• Title/Summary/Keyword: Burden of illness

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Study of the Positive and Negative Caregiving Experiences in the family members who care for the psychiatric mentally ill relatives (정신장애인 가족의 긍정적, 부정적 돌봄의 경험에 관한 연구)

  • Lee, Kwang-Ok;Kim, Hee-Jung
    • Research in Community and Public Health Nursing
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    • v.10 no.2
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    • pp.435-454
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    • 1999
  • The caregiving experiences of 100 family menbers of outpatients with schizophrenia and schizoaffective disorders were investigated for the presence of positive(positive family-patient relationship. patient' contribution to the family) and negative caregiving experience(objective and subjective burden) and their predictors. This study attempts to make the analysis of caregiving experience more useful by expanding the focus to incoporate these positive aspects of the experience of family caregiver. Objective burden consists of two elements: 'disruption of family life', 'care'(amount of caregiving related to activity of daily living). Subjective burden is defined as emotional reactions to the care giving and it comprised of 6 emotional subdimensions such as 'stigma', 'grief'. 'worry', 'pity', 'fear', 'despair'. Also we investigate the severity of patients' disturbing behaviors into two categories, positive and negative disturbing behaviors and patient' contribution to the family as a predictors of positive and negative caregiving experiences. This study use Pearson's correlation coefficient, Hierardhical regressions in the SAS Program. The results are as follows: 1. Respondents reported moderate level of objective burden 'disruption of family life' (mean = 2.48, range = 1-4), and 'care' (mean=2.54, range = 1-4), and slightly high level of total subjective burden(mean = 2.19, range = 1-4). Mean scores for the measure of the severity of behavioral disturbance indicated that the caregiver experienced negative disturbing behaviors around almost 'somtimes'(mean=2.28, range = 1-4), and positive disturbing behaviors 'almost not frequent'(mean=2.78. range=1-4). So they reported that they perceived patient's negative disturbing behaviors more than positive disturbing behaviors. Mean scores for the measure of the patient' contributions (mean = 1.99. range = 1-4) indicated that caregivers experienced these contributions a little. It means that there should be a positive aspect of possibilities of patient' family roles that can be developed in the daily life. Mean scores for the measure of the positive family-patient relationship indicated that caregivers experienced moderate level of positive family-patient relationship(mean=2.52, range = 1-4). 2. Hierardhical regression analysis 1) Hierardhical regression of 'disruption of family life' showed that the interaction between positive disturbing behaviors and patient' contributions (B = .20. p = .022) and caregiver's educational level(B=.06. p=.000) were 'significant and Hierardhical regression of 'care' showed that 'negative disturbing behaviors'(B= .35. p= .007). 'patient' contributions'(B= .28, p= .019). 'family income'(B=-.l1. p=.096) were significant. 2) Hierardhical regression of 'total subjective burden', 'stigma', 'grief', 'worry', 'pity'. 'fear', 'dispair' showed that 'positive disturbing behaviors'(B=.51. p=.000). 'negative disturbing behaviors' (B = .17, p = .026), 'caregiver's educational level'(B = .03. p=.036), 'family income'(B=.08. p=.041) were significant predictors of 'total subjective burden': 'positive disturbing behaviors'(B=.32. p=.066). 'negative disturbing behaviors'(B=.24, p=.096) 'durations of illness'(B= .03. p= .079) were significant predictors of 'stigma' 'negative disturbing behaviors'(B=.28. p=.005). 'patient sex'(B=-.32. p=.022). 'positive disturbing behaviors'(B=.28. p=.020), 'patient age'(B=.02. p=.010), 'caregiver age'(B=-01, p= .002) were significant predictors of 'grief' 'negative disturbing behaviors'(B= .28, p= .005). 'patient sex'(B= -.32. p=.039), 'caregiver age'(B=-.02, p= .023). 'caregiver's educational level'(B= .04, p = .044) were significant predictors of 'worry' 'patient sex'(B=-.46. p=.005). 'negative disturbing behaviors'(B= .28. p=.018), 'caregiver age'(B=-.01, p=.037) were significant predictors of 'pity' 'positive disturbing behaviors'(B=.83. p=.000). 'patient' contributions' (B = .22, p =.017). 'family income'(B=.09. p=.65) were significant predictors of 'fear' 'positive disturbing behaviors'(B=.49, p=.001). 'negative disturbing behaviors'(B= .24. p=.057) 'patient sex'(B=-.4l, p=.017), 'family income'(B=.14, p=.047) were significant predictors of 'dispair'. 3) Hierardhical regression of 'positive relationship' showed that 'patient contributions'(B=.32, p=.000). 'negative disturbing behaviors'(B= .24, p= .005), 'patient sex'(B=-.23, p=.036).

