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The Relevance of Caregiver Burden, Depressive symptoms and Mental Related Quality of Life in a Stroke Patient's Caregiver

뇌졸중 환자 보호자의 부양부담감 및 우울감과 정신건강관련 삶의 질과의 관련성

  • Kim, Min-jeong (Cheong Ju Medical Center) ;
  • Kim, Young-Ran (Department of Radiology, Wonkwang Health Science University) ;
  • Jung, Jae-Hun (Department of Occupational therapy, Chungbuk Health Science university) ;
  • Lee, Tae-Yong (Department of Preventive Medicine and Public Health, Chungnam National University School of Medicine)
  • 김민정 (청주의료원) ;
  • 김영란 (원광보건대학교 방사선과) ;
  • 정재훈 (충북보건과학대학교 작업치료과) ;
  • 이태용 (충남대학교 의학전문대학원 예방의학교실)
  • Received : 2017.04.21
  • Accepted : 2017.07.07
  • Published : 2017.07.31

Abstract

Objective: This study examined the caregiver burden, depressive symptoms, and mental-related quality of life of 226 caregivers of stroke patients, who had been hospitalized in 7 general hospitals located in Cheongju and Daejeon Metropolitan city. Methods: Data were collected from August 5, 2014 to October 5, 2014 and a structured self-administered questionnaire was used. The results were analyzed using a t-test, ANOVA for different comparisons of the mental related quality of life in the sociodemographic characteristics, care-related characteristics, health-related behavioral characteristics, caregiver burden, and depressive symptoms. Hierarchical multiple regression was conducted to determine the explanatory power of the independent variables on the dependent variables, with the variables showing significant differences in univariate analysis as independent variables. Results: According to the results of hierarchical multiple regression analysis, the relevant factors that influenced the mental-related quality of life were the relationship with a patient, burden by 'care', burden by sacrifice of 'personal life', and depressive symptoms. Conclusion: To enhance health-related quality of life, not only is a systematic complement on such factors needed, but the development and implementation of an intervention program to the caregiver burden and depressive symptoms is also urgently required.

연구목적: 본 연구는 청주시와 대전광역시에 소재한 7개의 종합병원에서 뇌졸중으로 진단받은 입원환자의 보호자 226명을 대상으로 부양부담감 및 우울감과 정신관련 삶의 질을 파악하고자 조사하였다. 연구방법: 자료 수집은 2015년 8월 5일부터 10월 5일까지이며 구조화된 설문지로 자기기입식 설문조사를 하였다. 조사대상자의 인구사회학적 특성, 건강관련 행위 특성 및 간병관련 특성, 부양부담감, 우울감에 따른 정신건강관련 삶의 질의 평균점수 비교는 t-test 및 ANOVA로 검정하였다. 단변량 분석에서 유의한 차이를 보인 변수를 독립변수로 하여 종속변수에 대한 독립변수들의 단계별 투입에 따른 설명력을 파악하기 위하여 위계적 다중회귀분석(hierarchial multiple regression)을 실시하였다. 연구결과: 위계적 다중회귀분석 결과, 정신관련 삶의 질에 영향을 미치는 관련변수로는 환자와의 관계, '보호'에 대한 부담감, '개인적 희생'에 대한 부담감, 우울감이 유의한 변수로 선정되었다. 결론: 정신건강관련 삶의 질을 높이기 위해서는 건강관련행위특성, 간병관련 특성에 대한 제도적 보완과 더불어 부양부담감과 우울감을 적절하게 대응할 수 있는 중재프로그램의 개발 및 실시가 필요할 것으로 생각된다.

