Purpose This study aims to explore the relationship between the discharge process and two-year prognosis in patients with Heart Failure (HF) who were hospitalized because of HF exacerbation.
Methods Medical records were reviewed to identify patients admitted for HF exacerbation. Information regarding the following discharge processes was collected: follow-up visits, discharge educational contents, and the presence of family caregivers during patient education. HF-related events, including emergency department visits, readmissions, or death because of HF, were defined as a composite of events. A multivariate Cox proportional hazards regression model was used after adjusting for covariates to explore the association between the discharge process and HF-related events.
Results A total of 201 patients were included in this study. In the two-year follow-up periods, 41 patients (20.4%) experienced at least one HF-related event. Follow-up visits were scheduled at an average of 8.11±2.92 days after discharge. Approximately 95.0% of the patients received discharge education with an average of 1.66±1.04 topics, and 69.7% of the families participated in this educational activity. In the multivariate Cox regression model, not having family members during education was associated with a longer time to HF-related events (hazard ratio: 2.09; 95% confidence interval: 1.001~4.346). However, follow-up visits and the amount of educational content received were not associated with time to HF-related events.
Conclusion The presence of family caregivers during education appears to be a protective factor against adverse prognosis in patients with HF. Our results highlight the importance of family engagement during discharg
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Purpose This study aimed to evaluate distress, family resilience, and Quality of Life (QoL) among family caregivers of cancer patients undergoing chemotherapy and explore whether family resilience moderates the association between distress and QoL. Methods This is a cross-sectional study. One hundred seventeen family caregivers of cancer patients undergoing chemotherapy were recruited through the oncology outpatient clinic and two oncology wards at a tertiary university hospital. The participants completed self-reported questionnaires, including the Hospital Anxiety and Depression Scale, Family Resilience Scale-Cancer, and Caregivers’ Quality of Life Index-Cancer. Descriptive statistics, independent t-tests, one-way Analysis of Variance (ANOVA), and hierarchical regression analysis were used for statistical analysis. Results The mean distress score was 15.31±6.91, the mean family resilience score was 112.71±14.11, and the mean QoL score was 71.19±18.90. After controlling for potential covariates, distress was found to be negatively associated with QoL (β=-.45, p<.001), whereas family resilience was positively associated with QoL (β=.49, p<.001), explaining 62.8% of the variance. However, family resilience did not moderate the association between distress and QoL in this study. Conclusion Distress and family resilience are crucial factors associated with QoL in the caregivers of cancer patients undergoing chemotherapy. This finding indicates that oncology nurses should develop interventions to relieve distress and enhance family resilience to improve family caregivers’ QoL. Further studies are required to confirm the moderating role of family resilience.
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Purpose This study aimed to identify how health literacy in patients with stroke and their family caregivers influences their health behavior.
Methods: A total of 95 patient-family caregiver dyads were recruited from March to September 2018. Health literacy was measured using the newest vital sign and the health behavior scale was used to identify the health behavior of patients. Data were analyzed using descriptive statistics, independent t-tests, one-way analysis of variance, Pearson’s correlation, and multiple regression.
Results: The mean age of patients with stroke and family caregivers was 69.44±8.25 and 54.01±14.42 years, respectively. The proportion of women in the family caregivers was 72.6%. The average health literacy score of patients with stroke and their family caregivers was 2.26±1.75 and 3.03±1.97, respectively. The multiple regression analysis revealed that patients’ interest in health (p<.001), health literacy (p=.037), age (p=.001), and caregivers’ gender (p=.028) were the significant factors influencing health behavior of patients with stroke.
Conclusion: In providing optimal care, nurses must ensure that information is provided to both patients and their family caregivers in a clear and effective manner. To improve health behavior in patients with stroke, various strategies are needed to increase their interest in health while considering their age and health literacy.
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PURPOSE This study was a systematic review and meta-analysis designed to investigate the variables related to burden of caregivers of people with dementia living at home. METHODS In total, 24 studies were identified through a systematic review and 11 studies met the inclusion criteria for the meta-analysis. EMBASE, MEDLINE (Ovid-MEDLINE, Pubmed) and several Korean databases were searched until April 2018. ‘R 3.5.1’ version was used to analyze the correlated effect sizes. RESULTS According to the results, variables related to caregivers' burden were categorized into factors related to patients and factors related to family caregivers. The effect sizes of correlations between factors associated with patients and caregivers' burden were as follows: problematic behavior & cognition (memory) (.42), problematic behavior (.37), cognition (memory) (.35), stage of dementia (.31), and ability to perform daily life functions (−.27). Factors associated with family caregivers correlated with caregiver burden as follows: health status (−.40), relation (.33), education (.25), time of caring (.24), income (−.21), age (.20), job (−.17), duration of caring (.15), and religion (.14). CONCLUSION Based on the findings, family caregiver needs to preferentialy try to manage problematic behavior & cognition (memory) of dementia and health professionals need to provide comprehensive nursing interventions to improve health for patients with dementia but also family caregivers.
