Original Article J Health Info Stat 2016;41(3):336-343 http://dx.doi.org/10.21032/jhis.2016.41.3.336 pissn 2465-8014 eissn 2465-8022 대학신입생의남녀별미용성형수술계획실태및관련요인 윤연옥 1, 감신 2, 이원기 2, 류동희 2, 정호영 2 1 경북대학교대학원보건학과, 2 경북대학교의학전문대학원 Aesthetic/Cosmetic Procedures Status and Its Related Factors in College Freshmen Yeon Ok Yun 1, Sin Kam 2, Won Kee Lee 2, Dong-Hee Ryu 2, Ho-Young Chung 2 1 Department of Public Health, Graduate School, Kyungpook National University, Daegu; 2 School of Medicine, Kyungpook National University, Daegu, Korea Objectives: This study was conducted to evaluate experience in aesthetic/cosmetic procedures, future planning status, and its related factors in college freshmen. Methods: The current study assessed data collected from 1,086 college freshmen who participated in a self-administered questionnaire survey. A path analysis model was designed. A study model was designed to figure out effects of related determining factors on possible future experiences in cometic plastic surgery. Results: Among the study subjects, 2.5% of male and 28.9% of female students had in the past with a total of 28.9% who had cosmetic surgeries before college entrance. In addition, 3.9% of male and 16.5% of female subjects were planning in the future. For female students, a path analysis model was designed to evaluate effects of self-esteem, body image, and sociocultural attitude toward appearance through acceptance of and the past experience on planning of in the future. Even though the standardized path coefficient reflecting the effect of self-esteem on acceptance of was not statistically significant, the effects of the past experience on the future plan was statistically significant at 5% significant level. All the other coefficients were found to be significant at 1% significant level. The magnitude of the indirect and direct effects of acceptance of was found to be the strongest, 0.394. Conclusions: Considering the present result, the proportions of those willing to have in the future were 16.5% for female college freshmen. Therefore, a proper approach is required to understand the present phenomenon and a health education course regarding this topic is also necessary in college as well as before college entrance. Key words: College freshmen, Cosmetic procedures, Experience, 