Korean Clinical Psychology Association
[ Review Article ]
Korean Journal of Clinical Psychology - Vol. 38, No. 2, pp.257-274
ISSN: 1229-0335 (Print) 2466-197X (Online)
Print publication date 31 May 2019
Received 14 Nov 2018 Revised 12 Mar 2019 Accepted 16 Mar 2019
DOI: https://doi.org/10.15842/kjcp.2019.38.2.010

암환자 디스트레스(distress)의 선별, 평가 및 관리

박예슬 ; 유은승
국립암센터 정신건강의학과
Screening, Assessment, and Management of Distress in Cancer Patients
Yesl Park ; Eun-Seung Yu
Department of Psychiatry & Behavioral Science, National Cancer Center, Goyang

Correspondence to: Eun-Seung Yu, Mental Health Clinic, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Korea; E-mail: ireneyu@ncc.re.kr


© 2019 Korean Clinical Psychology Association

초록

디스트레스(distress)는 암환자가 정신적으로 겪는 고통으로, 암 치료에 효과적으로 대처할 수 있는 능력을 방해하는 불쾌한 경험이다. 암환자의 디스트레스는 슬픔, 두려움과 같이 일반적으로 느낄 수 있는 정상적인 감정 반응부터 우울, 불안, 공황, 사회적 고립, 실존적 위기와 같이 심리사회적 기능을 손상하는 병적인 상태까지 다양하게 나타날 수 있다. 암환자의 35–45%가 임상적으로 유의한 수준의 디스트레스를 겪는 것으로 보고되고 있으며, 암 치료가 종결된 후에도 디스트레스는 지속되기도 한다. 국내 암경험자 174만 명 시대에 암생존율은 10년 전에 비해 1.3배 증가하였고 계속해서 상승하는 추세인데, 이들의 심리적 어려움에 대한 관심과 심리학적 개입에 대한 사회적 요구가 점차 증가하고 있음에도 불구하고, 통합적 암 관리에서 디스트레스 관리는 요원하며 임상심리학자의 개입은 부족한 실정이다. 본 연구는 1) 암환자의 디스트레스의 개념, 2) 디스트레스 관리의 기본 모델 및 원칙, 3) 디스트레스 선별 및 평가 도구, 그리고 4) 디스트레스 관리와 관련하여 국내 연구 및 임상 적용 현황을 고찰하였다. 더불어 종양학 현장에서 임상심리학자들의 역할과 임상가와 연구자가 나아갈 방향에 대해 논의하였다.

Abstract

Distress is an unpleasant emotional experience that may interfere with the ability to cope effectively with cancer. Distress can range from normal emotional responses, such as sadness and fear, to psychopathological states that damage psychosocial functioning, such as depression, anxiety, panic, social withdrawal, and existential crisis. It is reported that approximately 35– 45% of cancer patients experience clinically significant levels of distress, and the distress continues after treatment. Currently, about 1.74 million cancer patients and survivors live in Korea. Over the past 10 years, the survival rate has increased by 1.3 times and will most likely continue to increase. Although interest in cancer patients’ psychological difficulties and awareness of the need for psychological interventions are increasing, rarely is distress management provided by clinical psychologists in integrative cancer care systems. This comprehensive review aimed to explore 1) the concept of distress in cancer patients, 2) the basic model and principles of distress management, 3) available distress screening and assessment tools, and 4) current status of distress management and its clinical applications in Korea. Further, we discussed the roles of clinical psychologists and researchers in oncological settings in optimizing distress management in cancer patients.

Keywords:

cancer patients, distress, distress screening, distress assessment, distress management

키워드:

암환자, 디스트레스, 디스트레스 선별, 디스트레스 관리, 디스트레스 평가

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