• 대한간호
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• 제35권4호
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• pp.32-36
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• 1996

• 아동간호학회:학술대회논문집
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• 아동간호학회 1997년도 하계학술연찬회
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• pp.43-49
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• 1997

• Child Health Nursing Research
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• 제7권4호
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• pp.494-510
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• 2001

As a family respond to any stressful situation as a whole system, cancer diagnosis of a child, as a serious life event, could be emotional shock to destroy homeostasis of the family system. A family has a resilient capacity to adjust and adapt to stressful events. Previous studies have been focused on family stress and adaptation, but little attention has been given to family value as one of resilient factors. The data for model testing were collected from July 18, 2000 to August 30, 2000 and the analysis included 309 parents of children who are diagnosed as cancer, 18 or less years of age, and treated either hospitalized or at the outpatient clinics. The data analysis utilized SAS 6.12 and LISREL 8 for descriptive statistics, correlation, cluster analysis, factor analysis, and LISREL. The study findings are as follows. 1) Monthly income (γ=-0.28, t=-5.81) was the most important factor to explain family strain along with family support (γ=-0.11, t=-2.43), severity of children's illness (γ=0.26, t=5.22), and family stressor (γ=0.22, t=4.62). All of these factors together explained 40％ of variance in family strain. 2) Among general family value, the relationship with the parents (γ=0.28, t=4.89) and relationship with the children (γ=0.20, t=3.60) showed positive effects to family value for cancer children, while relationship with the spouse (γ=-0.19, t=-3.22) and the age of the cancer children (γ=-0.11, t=-2.21) showed negative effects. These predictors together explained 22％ of variance in family value for cancer children. 3) Family hardiness was explained mostly by family strain (γ=-0.53, t=-8.65) along with direct negative effects of family persistency and indirect negative effects of severity of children's illness, family stressor, relationship with the spouse, and the children's age. Family value for cancer children was the most important predictor with positive effect (γ=0.44, t=6.76) along with indirect effects of monthly income, relationship with the parents, relationship with the children, support from family and significant others, and confidence with the health professionals. 51％ of variance in family hardiness was explained by all of these predictors. 4) The most important predictor for family adaptation was family stressor (γ=-0.50, t=-6.85) with direct and indirect negative effects along with the severity of children's illness (γ=-0.27, t=-5.21). However, family value for cancer children showed compromised total effect (γ=-0.13, t=-1.99) with negative direct effects (γ=-0.28, t=-3.43) and positive indirect effects (γ=0.14, t=3.01). Similarly, confidence with the health professionals also showed compromised total effect (γ=0.09, t=1.99) with positive direct effects and negative indirect effects. Family hardiness showed the biggest positive direct effects while other factors such as monthly income, family stressor, family persistence, support of family and significant others, relationship with the parents, relationship with the children, and relationship with the spouse, and children's age showed indirect effects only. 39％ of variance in family adaptation was explained by all of these predictors.

• Child Health Nursing Research
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• 제7권2호
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• pp.179-190
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• 2001

The purposes of the study were to develop an instrument for family value and to identify the relationships of family value, family hardiness, and family adaptation by appling the family value scale to family with cancer children. The study was conducted in three phases. 1) A survey was conducted from July 20 to August 20, 1999 and 18 items of general family value scale was modified from the data of 153 fathers and 164 mothers. 2) In-depth interviews were made with 29 parents of cancer children from April 20, 1998 to May 20, 1999 to develop family value scale with cancer children, and 12 statements were developed. 3) The final survey was conducted from July 18, 2000 to August 30, 2000 and the data from 309 parents of children who are diagnosed as cancer, 18 or less years of age, and treated either hospitalized or at the outpatient clinics were analyzed to identify the relationships of the concepts. The data analysis utilized SAS 6.12 and LISREL 8 for descriptive statistics, correlation, and Regression for path analysis. The study findings are as follows. The psychometric testing of general family value scale was Cronbach's alpha = 0.78. The reliability of the family value scale with cancer children showed the reliability as Cronbach's alpha = 0.73. Demographic characteristics showing significant correlations were cancer children's age, period of illness, period after completing treatment, mother's age, mother's education level, monthly income, payment type, confidence with health professional, and severity of children's illness. The correlation coefficients among major variables showed that family stressor was positively related with family strains(r=0.33, p<.001), and negatively related with family hardiness(r=-0.21, p<.001). Family strains was negatively related with family hardiness(r= -0.41, p<.001) and family adaptation(r=-0.46, p<.001). Correlations of family hardiness was positive with family value with cancer children(r=-0.31, p<.001), and negative with general family value(r=-0.16, p<.01). Family hardiness was positively related with family adaptation(r=0.35, p<.001). The causal relationship between study variables showed that family strains predicts general family value(γ=0.12, t=2.02), family value with cancer children predicts family hardiness(γ=0.31, t=6.30), family strains predicts family hardiness(γ=-0.40, t=-7.70), family value with cancer children predicts family adaptation(γ=-0.23, t=-4.11), and family hardiness predicts family adaptation(γ=0.43, t=7.78).