서론 국제미용성형수술학회 (International Society of Aesthetic Plastic Surgery, ISAPA) 통계보고에따르면 2014년기준으로미용성형수술시행건수가많고전세계에서차지하는비중이높은국가는미국 (1,483,020 건, 15.4%), 브라질 (1,343,293건, 13.9%), 한국 (440,583건, 4.6%), 멕시코 (381,207 건, 4.0%), 일본 (326,398 건, 3.4%) 순이었고, 미용성형비수술시술시행은미국 (2,581,551건, 24.4%), 일본 (933,953건, 8.8%), 브라질 (715,212건, 6.8%), 한국 (539,730 건, 5.1%), 멕시코 (324,865건, 3.1%) 순으로미용성형시술전체건수는미국, 브라질, 일본에이어세계에서우리나라가 4번째였다. 우리나라에서는 2014년기준으로쌍꺼풀 ( 눈꺼풀 ) 시술 107,712 건, 코재건술 102,597 건, 지방이식술 83,577건, 지방흡입술 Corresponding author: Ho-Young Chung 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Korea Tel +82-53-200-5620, E-mail: hychung@knu.ac.kr Received: July 21, 2016 Revised: August 25, 2016 Accepted: August 29, 2016 This research was supported by Kyungpook National University Research Fund, 2013. No potential conflict of interest relevant to this article was reported. How to cite this article: Yun OY, Kam S, Lee WK, Ryu DH, Chung HY. Aesthetic/cosmetic procedures planning status and its related factors in college freshmen. J Health Info Stat 2016;41(3):336-343. Doi: http://dx.doi.org/10.21032/ jhis.2016.41.3.336 It is identical to the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) whichpermit sunrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 2016 336 http://www.e-jhis.org
Aesthetic/Cosmetic Procedures 29,167건, 유방확대수술 23,950 건이시행되었으며, 비수술미용성형시술은보톡스주사 275,688건, 히알루논산주사 179,232 건, 레이저시술 45,599건등이이루어졌다 [1]. 미국미용성형수술학회 (American Society for Aesthetic Plastic Surgery, ASAPS) 통계보고에따르면 2014년미국미용성형수술시장규모는 120억달러이상이라고한다 [2]. 한국의성형외과전문의수는 2,054명으로미국, 브라질, 일본에이어상위 4번째이다 [1]. 현대사회가산업화되고서구화됨에따라외모를중요시하고날씬한몸매를아름다움의기준으로삼는사회문화적인경향이두드러지고있다. 외모에대한관심은성인뿐만아니라초등학생에게도발견되는데아동들은사회생활이시작되는시점인초등학교입학후부터자신의신체를다른사람과비교하면서다른사람에게보여지는자신의모습에대해많은관심을갖기시작하는데, 초등학교남학생의 16.1%, 여학생의 21.4% 가성형수술을받을의도가있다고하였다 [3]. 서울에재학중인 402명의대학생을대상으로설문조사한결과 93% 가외모를중요하다여겼고동시에미용성형수술의필요성을인식하는것으로나타났으며경제적인여건이허락한다면남학생의 20%, 여학생의 33% 에서바로미용성형수술을시행할것으로답하였다 [4]. 청소년들은성장이완료되지않은상태로성형수술로인해뼈의성장이나연골의성장에영향을줄수있으며향후모양에변형이생길가능성이있다. 또한, 육체적으로정신적으로완전히성숙되지않은상태로유행이나호기심에이끌려섣불리미용성형수술을계획하는것은상당히위험하며심각한부작용에시달릴수도있다. 그럼에도불구하고청소년기에미용성형수술 ( 시술 ) 을이미경험하는것은현재우리나라의외모지상주의사회분위기, 성형수술의료계의비즈니스전략, TV 등대중매체에서성형화된외모로활약중인연예인들의모습이큰영향을미친것이라하겠다 [5]. 지금까지외모에관련된연구, 고등학생및대학생과같은특정집단을대상으로미의식및미용성형수술에대해살펴본연구는많은편이나대학교입학이전의미용성형수술경험및계획을함께분석한연구는미흡한실정이다. 