• 한국노년학
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• 제38권3호
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• pp.501-519
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• 2018

본 연구의 목적은 초기 치매환자 가족 돌봄제공자의 공유 의사결정에 대한 인식을 탐색하는 데 있다. 이를 위해 서울시 3개 치매지원센터에 등록된 초기 치매환자를 돌보는 가족 돌봄제공자 12명(여성 8명, 평균연령=$71.4{\pm}10.4$세)을 대상으로 반 구조화된 개별 심층면담을 이용하여 수집된 자료에 대해 질적 내용분석을 시행하였다. 본 연구를 내용 분석한 결과 6개 범주, 17개의 하위 범주가 도출되었는데 구체적인 연구결과는 다음과 같다. 초기 치매환자 가족 돌봄제공자의 공유 의사결정에 관한 인식은 치매환자와의 의사소통 촉진 수단과 치매환자의 자율성 보장 수단, 치료 촉진 기회, 가족 돌봄제공자의 부담감 증가 원인, 치매환자와의 관계 악화 원인, 우선순위 변화에 따른 선택 사항의 여섯 가지 범주로 나타났다. 또한, 공유 의사결정의 상황과 시기 및 공유 의사결정에 대한 인식이 가족 돌봄제공자의 경험을 통해 만들어졌다는 점을 알 수 있었다. 따라서 치매 관련 교육 시 간접경험을 통해 공유 의사결정을 선택 사항으로 생각하는 가족 돌봄제공자들에게 공유 의사결정을 경험할 수 있는 기회 등을 제공하는 것이 공유 의사결정에 대한 인식 제고에 도움이 될 수 있을 것으로 사료된다. 이상 결과에 근거하여 초기 치매환자의 자기결정권 존중과 가족 돌봄제공자들의 부담감을 감소시키기 위해 공유 의사결정을 성공적으로 할 수 있는 실제적이고 총체적인 교육 프로그램의 개발 및 평가 연구를 제언한다.

• Journal of Hospice and Palliative Care
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• 제17권2호
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• pp.75-84
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• 2014

목적: 본 연구는 호스피스 환자 가족돌봄제공자의 수면의 질, 불안, 희망 및 건강상태의 관계를 확인하여 이들의 건강상태를 높이기 위한 중재를 위한 기초 자료를 제시하기 위함이다. 방법: 연구대상자는 D시에 소재한 3개 호스피스 병동에 입원한 환자를 주로 돌보는 가족 118명이다. 수집된 자료는 SPSS program version 18.0을 이용하여 서술통계, One-way ANOVA, Pearson correlation coefficients, 단계적 다중회귀분석 등을 실시하였다. 결과: 호스피스 환자의 가족돌봄제공자는 각각 4점 만점인 척도로 측정한 결과 수면의 질은 평균평점 2.55, 불안은 1.91, 희망은 2.78, 건강상태는 2.68로 나타났다. 회귀분석 결과 건강상태에 유의한 영향을 미치는 주요 요인은 수면의 질(${\beta}=0.526$), 성별(${\beta}=-0.195$), 불안(${\beta}=-0.232$) 및 희망(${\beta}=0.169$)으로 나타났다. 모형의 설명력은 59.8% (F=44.510, P<0.001)이었고, 그 중에서 수면의 질이 47.3%를 차지하였다. 결론: 결론적으로 호스피스 환자를 돌보고 있는 가족의 건강상태를 높이기 위해서 간호사는 수면의 질을 높이고, 불안을 감소시키고, 희망을 높이는 방안을 모색해야 할 것이다.

• 성인간호학회지
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• 제28권6호
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• pp.619-627
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• 2016

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.

• 대한간호학회지
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• 제48권4호
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• pp.454-464
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• 2018

Purpose: The purpose of this study was to identify factors influencing psychosocial well-being in family caregivers of patients with amyotrophic lateral sclerosis (ALS). Methods: A descriptive correlational design was used. The transactional model of stress and coping was used to investigate the psychosocial well-being of 137 family caregivers of patients with ALS. Data were collected through self-reported questionnaires from January to November 2016. Data were analyzed using an independent t-test, one-way ANOVA, Pearson's correlation, and hierarchical multiple regression analysis with the SPSS WIN 21.0 program. Results: The regression model had an adjusted $R^2$ of .49, which indicated that meaning-focused coping, social support, ALS patient-family caregiver relationship (especially a spousal relationship), and tracheostomy were significant predictors of caregivers' psychosocial well-being. Conclusion: Meaning-focused coping and social support significantly influenced caregivers' psychosocial well-being. Therefore, interventions to improve caregivers' psychosocial well-being must focus on increasing meaning-focused coping and social support resources.

• 성인간호학회지
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• 제26권6호
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• pp.603-613
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• 2014

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.

