• Korean Journal of Adult Nursing
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• v.12 no.3
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• pp.384-395
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• 2000

This study examined burdens of primary family caregivers, and family functioning of patients with cancer. In addition, the relationship between two concepts was assessed to develop nursing intervention to reduce the burdens of caregiving, and to improve family functioning. Ninety-two primary family caregivers of patients with cancer at a general hospital in Seoul participated in this study. The patients with cancer aged from 19 to 84 years with a mean age of 51 years, and sixty-one percent were male. About 30 percent of the patients suffered liver and billiary tract cancer. Fifty-six percent of the primary family caregivers were spouses of the patients and 70.7 percent were women. Primary family caregivers' burdens were assessed by the Burden Scale originally developed by Zarit (1980) and Novak & Guest(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales: time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financial burden. Family functioning was assessed by the Family APGAR developed by Smilkstein(1978). The results were as follows: 1. The average burden score was 86.1, indicating a moderate level of burden. The time-dependent burden scored highest followed by developmental, physical, social, financial, and emotional burdens. The mean score of family APGAR was 9.71; among subjects 82.6% were included in dysfunctional families. 2. Of the characteristics of patients, age, gender, number of admissions, and job were found to be associated with the level of burden. There was no significant difference between patient characteristics and family functioning. Of the characteristics of primary family caregivers, caregiver's perception of patient prognosis was significantly related to the level of burden, and family functioning. Caregiver's sex and age were also related to family functioning. The quality of relationship between a patient and a caregiver was significant situational factors affecting the level of burden, and family functioning. In addition, the income of family, and help from other family members were related to the level of burden. Given the results, it is essential to develop nursing intervention to reduce burden and to improve family functioning, such as support groups.

• 한국노년학
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• v.29 no.3
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• pp.1043-1061
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• 2009

The purpose of this study is to evaluate cost side by type of long term care services economically, and then to discuss the findings and implications for the results of analysis. For this research, primary caregivers that provide care the elderly requiring long term care services sanctioned by National Health Insurance Corporation were drawn and surveyed. Among collected data, data for 422 primary caregivers were used for this study. The subjects used in this study consisted of family caregivers from various settings that give care to the elderly. The results of this study can be summarized as follows. First, caregiver's household income level is low. Therefore, caregiving families with the elderly are likely to have financial difficulties. Second, under coverage of long term care insurance system, the direct cost caregiving households pay for the elderly is still very high. Third, indirect cost of caregiving households accounted for the larger proportion caregiving costs. Fourth, social cost burden for caregiving the elderly is very high. This cost amount is appropriately equal to household income of caregivers surveyed in the research. Fifth, service use cost of caregiving households is differentiated by type of long term care service. Sixth, direct cost of caregiving households is statistically significantly differentiated by type of long term care service, but is differentiated less than service use cost. Seventh, social indirect cost for caregiving the elderly is statistically significantly differentiated by type of long term care service. Eighth, social cost amounts for the elderly utilizing long term care service is very high, total social cost per capita by types of long term care service tend to converge on average social cost per capita of total service.

• The Korean Journal of Rehabilitation Nursing
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• v.5 no.1
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• pp.27-37
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• 2002

During acute stages of hospitalized stroke patients, family caregivers face many challenges. They often experience emotional distress, social isolation, and financial constraints. However, the burden of caregiving of stroke patients in acute stages has never been studied properly. The purpose of this study was to investigate the factors related to the caregivers' burden with acute stroke. The subjects were 123 acute stroke patients and their caregivers who were admitted to neurology and neurosurgery units at Dan Kook University Hospital in Chung-Nam area. An interview was performed with the use of standardized questionnaire which included data pertaining to the patients/caregivers characteristics, caregiver burden (Modified Zarit's Burden Scale), and social support (Personal Resource Questionnaire). Our results showed that the mean burden score was 3.11, indicating high level of burden. Among the sub-domain scores, financial burden was the highest. In univariate analysis, the factors related to caregiver burdens were: inability to communicate between patients and caregiver(p<.001); low cognitive function of the patients(p<.001); low level of ADL(p<.001); the gender of caregiver(p<.001); the current employment status of caregivers(p<.01); the presence of social support for caregiver(p<.001); and the availability of alternative caregivers(p<.001). In multiple regression analysis, social support for family caregivers (87%), low level of patient's cognition (2%), availability of 2nd caregiver (1%), and gender of caregiver (female, 0.4%) were significant explanatory factors of overall burden. The caregivers' burden in acute stages during hospitalization following stroke was high. Recognition of high levels of caregivers' burden and those relating factors affecting caregiver burden may allow us to develop different nursing strategies to unload the level of burden for caregivers in acute stages of stroke.

• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.629-640
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• 2000

The purpose of this study was to develop and validate the scale to measure dementia patient's caregiver burden of Korea. In the first phase of the study, 15 caregivers of dementia patients were interviewed to provide narrative data from which items were developed. Initially 65 items were generated from the interview data of 15 caregivers. Content validity was judged by two separate panels of experts with 27 professionals and 30 family caregivers. These items were analyzed through the Index of Content Validity and 33 items were selected which met .80 or more of the CVI. This preliminary FCBSD-K was tested with 207 adult caregivers for reliability and construct validity including item analysis and orthogonal(Varimax) factor analysis. Eight items were deleted because of high or low item-item correlation. The result of the second factor analysis produced six factors that coincided with the conceptual framework posed for the scale developed. The six factors were labeled as 'physio social factor' 'emotional factor' 'family cultural factor' 'role obligation' 'guilt feeling' and 'financial & supportive system factor'. The alpha coefficient relating to internal consistency was .9264 for reliability. In conclusion, cultural factor is related to dementia patient's caregiver burden and FCBSD-K was useful in assessing the dementia patient's caregiver burden in Korea.