이에본연구에서는청소년기인대학교입학이전미용성형수술경험실태를파악하고, 대학생이된후향후미용성형수술계획과영향요인을알아보고자하였다. 대상및방법 연구대상및조사방법대구지역대학 ( 교 ) 중인문사회계열, 자연공학계열, 예체능계열, 보건의료계열이있는대학교와대학, 대학 ( 교 ) 의규모를고려하여 6개대 [Internal component] Self-esteem Body image 학 ( 교 ) 을임의로선정한후인문사회, 자연공학, 예체능, 보건의료계열 별로 1 개학과를선정하여 2016 학년도남 여신입생전원을대상으로 설문조사하였다. 조사대상은 1,128 명이었으며, 이중설문에응답한 대상자는 1,086 명 ( 응답률 96.3%) 으로이들의자료를최종분석대상으 로하였다. 사전훈련을받은연구원이연구목적, 비밀유지, 연구참여철회가 능성등에대한설명을하고자료수집에동의한사람을대상으로신학 기시작시점인 2016 년 3-4 월에설문조사를시행하였다. 연구의틀과설문내용 1. 연구의틀 기존연구에서미용성형수술에대한욕구 / 태도에영향을주는요인 으로과거미용성형수술경험유무, 자아존중감, 신체이미지, 성형수술 에대한태도, 외모에대한사회문화적태도, 성형중독여부, 미용성형 수술에대한주변인물의영향등이유의한효과를가지는것으로나 타났다 [5-8]. 여고생을대상으로조사한연구에서는성형수술욕구에 사회문화적태도, 신체이미지, 자아존중감등이영향을미치는요인이 었다 [9]. 본연구에서는기존연구결과중에서본연구목적에부합하 는미용성형수술의결정요인을선택하여미용성형경험에는성형수술 에대한태도가직접적인영향을미치며, 자아존중감, 신체이미지, 외 모에대한사회문화적태도가성형수술에대한태도를통해간접적으 로미용성형수술에영향을미치고또한직접적으로도영향을미칠수 있을것으로보았다 (Figure 1). 연구도구 1. 미용성형수술경험관련문항 Acceptance of Figure 1. Framework of current study. Cosmetic surgery experience 경험한미용성형수술 ( 시술 ) 의종류는 International Society of Aesthetic Plastic Surgery (ISAPS)[1] 기준을적용하여문항을정리하였다. 미용성형수술 ( 시술 ) 의경험시기를알아봄으로써성인시기이전의미 용성형수술현황을파악하고자하였다. [External component] Sociocultural attitude toward appearance http://www.e-jhis.org 337
Yeon Ok Yun, et al. 2. 미용성형수술계획관련문항계획하는미용성형수술 ( 시술 ) 의종류도ISAPS [1] 기준을적용하여문항을정리하였다. 3. 미용성형수술결정요인관련문항 1) 자아존중감 Rosenberg [10] 의자아존중감척도 (self-esteem scale) 를사용하였으며, 총 10개의 4점척도문항으로구성되어있다. 점수가높을수록자아존중감이높음을의미한다 [10]. 2) 신체이미지 Multidimensional Body-Self Relations Questionnaire (MBSRQ) (1990) 를사용하였으며, 총 69개의 5점척도문항으로구성되어있다. 구체적으로는외모, 체형, 건강의평가및지향성과관련된 54개의문항과신체만족도와관련된 9개문항, 체중관련 6개문항으로이루어져있다. 본연구에서는 Cho and Koh [11] 의연구에서번안하여사용한외모평가및지향성과관련된 15개문항을선택하여설문하였다. 점수가높을수록긍정적신체이미지를가진것으로해석할수있다. 3) 외모에대한사회문화적태도 Heinberg et al. [12] 이개발한 Sociocultural Attitude Toward Appearance Questionnaire (SATAQ) 를사용하였는데, 여성의외모에대한인식과사회문화적태도를평가하고자개발된문항으로외모의사회적중요성에대한인식 (awareness) 과관련한 6문항과외모에대한사회적기준을인정하고자신의가치로받아들이는내면화 (internalization) 와관련된 8문항으로이루어져있으며문항은 5점척도로구분된다. 점수가높을수록외모에대한사회적기준을자신의것으로받아들이는정도와외모의사회적중요성에대한인식정도가크다고해석가능하다. 4) 성형수술에대한태도 Henderson-King and Henderson-King [13] 의 Acceptance of Cosmetic Surgery Scale (ACSS) 을사용하였으며총 15개의 7점척도문항으로구 성되어있다. 점수가높을수록성형수술에대한태도가긍정적임을의미한다. 분석방법빈도분석및카이제곱검정을통해대상자의전공학과특성에따른미용성형수술경험유무를비교분석하였다. 빈도분석및카이제곱검정을통해대상자특성에따른미용성형수술계획유무를비교분석하였고, 미용성형수술계획군과비계획군에서의자아존중감, 신체이미지, 성형수술에대한태도, 외모에대한사회문화적태도점수는 student s t-test 와분산분석 (ANOVA) 을사용하여비교하였다. 