Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
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Factors Related to Family Caregivers' Burden with the Community-Dwelling Disabled Elderly under the Long-Term Care Insurance System

장기요양 재가서비스 이용자를 돌보는 가족주부양자의 부양부담감에 영향을 미치는 요인

  • Han, Eun-Jeong (Institute for Health Insurance Policy Research, National Health Insurance Service) ;
  • Lee, Jung-Myun (Institute for Health Insurance Policy Research, National Health Insurance Service) ;
  • Kwon, Jin-Hee (Institute for Health Insurance Policy Research, National Health Insurance Service) ;
  • Shin, Seul-Bi (Institute for Health Insurance Policy Research, National Health Insurance Service) ;
  • Lee, Jung-Suk (Institute for Health Insurance Policy Research, National Health Insurance Service)
  • 한은정 (국민건강보험공단 건강보험정책연구원) ;
  • 이정면 (국민건강보험공단 건강보험정책연구원) ;
  • 권진희 (국민건강보험공단 건강보험정책연구원) ;
  • 신슬비 (국민건강보험공단 건강보험정책연구원) ;
  • 이정석 (국민건강보험공단 건강보험정책연구원)
  • Received : 2013.07.12
  • Accepted : 2014.03.20
  • Published : 2014.03.31
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Abstract

Background: Informal care is increasingly recognized as placing a significant burden on the lives of family caregivers. The purpose of this study is to investigate factors related to family caregivers' burden with the community-dwelling disabled elderly under the long-term care insurance system, using the Stress Process Model developed by Pearlin (1990). Methods: Total 1,233 family caregivers with the disabled elderly, using the long-term care services in their home from May to June 2009, completed questionnaires finally. The questionnaire of this study consists of a total of 32 questions, including 11 questions related to background and context, 17 questions related to objective stressors, and 4 questions related to coping resourses. Family caregivers' burden is measured by the Korean Revised Caregiving Appraisal Scale (K-RCAS, Cronbach's alpha=0.86). To investigate factors related to family caregivers' burden, multiple regression analysis was conducted. Results: The average score of caregivers' burden was 22.0 (${\pm}6.12$). In multiple regression analysis, there were statistically significant factors affecting on the family caregivers' burden, that are related to background and context (region, living status, education level, relationship with beneficiary), objective stressors (duration of caregiving), coping resourses (caregiver's health status). Conclusion: This study found that family caregivers experience a considerable burden. The findings suggest that policies must be taken to relieve family caregivers of their duties temporarily, and to support them with counselling and education.

