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Journal of the Korean Academy of Family Medicine 1994;15(12):1088-1107.
Published online December 1, 1994.
Analysis of Factors Correlated with the Family Function of Alcoholics and their Family.
Hang Seog Cho, Jeong Ik Woo, Il Young So, You Seon Moon, Hye Ree Lee, Jong Seong Kim
알콜중독환자와 가족의 가족기능에 영향을 주는 요인에 관한 분석
조항석, 우정익, 소일영, 문유선, 이혜리, 김종성
순천향대학병원 가정의학과 예방의학과
Abstract
Background
: Alcoholism developed by the interaction of biologic, psychologic, sociologic factors and family structure etc. Alcohlics influence of lives of their families and emotional status of their family members harmfully. Therefore family functions of alcoholics are dysfunctional states more easily. For the understanding of alcoholics' family and the proper family therapy of alcoholic family we evaluate factors that correlated with functions of alcoholics and family functions of thier families.

Methods : There were 32 subject groups, each group contains 1 patient and 1 person among family members. The control group are consisted of 32 nonalcoholic persons. Questionnaire was consisted of sociodemographic data, Family APGAR, FACES III, SCR-90R(for evaluation of psychiatric symptom) and MAST(Michigan Alcoholism Screening Test). The results were analyzed by descriptive, comparative and correlative analysis.

Results : Mean age of the patients, their family members and control were 40.9, 38.9 and 32.7 years of age respectively. Other demographic factors showed no statistically significant differences between alcoholic group and control group. The APGAR scores of alcoholics, their family members and controls were 4.5±2.1, 4.3±2.3 and 6.6±2.0 respectively(P<0.01). In alcoholics, praranoid scale was highest among psychiatric symptoms and psychotism, depression, interpersonal sensitivity, anxiety, obscessive-compulsive scale were higher than control(P<0.01). In alcoholics' families, family obscessive-compulsive(P<0.01), depression, hostility, psychotism scale were higher than that of controls(P<0.05). There were significant correlations of psychiatric symptoms between alcoholics and their family members in depression, anxiety, somatization scale(P<0.05). In cases of another alcohol abuser were in family, Family APGAR score, Adaptability and Growth scale of Family APGAR, FACES III Adaptability score were significantly low. In cases of higher MAST scores(above 30), growth and affection of Family APGAR and FACES III Cohesion were significantly were significantly lower than that of lower MAST scores(less than 30), obscessive-compulsive influence of Resolve score of Family APGAR of alcoholics. Some psychiatric symptoms influence on Family APGAR and FACES III of alcoholics families. Obscessive-compulsive influence on Family APGAR. Phobic anxiety influence on Resolve of Family APGAR. Obscessive-compulive, phobic anxiety influence of Growth of APGAR. Somatization, interpersonal sensitivity, depression influence on FACES III Adaptability.

Conclusion : We conclude that family function scores of alcoholics and their family members were lower than that of controls. Alcoholics and thier family members showed tendency of increasing the incidences of phychiatric symptoms. Severity of alcoholic, alcohol abuser in family, psychiatric symptoms influence on family function. Therefore in family therapy, we should evaluate family function score of all family members and should consider the severity of alcoholic, alcohol abuser in family, importance and severity of psychiatric symptoms of alcoholics and their family members.
초록
연구배경 : 알콜중독은 생물학적, 심리적, 사회적 요인과 가족관계등이 상호작용하여 발생한다고 알려져 있다. 알콜중독자가 있음으로 해서 가족들의 심리상태와 생활에 영향을 주게되어 전반적인 가족의 기능이 역기능적 형태로 된다. 알콜중독의 가족치료에 있어 가족을 이해하고 체계적인 가족중재를 위한 방안으로 알콜중독 환자가족의 가족기능과 알콜중독 환자 및 가족이 작성한 가족 기능지수에 영향을 주는 요인들을 알아보고자 하였다.

방법 : 대상군 32가족 64명(환자 1명, 가족 1명)과 대조군 32명에게 인구 사회학적 특성을 묻는 설문지와, 가족기능을 보기위해서 Family APGAR, FACES Ⅲ를 이용하였고 알콜중독의 정도를 보기위해 MAST를 이용하였고 정신증상을 파악하기 위해 간이정신 평가를 위한 설문지(SCL-90R)을 이용하였다. 통계처리는 chi-square test, T-test, ANOVA, 상관분석(Pearson's correlation), 다중 회귀분석을 이용하였다.

결과 : 환자 및 가족의 Family APGAR 평균점수는 대조군에 비해 통계학적으로 유의하게 낮았다. FACES Ⅲ Adaptability 평균점수와 환자 및 가족의 Cohesion 평균점수는 대조군보다 통계학적으로 유의하게 낮았다. 알콜중독환자는 편집증, 정신증, 우울, 대인 과민성, 불안, 강박증이, 환자의 가족은 강박증, 우울, 적대감, 정신증 영역에서 대조군에 비해 통계학적으로 유의하게 높았다. 알콜중독환자와 그 가족간에는 우울, 불안, 신체화영역이 통계학적으로 유의한 상관관계를 나타내었다. 알콜중독환자의 Family APGAR의 Adaptability 항목은 Global severity index, Positive symptom total, Positive symptom distress index가, Resolve 항목은 강박증이 통계학적으로 유의하게 영향을 주었다.가족의 Family APGAR 전체점수는 강박증이, Growth 항목은 강박증 및 불안 공포가, Resolve 항목은 불안공포가, FACES Ⅲ의 Adaptability 및 Cohesion 영역은 Positive symptom distress index가 통계적으로 유의하게 영향을 주었다.

결론 : 알콜중독환자와 그 가족이 작성한 가족기능지수는 대조군에 비해 낮았다. 알콜중독환자와 가족은 정신증상 발현율이 높다. 가족내 상습음주자가 있는 경우와 알콜중독의 정도가 심할수록 가족기능이 낮았으며 환자 및 가족의 정신증상은 가족기능에 영향을 미친다. 따라서 알콜중독환자는 가족중재가 필요하며, 환자의 가족기능을 평가할 때는 가족의 가족기능과 함께 해석해야 하며 정신증상 동반유무 및 정도를 고려하여야 한다.


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