미용성형계획여부에영향을주는결정요인에대한분석에는경로분석을사용하였다. 경로분석은남학생의경우 363명중 3.9% 에불과한 14명만이미용성형계획을하고있다고하여여학생만을대상으로시행하였다. 경로분석시모형적합도는대표적으로절대적합지수를나타내는카이제곱통계량을자유도로나눈 Q통계량, 조정된적합지수 (adjusted goodness of fit index, AGFI) 와평균제곱잔차제곱근 (root mean square residual, RMR) 으로평가하였으며연구모형보다더좋은모형이있는지살펴보기위하여수정지수 (modification index, MI) 를검토하였고측정모형의척도가동일하지않은점을고려하여경로계수는표준화경로계수를사용하였다. 통계분석은경로분석에는 IBM SPSS Amos 21.0.0 프로그램 (Copyright IBM Coporation 2012) 을이용하였으며, 다른나머지분석은 SPSS 23.0 프로그램 (SPSS Inc., Chocago, IL, USA) 을사용하였고통계적유의수준은 p < 0.05로하였다. 연구결과 대학신입생의미용성형수술 ( 시술 ) 경험실태연구대상자의미용성형수술 ( 시술 ) 경험률은남학생이 363명중 9명으로 2.5%, 여학생은 723명중 209명으로 28.9% 였다. 전공계열별로는남학생의경우예체능계열이 78명중 5명이경험하여 6.4% 로가장높았고, 여자의경우도예체능계열이 37.3% 로가장높았으며모든학과 Table 1. Cosmetic surgery experience rate of study population according to academic departments by sex Variables Male freshmen Female freshmen χ 2 p value Academic departments Literature, humanities and social science 0/94 (0.0) 35/165 (21.2) 23.05 <0.001 Science and engineering 3/119 (2.5) 23/113 (20.2) 18.52 <0.001 Fine arts, music, and athletics 5/78 (6.4) 82/220 (37.3) 26.53 <0.001 Public health and medicine 1/72 (1.4) 69/225 (30.7) 25.96 <0.001 Total 9/363 (2.5) 209/723 (28.9) 105.20 <0.001 Unit, n (%). 338 http://www.e-jhis.org
Aesthetic/Cosmetic Procedures 에서남학생보다는여학생이성형수술 ( 시술 ) 을받은비율이유의하게 높았다 (p < 0.001) (Table 1). 남학생의미용성형경험여부에따른미용성형계획여부별자아존 중감, 신체이미지, 외모에대한사회문화적태도, 성형수술에대한태 도점수는미경험군에서는자아존중감, 성형수술에대한태도에서차 대학신입생의미용성형수술 ( 시술 ) 계획과관련요인연구대상자들의미용성형수술계획은남학생이 363명중 14명이계획하고있다고하여계획률은 3.9% 이었고, 여학생은 723명중 119명이계획하고있다고하여계획률은 16.5% 로여학생이남학생에비교하여유의하게높았으며 (p < 0.001), 학과별로도모든학과에서여학생이남학생보다미용성형수술계획률이유의하게높았다 (p < 0.05). 미용성형경험여부에따른미용성형계획률은남학생의경우미용성형경험군에서 22.2% 로미경험군의 3.4% 보다유의하게높았으며 (p = 0.043), 여학생도경험군에서 26.8%, 미경험군에서 12.3% 로경험군에서유의하게높아 (p < 0.001) 남녀모두미용성형경험군에서높았다 (Table 2). 이가있었고, 경험군에서는자아존중감에서유의한차이가있었다 (p < 0.05) (Table 3). 여학생의미용성형경험여부에따른미용성형계획여부별자아존중감, 신체이미지, 외모에대한사회문화적태도, 성형수술에대한태도점수는미경험군에서는자아존중감, 외모에대한사회문화적태도, 성형수술에대한태도에서차이가있었고, 경험군에서는신체이미지, 외모에대한사회문화적태도, 성형수술에대한태도에서유의한차이가있었다 (p < 0.05) (Table 4). 