• Journal of Preventive Medicine and Public Health
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• v.42 no.4
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• pp.243-250
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• 2009

Objectives : The purposes of this study is to estimate the cost of cancer care after its diagnosis and to identify factors that can influence the cost of cancer care. Methods : The study subjects were patients with an initial diagnosis one of four selected tumors and had their first two-years of cancer care at a national cancer center. The data were obtained from medical records and patient surveys. We classified cancer care costs into medical and nonmedical costs, and each cost was analyzed for burden type, medical service, and cancer stage according to cancer types. Factors affecting cancer care costs for the initial phase included demographic variables, socioeconomic status and clinical variables. Results : Cancer care costs for the initial year following diagnosis were higher than the costs for the following successive year after diagnosis. Lung cancer (25,648,000 won) had higher costs than the other three cancer types. Of the total costs, patent burden was more than 50% and medical costs accounted for more than 60%. Inpatient costs accounted for more than 60% of the medical costs for stomach and liver cancer in the initial phase. Care for latestage cancer was more expensive than care for early-stage cancer. Nonmedical costs were estimated to be between 4,500,000 to 6,000,000 won with expenses for the caregiver being the highest. The factors affecting cancer care costs were treatment type and cancer stage. Conclusions : The cancer care costs after diagnosis are substantial and vary by cancer site, cancer stage and treatment type. It is useful for policy makers and researchers to identify tumor-specific medical and nonmedical costs. The effort to reduce cancer costs and early detection for cancer can reduce the burden to society and improve quality of life for the cancer patients.

• 한국노년학
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• v.28 no.4
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• pp.1147-1164
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• 2008

There has been a sharp increase in the number of grandmothers raising grandchildren in contemporary Korean society. However, little is known about the complexity of the experiences of the custodial grandparenting. Most of the studies mainly examined burden/cost and have paid little attention to the positive aspects of custodial grandparenting. In order to overcome this limitation of previous research, this study aims 1) to examine not only the costs but also the rewards of custodial grandparenting and to explore related factors, 2) to develop the typology based on relative rewards-burden perception of grandmothers about custodial grandparenting and explore the group differences. The data were gathered from 449 grandmothers raising their grandchildren as a primary caregiver, using a structured questionnaire. The data were analyzed using descriptive statistics, correlation, hierarchical multiple regression and ANOVA, with SPSS WIN 12.0 program. Main findings are as follows: First, custodial grandmothers report not only care-giving burden such as physical burnout and economic burden but also various rewards such as joy of watching their grandchildren grow and feeling good about themselves to be a help with their adult children, i.e. grandchildren's father or mother. Second, factors related to the level of perceived cost of grandparenting are different from the factors affecting the positive aspects of grandparenting. Third, results of the two by two cross-tab analysis based on the level of rewards and burden show that about 32 percent of the grandparents belong to Type II group(high rewards-low cost). This result is quite contrary to the assumption of previous research focusing mostly on cost and burden of custodial grandparenting. Fourth, four groups were different in terms of grandmother & grandchildren's characteristics. Implications of these results are discussed.

• Journal of the Korean Home Economics Association
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• v.34 no.4
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• pp.145-160
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• 1996

The purpose of this study was to identify caregiving situations and to examine resources for adjustment among family caregivers of the elderly with dementia. Thereby the study can provide the basic information for the development of education programs for family caregivers through in-depth interview. The main result of this study was as follows : 1) The major problems identified by family caregivers I caring for the elderly with dementia were related to care recipient's toileting and to care recipient's confusion and wandering. 2) The family caregiver expressed feelings of burden including chronic fatigue, depression, guilt and frustration. 3) The factors influencing the adjustment of family caregivers for demented elderly were quality of relationship, motivation for caregiving, circumstances of caregiving, social support and coping strategies.

• Journal of Families and Better Life
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• v.14 no.2
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• pp.77-96
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• 1996

The purposes of this study were to understand caregiving situation and to develop education program for families with the demented elderly,. Family caregivers of elderly patients with dementia clearly experience high levels of stress which often leads to such negative caregiver outcomes as depression interference with social activities and health difficulties. That is providing care is stressful for caregivers because the demands of the caregiving situation threaten to overwhelm the caregivers' coping resources. Therfore the families with demented elderly persons need assistances in order to alleviated burden of caregiving, In this study the educational program was designed to increase caregivers' confidence in problem-solving, And it was designed to provided information to demented elderly. The educational program of this study was given 5 session. And it was included the understanding of dementia the family caregiving experiences of the demented elderly persons the time for elf-care the search for helping the improving of interpersonal relations and communications.