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PURPOSE This study aimed to compare the needs of family caregivers and program providers in family support program by exploring perspectives about the program in the long-term care system. METHODS This was a secondary analysis study using the content analysis method. The data of 11 family caregivers and 7 program providers that were collected from focus group interviews in two primary studies were used. Each data was collected in April and May 2015. The units of analysis were dyads of family caregivers and program providers. RESULTS The data were deductively analyzed within three main categories: program purpose, program content, and program method. Within the main categories, ten subcategories represented the essential elements for developing a family support program. There were differences between family caregivers and program providers in terms of the contents and intentions of the family support program. Family caregivers wanted to receive help from the family support program in a passive manner, while program providers expected the family support program to improve families' ability to solve their own problems. CONCLUSION Based on the results of this study, it is important to establish the strategies of customized and flexible program considering the needs of the caregivers to make family support program more effective. Further, it is necessary to fill the gap between the needs of the two groups and focus on family-centered approaches to conduct family support program more effectively.
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PURPOSE The purpose of this study was to identify factors associated with family caregivers' self-management of acute stroke survivors. METHODS The study participants were 130 stroke survivors and their caregivers. Data on participant characteristics, depression, task difficulty, survivor memory and behavioral problem, and self-management were collected from July 1 to September 30, 2017 using a structured questionnaire. Data were analyzed with the SPSS/WIN 23.0 program for descriptive statistics, using independent t-test, one-way analysis of variance, Pearson's correlation coefficient and enter multiple regression analysis. RESULTS Significant factors associated with self-management for family caregivers were survivors' age, the presence of comorbidities, the relationship between caregivers and survivors, and the presence of an alternative caregiver. Self-management has negative correlations with depression, task difficulty, and the occurrence of survivor memory and behavioral problems. The determining factors affecting caregiver self-management were caregiver depression (β=−.46, p < .001) and survivor age (β=.32, p=.004), and their explanation power was about 37%. CONCLUSION The results suggest that caregiver depression and survivor age should be considered in developing the nursing interventions to improve family caregiver self-management. Furthermore, findings underscore the importance of early screening and ongoing psychological assessments for depression in family caregivers of stroke survivors.
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PURPOSE This study aimed to develop a navigation program for family caregivers of stroke patients admitted to a rehabilitation hospital and evaluate differences in caregiver outcomes before and after the intervention. METHODS The navigation program consists of education, demonstration and return demonstration. To evaluate the program, we conducted a quasi-experimental study in 44 caregivers (22 experimental group received the navigation program vs. 22 controls group did not received). Caregivers completed the burden, anxiety, depression, self efficacy, caregiving mastery, quality of life, and patient's Activities of Daily Living (ADL). Data were collected using self-report structured questionnaires. The data were analyzed using the SPSS/WIN 21.0 with the χ2-test, and independent t-test. RESULTS Compared with the control group, caregivers who received the navigation program reported significant decrease in caregiver burden, depressive symptoms and anxiety and significant improvement in their mastery, self-efficacy, quality of life and patient's ADL. CONCLUSION Delivering the navigation program to family caregivers of stroke patients in a rehabilitation hospital setting was feasible. Our results provide preliminary support for the navigation program to reduce negative outcomes (e.g., burden, anxiety, depression) and improve positive outcomes (e.g., mastery, self efficacy, quality of life, patient's activities of daily living) in family caregivers who experience first stroke diagnosis of their loved one.
PURPOSE This study was designed to explore positive and negative aspects of the caregiver reaction and identify factors influencing psychological well-being among family caregivers of home-based cancer patients. METHODS The participants were 139 family caregivers from two cities. These caregivers took care of he family member in the home. Data were collected utilizing the Caregiver Reaction Assessment Scale and the Psychological Well-being Scale. RESULTS Self-esteem was the highest reaction reported among the family caregivers. There were significant correlations between caregiver reaction and their psychological well-being. In multiple regression analysis, self-esteem and family support were predictors of psychological well-being among family caregivers (F=13.71, p < .001, Adj. R²=.393). CONCLUSION The results demonstrated that self-esteem and family support impacts the psychological well-being among cancer family caregivers. Thus, nursing intervention are needed to enhance self-esteem to improve psychological well-being among family caregivers.
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PURPOSE The purpose of this study was to identify the factors which contribute to the burnout of a family member providing care to a family member in the intensive care unit (ICU). METHODS Data about participants' characteristics, stress, burden, social support and burnout were collected from March 1 to September 15, 2016. Data were collected through interviews and a self-report questionnaire. One hundred and twenty-three participants who were the primary caregiver participated in the study. RESULTS The reported mean stress score was 2.13±0.78 and of reported burden was 3.24±0.27. The mean score of social support was 3.17±0.59 and of burnout was 2.61±0.58. There were significant differences in education level, financial burden, assistant, and health status in burnout of the family caregivers. Burnout had significant correlations with stress (r=.76, p < .001), burden (r=.43, p < .001), and social support (r=-.62, p < .001). The influencing factors on burnout were stress (β=0.63, p < .001), burden (β=0.14, p=.010), and social support (β=-0.32, p < .001). These variables explained 71.8% of the total variance in burnout. CONCLUSION The results suggest that stress, burden, and social support should be considered in developing the nursing interventions to improve the burnout among family caregivers of the ICU patients.