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A Study of well-being in Caregivers Caring for Chronically Ill Family Members (만성 질환자 가족의 부담감에 관한 연구)

  • 서미혜;오가실
    • Journal of Korean Academy of Nursing
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    • v.23 no.3
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    • pp.467-486
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    • 1993
  • Today, more chronically ill and handicapped people are being cared for at home by a family member caregiver. The task of caring for a family momber may mean that the caregiver has less time and money and more work which may result in increased fatigue and symptoms of illness. This study was done to examine the well-being of family caregivers. Fifty three family caregivers were interviewed. Concepts were measured using existing tools and included : Burden(25 item 5 point scale), Social sup-port (21 item 7 point scale), Health status defined by a symptom checklist(48 item S point scale), and Well -being defined by a quality of life scale (14 item 7 point scale) and caregiving activities. Data collection was done by interview and Q-sort. Social support and well - being were positively correlated as were symptoms and burden. Symptoms and burden were negatively correlated with social support and well-being. Items on the quality of life scale had a mean score range from 3.09 to 4.96. Quality of life related to income was lowest (3.09) but the desire to use more money for the patient was rated 2.90 on the burden scale where the item means ranged from 0.73 to 3.55. The high mean of 3.55 was for obligation to give care and the low 0.73 was (or not feeling that this was helping the patient. Mean scores for symptoms ranged from 0.26 to 2.15 with the 2.15 being for “worry about all the things that have to be done.” Over half of the patients were dependent for help with some activities of daily living. The caregivers reported doing an average of 3.40 out of five patient care activities including bathing (77.4%), shampooing (67.9%), and washing face and hands (49.1%), and 3.74 out of seven home maintenance activities including laundry (98.1%), cooking (83.0%), and arranging bed-ding(75.5%). The caregivers reported their spouse as one of the main sources of social support, including in times of loneliness and anger The mean score for loneliness as burden was 2.15 and ranked fourth and 31 (58.5%) of the sample reported being lonely recently and not being satisfied with the support received. Similarly anger caused by the patient was given a mean score of 2.13, and anger was reported to have been present recently by 38 (71.7%) of the sample and satis-faction with the support given was low. Having someone to help deal with anger ranked twelfth out of 21 items on the social support scale and had a mean score of 3.98 (range 3.49 to 5.98). Spouses were reported as a major source of social support but the fact that 50% of the caregivers were caring for a spouse, may account for the quality of this source of social support having been affected. These caregivers faced the same problems as others at the same stage of life. but because of the situation, there was a strain on their resources, particularly financial and social. In conclusion it was found that burden is correlated negatively to quality of life and positively to symptoms, but in this sample, symptoms and bur-den were scored relatively low. Does this indicate that the caregivers accept caregiving as part of their destiny and accept the quality of their lives with burden and symptoms just being a part of caregiving\ulcorner Does the correlation between the bur-den and symptoms indicate they are a measure of the same phenomenon or that the sample was of a more mobile, less burdened group of caregivers\ulcorner Quality of life was the one variable that was significant in explaining the varience on burden. Further study is needed to validate the conclusions found in this study but they indicate a need for nurses to ap-proach these caregivers with a plan tailored to each individual situation and to give consideration to interventions directed at improving quality of life and expanding social support networks for those caring for spouses.

