(A) study of the correlation between locus of control, self-esteem and depression in patients : with specific reference to cancer patients : 암환자를

간호학과/석사[한글] 본 연구는 Rotter의 사회학습이론과 Seligman의 학습된 무력감이론의 범위내에서, 암환자의 우울정도와 자아존중감 및 통제위성격올 일반내과 환자와 비교하고 내 ·외통제성적에 따른 자아존중감, 우울과의 관계를 규명하여 암환자의 심리적인 간호에 통제위 개념의 중요성을 제시 하고자 하였다. 연구대상에서 암환자군은 Y암센타와 S병원에 자료수집 기간 동안 치료를 받기 위해 재방문한 환자중 연구대상 기준에 적합한 100명으로 하였다. 일반환자군은 S병원 내과외래에 추후관리를 받기 위해 재방문한 환자중 연구대상 기준에 맞는 100명으로 하였다. 자료수집방법은 질문지법과 면담방법을 사용하였다. 연구도구는 통제위성격 측정에 Wa1llston외 3인의(Health Locus of Control)도구, 자아존중감 측정에 (Self-Esteem도구, 우울 측정에 Zung의 자가평가 Rating Depression) 도구를 사용하였다. 자료수집 기간은 1983년 9월 17일 부터 동년 10월 6일까지 20일간이었다. 수집된 자료는 x**2-teat, t-teat, ANOVA, Pearson Correlation Coefficient. ANCOVA등의 통계 방법으로 분석하였다. 연구결과를 요약하면 다음과 같다. 1. 제 1 가설 : "암환자군은 일반환자군 보다 외적통제위 성향을 나타낼 것이다"는 채택되었다. (t=4.29, df=197, p<.001) 2 제 2 가설 : "암환자군은 일 반환자군 보다 자아존중감 정도가 낮을 것이다"는 채택되었다. (t=3.78, df=196. p<.001) 3. 제 3 가설 : "암환자군은 일반환자군 보다 우울정도가 높을 것이다 "는 채택되었다. (t=3.86, df=198, p<.OO1) 4. 제 4 가설 : "외적통제위이다 "는 기각되었다. (r=-.1248, p>.05) 5. 제 5 가설 : "외적통제위 성향일수록 우울정도는 높을 것이다" 는 채택되었다. (r=.1700, p<.05) 6. 제 6 가설 : "자아존중감 정도가 높을수록 우울정도는 낮을 것이다"는 채려되었다. (r=-.5058, p<.001) 7. 통제위성격에 유의한 영향을 미친 일반적 특성은 성별, 수술 경험 유·무, 진단명등이었다. 8. 자아존중감에 유의한 영향을 미친 일반적 특성은 성별, 믿음정도, 직업 유.무 진단명, 생활수준등 이었다. 9 우울에 유의한 영향을 미친 일반적 특성은 성별, 믿음정도, 직업, 진단명, 수술경험 유.무, 생활수준등이었다. 결론적으로, 암환자는 여전히 다른 질병을 가진 환자들 보다 자신의 질병상태를 스스로 통제할 수 없다고 지가하며, 47%에서 경증이상의 우울을 나타내어 심한 정서적인 반응을 겪고 있음을 알수있었다. 또한 외적통제위 성향외 환자가 내적통제위 성향의 환자보다 우울정도가 더 심하므로, 우울을 감소시키기 위한 간호중재애 통제위가 중요한 개념임을 알 수 있었다. [영문] This study was dome to demonstrate the importance of providing psychological care in regard to the locus of control in cancer patients. Therefore the study was designed to test the correlation between locus of control, self-esteem and depression in the ill individual and to identify the difference in the degree of depression. self-esteem and locus of control between cancer patients and non-cancer medical outpatients within the context of Rotter's social learning theory and Seligman's theory of learned helplessness. The subjects for this study were 100 cancer patients who were eithet outpatients or inpatients for lass than 3 days at Y cancer center or S University Hospital and 100 non-cancer medical outpatients at S University Hospital. Data collection was done from September 17th to October 6th, 1983, by means of questionare and interview. The instruments for this study were Wallston and Colleagues, Health Locus of Control Scale, Rosenberg's Self-Esteem Sale and Zung's Self-Ratting Depression Scale. analysis of data was done by use of χ**2-test, t-test, ANOVA, Pearson Correlation Coefficient and ANCOVA. The results of this study cab be summarized as follows. 1. The ftrst hypothesis, "The cancer patient will show a higher level of external locus of control than the non-cancer medical patient," was accepted. (t=4.29, df=197. p<.001) 2. The second hypothesis, "The cancer patient will show s lower level of self-esteem than the non-cancer medical patient," was accepted. (t=3.78, df=196, p<.001) 3. The third hypotheses, "The cancer patient wall short a higher level of depression than the non-cancer medical patients, "was accepted. (t=3.86. df=198, p<.001) 4. The fourth hypothesis, "The higher the level of external locus of control, the lower the level of self-esteem" was rejected. (r=-.1248, p >.05) 5. The fifth hypothesis, "The higher the level of external locus of control, the higher the level of depression" was accepted. (r=.1700, p<.05) 6. The sixth hypothesis, "The higher the level of self-esteem, the lower the level of depression" was accepted. (r=-.5058, p<.001) 7. Analysis of factors influencing lotus of control ; 1) Gender: Women were found to have a higher level of external locus of control. 2) Surgical or non-surgical experience: Sugical patients were found to have a higher level of external locus of control than non-surgical patients. 3) Diagnosis : Subjects who had endocrine or other metabolic diseases were found to have a higher level of external locus of control than other subjects. 8. Analysis of factors influencing self-esteem; 1) Occupation: Man who were receiving a salary were found to have a higher level of external locus of control than mon who were not receiving a salary or who had no occupation. 2) Surgical or non-surgical experience: Surigcal subjects were found to have a lower level of self-esteem than other subjects. 3) Diagnosis : Subjects who had genitourinary diseases were found to have a lower level of self-esteem than other subjects. 4) Standard of living: Subjects in the lower economic level were found to have a lower level of self-esteem than other subjects. 9. Analysis of factors influencing depression: 1) Gender: Women were found to have a higher level of depression than men. 2) Degree of faith: Subjects who had a strong degree of faith were found to have a lower level of depression than other subjects. 3) Occupation : Subjects with no occupation were found to have a higher level of depression than other subjects. 4) Surgical or non-surgical experience : Surgical subjects were found to have a higher level of depression than other subjects. 5) Diagnosis : Subjects with genitourinary disease were found to have a higher level of depression than other subjects 6) Standard of living: Subjects in the lower economic level were found to have a higher level of depression than other subjects. In conclusion, it was found that cancel patients perceive that they can not control their disease condition by themselves and they suffer severe emotional reactions as compared with non cancer medical outpatients. It was also found that the higher the level of the external locus of control the greater the degree of depression. A conclusion of this study is that an important nursing intervention to help diminish depression, is to assist the patient in changing the locus of control from that of external to internal control.restrictio