttraumatic growth was 2.19±0.98 out of a scale of 5. Changed perception of self was 2.47±1.20, Relating to others was 2.21±1.06, New possibilities was 2.13±1.02 and Spiritual change was 1.43±1.43. The average score of Cognitive emotion regulation was 2.88±0.56 out of a scale 5. Adaptive emotion regulation was 3.25±0.74 and Maladaptive emotion regulation was 2.41±0.59. The average score of Psychosocial adjustment was 2.02±0.48 out of a scale of 3. Extended family relationship was 2.26±0.73, Domestic environment was 2.18±0.58, Psychological distress was 2.17±0.75, Social environment was 2.12±0.86, Health care orientation was 2.06±0.48, Vacational environment was 1.76±0.73 and Sexual relationship was 1.56±0.87. 2. Regarding the general characteristics, Psychosocial adjustment showed significantly different scoring according to Age (t=4.71, p<.001), Spouse (t=3.08, p=.002), Job (t=3.25, p=.001), Monthly income (t=-5.50, p<.001), Level of education (t=-2.87, p=.005), Cohabiting family (F=7.78, p<.001), Postoperative treatment (t=-2.16, p=.033) and Subjective health status (t=6.38, p<.001). 3. Psychosocial adjustment was found to have positive correlations with Posttraumatic growth (r=.17, p<.05) and Adaptation emotion regulation (r=.29, p<.001). One the other hand, Psychosocial adjustment was found to have negative correlation with Maladaptive emotion regulation (r=-.19, p<.05). Posttraumatic growth was found to have positive correlation with Adaptive emotion regulation (r=.50, p<.001). Adaptive emotion regulation was found to have positive correlation with Maladaptive emotion regulation (r=.31, p<.001). 4. Subjective health status (β=.30, p<.001) was the strongest influential factor of Psychosocial adjustment, followed by Cohabiting family (β=.23, p=.001) Adaptive emotion regulation (β=.21, p=.012), Age (β=.21, p=.014), Spouse (β=.20, p=.003), Maladaptive emotion regulation (β=-.20, p=.005) and Postoperative treatment (β=.14, p=.045). These independent factors accounted for 45% of the Psychosocial adjustment.

Conclusion In order to increase the psychosocial adjustment of patients with gastric cancer surgery in this study, it would be necessary to develop and provide an intervention program to apply cognitive emotion regulation.

Key words: Cognition, Emotions, Psychological Posttraumatic Growth, Social Adjustment, Stomach Neoplasms