• 한국노년학
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• v.37 no.2
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• pp.461-474
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• 2017

The purpose of this study was to develop the caregiver guideline for participation in activities daily living for the elderly with early dementia in home including easily adaptable and professional strategies as early intervetion. The process of this study was 3 stage. First stage, the development of preliminary caregiver guideline as the first stage of this study was to translate to Korean and reclassify the items about caregiver guideline for participation from reports of foreign association or government related dementia, and it consisted of 3 areas, 128 statements for questionnaire for Delphi investigation. Second stage, the guideline was to conduct the content validity, and delete, reclassify, integrate, revise inappropriate items through 2 rounds and 16 Delphi panels. Third stage, the establishment of the final version of caregiver guideline. It consisted of 8 areas: home modification and assistive device, home activities of daily living, health management, communication, psycho-emotional support, leisure activities, social participation, general strategies. All 68 items was arranged in important order. The content validity, stability, agreement index in this study were 0.81, 0.15, 0.79 respectively. When content validity, stability was above 0.49, below 0.5 in Delphi survey with 15 panels, it was not required additional survey. The result of this study meaned that it was not required to additional Delphi survey, and the result was stable and agreeable. This developed guideline was useful and practical to maintain the elderly's with dementia independent and healthy life as education materials for their caregivers, so it will expect to decrease caregiver's burden. Lastly, it stated limitation and suggestion for further study.

• Safety and Health at Work
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• v.5 no.1
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• pp.7-12
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• 2014

Background: In Japan, more than 60% of employees are reported to suffer from anxiety and stress. Consequently, Japanese society has begun to address such important issues as psychogenic disability and job-related suicide. Furthermore, given the aging of society and the surge in the number of elderly people requiring care, it is necessary to adequately and proactively support employees who care for their elderly relatives. The purpose of the present study was to investigate caregiver burden in caring for elderly relatives and work-related stress factors associated with mental health among employees. Methods: We studied 722 men and women aged 18-83 years in a cross-sectional study. The K10 questionnaire was used to examine mental health status. Results: The proportion of participants with a high K10 score was 15% (n = 106). Having little conversation with their supervisor and/or coworkers significantly increased the risk of depression [odds ratio (OR) 1.8], as did high job overload (OR 2.7) and job dissatisfaction (OR 3.8), compared with employees who frequently conversed with their supervisor and/or coworkers. Caring for elderly relatives as a prominent characteristic of an employee was a significant risk factor for depression (OR 2.1). Conclusion: The present study demonstrated that employees who were caring for elderly relatives were significantly associated with an increased risk of depression. To prevent depressive disorders, it may be important to focus on reducing the work-caregiving role conflict, as well as enhancing employees' job control and better rewarding their efforts in the workplace.

• Research in Community and Public Health Nursing
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• v.13 no.4
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• pp.629-638
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• 2002

The impact of chronic diseases on patients and their families depends on how well the family members cope with it. Therefore, research on strategies for facilitating the coping of the families in a desirable manner is very important. Dementia management strategies refer to specific means families of dementia patients use to cope with dementing illness of their family members. This study was designed to examine type of dementia management strategies utilized by families and to identify factors influencing them. The subjects in this study were 103 conveniently selected demented patients and their primary caregivers who were registered to a public health center located in Chungcheong Province. The subjects were visited by 20 home visiting nurses, and the data were collected using a structured questionnaire. The data were collected form May 2, 2001 to June 2, 2001. The findings of this study were as follows. 1. The most frequently used types of dementia management strategies were active management (M=3.36, S.D=.96), and encouragement (M=2.94, S.D=.99). Criticism was least used type of dementia management strategy (M=2.71, S.D=.99). 2. The factors influencing each management strategy were as follows; 1) The criticism management strategy was most frequently used by the primary caregivers who graduated elementary school (F=3.21, p<.05). 2) The encouragement strategy was most frequently used by the primary caregivers in a case when the patients were in the mild stage of dementia (F=2.76, p<.05), when the patients never had any treatment experiences (F=2.01, p<.05), when the family could afford the provision of treatment for the patients (F=-2.44, p<.050), and when the primary caregiver had a job (t=2.90, p<.01). 3) The active management strategy was most widely used by the primary caregivers who could afford the provision of treatment for the patients (F=-2.31, p<.05) and were in their 70s (F=3.04, p<.05). This type of management strategy was significantly more used by those who discussed the difficulties of caring with their family members (F=3.46, p<.05). 3. The use of criticism management strategies was significantly correlated with the total level of burden of the primary caregivers. But the types of encouragement and active management strategies had negative correlations with the caregivers' burden although they were not significant. Since the findings of this study showed that the criticism management strategy had a significant positive relationship with caregivers' burden, those who are more likely to use the negative management strategy should be identified in future studies. The primary caregivers who are more likely to use negative strategy should be more closely monitored and be focused as the group who should be intervened in future studies.

• The Journal of the Korea Contents Association
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• v.13 no.11
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• pp.778-790
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• 2013

The purpose of the study was to examine the effects of the Fall Prevention Education Program (FPEP) on those providing direct care in elderly care facilities regarding fall-related knowledge, fall-related burden, and caring behaviors for fall prevention. The FPEP developed in the study was implemented for 80 minutes per session and four sessions in total. Participants included a total of 47 subjects, 24 in the experimental group and 23 in the control group. The program was implemented from July 16 through August 31, 2012. Data were analyzed using ${\chi}^2$-tests, Fisher's exact probability tests, independent t-tests, and analyses of covariance using the SPSS/Win 19.0 program. According to the pre-and post-test, the experimental group participated in the program showed an increase in fall -related knowledge (t=6.71, p<.001), a decrease in fall-related burden (t=-2.31, p=.026), and an increase in caring behaviors for fall prevention (F=49.50, p<.001) as compared to the control group. The results of the study demonstrated that the FPEP developed for those providing direct care in elderly care facilities was an effective intervention for decreasing fall-related burden and increasing fall-related knowledge and caring behaviors for fall prevention.

