웃음요법이 유방암 환자의 우울, 삶의 질, 극복력, 면역반응에 미치는 효과

Abstract

본 연구는 웃음요법이 유방암 환자의 우울, 삶의 질, 극복력, 면역반응에 미치는 효과를 확인하기 위하여 시도한 비동등성 대조군 전후설계의 유사 실험 연구이다. 대상자는 유방암 진단을 받고 수술 후 방사선요법, 항암화학요법을 모두 마치고 추적관찰중인 환자이며 대상자 선정기준에 적합한 실험군 16명, 대조군 21명으로 총 37명이었으며, 연구 기간은 2009년 8월부터 11월까지였다. 실험군에게 웃음요법을 1회 60분, 주2회 총8회를 제공하였고 자료수집은 웃음요법 전후에 우울, 삶의 질, 극복력을 구조화된 설문지를 이용하였다. 면역반응은 혈액검사를 통해 Total T cell, T helper(Th), T suppressor(Ts), Th/Ts ratio, Total B cell, T cell/B cell ratio, NK cell의 변화를 분석하였다. 수집된 자료는 SPSS WIn 17.0 version program을 이용하여 기술통계, Chi-square test, Fisher's exact probability test, Mann-Whitney U test로 분석하였다. 본 연구 결과, 1. 우울 정도는 두 집단간에 유의한 차이가 없었다. 2. 삶의 질은 두 집단간에 유의한 차이가 있었다.; 실험군은 대조군보다 삶의 질이 유의하게 높아졌다(Z=-4.558, p<.001). 3. 극복력은 두 집단간에 유의한 차이가 있었다.; 실험군은 대조군보다 극복력이 유의하게 높아졌다(Z=-3.612, p<.001). 4. 면역반응(Total T cell, T helper(Th), T suppressor(Ts), Th/Ts ratio, Total B cell, T cell/B cell ratio, NK cell)은 두 집단 간에 유의한 차이가 없었다. 이상의 연구결과와 같이 웃음요법이 유방암 환자의 삶의 질, 극복력을 증진시키는 효과를 입증하였으므로 웃음요법이 유방암 환자에게 도움을 주는 유익한 간호중재로 실무에서 활용할 수 있을 것으로 사료된다.

주요어:웃음요법, 우울, 삶의 질, 극복력, 면역, 유방암|This study was designed to examine the effects in breast cancer patients of laughter therapy on level of depression, quality of life, resilience and immune responses. The laughter therapy consisted of stretching, humor dance, and laughter. The subjects in this study were breast cancer patients who diagnosed breast cancer and finished chemotheraphy, radiation theraphy in G city, Korea. The subjects consisted of 37 breast cancer patients; 16 in the experiment group and 21 in the control group. Data were collected from August 2009 to November 2009. The experimental group attended 8 sessions of a laughter therapy. Sessions were 60 minutes each, held twice a week. The questionnaires about pre and post perceived depression and quality of life, resilience were used to identify the effects of laughter therapy. Immune responses were used to examine serum Total T cell, T helper(Th), T suppressor(Ts), Th/Ts ratio, Total B cell, T cell/B cell ratio, and Nk cell. The data were analyzed by discriptive statistics, Chi-square, Fisher's exact probability test, and Mann-Whitney U test using SPSS Win 17.0. The findings of this study were as follows: 1. there was no significat difference between two groups in general characteristics and depent variable. 2. There was no significant difference in depression level between the two groups 3. There was a significant difference in the increment in quality of life between the two groups; the increment in quality of life in the experimental group was significantly greater than in the control group. 4. There was a significant difference in the resilience between the two groups; the increment in resilience in the experimental group was significantly greater than in the control group. 5. There were no significant difference in immune responses(Total T cell, T helper(Th), T suppressor(Ts), Th/Ts ratio, Total B cell, T cell/B cell ratio, and Nk cell) between the two groups. The findings show that this laughter therapy could be effective in increasing the quality of life and resilience of breast cancer patients. Accordingly, laught therapy can be applied as an intervention to help breast cancer patients.

Key Words : Laughter therapy, Depression, Quality of life, Resilience, Immunity, Breast cancer