Keywords

References

  1. Statistics Korea. Http://sgis.kostat.go.kr/publicsmodel/, 2012.
  2. Kim S. K., Experience of family caregivers caring for the patients with stroke, Korean journal of nursing query, pp. 67-88, vol. 3, no. 1, 1994.
  3. Statistics Korea. Http://sgis. kostat.go.kr/publicsmodel/, 2002.
  4. Kim J. H. Kang H. S., Kim. W. O., Wang. M. J., Chang. C. M.,, Factors Affecting the Quality of Life in Stroke Patient at Home, Korean academic society of rehabilitation nursing, vol. 9, no. 1, pp. 49-55, 2006.
  5. Kim I. K., Yang S. H., A Study on the Burden and Coping Behaviors of Stroke Patients' Family Members, Journal of Korean Clinical Nursing Research, vol. 10, no. 1, pp. 28-41, 2004.
  6. Anderson C. S., Linto J, Stewart-Wynne EG. A population-based assessment of the impact and burden of caregiving for long-term stroke survivors. Stroke vol. 26, no. 5, pp. 843-849, 1995. DOI: https://doi.org/10.1161/01.STR.26.5.843
  7. Yoon H. S., Cha H.B., Cho Y.S., Factors Affecting Family Caregivers' Burden and Depression to Elderly with Stroke, The Korean Gerontological society, vol. 20, no. 2, pp. 137-153, 2000.
  8. Robert J. H., Rosemarie B. K., Allen WH, Partrick S., Accidents in Older caregivers of Persons Surviving Stroke and Their Relation to Caregiver Stress. Rehabil Psychol, vol. 51, no. 2, pp. 15-156, 2006.
  9. Kim E. Y., Shin E. Y., Kim Y. M., Caregiver Burden and Health-related Quality of Life Among Stroke Caregivers, J Korea Community Health Nursing Academic Society, vol. 18, no. 1, pp. 5-13, 2004. DOI: https://doi.org/10.4040/jkan.2004.34.1.5
  10. Han J. H., Park Y. H., Caregiver's Burden and Quality of Life of Male Spouses with Stroke Wives, The Journal of Korean Academic Society of Adult Nursing, vol. 24, no. 6, pp. 615-626, 2012. DOI: https://doi.org/10.7475/kjan.2012.24.6.615
  11. Han K. S., Kim S. Y., Lee S. J., Park E. S., Park Y. J., Kim J. H., Lee K. M., Kang H. C., Yeun. J. W., Family Functioning and Quality of Life of the Family Care-giver in Cancer Patients, Journal of Korean Academy of Nursing, vol. 36, no. 6, pp. 983-991, 2006. DOI: https://doi.org/10.4040/jkan.2006.36.6.983
  12. Jung Y. B., Park J. H., Burden and Depression among Family Caregivers of Stroke patients. Kyungpook National University, vol. 8, no. 1, pp. 105-116, 2004.
  13. Elisabeth T. P, Luc P. W, Lindwein M. S, Robbert S, Betty MJ. Risk factors for burn-out in caregivers of stroke patients and possibilities for intervention. Clin Rehabil vol. 15, no. 6, pp. 669-677, 2001. DOI: https://doi.org/10.1191/0269215501cr446oa
  14. Lee K. O., Yang H. Y., Family Caregiver Burden and Quality of Life According to the Levels of CVA Patient's Self-Care, The Korean Academy of Psychiatric and Mental Health Nursing, vol. 11, no. 2, pp. 192-205, 2002.
  15. Min Y. S., Yong J. S., Relationships Among Burden, Social Support and Quality of Life for the Family Caregiver of Hemodialysis Patients, The Korean Academy of Psychiatric and Mental Health Nursing, vol. 12, no. 3, pp. 358-366, 2003.
  16. Esther S. Family burden and quality of life. Qual Life Res vol. 12, no. 1, pp. 33-41, 2003. https://doi.org/10.1023/A:1023513218433
  17. Sawatzky R, Pamela AR, Johnson JL, Kopec JA, Zumbo BD. Self-reported physical and mental health status and quality of life in adolescents: a latent variable mediation model. Health Qual Life Outcomes 8, pp. 17-27, 2010. DOI: https://doi.org/10.1186/1477-7525-8-17
  18. Choi Y. J., A Study on Factors that Affect Quality of Life of the Elderly by Age, Hanyoung Theological University, 2008.
  19. Ware J. E., Kosinski M, Dewey J. E., Gandek B. How to Score and Interpret Single-Item Health Status Measure : A Manual for Users of the SF-8 Health Survey. Qaulity Metric Incorpotated, Lincoln(RI), 2001.
  20. Cho S. I. KLoSA, basic analysis report. Seoul: Korea Labor Institue, 2009.
  21. Statistics Korea. Http://sgis.kostat.go.kr/publicsmodel/, 2006.
