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학위논문
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박민애 (가천대학교, 嘉泉大學校)

지도교수
徐和廷
발행연도
2019
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가천대학교 논문은 저작권에 의해 보호받습니다.

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이 논문의 연구 히스토리 (2)

초록· 키워드

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유방암 환자에서 우울증과 불안장애는 흔히 발병한다. 특히 우울증과 불안장애는 자살 또는 사망과의 관련성이 유의하게 밝혀져 그 관리가 중요하다. 최근 유방암 환자에서의 정신질환 발생에 관한 연구들이 다수 발표되고 있다. 그러나 다수의 연구가 설문지 기법을 이용하거나 단면연구(Cross-secrtional study)라는 특성이 있다. 이러한 연구모형에는 독립변수와 종속변수 간의 인과관계를 확인할 수 없다는 점, 심각한 정신질환자의 자가 설문을 신뢰하기 어렵다는 점, 임상자료가 연구에 활용되지 않는다는 점 등의 한계가 있다. 이러한 문제의 해결책으로 본 연구에서는 국민건강보험 공단에서 9년 동안 수집한 청구 데이터를 활용하여 유방암 환자에서의 기분장애 발생에 영향을 주는 위험요인을 확인하였다.
기분장애 발생은 우울증과 불안장애 진단명 또는 항우울제 복용 30일 이상으로 정의하였다. 전체 유방암 환자 2,696명 중 유방암 진단 1년 전으로 기분장애 병력이 있는 환자, 유방암 진단 시점에서 20세 미만인 환자를 제외하여 총 2,351명의 환자가 연구 대상자으로 포함되었다.
Stata/IC 15.0을 활용하여 교차분석, 카플란 마이어 생존분석, Cox''s 비례위험 회귀(Cox''s proportional hazards regression)분석을 시행하였다. 그 결과 폐경여부(HR 1.3, 95% CI 1.04, 1.64) 사망여부(HR 0.56, 95% CI 0.38, 0.83), CCI(Charlson Commorbidity Index) (HR 3.73, 95% CI 1.54, 9.02), 당뇨(HR 1.40, 95% CI 1.08, 1.81), 고혈압(HR 1.38, 95% CI 1.10, 1.73), 만성폐쇄성폐질환(HR 1.29, 95% CI 1.03, 1.62), 뇌혈관질환(HR 1.92, 95% CI 1.42, 2.60)이 기분장애를 발생시키는 위험요인으로 밝혀졌다.

주요 용어: 유방암, 기분장애, 우울증, 불안장애, 위험요인, 시간의존

목차

국문초록···········································································ⅶ
Ⅰ. 서론···················································································· 1
1. 연구의 필요성·································································1
2. 연구의 목적··········································································7
Ⅱ. 연구방법···············································································8
1. 자료원··········································································8
2. 연구대상자 선택기준················································································13
3. 주요 변수의 정의················································································17
4. 분석방법················································································23
Ⅲ. 연구결과··································································································· 24
1. 연구대상의 일반적 특성·······················································24
2... 변수에 따른 유방암 환자의 기분장애 발생 양상······················································28
3.. 유방암 환자에서의 시간의존 하 기분장애 발생 위험요인·····················································38
Ⅳ. 고찰········································································································ 42
참 고 문 헌·······················································································50
Abstract 55

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