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PURPOSE There is limited available research about the experiences of family caregivers and their care of family members with cancer. The purpose of this study was to explore the experience of distress among family caregivers. Further, this study explored what aspects of caring for family member contributed to the distress. METHODS Data were collected through in-depth interviews with thirteen family members primarily responsible for the care of the member with cancer. All interviews were audio-taped, transcribed, and analyzed with qualitative content analysis. RESULTS The findings showed that the patients' physical, psychological, socio-relational, and spiritual symptoms influenced their caregivers' distress. The four categories that emerged from the data included “focusing attention only on the patient battling with cancer,â€â€œbeing trapped in turmoil of complex emotions and feelings,â€â€œhaving had to endure alone,†and “hanging in there at the crossroads of life and death.†With respect to these categories, fourteen sub-categories were ultimately identified. CONCLUSION Based on this study, researchers need to focus more attention on, and explore such co-existing distress to develop an adequate support program for the family caregivers of cancer patients.
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PURPOSE This study was designed to assess the effects of skill teaching of oral liquid medication on the dose loss and caregivers' administering behavior. METHODS A nonequivalent control group no-synchronized design was used. 104 participants were assigned to one of two groups. A intervention group received a skill teaching and the control group received the conventional teaching about oral medication. RESULTS The mean amount of the dose loss by all participating caregivers was 23.3% of the prescribed dose and 61.5% of the caregivers showed dose loss more than 20% of the prescribed dose. Caregivers' age (Exp=3.56, p=.017) and time taken for administration (Exp=7.97, p < .001) were related to more dose loss. Toddlers' posture sitting in a stroller upon medication (Exp=.14, p=.009) and re-administering the remains after checking the medication bottle (Exp=.22, p=.040) influenced on reduction in dose loss. Before and after the skill teaching, a significant decrease in the dose loss was found in the high-viscous liquid medication only (t=−4.95, p < .001). The difference in the dose loss between the two groups were significant in the high-viscous liquid medication (t=4.95, p < .001). Also, caregivers' administration behavior were significantly improved in the intervention group. CONCLUSION The findings of this study showed that the skill teaching of oral liquid medication designed for toddlers' caregivers was effective in reduction of dose loss and improvement in administering behaviors with confidence.
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PURPOSE The purpose of the study was to provide deep understanding of the reported experiences of families with their loved one in the intensive care unit (ICU), focusing on interactions with healthcare providers. METHODS The data were collected by individual interviews of eleven participants. The transcribed data were analyzed using qualitative content analysis to identify major themes and sub-themes that represented the experiences of families. RESULTS Five themes and 13 sub-themes emerged. “Captive of patients' delayed death: Fear and anxiety†describes psychological problems arising when the family member became critically ill enough to warrant being admitted to the ICU. “Families as the weak: Suppression and resistance†describes interpersonal difficulties arisingdue to lack of information and trust with healthcare providers. “Deprivation of authority and duty as families: Helplessness†illustrate situational barriers in attempting to protect and support family member. “Re-establishment of trust relationship with healthcare providers: Gratitude and appreciation†describes how they satisfied with themselves by regaining trust relationship. Lastly, “Acceptance of reality through direct care participation: Relief and peace†illustrates peace of mind by gaining sense of reality through active direct care participation. CONCLUSION This study demonstrates the positive and negative experiences of families with ICU patients. The results will be useful in developing family-centered nursing interventions.
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PURPOSE This study was to test a structural model of spirituality and the quality of life of stroke survivors' caregivers in order to provide guidelines for the development of intervention and strategies to improve their quality of life. METHODS Data were collected from 133 family caregivers of stroke patients who were hospitalized in C university hospital located in Seoul. Data collection using survey questionnaires was done from May, 2013 to February, 2014. RESULTS Fitness of the hypothetical model was appropriate. Physical component of quality of life of family caregivers is directly affected by two variables (51.5%), burden and depression. Mental component of quality of life of family caregivers is directly affected by three variables (77.6%), depression, burden, and functional dependence of patients. Depression as well as burden were directly affected by spirituality and functional dependence of patients respectively. Thus, spirituality directly affected depression and burden and indirectly affected the quality of life of family caregivers. CONCLUSION Therefore, spiritual intervention to improve the stroke caregivers' quality of life might be necessary to support and strengthen their spirituality as a mediating variable that can contribute to decreasing their depression and burden.
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PURPOSE The purpose of this study was to explore the quality of life (QoL) in patients with Alzheimer's disease (AD) and their and caregivers and its influencing factors. METHODS A descriptive research design was used. 211 pairs of AD patients and their caregivers were recruited from a neurology outpatient clinic of S medical center in Seoul, Korea. Caregivers completed several structured questionnaires regarding AD patients' QoL as well as their QoL, patients' behavioral and psychological symptoms, patients' activities of daily living (ADL), social support, and quality of relationship between AD patients and caregivers. Cognitive status of AD patients was assessed by the researchers using Korean Mini-Mental State Examination. RESULTS The scores of QoL were 26.91 for AD patients and 85.62 for their caregivers. In the multiple regression, factors associated with AD patients' QoL were the quality of relationship (β=.44), ADL (β=-.33), patient's age (β=.20), caregivers' QoL (β=.20), and patient's gender (β=.11). Factors associated with caregivers' QoL were the quality of relationship (β=.34), relationship (β=.32), patient's QoL (β=.26), caregivers' gender (β=.18), social support (β=.12), and the level of caregivers' education (β=.12). CONCLUSION To improve the QoL in AD patients and their caregivers, strategies to promote their quality of relationship are needed.
