• Title/Summary/Keyword: Burden of illness

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A Theory Construction on the Care Experience for Spouses of Patients with Chronic Illness (만성질환자 배우자의 돌봄 경험에 대한 이론 구축)

  • Choi, Kyung-Sook;Eun, Young
    • Journal of Korean Academy of Nursing
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    • v.30 no.1
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    • pp.122-136
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    • 2000
  • Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

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A Qualitative Study on the Acknowledgement of the cause of the illness in the Patients with RA (류마티스관절염 환자의 원인지각에 관한 질적 연구)

  • Eun, Young
    • Journal of muscle and joint health
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    • v.3 no.2
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    • pp.151-165
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    • 1996
  • The purpose of this study is to describe the acknowledgement of the cause of the illness in the patients with RA. I used naturalistic inquiry as a research methodology. The purposive sampling was conducted. 23 subjects who experienced RA, lived in middle-sized city in Korea, and 19 women and 4 men. I collected data using indepth structured interview, "What is the acknowledgement of the cause of the illness?" I used inductive data analysis-such as unitizing and categorizing. This process is used constant comparative method. Summerising the results of this study, the acknowledgement of the cause of the illness are composed of physical constitution, fatalism, the attribution of physical overload, the attribution of stress, the lack of nutrition. The factors which affect the acknowledgement of the cause of the illness are composed of internal factors, external factors, environmental factors. The internal factors are the weakness of the childhood, the illness experience in the family members, juvenile rheumatoid arthritis, personality, lack of nutrition. The external factors are pregnancy, delivery, role burden and conflict, economic problem. The environmental factors are humid condition, abrupt environmental change. It is needed to explaine the coping pattern according to the acknowledgement of the cause of the illness in the next research.

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Factors Influencing the Burden Felt by Main Family Caregivers of Elderly Patients with Brain and Spinal Diseases (뇌.척추질환 노인 환자 주 가족수발자의 부담감에 영향을 미치는 요인)

  • Park, Hee-Kyung;Park, Kyung-Min
    • Research in Community and Public Health Nursing
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    • v.22 no.4
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    • pp.389-398
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    • 2011
  • Purpose: This study of this study was to identify factors influencing the burden of main family caregivers who take care of elderly patients with brain and spinal diseases. Methods: This was conducted as descriptive research and data were collected from 255 main family caregivers who were taking care of elderly patients with brain and spinal diseases from 4 hospitals in Daegu and Gyeongbuk Province. Stepwise-multiple regression was used to identify the influencing factors of burden felt. Results: As the score of burden felt by the main family, economic, social, physical, interdependent and emotional burdens were high in order. Factors influencing burden felt by main family care givers taking care of elderly patients with brain and spinal diseases were changed relation with patient after hospitalization, daily life ability, marital status, education and family caregiver's personality (explanatory power of 24.6%). Family caregivers felt a heavier burden when their relation with the patient was changed negatively or when the patient's activity of daily living was low. Conclusion: Based on these results, we need to develop coping measures and interventional programs for reducing the burden felt by the main family caregivers of elderly patients with brain and spinal diseases.

Influence of Caring Burden and the Way of Coping on Burnout in Caregivers of Cancer Patients (암 환자 돌봄제공자의 돌봄부담감과 대처방식이 소진에 미치는 영향)

  • Heo, Su Bin;Shin, So Young
    • Korean Journal of Occupational Health Nursing
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    • v.28 no.2
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    • pp.114-123
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    • 2019
  • Purpose: The aims of this study were to identify the effects of caring burden and the way of coping on burnout in caregivers of cancer patients. Methods: One-hundred and forty family caregivers of cancer patients who visited the cancer center at one tertiary hospital in metropolitan city B were included. The data collection was conducted from August 1st to October 1st, 2018, using a structured, self-reported questionnaire. The collected data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression. Results: In the multiple regression analysis, the subject's gender (${\beta}=.12$, p=.028) and caring burden (${\beta}=.74$, p<.001) had a significant effect on burnout. The explanatory power of the subject's gender, education level, religion, caring time, number of family caregivers, monthly income, economic burden, expectation for treatment, caring burden, the way of aggressive coping, and the way of passive coping with burnout was 63.8% (F=23.28, p<.001). Conclusion: Reducing the caring burden in family caregivers of cancer patients will ultimately contribute to reducing burnout, thereby contributing to an improvement in the psychological well-being and quality of life of family members, as well as positively contributing to the recovery of patients.

Sources of Anxiety and Burden of Family Caregivers of Stroke Patients: The Role of Self-efficacy and Knowledge about Care (뇌졸중 환자 가족 간호제공자의 불안과 부담감의 예측 요인: 자기효능과 돌봄에 대한 지식을 중심으로)

  • Kim, In-Ja
    • Korean Journal of Adult Nursing
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    • v.24 no.1
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    • pp.1-10
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    • 2012
  • Purpose: Among the sources of anxiety and burden of family caregivers of stroke patients, this study investigated the role of self-efficacy and knowledge about care. Methods: Descriptive and correlational study design was used. One hundred and thirteen subjects were included. They were anticipated family caregivers of stroke patients. All patients were hospitalized at the intensive care unit (ICU) for the first time as a stroke patients. Data of family caregivers were collected during the time that patients were in the ICU with self-reported standardized questionnaire. Pearson's correlation coefficients and regression analysis were used to explore the role of self-efficacy and knowledge. Results: Self-efficacy was correlated with burden, but not with anxiety. Knowledge about care was correlated with anxiety and burden. Only knowledge about care was the significant predictor of anxiety and burden of anticipated family caregivers. Conclusion: The knowledge about care for stroke patients is important especially to the family caregivers who have to care stroke patients for the first time to reduce their anxiety and burden.