• Korean Journal of Family Social Work
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• no.53
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• pp.235-263
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• 2016

The purpose of this study was to examine the relationships among caregiving stress, depression, and partner violence by gender. Data were gathered though questionnaires surveying 223 cases living in the Seoul and Kyeonggi, Pusan areas. In analyzing precess, the researchers used t-test, ANOVA, correlation and regression. Additionally, bootstrapping was used to verify the significant mediating effect of depression. The findings are follows: First, approximately 37.3 percent of adult children caregivers reported having experienced partner violence in the past year. And the depression mean score among adult children caregivers was 1.00, higher compared to 0.73 of general population. Female caregiving burden and depression level was higher than those of male. Second, the results from regression analysis revealed that caregiving stress influenced to partner violence positively. Depression has the full mediating effect between caregiving stress and partner violence. The results suggest a necessity of intervention to reduce caregiving stress, depression and prevent partner violence in the dementia caregiver's family. The implications for social work practice were also discussed.

• 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 Korean Academy of Nursing
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• v.37 no.5
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• pp.693-702
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• 2007

Purpose: The purpose of this study was to develop and evaluate the effects of a support group intervention on the burden of primary family caregivers of stroke patients. Method: A nonequivalent control group pretest-posttest design was used. The subjects were 36 primary family caregivers of stroke patients [experimental(N=18) and control(N=18) groups] in a neurosurgery ward of a university hospital. The experimental group members participated in six sessions of a support group intervention for two weeks and the degree of their caregiving burden was evaluated. Data was analyzed by Chi-square tests, t-tests, and paired t-tests using SPSS 10.0. Result: The experimental group had a significantly lower total burden score (t=2.06l, p= .047)and sub-scales of emotional(t=-3.319, p= .002), time-dependent(t=-2.045, p= .049) and developmental(t=-2.656, p= .012) burden scores than the control group, while no significant differences were found in physical, social or financial burden scores between the two groups. Within the experimental group, there was a significant decrease in physical(t=2.507, p= .023), emotional(t=4.754, p= .000), social(t=2.932, p= .009), time- dependent(t=5.015, p= .000) and developmental(t=7.541, p= .000) burden scores but not the financial burden score. Conclusion: The results suggest that a support group intervention can be utilized as an effective nursing program to reduce the burden of primary family caregivers of stroke patients.

• Korean Journal of Social Welfare Studies
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• v.44 no.3
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• pp.31-56
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• 2013

The purpose of this study was to investigate the changes that family caregivers have experienced since using the Korean Long-Term Care Insurance(LTCI) system. In-depth interviews were conducted to determine how the services offered within the LTCI program had affected family caregiving and what changes they had incurred. Results from the qualitative content analysis show that the LTCI program significantly reduced the caregiving burden among family caregivers although burdens that family caregiver perceived varied greatly depending on the types of service that the family selected, and assigned family caregivers different identities and diverse roles(i.e., service user, family caregiver, certified care provider) depending on the service they use. The phenomenon of 'certified family care provider', which was not an intention of LTCI, demonstrates the practical need of elderly persons who require both care and the comfort of family and economic status of the family. Despite the positive impact of the LTCI policy on the family caregivers' burden and family relationship, the current LTCI system should be modified in order to better meet the needs of beneficiaries and their family caregivers.

• 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.

• Korean Journal of Social Welfare
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• v.61 no.2
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• pp.325-348
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• 2009

This study intends to investigate the main and mediating effects which caregiving appraisal and positive reappraisal exert on quality of life (QOL) of primary family caregivers of cancer patient considering the relationship with social support. The processes of this study areas follows. First, the variables which research model were chosen on the basis of stress-appraisal-coping theory through reviews of the previous studies. Second, a survey was conducted upon 295 primary caregiver of patient with cancer at National Cancer Center. Collected data were analyzed by SPSS 12.0 and SEM (Structural Equation Modeling) method using AMOS 5.0. The summary of the result is as follows. First, the entire model including measurement and structural model shows sufficient fit index of CFI(.951), TLI(.940) and RMSEA(.062). Second, the results of analysis of direct effects among variables are as follows. The 'Social support' has statistically significant direct effect on the 'feeling of burden' and 'growth'. The 'feeling of burden' has statistically significant direct effect on the 'growth' and 'QOL-mental and physical'. The 'growth' has statistically significant direct effect on the 'QOL-mental'. Third, the results of analysis of mediating effects of the 'social support and QOL' and 'feeling of burden and QOL' are as follows. The effects of 'social support' on 'QOL-mental' are significantly mediated by the 'feeling of burden' and 'growth'. The effects of 'social support' on 'QOL-physical' are significantly mediated by the 'feeling of burden'. The effects of 'feeling of burden' on 'QOL-mental' are significantly mediated by 'growth'. Through this research, these implications in social work study and practice are found: (1) this study extended the scope of study in the caregiver's health area from negative sides into positive ones by using growth variables as positive reappraisalof caregiving in research model, which has not been tried on the Korean family caregivers of the cancer patient. (2) The effects of positive reappraisal on QOL-mental can provide a foundational necessity for social workers to help family caregivers find positive meaning in their caregiving experience. This approach of social work practice will improve QOL of family caregivers. (3) This study present a framework including social support, negative appraisal, positive reappraisal, and QOL variables available to social work practice and explaining affective relationships among these variables in various aspects.