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PURPOSE Depression is a common sign of suffering among the patients with Parkinson's disease (PD). Frequent and severe neuropsychiatric symptoms lead to high levels of distress in patients and their caregivers, which results in the high levels of caregiver burden. The aim of this study was to determine the predictors of caregiver burden in caregivers of the patients with Parkinson's disease (PD). METHODS The study included 183 consecutive PD patients and their caregivers. Patients were assessed using the Hoehn and Yahr scale, Mini Mental State Examination (MMSE), Beck Depression Inventory (BDI), and Schwab and England Activities of Daily Living Scale. Caregivers' depressive symptoms were evaluated using the Caregiver Burden Inventor (CBI), BDI, and World Health Organization Quality of Life Scale. RESULTS All of the patients reported one or more neuropsychiatric symptoms. Patients' and caregivers' depressive symptoms, caregivers' age and education, time for caregiving, and quality of life were significantly associated with the increased caregiver burden. After controlling the level of education as a potential confounding variable, depression in both patients and caregivers, time for caregiving, and quality of life explained 45.6% of the variance in caregiver burden. CONCLUSION Substantial attention needs to be given to the early identification of depression in PD patients and their caregivers to improve caregivers' quality of life and burden.
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PURPOSE The purpose of this study was to explore and identify the role adaptation processes of family caregivers with patients transferred from intensive care unit to general ward. METHODS Using a grounded theory methodology, in-depth individual interviews were conducted. Data were collected from 11 participants. The participants were asked about their experiences of role adaptation considering situational contexts and interactional strategies. Transcribed data and field notes were analyzed using constant comparative analysis. RESULTS The core category was 'becoming almost a nurse with hope and fear.' The identified phenomena by the participants were the joy of being alive, having hope for a full recovery, anxiety and fear of uncertain future, feeling burdensome on a given role. The results included both role adaptation and mal-adaptation of caregivers. CONCLUSION The role adaptation processes of family caregiver with patients transferred from intensive care unit to general ward can be explained as becoming almost a nurse with hope and fear. The findings of the study provided fundamental information for developing programs to support the given family caregivers for successful role adaptation.
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PURPOSE This study's purpose is to classify and analyze caregivers' recognition of the elderly suicidal intents. METHODS This study uses applied Q-methodology to measure human subjectivity in depth. Concretely, 35 statements are composed in depth interviews and literature investigation. Then, Q-cards and distributive chart of Q-sampling were given to 25 caregivers randomly-selected, who were asked to arrange them on a 7-score based. After coding Q-factor analysis is carried out with the PC-QUANL program. RESULTS Four types of indicators of the elderly suicidal intents were identified by the caregivers. These are Knowledge-based recognition, Behavioral measure based recognition, Negative comprehension and Sympathy. CONCLUSION In this study, four types of recognition were yielded among the caregivers and the characteristics of each type were analyzed. These findings may be useful in assessing suicidal potential and nursing interventions.
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PURPOSE The purpose of this study was to examine the relationships among perceived health, parental stress, social support, and quality of life of grandparent caregivers and to identify the factors influencing quality of their life. METHODS A descriptive correlational design was used. The data were collected by questionnaires from a convenience sample of 130 participants taking care of their grandchildren from ten children's daycare centers in Seoul, Korea from August to September, 2013. Data were analyzed using t-test, ANOVA, Pearson's correlation efficients, and multiple regressions. RESULTS Perceived health, parental stress and social support were correlated significantly with quality of life. As a result of the multiple regression analysis, education level, age of grandchildren, perceived health, parental stress and social support accounted for 48% of the variance in quality of life. Perceived health, parental stress, and social support were identified as factors influencing quality of life and the variable that most affected quality of life was perceived health. CONCLUSION The results of the study indicate that health of people taking care of their grandchildren must be promoted while relieving their parental stress with appropriate social support in order to improve quality of life.
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PURPOSE This study was aimed to survey the actual caregiving conditions of family caregivers who are caring patients with rare and incurable diseases using home ventilators at home, and to clarify any factors affecting their burdens and quality of life. METHODS A questionnaire survey was performed by the 159 subjects, and the questionnaires contained the actual conditions of caregiving activities, and caregiver's burdens and quality of life. The collected data was analyzed by ANOVA, Pearson's correlation, and stepwise linear regressions. RESULTS The mean of burden scores was 3.55 out of 5, and influencing variables included the relationships with patient (spouse), respite (moderate), health status, and diagnosis (non ALS), with the explanatory power of 30.0%. The mean of the quality of life was 2.58 point, and the influencing variables included burdens, health status, and respite (enough), with the explanatory power of 39.0%. CONCLUSION In order to improve the quality of life among family caregivers caring for patients with using a home ventilator, it is required to develop strategies for reducing caregiving burdens as well as to introduce family respite welfare systems to family caregivers.
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PURPOSE The purpose of this study was to investigate the levels of burden, family resilience and adaptation of caregivers of elderly patients with dementia, and further to identify factors influencing their adaptation. METHODS A cross-sectional descriptive study was designed. Data were collected from questionnaires distributed to 131 family caregivers of elderly patients who visited at the Centers for Dementia in Seoul during 2012~2013. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation analysis, and stepwise multiple regression. RESULTS The average age of the care giving subjects was 63.58, and 31.3% were male, and 41.2% were the spouses. Statistically significant relationships were found between burden and adaptation (r=-.38, p<.001), and between family resilience and adaptation (r=.52, p<.001), and between burden and family resilience (r=-.35, p=.001). Thirty percent of adaptation was explained by burden and family resilience. The most influencing factor to adaptation was family resilience which explained about 27% of the variance. CONCLUSION The results of the study clearly indicate that family resilience explains better than burden on adaptation of family caregivers. Thus, to develop more effective nursing intervention for family caregivers of elderly patients with dementia, it would be necessary to integrate family resilience in the programs. 27% is not that much and I wonder if we have to do more work to identify the factors that influence care giving.