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The Experience of Parents Whose Child is Dying with Cancer (암 환아 부모의 경험에 대한 질적 연구)

  • ;;Ida Martinson
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.491-505
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    • 1992
  • The purpose of this research was to understand the structure of the lived experience of parents of a child terminally ill with cancer The research question was “What is the structure of the experience of parents of a child terminally ill with cancer\ulcorner” The sample consisted of 17 parents of children admitted to the cancer units of two university hospitals in Seoul. The unstructured interviews were carried out from October 10, 1991 through January 10, 1992. They were audio-recorded and analysed using Van Kaam's method. Parents ascribed the cause of the cancer to the mother's emotional imbalance during pregnancy, the mother's stress, failure to observe religious rites, food, the parent's sin, misfortune and pollution. The theme clusters were tension, fear and depression experienced during pregnancy, stress that children suffer from abusive parents, failure to observe religious activites, bad luck, and sins committed during a previous life. When the child suffered a recurrence of cancer, the parents experienced negative emotions, nervousness, sorrow. depression and death. The theme clusters were feelings of despair, helplessness, regret, guilt, insecurity, emptyness and apathy. The long struggle with cancer resulted in the loss of economic security, loss of psychological and physical well being, and social withdrawal. The theme clusters were the economic burden of medical cost, giving up treatment, debt, limited medical insurance coverage and blood transfusion. The loss of psychological well being included stress, lack of support systems, inability to carry out responsibilities, lack of trust of the medical ten family breakdown, inappropriate expression of emotion and not disclosing the diagnosis to the child. Physically the parents suffered fatigue, insomnia, loss of appetite, loss of weight, dizzness, headache, psychosomatic symptoms, and increased consumption of liquor and cigarettes. Social withdrawal was manifested by taking time off from work to look after the child, decrease of outside social activities and feelings of isolation. Influences on family life were spousal conflicts, negative response of siblings, separation of the family members and economic hardship. The theme clusters were blaming a spouse for the cause of the illness and disagreements, maladjustment, lonliness, hostility and depression of siblings. The high price of medical care over the long period was a major factor influencing the life of the family. Positive experiences during the child's long illness were the strengthening of support systems and religious beliefs and financial help from social organizations. The support of one's spouse primarily helped to overcome the stress of the long illness. In addition, support was received from parents of other children with cancer and from nurses and religious leaders. The nurse, by providing empathetic support, should be a person with whom parents can express their feelings and share their experiences.

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Risk assessment for norovirus foodborne illness by raw oyster (Ostreidae) consumption and economic burden in Korea

  • Yoo, Yoonjeong;Oh, Hyemin;Lee, Yewon;Sung, Miseon;Hwang, Jeongeun;Zhao, Ziwei;Park, Sunho;Choi, Changsun;Yoon, Yohan
    • Fisheries and Aquatic Sciences
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    • v.25 no.5
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    • pp.287-297
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    • 2022
  • The objective of this study was to evaluate the probability of norovirus foodborne illness by raw oyster consumption. One hundred fifty-six oyster samples were collected to examine the norovirus prevalence. The oyster samples were inoculated with murine norovirus and stored at 4℃-25℃. A plaque assay determined norovirus titers. The norovirus titers were fitted with the Baranyi model to calculate shoulder period (h) and death rate (Log PFU/g/h). These kinetic parameters were fitted to a polynomial model as a function of temperature. Distribution temperature and time were surveyed, and consumption data were surveyed. A dose-response model was also searched through literature. The simulation model was prepared with these data in @RISK to estimate the probability of norovirus foodborne. One sample of 156 samples was norovirus positive. Thus, the initial contamination level was estimated by the Beta distribution (2, 156), and the level was -5.3 Log PFU/g. The developed predictive models showed that the norovirus titers decreased in oysters under the storage conditions simulated with the Uniform distribution (0.325, 1.643) for time and the Pert distribution (10, 18, 25) for temperature. Consumption ratio of raw oyster was 0.98%, and average consumption amount was 1.82 g, calculated by the Pert distribution [Pert {1.8200, 1.8200, 335.30, Truncate (0, 236.8)}]. 1F1 hypergeometric dose-response model [1 - (1 + 2.55 × 10-3 × dose)-0.086] was appropriate to evaluate dose-response. The simulation showed that the probability of norovirus foodborne illness by raw oyster consumption was 5.90 × 10-10 per person per day. The annual socioeconomic cost of consuming raw oysters contaminated with norovirus was not very high.

