대한간호학회지 (Journal of Korean Academy of Nursing)

한국간호과학회 (Korean Society of Nursing Science)
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치매노인 주 돌봄제공자의 자기돌봄이 소진에 미치는 영향

Influence of Self-care on Burnout in Primary Family Caregiver of Person with Dementia

  • 투고 : 2020.11.26
  • 심사 : 2021.02.08
  • 발행 : 2021.04.30
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초록

Purpose: The purpose of this study was to identify the influence of self-care on burnout experienced by primary family caregivers of persons with dementia. Methods: The subjects of the study were 156 primary family caregivers of persons with dementia at home in Korea. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and hierarchical multiple regression using IBM SPSS Statistics ver. 24.0 for Windows. Results: The mean scores for self-care and burnout were 42.35 and 61.60, respectively. Self-care, subjective health status, living with a person with dementia, and behavioral and psychological symptoms of dementia were significant factors affecting burnout in family caregivers. Self-care was identified as the strongest factor affecting burnout, explaining 13.9% of burnout with controlling factors in caregivers and care receivers. Conclusion: To prevent burnout in primary family caregivers of persons with dementia, self-care of family caregivers should be emphasized. In nursing education, family caregivers should be recognized and approached as nursing clients who are responsible for taking care of their health. In nursing practice and research, digital self-care or self-care improvement intervention programs should be designed to help family caregivers, and further studies on self-care centered on health of family caregivers should be conducted.