PURPOSE The purpose of this study was to examine the training effectiveness and behavior towards the elderly of 180 caregiver trainees. METHODS Data were collected from five caregiver training institutions located in G city. All subjects were surveyed about the training effectiveness and behavior towards the elderly by using the Training Effectiveness Scale and the Behavior towards the Elderly Scale. Data were analyzed by SPSS/WIN 12.0 program. RESULTS The study subjects gained a training effectiveness score of 3.84 out of 5 points and a behavior towards the elderly score 3.40 out of 4 points. The training effectiveness differed significantly depending on subject's characteristics, intention to work as a caregiver, and hours of training. There were significant differences in behavior towards the elderly depending on their age and hours of training. The training effectiveness was significantly correlated with the level of behavior towards the elderly. CONCLUSION These findings demonstrated the necessity of developing a level of educational training that will help improve caregiver trainees' care by positively changing their behavior towards the elderly.
PURPOSE This study is to examine how dementia day care service affects fatigue, depression and life satisfaction of caregiver. METHODS: The study was conducted using a convenient sampling method from 6 Dementia Day Care Center in Incheon. Thirty nine primary caregivers answered the questionnaires. Pre-test was done before demented elders start using the dementia day care center and post-test was done five months after. Data were analyzed by using descriptive statistics and paired t-test. RESULTS: There was a significant difference in caregivers' fatigue level after using dementia day care service(t=2.188, p=.035). Results of subcategories were as follows; There was a significant difference in caregivers' physical fatigue level(t=2.270, p=.029) and psychological fatigue level(t=2.277, p=.029) after using dementia day care service. However, there was not significant difference in caregivers' neurological fatigue level(t=1.312, p=.197). There was a significant difference in caregivers' depression level(t=3.066, p=.004) and life satisfaction(t=-2.131, p=.040) after using dementia day care service. CONCLUSION: The results indicated that dementia day care service is helpful for family with demented elders. Therefore it is necessary to expand dementia day care center in terms of its size and numbers in order to support increasing number of demented elders and their families.
PURPOSE This study aimed to develop the first standardized education & training program for education of senile long-term care managers to improve the quality of senile long-term care service. METHODS The study developed programs through literature review, specialists' conference and interview with the linear approach from February, 2007 to May, 2007. RESULTS Senile long-term care managers should have qualification of 51 items in knowledge, 35 items in technology and 17 items in attitude. Total 8 subjects were education & training subjects of senile long-term care managers and the study proposed targets of each subject and education & training level divided into top, middle and bottom. Total education & training hours were composed of 70 hours in theory, 50 hours in practical technique and 40 hours in social welfare practice in agencies. CONCLUSION The study will contributed development of the first education & training programs for education of senile long-term care managers. Therefore, the study proposes that the study will be applied to a systematical education & training course through program verification after applying real programs to senile long-term care managers and that it is necessary to develop the standardized education & training program for higher senile long-term care managers.
PURPOSE The objective of this study was to define the predictors of health related quality of life(HRQoL) of women caregivers of the demented elderly patients. METHODS The subjects of this study were 140 pairs of patients with dementia and their caregivers. The characteristics of dementia patients and caregivers, Barthel index and SF-36 were measured in this study. T-test, ANOVA, Pearson correlation coefficient, and stepwise multiple regression were used for data analysis. RESULTS The health related quality of life(HRQoL) score of women caregivers was 288.35+/-66.10 for norm based scoring. HRQoL of women caregivers was correlated with patients' ADL, severity of dementia, caregivers' age, burden, and family support. The major factors that affected the physical components of women caregivers of patients with dementia was the age of the caregiver, burden, and ADL which explained 36.0% of HRQoL. The main predictors of women caregivers' emotional state was the caregiver's burden. CONCLUSION Patients' support systems must be implemented to improve the physical HRQoL of caregivers. A caregivers' burden relief program needs to be prepared to increase their emotional HRQoL and further studies and efforts will be needed to evaluate those effects.
PURPOSE This study was designed to systematically explore and elicit information about terminally ill cancer patients' and primary family caregivers' subjectivity of death. METHOD Using Q-methodology, 21 terminally ill cancer patients and 19 primary family caregivers sorted 40 statements during personal interviews. RESULTS The results of this study show that terminally ill cancer patients have four factors ('Attachment to life', 'Hope for heaven', 'Resignation to reality', 'Avoidance of pain') of response and primary caregivers have four factors('Dependence on religion', 'Faithfulness to reality', 'Obedience to fate', 'Agony of reality'). Comparing the subjectivities of death of terminally ill cancer patients and primary family caregivers, 'Hope for heaven' and 'Dependence on religion' reveal the similarities of their outlook. On the other hand, 'Attachment to life', 'Resignation to reality', 'Avoidance of pain', 'Faithfulness to reality', 'Obedience to fate', 'Agony of reality' reveals different aspects of their outlook. The group of terminally ill cancer patients and their families divided into four types. Type A was 'Attachment to life and Agony of reality', type B was 'Attachment to life and Obedience to fate', type C was 'Hope for heaven and Dependence on religion' and type D was 'Resignation to reality and Faithfulness to reality'. The positive group was C or 'Hope for heaven and Dependence on religion'. CONCLUSION There are significant differences found in the subjective structure of death among terminally ill cancer patients and primary family caregivers. Therefore, it is necessary to develop an individualized nursing intervention for terminally ill cancer patients and family caregivers.