A Study on the Febrile Illness in Autumn among Farmers in Gyeongju-si - Scrub typhus, Leptospirosis, HFRS - (경주시 일부 농업인의 가을철 발열성 질환 실태조사 - 쯔쯔가무시증, 렙토스피라증, 신증후군출혈열 -)

  • Kim, Dong-Seob;Acharya, Dilaram;Yoo, Seok-Ju;Park, Ji-Hyuk;Lee, Kwan
    • Journal of agricultural medicine and community health
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    • v.44 no.1
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    • pp.1-10
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    • 2019
  • Objectives: This study aimed to assess the status of Scrub typhus, Leptospirosis and HFRS(hemorrhagic fever with renal syndrome) among farmers with febrile illness. Methods: We involved a total of 841 farmers who had febrile illness(508 and 333 village residents were, respectively, three and four district of Gyeongju city) selected during autumn of 2014 and 2015. Data were collected by survey questionnaires and blood sample examination. Results: Serum response rate for Scrub typhus and Leptospirosis was 1.5% each and 1.9% for HFRS. Serum response rate for Scrub typhus was significantly higher for tick-bite cases(38.5%), while Leptospirosis was significantly higher for those who were in fruit-planting work(23.1%). Similarly, serum response rate was significantly higher for HFRS who were working in venyl green house work(25.0%). Conclusions: Government authority should develop effective and efficient preventive strategies to create awareness of infectious diseases among farmers. Extending information, education and communication be reached to farmers that could change their perception and help early diagnosis and treatment and reduce the disease burden and its complication.

Mothers' Perceived Difficulties in the Management of Chronic Conditions of Children with Spina Bifida: A Qualitative Descriptive Approach (이분척추 환아의 어머니가 인식한 질병관리의 어려움: 질적 서술적 접근)

  • Lim, Seoung-Wha;Yi, Myungsun
    • Child Health Nursing Research
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    • v.22 no.4
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    • pp.247-256
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    • 2016
  • Purpose: The purpose of the study was to identify and describe the caregiving difficulties that mothers of children with spina bifida experience from their own perspectives. Methods: A qualitative descriptive study was designed. Data were collected from five mini-focus group interviews and four individual interviews using open-ended questions. Nineteen mothers of children with mild spina bifida participated in the study during 2014-2015. Data were analyzed using qualitative content analysis to identify major difficulties perceived by the mothers. Results: Five domains were identified with 12 subdomains. "Daily routine continence management" describes difficulties arising in bladder and bowel management for the child with spina bifida. "Management of school life of child" deals with difficulties in relation to the school facilities, such as the toilets, as well as teachers and friends. "Relationship with family and neighbors" illustrates problems in relations with their spouse, normal children, relatives and neighbors. "Maintaining physical and psychological health" includes physical and psychological problems of the mothers. "Finance" describes economic burden that the mothers face in the management of child's illness. Conclusion: The findings from this study provide insight into the practical issues related to the management of chronic conditions of children with spina bifida from the mothers' perspectives.

Transfer anxiety in parents of children transferred from pediatric intensive care units to general wards in South Korea: a hybrid concept analysis

  • Park, Jisu;Choi, Eun Kyoung
    • Child Health Nursing Research
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    • v.28 no.2
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    • pp.154-165
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    • 2022
  • Purpose: This study aimed to analyze the concept of transfer anxiety in parents of children transferred from pediatric intensive care units to general wards. Methods: The hybrid model by Schwarz-Barcott and Kim was used to analyze the characteristics of transfer anxiety in parents of children transferred from pediatric intensive care units to general wards. Results: Transfer anxiety was defined by the following attributes: 1) stress concerning the adaptation process, 2) concern about the child's condition worsening due to the parent's caregiving, and 3) involuntary changes in daily life due to the treatment. Transfer anxiety has the following antecedents: 1) uncertainty; 2) a lack of knowledge about the illness, medical devices, and caregiving; and 3) a lack of social support. It resulted in 1) caregiver burden, 2) a decrease in the capacity for coping with caregiving, 3) delays in the child's physical and psychological recovery, and 4) decreased quality of life. Conclusion: It is necessary to develop an assessment scale that considers the attributes of transfer anxiety in parents of children transferred from pediatric intensive care units to general wards. Furthermore, an effective nursing intervention should be developed to reduce transfer anxiety.