  22. Van Swieten JC, Koudstaal PJ, Visser MC, Schouten H. J., van Gijn J., Interoobserver agreement for the assessment of handicap in stroke patients. Stroke 19, pp. 604-607, 1988. DOI: https://doi.org/10.1161/01.STR.19.5.604
  23. Vernooij-Dassen MJ, Persoon JM, Felling AJ. Predictors of sense of competence in primary caregivers of demented persons. Soc Sci Med vol. 43, no. 1, pp. 41-49, 1996. DOI: https://doi.org/10.1016/0277-9536(95)00332-0
  24. Choi S. M., Kim H. S., Kwon S. U., Kim J. S., Factors affecting the burden on caregivers of stroke survivors in South Korea. Arch Phys Med Rehabil 86, pp. 1054-1058, 2005.
  25. Kyum K. C., Sang C. C., Beyong C. Y., Integrated Adaptation of CES - D in Korea, Korean Psychological Association, vol. 6, no. 1, pp. 59-76, 2001.
  26. Craig T. J., Van Natta P. A., Prevalence and persistences of depression symptoms in patients and community populations. Am J Psychiatry, 133. pp. 1426-1429, 1979.
  27. Myers J. K., Weissman M. M., Use of a self-report symptom scale to detect depression in a community sample. Am J Psychiatry 137, pp. 1081-1084, 1980. DOI: https://doi.org/10.1176/ajp.137.9.1081
  28. Eaton W. W., Kessler L. G., Rates of symptoms of depression in a national sample. Am J Epidemiol 114, pp. 528-539, 1981. DOI: https://doi.org/10.1093/oxfordjournals.aje.a113218
  29. Moon S. J., Lee M, J. Yoon K. S., Lee S. C., Lee H. Y., Kim M. K., The Center for Epidemiologic Studies-Depression Scale(CES-D) : Its Use in Korea, J Korean Neuropsychiatr Assoc, vol. 30, no. 4, pp. 752-767, 1991.
  30. Cho M. J., Development of the Korean version of diagnostic instruments and epidemiological studies for major psychiatric disorders, Ministry of Health and Welfare, 2001.
  31. Lee E. H., Problem with the use of questionnaires published on Korean journal of adult nursing, Korean J Adult nurs, vol. 24, no. 5, pp. 439-440, 2012. DOI: https://doi.org/10.7475/kjan.2012.24.5.439
  32. David L. R., William EH, Virgina GW, Olivio JC, George H., Race and gender differences in perceived caregivers availability for community-dwelling middle-aged and older adult, Gerontologist, vol. 47, no. 6, pp. 721-729, 2007. DOI: https://doi.org/10.1093/geront/47.6.721
  33. Kao H. F., McHugh M. L., The role of caregiver gender and caregiver burden in nursing home placements for elderly Taiwanese survivors of stroke, Res Nurs Health, vol. 27, no. 2, pp. 121-134, 2004. DOI: https://doi.org/10.1002/nur.20007
  34. Vincent C, Desrosiers J, Landreville P, Demers L. Burden of caregivers of people with stroke: Evolution and predictors, Cerebrovas Dis, vol. 27, no. 5, pp. 456-464, 2009. DOI: https://doi.org/10.1159/000210092
  35. Shin S. I., Study on quality of life and burden of caregiving for primary caregiver of stroke patients, Dongguk University, 2014.
  36. Park Y. R., A study on burden in family caregivers and perceived family support in patients with stroke, Kyung Hee University, 2000.
  37. Eo J. M., A study on the burden and life quality of cancer patients' family members, Hanyang University, 2004.
  38. Heo Y.H., Burden in family caregivers of the elderly with diseases, Chungnam National University, 2003.
  39. Morimoty T, Schreiner AS, Asano H. Caregiver burden and heath related quality of life among Japanese stroke caregiver. Age Ageing vol. 32, no. 2, pp. 218-223, 2003. DOI: https://doi.org/10.1093/ageing/32.2.218
  40. Nir Z, Greenberger C, Bachner YG. Profile, burden, and quality of life of Israeli stroke survivor caregivers: a longitudinal study. J Neurosci Nurs vol. 41, no. 2, pp. 92-105, 2009. DOI: https://doi.org/10.1097/JNN.0b013e318193456b
  41. Park S. H., A Research on Husband's Experience who Care for Old Spouses with Stroke, Seoul Christian University, 2010.
  42. Kim N. H., Tae Y. S., Choi Y. S., Bae J. H., Influencing Factors on stress in Caregivers of Stroke Patients Beong Admitted in Rehabilitation Centers, Journal of the Korea Academia-Industrial, vol. 17, no. 2, pp. 188-201, 2016. DOI: https://doi.org/10.5762/KAIS.2016.17.2.188