PURPOSE This study investigated the effect of a structured group intervention on knowledge about lung cancer, self efficacy and quality of life for family caregivers of patients with lung cancer using a nonequivalent control group quasi-experimental design. METHODS Subjects were 11 family caregivers for both the control and the experimental group. The experimental group participated in once a week for 2-hour session for 4 weeks. Four topics of educational program were lung cancer and treatment, side effects of treatments, symptoms management, and health management. Every session consisted of lecture, sharing experiences, and meditating time. Quality of life was measured using Jang(1996)'s tool. The tools for knowledge and self-efficacy were developed by the authors. RESULTS After the intervention, the experimental group showed higher self-efficacy in caring for the patients than did the controls. However, there were no significant differences in knowledge about lung cancer and quality of life between the two groups. CONCLUSION Findings indicate that the group intervention would be effective for family caregivers of lung cancer patients.
PURPOSE The research aims to understand the lived experience of the caregivers of chronic renal failure(CRF) patients and its essential meaning. The results of the study can be used as basic materials for developing comprehensive intervention methods of care givers of CRF patients. METHOD: The research used van Manen's hermeneutic and phenomenological research methods in order to describe the lived experience and to understand its meaning. It concentrates on the understanding the essence of experience and consists of existential survey, hermeneutic and phenomenological reflection and hermeneutic writings. Participants in this research were five women care givers of CRF patients who had hemolysis at C university hospital in a metropolitan city, the period of data collection was from July 27 to Sep. 4, 2004 and major data of results in the following 5 essential themes. 'sole responsibility for the patient enduring everything', 'creating their own field', 'heavy and painful life without hope of their private life', 'wishing not to be inherited and consoling each other'. CONCLUSION: The above findings point out that the experience of care givers of CRF patient affected and changed all parts of an individual life and his or her family life. Therefore, it suggests that total family nursing care must be considered in order to provide the holistic caring for CRF patients and their care givers.
PURPOSE The purpose of the study is to investigate the correlation between burden, health status and well-being in spouse caregivers of patients with stroke. METHOD: The subjects of this study were 160 spouse caregivers registered at general hospital in Seoul and Seongnam. The data were collected from July 2th to October 30th, 2003. The Suh & Oh's burden scale, Yang's health status scale and Park's well-being scale were employed to measure burden, health status and wellbeing respectively. Collected data were analyzed using SPSS 12 version to obtain summary statistics for the descriptive analysis, Pearson Correlation, and Stepwise Multiple Regression. RESULTS: 1. The mean score of the degree of burden, health status and well-being were 3.52, 5.92 and 3.64 points. 2. The burden of the subjects were significantly negative correlated with psycho- logical health status(r=-.482. p<.01) and wellbeing(r=-.455, p<.01). 3. With the result of stepwise multiple regression, psychological health status and wellbeing were the main variables which could explain burden by 27.1%. CONCLUSION: The findings of this study will provide practical guidelines for developing emotional nursing interventions for the spouses taking care of CVA patients who would experience a heavy burden and distress.
PURPOSE The purpose of this Study was to identify the factors that affect the caregiving burdens felt by the female family caregivers and quality of caregiving. METHOD: The subjects were 247 female family caregivers who were living with the elderly and were residing in Seoul. Data was collected from June 30, 2000 to Agust 11 by using questionnaire. The collected data was analyzed using descriptive statistics and hierarchial multiple regression with SAS/PC. RESULT: Situational factors had the greatest influence on the caregiving burdens. While the interactive factors of discrepancy between past and present image of elder and the caregiving belief were proven to be significant, the former had greater influence. The factors affecting the quality of caregiving, this is greatly influenced by situational factors and interactive factors. The discrepancy between past and present image of elder had relatively little influence while caregiving belief had the greatest influence. Among the situational factors, family stress had the greatest influence, while the caregiving burdens had little influence on the quality of caregiving. CONCLUSION: In order to improve the quality of caregiving in elderly by the female caregiver in the family, and to reduce the caregiving burdens, it is important to consider variables related to interaction as well as those directly concerned with caregiver and the elderly for nursing intervention.
PURPOSE The purpose of this study is to identify the effects of telephonic counseling on burnout, depression, life satisfaction, and perceived physical health among family caregivers of older adults with dementia. METHOD Subjects were randomly assigned into telephonic counseling group (n=21) and the comparison group (n=32). A weekly telephone counseling was conducted by research assistants for 12 weeks. T-test were used to answer the research questions. RESULT 1) There were no significant differences between the two groups on the level of burnout, depression, life satisfaction, and perceived physical health after telephone counseling. 2) Spouse caregivers under the telephone counseling tended to report higher perceived physical health than comparison group at the post-test (t=-1.88, p=.08). Spouse caregivers under the telephone counseling tended to report higher emotional exhaustion and lower feeling of self achievement. 3) Daughter-in-law caregivers under telephone counseling showed increased feeling of self achievement, improved physical health condition, and decreased depression. CONCLUSION This study showed potential effects of the problem-solving telephone counseling to improve perceived physical health and to reduce the level of burnout and depression. The findings suggest the necessity of screening most vulnerable subgroups of caregivers to increase the effectiveness of nursing intervention such as telephone counseling.
