• The Korean Journal of Rehabilitation Nursing
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• v.11 no.1
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• pp.25-31
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• 2008

Purpose: This study was implemented to investigate perceived illness intrusiveness in stroke patients by the characteristics of primary caregivers. Method: Retrospective cross-sectional survey design was used. The subjects were 225 stroke patients and their primary caregivers. Demographic variables, relationship variables, burden, depression and support were measured as primary caregivers' characteristics. Data were analyzed with SPSS win 14+. T-test, ANOVA and correlation test were used depending on variables. Result: Demographic variables such as age, gender, relation with patients, and living status were not related significantly with illness intrusiveness. But primary caregivers' burden, depression and support were related significantly with perceived illness intrusiveness of stroke patients. That is, burden, depression and quantitative support of primary caregivers were significantly positively correlated with perceived illness intrusiveness of stroke patients. On the other hand, qualitative support was negatively correlated with perceived illness intrusiveness. Conclusion: Primary caregivers' characteristics such as burden, depression and support were found to be correlated with stroke patients perception such as illness intrusiveness. So, it is recommended that nursing intervention targeting burden, depression and support of primary caregivers must be developed to reduce illness intrusiveness of stroke patients.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1531-1542
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• 2000

In this paper, we examined the depression of stroke patient's caregivers and analyzed influencing factors of the depression. The subjects were 215 caregivers who have takencare of stroke survivors in their home. The conceptual model of this study consisted of the caregiver's depression, perceived burden, illness intrusiveness, and patient's ADL. Modified Korean CES-D, modified subjective and objective Burden Scale, Illness intrusiveness(II), and Instrumental Activity of Daily Living(IADL) were used to measure concepts. Path analysis was used to test the model of this study. The results were as follows: 1. The mean depression score was 11.6 which was below the cut-off score of the CES-D. This score indicates that the subjects were higher than normal adults' mean score but not depressive. Eighty-six out of 215 caregivers(40%) were above the cut-off score. This finding was different from previous research results, and the reason might be the patients' capability of ADL. In a group of low capability patient's activities of daily living, caregiver's depression score was 15.5. 2. Caregiver's depression was positively related to caregiver's burden and illness intrusiveness, but negatively related to patient's activities of daily living. 3. The caregiver's perceived burden and illness intrusiveness directly influenced on their depression. Furthermore, the and caregiver's illness intrusiveness led to depression indirectly through their burden. A patient's activities of daily living didn't influence directly on depression but indirectly through caregiver's illness intrusiveness and burden.

• Korean Journal of Social Welfare
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• v.48
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• pp.150-178
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• 2002

The elderly have higher potential for contracting chronic diseases and suffering from development of a complication. Also, the extended old age period leads the elderly to demand more medical services. All those facts indicate that the elderly need more medical services than any other age groups. Consequently, medical care for the elderly with chronic diseases causes high costs burden. However, there is few studies researching the financial burden of chronic illness of the elderly. This study aimed to 1) understand how much the elderly with chronic diseases pay for medical expenses; 2) find out some specific factors related to health care financial burden; 3) suggest the alternative policies to decrease excessive financial burden of caring for the elderly with chronic illness. National Health and Nutrition Survey, which was surveyed by the Korea Institute for Health and Social Affairs in 1998, was used in this study. 4,707 persons with chronic diseases out of 5385 persons over age 60 were selectively sampled. Using SPSSWIN, correlation analysis, T-test, ANOVA and Regression were used as statistical methods in this study. Stepwise multiple regression was employed to analyze the data with a ratio of health care expenditure to income(financial burden) as a dependent variable. Out of Korean old people, 87% had the chronic diseases and their health care financial burden rate showed the average of 17.9%, which meaned they expended almost 20% income to buy medical services. The variables having a great influence on financial burden were monthly income, activity, limitation and single household of an old person. The excessive financial burden was experienced by people who had more than 4 activity limitations(37.1%) and were in the lowest Income level(32.6%), and single household of an old person(31.4%). The new policies should be considered to 1) reduce the financial burden in these groups and to develop the sliced medical cost system considering the characteristics of chronic illness and income level; and 2) develop the medical management system to care for the elderly with chronic illness.