• Journal of Korean Academy of Nursing
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• v.31 no.1
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• pp.81-93
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• 2001

The purpose of this study was to develop a continuing nursing care program for cancer patients and the caregivers staying at their home and to test its effects on patients' symptom distress, caregiver burden, and satisfaction of life. The continuing nursing care program was based on the homecare needs of cancer patients, and was provided by three clinical nurses who took care of the patients while they were hospitalized. The program consisted of discharge education about selfcare using education materials(book and handout) and provisions of direct care. These were counselling and education during which visiting patients' home one week after discharge and telephone counseling two weeks after discharge. Counseling by telephone was always available during the research period. A quasi-experimental research design was used to test the effects of the program. Subjects for this study were 53 cancer patients discharged from the hospital and caregivers. These subjects were assigned to an experimental group (n=23) receiving continuous nursing care, or to a control group (n=30) not receiving continuous nursing care. Data from control group was collected first to protect from contamination. Data collection was done from October of 1998 to February of 2000. The collected data was analysed using mean, t-test, and chi-square test computed by SPSS software. The summary of results was as follows: 1) The symptom distress was a little decreased at posttest, but there were no significant differences between the experimental and the control group in symptom distress. 2) The score of caregiver burden was significantly decreased in experimental group at posttest, but no differences in control group. 3) There were no significant differences between the experimental and control group in the satisfaction of life. 4) The score of satisfaction of continuing nursing care program in experimental group at posttest was 2.321 of 3. In conclusion, even though this study did not obtain evidence of effectiveness of continuing nursing care program on patients, such as. It is still expected to be effective by a more improved program. Therefore we want to give some suggestions for further studies. 1) It is needed to make a communication channel with the patient's doctor to response promptly and appropriately to patient's conditions. 2) The research is necessary on patients in terminal stage or early stage of cancer diagnosis who have many nursing needs. 3) It is needed to readjust the roles and job assignment of clinical nurse to implement effectively as a program provider.

• Research in Community and Public Health Nursing
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• v.13 no.4
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• pp.648-667
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• 2002

This was a descriptive study designed to identify the level of coping method and its influencing factors on the family caregivers of demented patients, and resolve the family caregivers' level of stress. The data were collected from September 10 to October 10, 2001. Subjects for this study were recruited from four clinics, which were chosen from 15 clinics located in Chunbuk-Do as the study sites because of their cooperation for the study. They were similar in terms of size, the characteristics of the local community. and the population and registration status of the demented patients. The instruments used for the study were as follows: 1. Problematic behaviors of demented patients are measured by the Memory and Behavior Problem Checklist (Zarit, 1980), and the Linguistic Communication Symptoms Questionnaire (Bayles and Tomoeda, 1991) 2. The ability to carry out daily activities was measured using the Barthel Index (1965) and Katz Index (1963), which as well-known ADL assessment methods. 3. Burden was measured using Cost of Care Index by the Kosberg and Cairl (1986). 4. Coping strategy was measured Bell's 18 methods (1977). The data were analyzed using SPSS/PC. The study results were as follows: 1. The total stress score was 2.90 out of a maximum score of 5. The highest score reported was 3.09 on the dimension of restriction of individual and social activities, and the lowest region reported was 2.58 on the dimension of mental and physical health. 2. The total score of the coping method was 2.65 out of a maximum score of 5. The highest score reported was 4.01 on the dimension of thinking that includes an ideation such that it is better than any possible worst case, and the lowest score reported was 1.45 on the dimension of the self-image as a scapegoat. 3. There were significant differences in coping method among the subjects by age (F=2.752 p=0.04), caregiver (F=4.33 p=0.003), care-giving period (F=2.68 p=0.049), and dementia stage (F=2.87 p=0.034). 4. There were highly negative correlations ($\gamma$=-0.301 p=0.000) between problematic behaviors of demented patients and the coping method of their family caregivers. The highest correlation coefficient ($\gamma$=-0.339 p=0.000) was found between aggressive behaviors of the demented patients and the coping method of their family caregivers. 5. There was a low negative correlation ($\gamma$=-0.201 p=0.019) between the ADL of the demented patients and the coping method of their family caregivers. 6. There were highly negative correlations ($\gamma$=-0.213 p=0.005) between stress and the coping method of the family caregivers. The highest correlation was found between financial burden ($\gamma$=-.327 P=.000) and the coping method of the family caregivers. There was no significant correlation among unpleasant aspects of the demented patients, willingness to the demented patients, and the coping method of the family caregivers.