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References

  1. Zarit SH, Todd PA, Zarit JM. Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist 1986;26(3):260-266. https://doi.org/10.1093/geront/26.3.260
  2. Campbell RL. Predictors of caregiver burden over a three month period following hospitalization of the patient [dissertation]. Philadelphia (PA): The University of Pennsylvania; 2001.
  3. Amirkhanyan AA, Wolf DA. Caregiver stress and noncaregiver stress: exploring the pathways of psychiatric morbidity. Gerontologist 2003;43 (6):817-827. https://doi.org/10.1093/geront/43.6.817
  4. Lee YM, Yoo IY. Care burden, depression and social welfare service utilization among family caregiver for demented elderly. J Korean Gerontol Soc 2005;25(3):111-121.
  5. Lee CJ, Lim BW. Effect on the life's quality of the long-term care service delivery system: focused on family caregivers' burden with the community-dwelling the disabled elderly under the long-term care insurance system. J Korean Policy Stud 2011;11(2):265-283.
  6. Lee HJ. Caregiver burden in caring for elders before and after long-term care service in Korea. J Korean Acad Nurs 2012;42(2):236-247. https://doi.org/10.4040/jkan.2012.42.2.236
  7. Lee YS, Suh MJ. A study on the family burden of chronically ill patient at hospital. Seoul J Nurs 1994;8(1):17-32.
  8. Han SE. A study on the determining factors of utilizing the nursing home. J Korean Acad Community Health Nurs 2001;12(3):582-588.
  9. Savundranayagam MY, Montgomery RJ, Kosloski K. A dimensional analysis of caregiver burden among spouses and adult children. Gerontologist 2011;51(3):321-331. https://doi.org/10.1093/geront/gnq102
  10. Act on Long-Term Care Insurance for Senior Citizens, Law No. 12067 (Aug 13, 2013).
  11. Kim CW. Performance analysis of implementing long-term care insurance: social performance of long-term care insurance. Seoul: Korea Institute of Public Finance, Ministry of Heath and Welfare; 2011.
  12. National Health Insurance Service. The level of awareness, satisfaction and opinion on long-term care insurance research report. Seoul: National Health Insurance Service; 2011.
  13. Seomun JH, Jung YJ. A qualitative study on caregivers' burden experiences for the long-term care qualified elderly. J Soc Sci Stud 2011;22(4):3-30.
  14. Han EJ, Lee JS, Kwon JH. Factors related to family caregiver financial burden of out-of pocket expenses for the nursing home service under long-term care insurance system. Korean J Health Policy Admin 2012; 22(3):383-402. https://doi.org/10.4332/KJHPA.2012.22.3.383
  15. Park CJ, Lee SJ. The family caregivers' stress pathways by types of long-term care services for the elderly. J Korean Gerontol Soc 2011;31(3):831-848.
  16. Kim YT, Cho DH. Effect on the care giving burden in terms of family relation's satisfaction of client's family of long-term care insurance: focused on the home based service. J Welf Aged 2012;56:115-136.
  17. Lee YW, Kim HS, Cho IS. Factors influencing care burdens of caregivers of elders with dementia who request dementia domiciliary welfare services. J Korean Acad Fundam Nurs 2008;15(3):274-283.
  18. Hannum Rose J, Bowman KF, O'Toole EE, Abbott K, Love TE, Thomas C, et al. Caregiver objective burden and assessments of patient-centered, family-focused care for frail elderly veterans. Gerontologist 2007;47(1): 21-33. https://doi.org/10.1093/geront/47.1.21
  19. Lee EH. Impact of family function in the burden of the caregiving elderly dimentia patients. J Welf Aged 2003;19:173-197.
  20. Lee JY, Kim YA. Relationship between family burden, family support depression, and satisfaction of the elderly caregiver. J Korean Acad Community Health Nurs 2009;20(1):41-48.
  21. Song MY, Choe GG. Buffering effects community-based service on primary care-giver's burden for senile dementia elderly. J Korean Gerontol Soc 2007;27(4):987-1014.
  22. Son YJ, Kang KS, Kim SJ. The home care need and the burden of a primary family care giver with senile dementia patients. J Korean Acad Community Health Nurs 2000;11(2):423-440.
  23. Han GH, Son JY. The effects of motives for caregiving and family relationship quality on caregiving burden/reward of the spouse caregivers of frail elderly in Korea: a focus on gender differences. Fam Cult 2009;21(2): 81-109. https://doi.org/10.21478/family.21.2.200906.004