PURPOSE The objectives for this study were to identify the factors that correlate with appraisal of illness and to explore what variables are predictive of cancer patients primary caregivers' cognitive appraisal for stress. METHOD The subjects were selected by convenient sampling and 130 caregivers who completed a questionnaire. Measures used in this study included the Family Inventory of Resources for Management, Social Support Index, Family Crisis Oriented Personal Evaluation Scales and Family Coping Coherence Index. Pearson correlation was used to identify the relationship among factors and multiple regression was used to determine the individual and cumulative effect of potential predictors on the caregivers' appraisal. RESULTS Patient's level of activity, severity of the disease, quality of relation between patient and caregiver, caregiver's subjective health status, economic status, family resources and coping were significantly correlated. Among the variables, coping, family resources, economic status and quality of relation between caregiver and patient predicted 49.2 percent of the variance in appraisal of caregivers' stress condition. CONCLUSION These findings suggest that coping mechanisms and family resources are important for positive appraisal. Nurses should provide adequate nursing care for the primary caregiver about professional care information and supportive counseling.
The purpose of this study was to identify correlation of stress, coping patterns and physical symptoms in cancer patient's caregiver. The stress was measured by VAS( Visual Analogue Scale). The coping methods were measured using the modified Ways of Coping Questionnaire by Yang (1998) and the actual physical symptoms were investigated. The phases of patient illness consisted of 1st (initial) stage, and 2nd (recurred) stage and 3rd (terminal) stage based on literature (Lewandowski & Jones, 1988). The data were collected by a survey conducted from March to July, 2000 and which included 196 cancer patients' caregivers from two hospitals in Seoul. The data were analyzed using paired t-test, unpaired t-test, ANOVA, Scheffe test and Pearson correlation coefficient. The results were as follows: 1. The average of caregivers' stress scores was 62.5. Problem-focused coping methods were significantly used more than emotion-focused coping methods by the cancer patients' caregiver. The mean number of caregivers' physical symptom was 1.03. 2. There were significantly high level of stress in women, those who were more than 60 years old, those who had a low education level, those who had no job, those who are patients' wives' and those who are terminal patients' caregiver. There were significantly low levels of coping in women, those who were more than 60 years old, those who had low education levels, those who had no job and those who are patients' wives. There were significantly higher number of physical symptoms in women, and those who have no job. 3. Caregivers' stress was significantly correlated to problem-focused coping methods (r=-.21, p=.006), and physical symptom (r=-.28, p=.0001). In conclusion, attempts to develop nursing interventions for cancer patients' caregiver in women, those who are more than 60 years old, with a low education level, have no job, and are cancer patients' wives could have an improvement on positive coping methods and provide relaxation from stress in the patients' experience.
The purpose of this study was to develop and validate the scale to measure dementia patient's caregiver burden of Korea. In the first phase of the study, 15 caregivers of dementia patients were interviewed to provide narrative data from which items were developed. Initially 65 items were generated from the interview data of 15 caregivers. Content validity was judged by two separate panels of experts with 27 professionals and 30 family caregivers. These items were analyzed through the Index of Content Validity and 33 items were selected which met .80 or more of the CVI. This preliminary FCBSD-K was tested with 207 adult caregivers for reliability and construct validity including item analysis and orthogonal(Varimax) factor analysis. Eight items were deleted because of high or low item-item correlation. The result of the second factor analysis produced six factors that coincided with the conceptual framework posed for the scale developed. The six factors were labeled as 'physio social factor' 'emotional factor' 'family cultural factor' 'role obligation' 'guilt feeling' and 'financial & supportive system factor'. The alpha coefficient relating to internal consistency was .9264 for reliability. In conclusion, cultural factor is related to dementia patient's caregiver burden and FCBSD-K was useful in assessing the dementia patient's caregiver burden in Korea.
This study examined burdens of primary family caregivers, and family functioning of patients with cancer. In addition, the relationship between two concepts was assessed to develop nursing intervention to reduce the burdens of caregiving, and to improve family functioning. Ninety-two primary family caregivers of patients with cancer at a general hospital in Seoul participated in this study. The patients with cancer aged from 19 to 84 years with a mean age of 51 years, and sixty-one percent were male. About 30 percent of the patients suffered liver and billiary tract cancer. Fifty-six percent of the primary family caregivers were spouses of the patients and 70.7 percent were women. Primary family caregivers' burdens were assessed by the Burden Scale originally developed by Zarit (1980) and Novak & Guest(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales: time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financial burden. Family functioning was assessed by the Family APGAR developed by Smilkstein(1978). The results were as follows: 1. The average burden score was 86.1, indicating a moderate level of burden. The time-dependent burden scored highest followed by developmental, physical, social, financial, and emotional burdens. The mean score of family APGAR was 9.71; among subjects 82.6% were included in dysfunctional families. 2. Of the characteristics of patients, age, gender, number of admissions, and job were found to be associated with the level of burden. There was no significant difference between patient characteristics and family functioning. Of the characteristics of primary family caregivers, caregiver's perception of patient prognosis was significantly related to the level of burden, and family functioning. Caregiver's sex and age were also related to family functioning. The quality of relationship between a patient and a caregiver was significant situational factors affecting the level of burden, and family functioning. In addition, the income of family, and help from other family members were related to the level of burden. Given the results, it is essential to develop nursing intervention to reduce burden and to improve family functioning, such as support groups.