자아존중감, 신체이미지, 외모에대한사회적태도가성형수술에대한태도및미용성형경험여부를통해앞으로의미용성형계획여부 Table 2. Cosmetic surgery planning rate of study population according to experience with by sex Male freshmen Female freshmen Experience with (n = 9) Non-experience with (n = 354) Total (n = 363) Experience with (n = 209) Non-experience with (n = 514) Total (n = 723) Academic departments Literature, humanities and social science 0/0 (0.0) 3/94 (3.2) 3/94 (3.2) 6/35 (17.1) 12/130 ( 9.2) 18/165 (10.9) NA p 1 = 0.221* p 2 = 0.029 Science and engineering 0/3 (0.0) 3/116 (2.6) 3/119 (2.6) 6/23 (26.1) 8/ 90 ( 8.9) 14/113 (12.4) p 1 = 1.000* p 1 = 0.037* p 2 = 0.004 Fine arts, music, and athletics 2/5 (40.0) 3/73 (4.1) 5/78 (6.4) 32/82 (39.0) 21/138 (15.2) 53/220 (24.1) p 1 = 0.031* p 1 < 0.001 p 2 = 0.001 Public health and medicine 0/1 (0.0) 3/71 (4.2) 3/71 (4.2) 12/69 (17.4) 22/156 (14.1) 34/225 (15.1) p 1 = 1.000* p 1 = 0.525 p 2 = 0.016 Total 2/9 (22.2) 12/354 (3.4) 14/363 (3.9) 56/209 (26.8) 63/514 (12.3) 119/723 (16.5) p 1 = 0.043* p 1 < 0.001 p 2 < 0.001 Unit, n (%). NA, not available. p 1 Comparison between experience and non-experience by chi-squired test. p 2 Comparison between male and female by chi-squired test. *Result of Fisher s exact test. Table 3. Score of self-esteem, body image (MBSRQ), sociocultural attitude toward appearance (SATAQ), acceptance of (ACSS) according to experience with in male freshmen Non-experience with (n=354) Experience with (n=9) (n = 12) Non-planning (n = 342) p-value (n = 2) Non-planning (n = 7) p-value Self-esteem 2.68 ± 0.52 3.01 ± 0.50 0.024 2.35 ± 0.21 3.27 ± 0.48 0.039 MBSRQ 3.29 ± 0.83 3.08 ± 0.50 0.389 2.90 ± 0.14 3.60 ± 0.71 0.229 SATAQ 3.20 ± 0.73 2.73 ± 0.50 0.052 2.93 ± 0.10 2.70 ± 0.61 0.633 ACSS 5.31 ± 1.72 3.26 ± 1.14 0.002 4.90 ± 1.27 5.20 ± 1.20 0.767 Unit, mean±standard deviation. http://www.e-jhis.org 339
Yeon Ok Yun, et al. Table 4. Score of self-esteem, body image (MBSRQ), sociocultural attitude toward appearance (SATAQ), acceptance of (ACSS) according to experience with in female freshmen Non-experience with (n=514) (n = 63) Non-planning (n = 451) p-value Experience with (n=209) (n = 56) Non-planning (n = 153) Self-esteem scale 2.74±0.57 2.87±0.49 0.045 2.79±0.50 2.85±0.50 0.417 MBSRQ 3.33 ± 0.52 3.25 ± 0.44 0.201 3.46 ± 0.47 3.28 ± 0.47 0.012 SATAQ 3.49 ± 0.53 3.16 ± 0.47 < 0.001 3.44 ± 0.49 3.28 ± 0.48 0.048 ACSS 5.20 ± 0.93 3.89 ± 1.12 < 0.001 5.47 ± 1.09 4.51 ± 0.97 < 0.001 Unit, mean±standard deviation. Table 5. Factor analysis model fit index Model fix index Values Criteria Judgements Q ( =χ²/df) 0.397 <3.0 Good Adjusted goodness