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참고문헌

  1. National Institute of Dementia (NID). Korean dementia observatory 2019. Seoul: NID; 2020 Feb. Report No.: NIDR1902-0028.
  2. Shi H, Mao C, Tang J, Liang H. Research on the health of and interventions for family caregivers of people with dementia: A bibliometric analysis of research output during 1988-2018. BMC Geriatrics. 2020;20(1):20. https://doi.org/10.1186/s12877-020-1421-7
  3. Smith CW, Graves BA. Implementation and evaluation of a self-care toolkit for caregivers of families with dementia. Journal of the American Association of Nurse Practitioners. Forthcoming 2020 Jul 29. https://doi.org/10.1097/JXX.0000000000000469
  4. Pinyopornpanish M, Pinyopornpanish K, Soontornpun A, Tanprawate S, Nadsasarn A, Wongpakaran N, et al. Perceived stress and depressive symptoms not neuropsychiatric symptoms predict caregiver burden in Alzheimer's disease: A cross-sectional study. BMC Geriatrics. 2021;21(1):180. https://doi.org/10.1186/s12877-021-02136-7
  5. Wiegelmann H, Speller S, Verhaert LM, Schirra-Weirich L, Wolf-Ostermann K. Psychosocial interventions to support the mental health of informal caregivers of persons living with dementia - a systematic literature review. BMC Geriatrics. 2021;21(1):94. https://doi.org/10.1186/s12877-021-02020-4
  6. Moreno-Camara S, Palomino-Moral PA, Moral-Fernandez L, Frias-Osuna A, Parra-Anguita L, Del-Pino-Casado R. Perceived needs of the family caregivers of people with dementia in a Mediterranean Setting: A qualitative study. International Journal of Environmental Research and Public Health. 2019;16(6):993. https://doi.org/10.3390/ijerph16060993
  7. Dall'Ora C, Ball J, Reinius M, Griffiths P. Burnout in nursing: A theoretical review. Human Resources for Health. 2020;18(1):41. https://doi.org/10.1186/s12960-020-00469-9
  8. Joling KJ, O'Dwyer ST, Hertogh CMPM, van Hout HPJ. The occurrence and persistence of thoughts of suicide, self-harm and death in family caregivers of people with dementia: A longitudinal data analysis over 2 years. International Journal of Geriatric Psychiatry. 2018;33(2):263-270. https://doi.org/10.1002/gps.4708
  9. Anderson JG, Eppes A, O'Dwyer ST. "Like death is near": Expressions of suicidal and homicidal ideation in the blog posts of family caregivers of people with dementia. Behavioral Sciences. 2019;9(3):22. https://doi.org/10.3390/bs9030022
  10. Chiao CY, Wu HS, Hsiao CY. Caregiver burden for informal caregivers of patients with dementia: A systematic review. International Nursing Review. 2015;62(3):340-350. https://doi.org/10.1111/inr.12194
  11. Bastawrous M. Caregiver burden-a critical discussion. International Journal of Nursing Studies. 2013;50(3):431-441. https://doi.org/10.1016/j.ijnurstu.2012.10.005
  12. Unson C, Flynn D, Glendon MA, Haymes E, Sancho D. Dementia and caregiver stress: An application of the reconceptualized uncertainty in illness theory. Issues in Mental Health Nursing. 2015;36(6):439-446. https://doi.org/10.3109/01612840.2014.993052
  13. Son JY. Effect of self-care by elderly women who take part in sports for all on health promotion act and successful aging awareness. Journal of Korean Association of Physical Education and Sport for Girls and Women. 2020;34(1):51-70. https://doi.org/10.16915/jkapesgw.2020.3.34.1.51
  14. Kim JE, Choi HK. The effects of self-care activities on the physical and mental health of primary caregivers of functionally impaired elderly. Korean Journal of Family Social Work. 2017;(55):157-188. https://doi.org/10.16975/kjfsw.2017..55.006
  15. Orem DE. A concept of self-care for the rehabilitation client. Rehabilitation Nursing. 1985;10(3):33-36. https://doi.org/10.1002/j.2048-7940.1985.tb00428.x
  16. Lu YY, Austrom MG. Distress responses and self-care behaviors in dementia family caregivers with high and low depressed mood. Journal of the American Psychiatric Nurses Association. 2005;11(4):231-240. https://doi.org/10.1177/1078390305281422
  17. Kim HJ, Choi KH, Kim SH, Cummings JL, Yang DW. Validation study of the Korean version of the brief clinical form of the neuropsychiatric inventory. Dementia and Geriatric Cognitive Disorders Extra. 2016;6(2):214-221. https://doi.org/10.1159/000445828
  18. Cerrato J, Cifre E. Gender inequality in household chores and work-family conflict. Frontiers in Psychology. 2018;9:1330. https://doi.org/10.3389/fpsyg.2018.01330
  19. Yang JO, Lee HK. Factors influencing burnout in primary family caregivers of hospital-based home care patients. Journal of Korean Academy of Community Health Nursing. 2018;29(1):54-64. https://doi.org/10.12799/jkachn.2018.29.1.54
  20. Gilhooly KJ, Gilhooly ML, Sullivan MP, McIntyre A, Wilson L, Harding E, et al. A meta-review of stress, coping and interventions in dementia and dementia caregiving. BMC Geriatrics. 2016;16:106. https://doi.org/10.1186/s12877-016-0280-8
  21. Garre-Olmo J, Vilalta-Franch J, Calvo-Perxas L, Lopez-Pousa S. A path analysis of dependence and quality of life in Alzheimer's disease. American Journal of Alzheimer's Disease & Other Dementias. 2017;32(2):108-115. https://doi.org/10.1177/1533317516688297
  22. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York (NY): Springer Publishing Company; 1984. p. 305.
  23. Ausar K, Lekhak N, Candela L. Nurse spiritual self-care: A scoping review. Nursing Outlook. Forthcoming 2021 Mar 6. https://doi.org/10.1016/j.outlook.2021.01.015
  24. Plath AM, Fickling MJ. Task-oriented self-care: An innovative approach to wellness for counselors. Journal of Creativity in Mental Health. Forthcoming 2020 Nov 7. https://doi.org/10.1080/15401383.2020.1842274
  25. Epps F, Skemp L, Specht JK. How do we promote health?: From the words of African American older adults with dementia and their family members. Research in Gerontological Nursing. 2016;9(6):278-287. https://doi.org/10.3928/19404921-20160928-01