• 대한간호학회지
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• 제46권6호
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• pp.836-847
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• 2016

Purpose: The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. Methods: A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, $x^2$ test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Results: Presence of family caregiver distress was significantly associated with days of nurse visits (${\beta}$=-.89, p=<.001) and home helper visits (${\beta}$=-.53, p=.014). Level of caregiver distress was also significantly associated with days of nurse visits (${\beta}$=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. Conclusion: The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.

• 종양간호연구
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• 제12권2호
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• pp.186-193
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• 2012

Purpose: The purpose of this narrative study was to understand how family caregivers interpreted themselves life during caring for dying patients with gliobalstoma, and how they integrated these experiences into their personal biographies. Methods: Three family caregivers were recruited for the study. Data were collected through a series of audio-taped unstructured interviews and conversations with participants. The interviews and observation were conducted between October and November, 2011. Data were analyzed using psychosocial analytical methods that combined case based, in-depth staged analysis of narratives. Results: The life experiences of the family caregivers with a dying family member were summarized as, in their own voices, 'the repetition of gliobalstoma,' 'a smart patient,' 'being obsessed with rehabilitation treatment,' 'the frustration from nothing but just looking at the suffering of the patient,' and 'a stubborn son'. Conclusion: Caregiving was characterised by various roles and life changes from the moment of diagnosis. Family caregivers of brain tumor reported experiences similar to those described by caregivers of people with other cancers. What differed for this group was the rapidity of change and the need for immediate information and support to assist with caring for a person with high-grade glioma.

• 대한간호학회지
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• 제41권3호
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• pp.354-363
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• 2011

Purpose: The purpose of this cross-sectional study was to examine the relationship between characteristics of severe ALS patient-caregiver couples and health related quality of life (HRQoL) in family caregivers. Methods: The participants in this study were 89 pairs of ALS patients using ventilators and a family caregiver. The characteristics of the ALS patients and caregivers, Korean-Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised, Zarit Burden Interview and SF-36 were measured in this study. The data were collected from August 2008 to April 2009. Descriptive statistics, Pearson correlation coefficients, and canonical correlation were used for data analysis. Results: The physical component summary and mental component summary of the HRQoL score for family caregivers were $147.49{\pm}31.63$ and $129.09{\pm}35.83$, respectively. HRQoL for caregivers was related to characteristics of the ALS patient-caregiver couples, such as patient's gender, caregiver's age, gender, marital status, daily time spent in caregiving and burden with one significant canonical variable. The significant variate showed that the lower the age, the time spent in caregiving and the burden of caregivers, the higher the HRQoL of caregivers. Conclusion: The support systems for caregivers considering caregiver characteristics such as demographics and burden should be implemented to improve the HRQoL of caregivers.

• 재활간호학회지
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• 제5권1호
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• pp.27-37
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• 2002

During acute stages of hospitalized stroke patients, family caregivers face many challenges. They often experience emotional distress, social isolation, and financial constraints. However, the burden of caregiving of stroke patients in acute stages has never been studied properly. The purpose of this study was to investigate the factors related to the caregivers' burden with acute stroke. The subjects were 123 acute stroke patients and their caregivers who were admitted to neurology and neurosurgery units at Dan Kook University Hospital in Chung-Nam area. An interview was performed with the use of standardized questionnaire which included data pertaining to the patients/caregivers characteristics, caregiver burden (Modified Zarit's Burden Scale), and social support (Personal Resource Questionnaire). Our results showed that the mean burden score was 3.11, indicating high level of burden. Among the sub-domain scores, financial burden was the highest. In univariate analysis, the factors related to caregiver burdens were: inability to communicate between patients and caregiver(p<.001); low cognitive function of the patients(p<.001); low level of ADL(p<.001); the gender of caregiver(p<.001); the current employment status of caregivers(p<.01); the presence of social support for caregiver(p<.001); and the availability of alternative caregivers(p<.001). In multiple regression analysis, social support for family caregivers (87%), low level of patient's cognition (2%), availability of 2nd caregiver (1%), and gender of caregiver (female, 0.4%) were significant explanatory factors of overall burden. The caregivers' burden in acute stages during hospitalization following stroke was high. Recognition of high levels of caregivers' burden and those relating factors affecting caregiver burden may allow us to develop different nursing strategies to unload the level of burden for caregivers in acute stages of stroke.

• 가정간호학회지
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• 제29권2호
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• pp.153-164
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• 2022

Purpose: This is a concept analysis study to evaluate family caregivers' competence in caring for individuals with mental illness. Method: A hybrid model was used to analyze through three phases scoping literature review. with family caregivers of individuals with mental illness. In the final analysis stage, the concept of caregiving competence was defined. These attributes were derived by integrating stages. Results: The characteristics of caregiving competence were identified as requesting help from the surroundings, minimizing negative effects related to diseases, skilled care, and ability to utilize community resources. The results indicate a need to promote the integration of individuals with mental illness and their families into the community by maintaining productive care. Conclusion: This study improves the accuracy and validity of caregiving competence's concept measurements.