of fit index (AGFI) 0.996 >0.9 Good Standardized root mean-square residual (RMR) 0.010 <0.1 Good p-value -0.07 0.27 0.17** 0.37** -0.21 0.29 0.41** 0.27** 0.08* Figure 2. Path analysis model for planning in female freshmen. MBSRQ, multidimensional body-self relations questionnaire; SATAQ, sociocultural attitude toward appearance questionnaire; ACSS, acceptance of scale. *p<0.05, **p<0.01. 에미치는영향력을평가하기위한여자대학신입생에대한경로분석모형의모형적합도는 Q통계량이 0.397로적합하였으며조정된적합지수는 0.996, 평균제곱잔차제곱근은 0.010으로모든적합지수가모형이잘적합되었음을나타내었다. 또한수정지수는통계적으로권장할만큼의새로운수정모형제시는없었다 (Table 5). 추정된표준화경로계수는자아존중감이성형수술에대한태도에미치는효과는 0.07 (p = 0.066) 로유의하지않았지만미용성형경험이성형계획에미치는직접효과경로계수 0.08은유의수준 5% 하에서유의하였고 (p < 0.05) 나머지경로계수는 1% 유의수준하에서모두유의하였다 (p < 0.01). 자아존중감, 신체이미지와외모에대한사회적태도중에서미형성형계획에미치는직간접효과를합한총효과크기가가 장큰요인은외모에대한사회적태도로효과크기가 0.160이었고다음은신체이미지로 0.067이고자아존중감은 0.026이었다. 성형에대한태도가직간접적으로효과크기는 0.394로가장높았고미용성형경험여부도직접적으로 0.078의효과가있었다 (Figure 2). 고찰및결론 대학신입생의미용성형수술 ( 시술 ) 경험실태연구대상자전체의미용성형수술 ( 시술 ) 전체경험률은남학생의경우 2.5%, 여학생의경우는 28.9% 로여학생에서더많이경함하고있었다. 본연구에서세부적으로분석한결과대학입학전의성형수술은 340 http://www.e-jhis.org
Aesthetic/Cosmetic Procedures 대부분고등학교에서대학입학전사이에이루어지고있었다. 본연구에서미용성형수술이주로고등학교시절과여학생에서이루어지고있었는데, 이는청소년들이보통이상으로외모에대한사회문화적기준을수용하여인식하고내면화하는경향이있는데, 고등학생이중학생보다이러한경향이강하고, 여학생의경우남학생보다이러한경향이강하다고한연구와부합하고있었다 [14]. 여고생들은타인을많이의식하여신체와외모에대한관심이많은시기인데, 여고생들의신체만족도는낮은편이었다고하였다 [15]. 청소년들은성장이완료되지않은상태로성형수술로인해뼈의성장이나연골의성장에영향을줄수있으며향후모양에변형이생길가능성이있고, 청소년들은육체적으로정신적으로완전히성숙되지않은상태로유행이나호기심에이끌려섣불리미용성형수술을계획하는것은상당히위험하며심각한부작용에시달릴수도있다. 그럼에도불구하고청소년기에미용성형수술 ( 시술 ) 을이미경험하는것은현재우리나라의외모지상주의사회분위기, 성형수술의료계의비즈니스전략, TV 등대중매체에서성형화된외모로활약중인연예인들의모습이큰영향을미친것이라하겠다 [5]. 사람들이성형수술을하는이유는성형수술로얻는이득이있어서인데, 관련연구에서는사람들이어떤측면에서외모로인해불행함을느끼기때문에성형수술을추구한다고하였다 [7,16]. 한국청소년들중자살을고려하는경향은외모차별을경험한청소년들사이에서더높을정도로 [17], 외모차별은심각한사회문제로등장하고있다고하였다. 따라서외모지상주의를극복하는사회적환경이조성되어야할것이다. 또한외모나신체적이미지를결정론적관점에서인식하기보다는학생들의자신의신체매력을제대로인지하고향상시킬수있는방향설정이필요할것이다 [18]. 대학신입생의미용성형수술 ( 시술 ) 계획과관련요인연구대상자들의미용성형수술계획은남학생이 363명중 14명이계획하고있다고하여계획률은 3.9% 이었고, 여학생은 723명중 119명이계획하고있다고하여계획률은 16.5% 이었다. 계획률은남녀모두에서예체능계열이높았다. 여자대학생들이남자대학생에비해미용성형계획률이높았는데, 여대생들은다른사람의시선을중시하며, 부모와친지, 친구의평가를중요하게생각함으로주관적규범이본인의의사와는다르게작용할수있다고하였는데, 여대생들은마른체형이아름답고성적매력이있으며, 주위로부터끊임없이자신의외모에관심을기울이게하는사회적압력이여대생들의무분별하고반복적인성형수술을부추기는것이다 [5] 라고하였다. 미용성형경험여부에따른미용성형계획률은남학생의경우미용성형경험군이 22.2%, 미용성형미경험군이 3.4%, 여학생의경우는각각 26.8% 와 12.3% 로미용성형경험군에서미용성형계획률이높았다. 