• Child Health Nursing Research
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• 제7권3호
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• pp.322-341
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• 2001

The family value is expected to play a crucial role in adjusting a new environment for the family, especially in the critical situation as having a child with cancer in the family. The purpose of the study was to analyze the family values of the family with cancer children in order to offer descriptive data, which will facilitate family adjustment with cancer children. The survey was conducted from July 18, 2000 to August 30, 2000 and the analysis included 309 parents of the children who have been diagnosed as cancer, 18 years of age or less, and treated either hospitalized or at the outpatient clinics. Two instruments were used to measure family value. The modified form of General family value scale was 18 items with a 5 points of Likert response format (Cronbach alpha= .78) and Family value scale was developed for the study with 12 items on a 5 points of Likert response format(Cronbach alpha= .73). The data analysis utilized SAS 6.12 for percentage, frequency, Mean, and t-test of demographic characteristics and mean, F score, ANOVA, and Duncan follow-up test of variable relationships. The study findings were as follows. 1) In General family value, the fathers gave the higher scores to 'The children should live with their parents'(M=4.01), and 'A parents and their children are like one body' (M=3.91). The item with lowest score was 'Its not impossible for man to have extramarital relationship'(M=1.92). The mothers thought the most important items were 'A parents and their children are like one body'(M=3.79), and 'A wife needs to be patient to keep harmony of the family' (M=3.56), and the item with lowest score was 'Its not impossible for man to have extramarital relationship'(M=1.44). 2) The mean scores of the mothers were higher than the fathers for all items in family value with cancer children, while fathers gave more points for items in general family value. Both of parents gave the highest score to 'The health of the family is most important to me'(M=4.85 for fathers, M=4.97 for mothers), and followed by 'The husband and wife need to be patient and understand each other to overcome the difficulties'. The item with lowest scores was 'The parents can have conflicts in making decisions since their child was sick'(M=3.34 for fathers, M=3.37 for mothers). 3) There were significant differences between fathers and mothers in items of General family value; fathers gave more points to the items of 'The children should live with their parents', 'Its essential to hold the ceremony to respect their forefathers', 'Its not impossible for man to have extramarital relationship', 'A woman with two daughters should have one more baby to succeed the generation', 'The husbands are responsible for the household economy', and 'When his mother and wife dont get along, the man should be on his mothers side'. However, there was no significant difference between fathers and mothers in items of Family value with cancer children. 4) The general family value was significantly different by the birth order of cancer children, mothers age, mothers education level, and types of payment. On the other hand, the family value with cancer children was significantly different by the age of cancer children, period of illness, period after completing treatment, family type, the number of family members, and the number of total children.

• Journal of Hospice and Palliative Care
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• 제7권2호
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• pp.221-231
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• 2004