The purpose of this research was to examine the effect of support group intervention on the various adaptations of primary family caregivers caring for Cerebro-Vascular Accident patients. The nonequivalent control group pretest- posttest design within the framework of Lazarus & Folkman's stress-adaptation model was used for this experimental study. The subjects were 86 primary family caregivers caring for Cerebro-Vascular Accident patients at K hospital in Taegu, D herbal hospital in Kyung Ju, H hospital in Pohang from March, 1998 to July, 1998. Among 86 subjects, 43 were placed in an experimental group and 43 in a control group. The experimental group was treated by researcher who administered informational and emotional support group intervention once a week over a five weeks period. The data were collected through interviews. Collected data was analized by means of a chi-square test, t-test, ANCOVA, and Pearson correlation coefficient. The results of this research were as follows: 1. Physical, emotional, and social adaptation scores in the experimental group were revealed to be significantly higher than those of the control group. 2. There was significant positive correlation among physical health, subjective burden, depression and objective burden. Accordingly, it is concluded that informational and emotional support group intervention was a useful nursing intervention on the various adaptations of primary family caregivers caring for Cerebro-Vascular Accident patients.
This longitudinal study examines the burdens and related factors for stroke patient's primary family caregivers. Sixty-one patients treated for stroke at a general hospital in Chung-nam province and family member caregivers participated in this study from July 28, 1998 to August 1, 1999. Family caregivers' burdens were assessed by the burden scale originally developed by Zarit(1980) and Novak &Geust(1989) and modified by Oh's(1993) for use in Korea. The burden scale instrument consists of five subscales.: financial burden, social burden, physical burden, dependency burden, and emotional burden. Repeated ANOVA and Stepwise multiple regression were used in the data analyses. The results were as follows: The burden mean score was 3.23 in the hospital, 3.26 after hospital release, and 3.27 in the home environment. In the hospital, a patient's degree of cognition, and social support for family caregivers were significant factors affecting the sense of burden felt by family caregivers. After hospital release, the significant factors affecting the sense of burden were the degree to which stroke patients could participate in daily living activities, social support for family caregivers, and changing to a second caregiver. In the home environment, the most significant factor affecting the sense of burden was social support for family caregivers.
The purpose of this study was to explore and describe the lived experience of the family caregivers with the demented elderly. For investigate purposes of this study, data collection was done from May 9th to October 16th 1997, by means of in-depth interviews with 6 individuals in caregiving families. The research question was "What are the lived experiences of being a family caregiver with the demented elderly? "All interviews were tape-recorded and transcribed for the analysis using Colaizzi's method. The main results of this study were as follows : 1) Family caregivers ascribed the cause of the dementia to 'environmental change' and the 'introverted personality of the elderly'. 2) Family caregivers let the demented elderly alone initially and then they restrained the elderly who was in a fit of dementia. 3) The coping response of family caregivers varied. The coping reponses were (1) having their moods go up and down, (2) enduring and praying, (3) avoiding the elderly, (4) hoping for release from responsibility, (5) enduring their conditions(obligations), (6) accepting the elderly, (7) taking an objective view, and (8) taking safety measures. 4) The long ordeal of coping with a demented elderly person resulted in the (1) loss of physical and psychological well-being, (2) ethical conflicts, (3) family conflicts, (4) become desperate, (5) rejection of the aging process, (6) sympathy and understanding for the elderly, (7) awareness that the support system is important and (8) hope of sharing their responsibility. The results of this study may help nurses to understand the lived experiences of the family caregivers with the demented elderly better, in order to provide more basic data for the development of educational programs for dementia family caregivers. It may help to make the coping process easier and more successful for the family members of the demented elderly.
Cancer has been the leading cause of death in this country and produces high levels of stress not only in the patients themselves but also in their families. Caregiving during serious illness is a new experience for many family caregivers and social support and coping strategies have been found to reduce unfavorable health outcomes to stressful events such as cancer. The purpose of this investigation was to identify the relationship of caregiving stress, coping methods, social support, and health in caregivers of patients with cancer according to the phases of cancer illness. The subjects were 92 primary cargivers of cancer patients based on their phases of illness that consisted of 1st (initial) stage, 2nd (metastatic or recurring) stage, 3rd (terminal) stage recruited from two general hospitals in Seoul and Choongnam. The mean age of subjects was 39.1 years and 64.1% of subjects were female and 72.8% were married. The relationships to the patient were children(50%) or spouses (45.7%). According as the phase of illness progressed, caregiver's stress rose higher and their health got worse but coping methods and social support did not show a significant change. In the 1st stage the major predictors for the health of caregivers were family network support(R2=0.261, p=0.003) and the stress of the caregivers (R2=0.168, P=0.007). In the 2nd stage the most important predictor for the health of the caregivers was the stress of the caregivers (R2=0.483, P=0.000). Also in the 3rd stage the main predictor for health was the stress of the caregivers (R2=0.381, p=0.006). A better understanding of the stress process in family caregivers is needed so that nurses can provide family-centered care, taking into account caregiver, as well as patient, well-being.
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