  26. Lu YY, Wykle M. Relationships between caregiver stress and self-care behaviors in response to symptoms. Clinical Nursing Research. 2007;16(1):29-43. https://doi.org/10.1177/1054773806295238
  27. Joo KB, Kim KB. A study of care burden, burnout, and quality of life among family caregivers for the elderly. Korean Journal of Women Health Nursing. 2008;14(4):278-289. https://doi.org/10.4069/kjwhn.2008.14.4.278
  28. Kim JS, Lee HJ, Kim KR. Caregiving appraisal, burnout and coping strategies according to the types of family relationship. Journal of the Korea Gerontological Society. 2004;24(4):39-51.
  29. Lee SH, Choi HK. Factors affecting subjective burden and objective burden of family caregivers in dementia patients. Proceedings of the 2017 Spring Conference of KGS; 2017 May 26; Seoul. Seoul: Korea Gerontological Society; c2017. p. 271-273.
  30. Kang CM, Kim JS, Jeong JH. Factors influencing quality of caregiving by caregivers for elders with dementia. Journal of Korean Academy of Community Health Nursing. 2016;27(3): 193-201. https://doi.org/10.12799/jkachn.2016.27.3.193
  31. Hong MJ, Tae YS, Noh MY. Relationships between stress, ways of coping and burnout of family caregivers of cancer patients. Asian Oncology Nursing. 2012;12(1):92-99. https://doi.org/10.5388/aon.2012.12.1.92
  32. Kim TH, Jhoo JH, Park JH, Kim JL, Ryu SH, Moon SW, et al. Korean version of mini mental status examination for dementia screening and its' short form. Psychiatry Investigation. 2010;7(2):102-108. https://doi.org/10.4306/pi.2010.7.2.102
  33. Hwang IH, Oh DH. Questionnaires for assessing stress and mental health. Hanyang Medical Reviews. 2014;34(2):91-95. https://doi.org/10.7599/hmr.2014.34.2.91
  34. Stern Y, Albert SM, Sano M, Richards M, Miller L, Folstein M, et al. Assessing patient dependence in Alzheimer's disease. Journal of Gerontology. 1994;49(5):M216-M222. https://doi.org/10.1093/geronj/49.5.m216
  35. Sousa VD, Zauszniewski JA, Bergquist-Beringer S, Musil CM, Neese JB, Jaber AF. Reliability, validity and factor structure of the Appraisal of Self-Care Agency Scale-Revised (ASAS-R). Journal of Evaluation in Clinical Practice. 2010;16(6):1031-1040. https://doi.org/10.1111/j.1365-2753.2009.01242.x
  36. Pines AM, Aronson E, Kafry D. Burnout: From tedium to personal growth. New York: The Free Press; 1981. p. 37-38.
  37. Ahn EJ, Lee YS. Burnout and burden of family care-givers for caring of terminal patients with cancer. Asian Oncology Nursing. 2005;5(1):40-51.
  38. Kim KB, Sung JM, Sok SR. A study on the health status, burnout, and burden of primary family caregivers of the elderly in-patients. Journal of Korean Academy of Community Health Nursing. 2008;19(2):216-225.
  39. Kim AJ, Choi EJ. Factors affecting the quality of life of family with terminal cancer patients hospitalized in hospice institutions. Journal of East-West Nursing Research. 2019;25(1):50-59. https://doi.org/10.14370/jewnr.2019.25.1.50
  40. Park MJ, Park SH, Chung MY. Factors affecting caregivers' burnout caring for a family member in an intensive care unit. Korean Journal of Adult Nursing. 2017;29(5):517-526. https://doi.org/10.7475/kjan.2017.29.5.517
  41. Yoon KA. Effects of caregiving burden on gain and family quality of life among dementia family caregivers: The moderating role of coping strategies. Korean Journal of Gerontological Social Welfare. 2017;72(1):257-282. https://doi.org/10.21194/kjgsw.72.1.201703.257
  42. Song MR, Lee YM, Cheon SH. An analysis of the meaning of respite for family caregivers of elderly with dementia. Journal of Korean Academy of Nursing. 2010;40(4):482-492. https://doi.org/10.4040/jkan.2010.40.4.482
  43. Hammar LM, Williams CL, Meranius MS, McKee K. Being 'alone' striving for belonging and adaption in a new reality - the experiences of spouse carers of persons with dementia. Dementia. 2021;20(1):273-290. https://doi.org/10.1177/1471301219879343
  44. World Health Organization (WHO). Self-care health interventions [Internet]. Geneva: WHO; c2020 [cited 2021 Jan 20]. Available from: http://www.who.int/news-room/factsheets/detail/self-care-health-interventions.
  45. Choi JH, Lee JY. Factors influencing the family burden of taking care of elderly with dementia. Journal of Korean Home Management Association. 2018;36(3):91-101. https://doi.org/10.7466/JKHMA.2018.36.3.91
  46. Truzzi A, Valente L, Ulstein I, Engelhardt E, Laks J, Engedal K. Burnout in familial caregivers of patients with dementia. Revista Brasileira de Psiquiatria. 2012;34(4):405-412. https://doi.org/10.1016/j.rbp.2012.02.006
  47. Toot S, Swinson T, Devine M, Challis D, Orrell M. Causes of nursing home placement for older people with dementia: A systematic review and meta-analysis. International Psychogeriatrics. 2017;29(2):195-208. https://doi.org/10.1017/S1041610216001654
  48. Isik AT, Soysal P, Solmi M, Veronese N. Bidirectional relationship between caregiver burden and neuropsychiatric symptoms in patients with Alzheimer's disease: A narrative review. International Journal of Geriatric Psychiatry. 2019; 34(9):1326-1334. https://doi.org/10.1002/gps.4965
  49. Algase DL, Beck C, Kolanowski A, Whall A, Berent S, Richards K, et al. Need-driven dementia-compromised behavior: An alternative view of disruptive behavior. American Journal of Alzheimer's Disease. 1996;11(6):10-19. https://doi.org/10.1177/153331759601100603
  50. Tretteteig S, Vatne S, Rokstad AMM. Meaning in family caregiving for people with dementia: A narrative study about relationships, values, and motivation, and how day care influences these factors. Journal of Multidisciplinary Healthcare. 2017;10:445-455. https://doi.org/10.2147/JMDH.S151507