목적: 본 연구는 암환아 가족의 호스피스 요구도를 파악하여 앞으로 암 환아 간호시, 대상자의 요구에 적절한 호스피스 간호를 제공하기 위한 목적으로 시도되었다. 방법: 자료수집은 2004년 2월부터 7월까지 서울의 2개 대학병원에서 암으로 진단 받고 입원한 아동의 가족 104명을 대상으로 하였다. 대상자의 아동 호스피스 요구도를 측정하기 위해서는 아동 호스피스에 대한 국내 외 문헌고찰과 아동 호스피스 전문가와 관련자, 암 환아 가족 20명을 대상으로 면담하여 개발한 암 환아 가족의 아동 호스피스 요구 측정도구[10]를 사용하였다. 결과: 1. 대상자의 아동 호스피스 요구 정도는 4점 만점에 $2.77{\sim}4.00$점의 범위로 평균 3.41점(.38)으로 높게 나타났다. 각 요인에 따른 요구정도는 아동의 정서적 간호 말기 주요 신체적 증상의 조절, 2차적인 생리적 문제의 조절, 가족이 어려움 수용, 죽음준비를 위한 영적 돌봄의 순으로 나타났다. 2. 대상자의 일반적 특성에 따른 아동 호스피스의 요구 정도는 아동 어머니의 연령(F==4.980, P=.009), 형제나 친척 중 암 환자의 유무(t=2.423, P=.017)에 따라서만 유의한 차이가 있었다. 즉, 대상자의 아동 호스피스 요구정도는 어머니의 연령이 $36{\sim}40$세인 경우가 요구 정도가 가장 높고 35세 이하인 경우가 가장 낮았으며 형제나 친척 중 암 환자가 있는 경우가 없는 경우보다 요구 정도가 더 높았다. 결론: 아동 호스피스에 대한 암 환아 가족의 요구 정도는 정서적, 신체적, 사회적, 영적 돌봄의 순으로 나타나 가족이 자녀의 죽음을 앞두고 자녀의 신체적 증상관리와 함께 자신의 죽음에 대한 이해가 어려운 자녀의 불안과 두려움을 경감시켜주기 원하는 부모의 특성이 파악되었다. 또한 호스피스에 대한 요구도는 높았으나 자녀에 대한 호스피스 돌봄의향은 낮게 나타나 암 환아 부모들이 적극적인 치료와 호스피스에 대한 양가감정을 가지고 있음을 유추해 볼 수 있었다. 본 연구의 결과는 암 환아 가족들을 위해 간호사가 제공해야 하는 호스피스 돌봄의 방향을 제시하고 있다고 생각되며 이를 위해서는 호스피스 관련 기관뿐만 아니라 국가적 차원의 아동 호스피스에 대한 관심과 지원이 요구된다고 생각한다.

• 대한간호학회지
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• 제22권4호
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• pp.636-652
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• 1992

This study identified the impact of childhood cancer on the Korean family. The purpose was to contribute knowledge for family nursing and pediatric hospice care practice with sick children and their families. This descriptive study was conducted during a 6 month period with children who were being treated for cancer at six university hospitals in Seoul. The data were gathered from members of 68 families ; 24(Group A), with a child newly diagnosed with cancer : 27(Group B), with a child under treatment and without complications, and 17 (Group C), with a child in relapse. Medical records, structured questionnaires and interviews were used for data collection. The questionnaires and interview schedules had been used previously in Martinson's research in the USA and China. The findings, conclusions, and suggestions are as follows. 1. The impact of childhood cancer on the family. Members of the family experienced fear, helplessness, guilty feelings, and anger at the time of the initial diagnosis and at relapse. Mothers complained of headache, anorexia and poor appetite, weight loss, sleep disturbance, and bad dreams. Many of the fathers either lost or changed jobs, and all working mothers stopped working. Half the parents reported changes in their marital relationships such as frequent quarrels but also stronger unity. Family members perceived cancer as the most frightening disease. Change in their world view was expressed as living on faith understanding suffering, determining to live a better life, wanting to live an upright life and valuing health as the most important. Religious activities are found most helpful through this difficult experience. Financial debt due to the treatment and care of the sick child, burdened 22 families. The above mentioned impact was most evidant in Group B(those presently undergoing treatment) and Group C(those in relapse). Findings indicate that nursing care should embrace the family of a child who is being treated for cancer. 2. Characteristics of the child with cancer The majority of the children in this sample had a diagnosis of leukemia. Their mean age was 6.8 and the ratio of boys to girls was 1.12 ; 1. The mean hospitalization frequency was 13.5 times and the mean duration of illness was 16.8 months. Most of 1.he children perceived cancer as the most frightening disease ; 32.7% of the children described their sickness as serious. Children in Group C were hospitalized more frequently, stayed in hospital for longer periods, and expressed their sickness as quite serious more often than the other two groups. These findings indicate how much comprehensive pediatric hospice nursing care services are needed along with relevant research and nursing education. 3. Characteristics of the families. The mean age of the father was 39.5 and the mother, 36,6 ; they are in their most productive life period. Mothers especially expressed feelings of financial uneasiness and powerlessness about giving up their jobs, and guilty feelings for not providing enough care and concern to other children due to taking care of the sick one. The burden of caring for the sick child can bring negative changes in family dynamics which they think provoke potential health problems in members of the family These findings suggest a need for nursing support and counselling resources. Findings also suggest the need for ethical inquiry about such questions as who should give information to the child in regard to diagnosis and prognosis, when, and how. Other suggestions included : 1) Quality health care for childhood cancer such as home care and pediatric hospice programs should be established. 2) Special and practical consideration for long-term patients should be made in the present insurance coverage. The reimbursement period for long-term patients should be lengthened. 3) Further in-depth qualitative studies are needed. 4) Education programs including guided practice experience for pediatric hospice care practitioners are needed.