• Journal of Korean Academy of Nursing
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• v.30 no.3
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• pp.595-605
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• 2000

The purpose of this study was to describe the perceived burden of the stroke patient's caregiver and related factors to analyze relationships between perceived burden and social supports. A convenient sample of 225 caregivers who take care for a stroke patient at home participated in this study. Caregiver's perceived burden was measured by the objective and subjective burden scale developed by Montgomery (1985). Related factors of burden were studied in terms of the patient's instrumental activties of daily living, cognitive function, caregiver's demographic variables and caregiver's illness intrusiveness. The results were as follows: (1) The mean of objective burden score was 4.5, and subjective burden score was 3.1. These scores show that caregivers perceive moderate level of burden. (2) Caregivers' objective burden was significantly related to caregivers's illness intrusiveness (r=.62), patient's IADL (r=-.33), and patient's cognitive function (r=-.15). The subjective burden was related to the caregiver's illness intrusiveness (r=.29), the patient's IADL (r=.24), and the caregiver's age(r=.23). (3) The percentage of stroke caregivers who perceived physical support was 49.1%. The percentage of those who perceived emotional support was 61.0%, and those who perceived financial support totaled 37.6%. (4) Caregivers who received any type of social supports perceived lower subjective burden, and caregivers who received physical or psychological support perceived lower objective burden. These results emphasized the necessity of a rehabilitation programs for stroke patients and support program for family caregivers.

• Korean Journal of Adult Nursing
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• v.21 no.2
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• pp.187-198
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• 2009

Purpose: This study was to compare and examine the factors influencing burden of primary family caregivers according to the severity of illness of elderly patients admitted in an intensive care unit. Methods: Subjects were the families of elderly patients in intensive care units of K, S and Y hospitals in Seoul. Data were collected from March to October 2007. Subjects were 108 persons over age 65. Data were analyzed by SAS statistics. Results: First, groups 5 and 3 showed higher burden than that of group 4. Second, high correlation was found between stress and burden, stress and anxiety, and burden and anxiety. Third, factors influencing family burden were found to be stress for group 5, stress, anxiety, and monthly income for group 4, and stress and patient age for group 3. Conclusion: Specific nursing interventions to decrease the stress of primary family caregivers of serious ill elderly patients in an intensive care unit are needed. Additionally, more effective and systematic activation of a long-term medical insurance system for seriously ill seniors is considered necessary to mediate the burden of primary family caregivers.

• Journal of muscle and joint health
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• v.6 no.1
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• pp.85-99
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• 1999

Chronic disease such as rheumatoid arthritis is believed to induce a significant psychosocial stressors. The concept of illness intrusiveness-illness induced life style disruptions-was hypothesized to affect psychosocial status. And demographic, socioeconomic, disease and social characteristics were hypotehsized to affect illness intrusiveness. Hierarchial multiple regression analyses were used. As a result, among the demographic factors gender was identified as contributor to directly increase the psychosocial stress and education level was identified to affect the psychosocial stress through illness intrusiveness. Among socioeconomic factors, the burden about the cost of medical treatment was found to indirectly affect the psychosocial stress through the illness intrusiveness. Also income and job were found to affect directly the psychosocial status. Among the disease characteristics, only the pain level was identified to increase the psychosocial stress through the illness intrusiveness. Among the social characteristics, perceived social support is identified to increase the psychosocial stress through the illness intrusiveness. Based upon these results, some suggestions were made for minimizing illness intrusiveness in rheumatoid arthritis and future research.