  24. Nakagawa Y, Nasu S. Association between components of family caregivers' sense of burden and types of paid care services provided in Japan. Aging Ment Health 2011;15(6):687-701. https://doi.org/10.1080/13607863.2011.562181
  25. Lee SB. Effect on burden of families taking care of families who use long-term care insurance service [master's thesis]. Seoul: Dongguk University; 2012.
  26. Pearlin LI, Mullan JT, Semple SJ, Skaff MM. Caregiving and the stress process: an overview of concepts and their measures. Gerontologist 1990; 30(5):583-594. https://doi.org/10.1093/geront/30.5.583
  27. Schumacher KL, Dodd MJ, Paul SM. The stress process in family caregivers of persons receiving chemotherapy. Res Nurs Health 1993;16 (6):395-404. https://doi.org/10.1002/nur.4770160603
  28. Lee J, Friedmann E, Picot SJ, Thomas SA, Kim CJ. Korean version of the revised Caregiving Appraisal Scale: a translation and validation study. J Adv Nurs 2007;59(4):407-415. https://doi.org/10.1111/j.1365-2648.2007.04346.x
  29. Lawton MP, Moss M, Hoffman C, Perkinson M. Two transitions in daughters' caregiving careers. Gerontologist 2000;40(4):437-448. https://doi.org/10.1093/geront/40.4.437
  30. Bien B, Wojszel B, Sikorska-Simmons E. Rural and urban caregivers for older adults in Poland: perceptions of positive and negative impact of caregiving. Int J Aging Hum Dev 2007;65(3):185-202. https://doi.org/10.2190/AG.65.3.a
  31. Bedard M, Koivuranta A, Stuckey A. Health impact on caregivers of providing informal care to a cognitively impaired older adult: rural versus urban settings. Can J Rural Med 2004;9(1):15-23.
  32. Kivett VR, Stevenson MI, Zwane C. Very-old rural adults: functional status and social support. J Appl Gerontol 2000;19(1);58-77. https://doi.org/10.1177/073346480001900104
  33. Dwyer MC, Miller RW. Using GIS to assess urban tree canopy benefits and surrounding greenspace distributions. Urbana: International Society of Arboriculture; 1990.
  34. Lee MA. Rural-urban differences in factors affecting caregivers' burden of impaired elders in Korea. J Welf Aged 2009;44:71-88.
  35. Arai Y, Kumamoto K, Washio M, Ueda T, Miura H, Kudo AK. Factors related to feelings of burden among caregivers looking after impaired elderly in Japan under the Long-Term Care insurance system. Psychiatry Clin Neurosci 2004;58:396-402. https://doi.org/10.1111/j.1440-1819.2004.01274.x
  36. Yoon HS, Cha HB, Cho YS. Factors affecting family caregivers' burden and depression to elderly with stroke. J Korean Gerontol Soc 2000;20 (2): 137-153.
  37. Kim KS, Kim BJ, Kim KH, Choe MA, Yi MS, Hah YS, et al. Kwon SH. Subjective and objective caregiver burden in Parkinson's Disease. J Korean Acad Nurs 2007;37(2):242-248. https://doi.org/10.4040/jkan.2007.37.2.242
  38. Seol Y. Analysis on recent trend of polarization and inequality: approach using household demographics. Seoul: Korea Economic Research Institute; 2009.
  39. Sung MJ, Kim JM. Income inequality and redistribution policies based on sectoral studies in Korea. Seoul: Korea Institute of Public Finance; 2004.
  40. Rhee, KO, Lee, MJ. A study on caregiving burden among family caregivers of impaired elderly. J Korean Gerontol Soc 2000;20(2):215-228.
  41. Han GH, Lee SY. The effect of motivation and social support on burden of spouse caregivers: focused on gender differences. J Korean Gerontol Soc 2009;29(2):683-699.
  42. Bang SH, Jang HJ. Activities of daily living of the elderly with a chronic disease and burden on family care-givers. J Korean Acad Nurs 2007; 37(1):135-144. https://doi.org/10.4040/jkan.2007.37.1.135
  43. Monahan DJ, Hooker K. Health of spouse caregivers of dementia patients: the role of personality and social support. Soc Work 1995;40(3): 305-314.
  44. Kumamoto K, Arai Y, Zarit SH. Use of home care services effectively reduces feelings of burden among family caregivers of disabled elderly in Japan: preliminary results. Int J Geriatr Psychiatry 2006;21(2):163-170. https://doi.org/10.1002/gps.1445
  45. Lim JS, Hyun KR, Lee HY. Informal care activation plan for the development of long-term care systems. Seoul: National Health Insurance Service; 2011.
  46. Han EJ, Lee JM, Cho JW, Kim DH. Improvement plan on supportive system of long-term care services utilization. Seoul: National Health Insurance Service;2012.
  47. Kwon JD. Research on the demented elderly in Korea. Seoul: Hong Ik Je Publisher;1999.

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