우리나라 1개대학교 1-4학년여대생을대상으로한연구에서미용성형경험군이비경험군보다성형을받아들이는정도가높았고, 사회적동기도더높았으나미용성형욕구는미용성형비경험군이경험군보다더높았다고한보고도있었는데 [19], 이와는다른결과였다. 해당연구는 1개대학교의 1-4학년여대생을대상으로하였고, 본연구는 6개대학 ( 교 ) 모든계열의신입여대생을대상으로하여직접비교는어려울것인데, 학년과학과에따라차이가있을수있으므로추후연구가필요한것으로생각한다. 남학생의미용성형경험여부에따른미용성형계획여부별자아존중감, 신체이미지, 외모에대한사회문화적태도, 성형수술에대한태도점수는미경험군에서는자아존중감, 외모에대한사회문화적태도, 성형수술에대한태도에서차이가있었고, 경험군에서는자아존중감에서유의한차이가있었다. 남학생의경우미용성형수술경험군과비경험군모두에서미용성형수술미계획군에서자아존중감점수가높았는데, 이는 20대를대상으로한연구에서남성은자아존중감이높을수록미용관련소비행동이소극적이라는보고 [20] 와부합하고있었다. 여학생의미용성형경험여부에따른미용성형계획여부별자아존중감, 신체이미지, 외모에대한사회문화적태도, 성형수술에대한태도점수는미경험군에서는미용성형계획군에서자아존중감점수가낮았고, 외모에대한사회문화적태도와성형수술에대한태도점수가높았고, 경험군에서는미용성형계획군에서신체이미지, 외모에대한사회문화적태도, 성형수술에대한태도점수가유의하게높았다. 이는여대생의경우미용성형비경험군에서는성형을받아들이는정도, 신체만족도가유의한변수였고, 경험군에서는성형을받아들이는정도가유의한변수라고한연구 [19] 와일부부합하고있었다. 자아존중감, 신체이미지, 외모에대한사회적태도가성형수술에대한태도및미용성형경험여부를통해앞으로의미용성형계획여부에미치는영향력을평가하기위한여자대학신입생에대한경로분석모형에서추정된표준화경로계수는자아존중감이성형수술에대한태도에미치는효과는유의하지않았지만미용성형경험이성형계획에미치는직접효과경로계수 0.08은유의수준 5% 하에서유의하였고, 나머지경로계수는 1% 유의수준하에서모두유의하였다. 자아존중감, 신체이미지와외모에대한사회적태도중에서미형성형계획에미치는직간접효과를합한총효과크기가가장큰요인은외모에대한사회적태도로효과크기가 0.160이었고다음은신체이미지로 0.067이고자아존중감은 0.026이었다. 성형에대한태도가직간접적으로효과크기는 0.394로가장높았고미용성형경험여부도직접적으로 0.078의효과가있었다. 우리나라대학생을대상으로한연구에서외모추구성향, 외모중시, http://www.e-jhis.org 341
Yeon Ok Yun, et al. 외모관심도요인이미용성형수술구매의도또는미용성형행동에영향을미친다고한보고와부합되고있었다 [6-8]. 또한이들연구에서는자아존중감이부 (-) 의영향을미친다고하였는데, 본연구에서여자대학생을대상으로한경로분석에서유의하지는않았지만부 (-) 의영향을미치고있었고, 단순분석에서남학생에서는유의한부 (-) 의영향을미치고있었고, 여학생에서는미용성형수술미경험군에서유의한부 (-) 의영향을미치고있어일부부합되고있었다. 여자대학생의경우외모지상주의가높을수록미용성형의경험이반복되며, 또한미용성형에대한더큰관심을갖게되고, 미용성형을통해외모를변화시키고자하는욕구가높아지고, 이에따라외모지상주의욕구가강화되어미적기준상승으로새로운외모향상추구동기로이어질수있음으로이에관해보다심층적으로이해할수있는근거를마련할필요가있을것이다 [5]. 본연구의제한점으로일개대도시의 6개대학의신입생을대상으로하여우리나라대학신입생을대표하는데문제가있을수있고, 미용성형에는많은요인들이작용할수있으나이를모두고려하지는못하였다는것이다. 그러나일개대도시소재대학교를규모에따라분류하여임의추출하여선정된학과의신입생전수를조사하였고, 연구결과가기존의연구결과와부합되고있어연구결과를어느정도는받아들일수있을것으로생각한다. 또한선형회귀모형을기반으로한구조방정식모형을사용하여복잡한인과관계를제시한것은의의가있다고생각하지만일부결과변수가이분형으로계수추정에있어과소추정되었을수있다는점이제한점이며향후연구에서이분형보다는연속형에가까운척도개발도고려해볼필요가있다고생각한다. 이상의결과여학생의경우청소년시기인대학입학이전에 28.9% 가이미미용성형수술 ( 시술 ) 을경험하였으며, 대학에입학하여향후미용성형수술 ( 시술 ) 계획률이여학생의경우미용성형경험군은 26.8%, 미경험군은 12.3% 로청소년시기의미용성형경험이대학진학이후의미용성형수술계획에영향을미치고있으므로성장이완료되지않은무분별하게미용성형을하지않도록하는방안이강구되어야하겠다. 또한여자대학신입생의미용성형계획에는신체이미지, 외모에대한사회적태도, 성형수술에대한태도가영향을미치고있었으므로대학에서도올바른미용성형수술이이루어지도록성형수술에대한태도에대해보건교육과지도가필요할것으로생각된다. REFERENCES 1. International Society of Aesthetic Plastic Surgery (ISAPA). International Survey on Aesthetic/Cosmetic Procedures Performed in 2014. Hanover, NH: ISAPA; 2015. 