Effects of a Psychiatric Nursing Clinical Practice Program Using Situation-Oriented Case-Based Learning: A Qualitative Study

  • Lee, Sowon;Kim, Boyoung
    • International Journal of Advanced Culture Technology
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    • v.10 no.3
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    • pp.210-219
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    • 2022
  • Psychiatric nursing is a specialty where nursing students experience many difficulties in applying what they have learned in theory to clinical practice. Therefore, a situation-oriented case-based strategy is required to help them overcome the limitations of psychiatric nursing clinical practice and reduce their burden. This study aimed to measure the effectiveness of a psychiatric nursing clinical practice program using situation-oriented case-based learning. Participants comprised 63 nursing students in psychiatric nursing classes. The students were asked to create a scenario of interaction between a nurse and patient based on a case study. Empathy, therapeutic communication ability, and attitudes toward mental illnesses were measured. We analyzed the effectiveness of the program by comparing changes in the nursing students' empathy, therapeutic communication ability, and attitude toward mental illness after the program. The participants showed significant increases in empathy and therapeutic communication abilities. However, there were no significant changes in attitudes toward mental illnesses. Based on the results of this study, it is expected that situation-based learning will be effective for students who have difficulties in certain aspects, such as COVID-19, or where there are limited clinical practice opportunities, such as psychiatric nursing.

The Experience of Children with a Schizophrenic Parent -Case Study- (정신분열병 환자 자녀의 경험)

  • Park, Mi-Young;Oh, Ka-Sil
    • Korean Parent-Child Health Journal
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    • v.15 no.1
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    • pp.1-13
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    • 2012
  • Purpose: The purpose of this thesis is to investigate the experience of children with a schizophrenic parent. Methods: The research methods included biographical in-depth interviews, structured questionnaires, and child's drawings. Data were collected from September until November, 2005 at one university hospital, and interviews were recorded on audio tapes and thereby transcribed. The subjects were three adolescent children (10~15 years old) of a parent with schizophrenia. Results: This study has five themes: It is often the case that the children with a schizophrenic parent are uninformed about their parent's illness, have difficulties dealing with symptoms are confused about their parent's image and display contradictory feelings of fear and sympathy toward their father; The children tend to harbor expectations on mother's role in the family affairs, and simultaneously show pity for her; Family relations without solidarity caused by the absence of their father make the children feel severance, separation, and isolation in and out of the family; The children feel the burden to assume additional household responsibilities; The children are reluctant to mention their father's disease. Conclusion: the study subjects have met negativeness in both developmental characteristics and needs, which supports the need for intervention programs that meet their actual experience.

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Comparative Study on Self-Care Behavior, Diabetes-related Stress, and Stress Coping among Good, Inadequate, and Poor Glycemic Control Groups (혈당 조절 양호, 불충분, 불량 군 간의 자가간호행위, 당뇨관련 스트레스, 스트레스 대처의 비교)

  • Kang, Hye-Yeon;Gu, Mee-Ock
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.19 no.2
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    • pp.168-178
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    • 2012
  • Purpose: The purpose of this study was to compare self-care behavior, diabetes-related stress and stress coping style among 3 blood glucose control groups (good, inadequate, and poor blood glucose control groups). Methods: Participants were 102 type 2 diabetic patients (good group: 41, inadequate group: 31, poor group: 30). Data were collected from Feb 19 to Mar 24, 2010 and were analyzed using Chi-square, Fisher's exact test and ANCOVA with SPSS/WIN 12.0. Results: Using ANCOVA with frequency of admission, and illness duration as covariates, significant differences were found among the 3 groups in self-care behavior (total score) and the exercise subscale. Using ANCOVA significant differences were found among 3 groups in diabetes-related stress (total score), emotional burden subscale and regimen distress subscale. Using ANCOVA no difference in stress coping was found among the 3 groups, but there was a significant difference in the problem-oriented coping subscale. Conclusions: Self-care behavior, diabetes-related stress, and stress coping style are factors influencing blood glucose control. The results of this study suggest that for improving blood glucose control, self care education program focused on diet and exercise in addition to stress management program for promoting problem oriented coping capability are recommended.