Comparison of Position and Trend of Disease Burden in Korea and Organization for Economic Cooperation and Development Countries (한국과 경제협력개발기구 국가의 질병부담 위치와 추이 비교)

  • Yun Hwa Jung;Hye Jin Joo;Eun-Cheol Park
    • Health Policy and Management
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    • v.33 no.2
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    • pp.129-140
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    • 2023
  • Background: This study aims to compare the burden of disease in Korea with other Organization for Economic Cooperation and Development (OECD) countries using the OECD health statistics from 1985 to 2020. Methods: We analyzed potential years of life lost (YLL) per 100,000 population using the Positive value for relative comparison (PARC) index, trend test, and average annual percentage change (AAPC) with logistic regression analysis. Results: The relative disease burden was good for many diseases, but the disease burden was severe for a few diseases in Korea. Diseases with a high relative burden of disease in Korea are as follows; intentional self-harm (YLL2020 575.6, AAPCYLL 2.6%; PARC2020 -1.000, AAPCPARC -15.8%), malignant neoplasms of the liver (YLL2020 136.6, AAPCYLL -3.9%; PARC2020 -1.000, AAPCPARC 0.0%), malignant neoplasms of the stomach (YLL2020 9.0, AAPCYLL 3.2%; PARC2020 -0.556, AAPCPARC -22.9%), Parkinson's disease (YLL2020 575.6, AAPCYLL 2.6%; PARC2020 -1.000, AAPCPARC -15.8%). Conclusion: Diseases with a high burden of disease are needed to be prioritized in the planning and execution of healthcare policies that can contribute to the efficient use of healthcare resources.

A Prediction Model for Unmet Needs of Elders with Dementia and Caregiving Experiences of Family Caregivers (재가치매 환자의 미충족요구와 가족부양자의 돌봄경험 예측모형)

  • Choi, Sora;Park, Myonghwa
    • Journal of Korean Academy of Nursing
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    • v.46 no.5
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    • pp.663-674
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    • 2016
  • Purpose: The purposes of this study were to develop and test a prediction model for caregiving experiences including caregiving satisfaction and burden in dementia family caregivers. Methods: The stress process model and a two factor model were used as the conceptual frameworks. Secondary data analysis was done with 320 family caregivers who were selected from the Seoul Dementia Management Survey (2014) data set. In the hypothesis model, the exogenous variable was patient symptomatology which included cognitive impairment, behavioral problems, dependency in activity of daily living and in instrumental activity of daily living. Endogenous variables were caregiver's perception of dementia patient's unmet needs, caregiving satisfaction and caregiving burden. Data were analysed using SPSS/WINdows and AMOS program. Results: Caregiving burden was explained by patient symptomatology and caregiving satisfaction indicating significant direct effects and significant indirect effect from unmet needs. The proposed model explained 37.8% of the variance. Caregiving satisfaction was explained by patient symptomatology and unmet needs. Mediating effect of unmet needs was significant in the relationship between patient symptomatology and caregiving satisfaction. Conclusion: Results indicate that interventions focusing on relieving caregiving burden and enhancing caregiver satisfaction should be provided to caregivers with high levels of dementia patients' unmet needs and low level of caregiving satisfaction.

The Iceberg Nature of Fibromyalgia Burden: The Clinical and Economic Aspects

  • Ghavidel-Parsa, Banafsheh;Bidari, Ali;Maafi, Alireza Amir;Ghalebaghi, Babak
    • The Korean Journal of Pain
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    • v.28 no.3
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    • pp.169-176
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    • 2015
  • This review has focused on important but less visible aspects of fibromyalgia (FM) with respect to the high impact of this disorder on patients and societies. FM is a common but challengeable illness. It is characterized by chronic widespread pain, which can be accompanied by other symptoms including fatigue, sleep disturbances, cognitive dysfunction, anxiety and depressive episodes. While our understanding of this debilitating disorder is limited, diagnosis and treatment of this condition is very difficult, even in the hands of experts. Due to the nature of disease, where patients experience invalidation by medical services, their families and societies regarding the recognition and management of disease, direct, indirect and immeasurable costs are considerable. These clinical and economic costs are comparable with other common diseases, such as diabetes, hypertension and osteoarthritis, but the latter usually receives much more attention from healthcare and non-healthcare resources. Present alarming data shows the grave and "iceberg-like" burden of FM despite the benign appearance of this disorder and highlights the urgent need both for greater awareness of the disease among medical services and societies, as well as for more research focused on easily used diagnostic methods and target specific treatment.

The Socioeconomic Burden of Cancer in Member Countries of the Association of Southeast Asian Nations (ASEAN) - Stakeholder Meeting Report

  • Jan, Stephen;Kimman, Merel;Kingston, David;Woodward, Mark
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.407-409
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    • 2012
  • The ACTION (Asean CosTs In ONcology) Study will be one of the largest observational studies of the burden of cancer ever conducted in Asia. The study will involve 10,000 newly diagnosed patients with cancer and will be carried out across eight low- and middle income countries within the ASEAN region (Indonesia, Thailand, Malaysia, Cambodia, Myanmar, Viet Nam, Laos and the Philippines). Patients will be interviewed three times over 12 months to assess their health, use of health care services, out of pocket costs related to their illness, social and quality of life issues. The project is a collaboration between the George Institute for Global Health, the ASEAN Foundation and Roche. The aim of the study is to assess the health and socioeconomic impact of cancer on patients in ASEAN communities, and the factors that may impact on these outcomes.