2. American Society for Aesthetic Plastic Surgery. Quick facts: Highlights of the ASAPS 2015 statistics on, 2015. Available from: http://www.surgery.org/sites/default/files/2015-quick-facts.pdf. [accessed on April 21, 2016]. 3. Kim Y. Elementary students satisfaction of appearance and their efforts for better appearance [dissertation]. Kyungpook National University; Korea, 2008. 4. Min B. A study on college students understanding of aesthetic surgery [dissertation]. Korea University; Korea, 2003. 5. Park B, Kim J. Structural equation modelling intention of revision facial in female college students. J Korean Acad Indus Coop Soc 2015;16(12):8707-8718 (Korean). 6. Hwang Y, Jo K, Yoo T. The study on behavior according to appearance concern, body cathexis, and self-esteem. J Fashion Business 2003;7(4):17-25 (Korean). 7. Yoon S. A study on the purchase decision making regarding cosmetic surgery services: centered on cultural values and media exposure. J Culture Indus 2013;13(2):11-20 (Korean). 8. Lee J, Yoon S, Han H. The effect of lifestyle which influence on the purchase intention on : based on the moderation effect of exposure to the media. J Culture Indus 2013;13(4):85-96 (Korean). 9. Lee H. Factors influencing need for among high school girls. Korean J Women Health Nurs 2011;17(2):126-136 (Korean). 10. Rosenberg M. Society and adolescent self-image. Princeton, NJ: Princeton University Press; 1965. 11. Cho S, Koh A. The effects of sociocultural attitude toward appearance and body images on clothing benefits sought -the comparison of age difference in female adolescents. J Korean Soc Cloth Text 2001;25(7): 1227-1238 (Korean). 12. Heinberg LJ, Thompson JK, Stormer S. Development and validation of the sociocultural attitudes towards appearance questionnaire. Int J Eat Disord 1995;17(1):81-89. 13. Henderson-King D, Hendesron-King E. Acceptance of scale development and validation. Body Image 2005;2:137-149. 14. Wee E. A study on differences in body comparison, body satisfaction, and appearance management behaviors according to socialcultural attitudes toward appearance among adolescents in Gwangju and Jeonnam province- by sex and age. J Korean Home Econ Edu Assoc 342 http://www.e-jhis.org
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