• The Journal of Korean Academic Society of Nursing Education
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• v.12 no.1
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• pp.95-103
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• 2006

Purpose: This is to find out the correlation between a families burden on a cerebrovascular accident patient and the demand for nursing home. Method: The data was established by using structured questionnaires for 102 nursing families of cerebrovascular accident patient at three university hospitals. Result: 1) The total burden was showed to be at 3.21, which was some what higher than average. Total average of demand for nursing home was at 3.30, which was higher than average. 2) This showed static correlations between the economic, social, physical dependent and psychological burden, and demand for nursing home. The result represents that the higher burden showed a significantly positive correlation to the higher demand for nursing home. Conclusion: If a systemic support of nursing home is prepared the differentiated nursing home matched perfectly on each burden, the burden on a family of the patient can be decreased effectively.

• Journal of Korean Academy of Nursing
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• v.29 no.3
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• pp.639-655
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• 1999

An explanatory design was employed to identify the relationship of physical, emotional & social readjustment and social support of post hospitalized stroke patients and their caregivers. A convenient sample of 254 patients who given follow-up care at the outpatient department after discharge and 225 caregivers were recruited. Mental Status Questionnaire (MSQ), Social Support Inventory Stroke Survivors (SSISS), Illness intrusiveness(II), Instument Activity of Daily Living(IADL), Center of Epidemilogic Studies-Depression(CES-D), social activity and caregiver burden were used for measurement in this study. Results showed patient's physical level measured by IADL and psychological level measured by depression were high. But social activity was low. Cognitive function, depression & social activity were not significantly different by the posthospitalized period, but IADL was. The source of professional support was mostly the physician at the outpatient department. The family support was found significantly related to patient's depression & social activity and caregiver's subjective burden. Professional support was found significantly related to patient's IADL & depression. Illness intrusiveness as a mediating variable was a sig nificantly predicting power on patient's IADL & depression. The path analysis was used to identify the variables to predict the physical, emotional, and social status of patients. As a result, patient's age, cognitive function, illness intursiveness and professional support significantly predicted the level of IADL ; patient's cognitive function, illness intrusiveness and family support significantly predicted the level of depression ; and patient's age and family support significantly predicted the level of social activity of posthospitalized stroke patients. Based upon these results, the rehabilitation programs to reduce the illness intrusiveness and improve cognitive funtion were recommended for the readjustment of the stroke patients. This model of the readjustment of the posthospitalized stroke patients is recommended as the framework for care of the stroke patients.

• Journal of Home Health Care Nursing
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• v.7 no.1
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• pp.83-93
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• 2000

This study was conducted to provide the data for the improvement of cerebral ischemia patient nursing services through the investigation of burden and hospital service satisfaction by family caregivers who were nursing the cerebral ischemia inpatients. The study subjects consisted of 125 family caregivers who were enrolled in four university hospitals with over 300 beds and one Chinese medicine hospital with over 100 beds. The Data were collected from all of the personal subjects using standardized questionnaires by interview from March 1 to March 30 in 2000. Data were analyzed by using t-test, ANOVA. Scheffe's multiple comparison, and Pearson's Correlation Coefficients. The results were as follows: 1. The mean score of burden felt by family caregivers who were nursing the stroke patient was 2.18. In relation to the characteristics of patients, higher scores were shown in male patients who were over 80 years old, and patients who had from 4 to 12 days care giving, over three month duration of admission, from one month to three month duration of illness. The burden felt by family caregivers revealed higher score of dependency in the Activities of Daily Living. 2. The mean score of hospital service satisfaction perceived by family caregivers was 3.35. The highest hospital service satisfaction score was shown in female caregivers, and caregivers whose patients graduated from element school, and treatment method was Chinese medicine, the duration of admission was under 1 month. As a result. the family caregivers' burden was seemed to be high when the patients who were old, male and as care giving time, duration of admission, duration of illness were getting longer. In conclution, hospital service satisfaction was good, but the satisfaction was tend to decrease that family caregivers who were male, higher education background and duration of patients' admission getting longer.

• Journal of Preventive Medicine and Public Health
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• v.50 no.4
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• pp.217-227
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• 2017

In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.