• 한국노년학
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• v.36 no.4
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• pp.1037-1058
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• 2016

This study aims to investigate the female caregivers'experiences of aggression by nursing home residents, and to identify the policy strategies for violence prevention referred by the female caregivers. A total of 121 female caregivers with more than 6 months of working experiences had participated in this study. Of these, 56.2% had experienced verbal aggression, 51.2% physical aggression, and 27.3% sexual aggression, which reveals that client violence toward caregivers in nursing homes was at an alarming level. Although, physical and verbal violences were mostly caused unintentionally, about a half of the sexual aggression were caused deliberately. Aggression occurred the most when caregivers were providing the following services: changing the diapers or clothes, giving a bath, and serving meals. It was found that 'hitting' was the most common form of physical aggression and it was 'swearing' and 'touching or physical contacting' in the case of verbal and sexual aggression, respectively. Though there was a difference depending on the type of aggression, the most frequent reactions against client violence were to start a conversation or calm down the nursing home residents, and to leave the scene or ignore the incident. This means that the caregivers are coping very passively through resolving the aggressions by themselves, or overlooking the situation. The most frequently recommended strategy to prevent resident aggression was to provide educational programs on violence prevention to nursing home residents and caregivers(42.7%). Compared to the previous studies, this study indicates some differentiated strategies to prevent violence in nursing homes, which include hiring male caregivers, assuring directors to pay closer attention toward caregivers, using refined language between caregivers and residents, and keeping caregivers to wear appropriate clothes. Based on the study results, some policy recommendations on the prevention of client violence in nursing homes were suggested.

• Journal of Hospice and Palliative Care
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• v.17 no.3
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• pp.161-169
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• 2014

Purpose: This study was conducted to comprehensively investigate nursing students' experience of their first encounter with death of a patient during clinical practice. Methods: This study took place from January 27 through March 6, 2012 with eight female senior nursing students enrolled at Pusan National University located in Y city who have experienced patient death. We collected their experience of their first death encounter during their clinical rotation by asking, "What is your first experience of patient's death during the clinical practice?" Husserl's phenomenological approach was applied in this study. Results: In this study, 17 themes, 15 clusters of themes and eight categories were derived. The categories included "Desire to avoid the reality of death", "Powerlessness", "Anticipation for recovery shifted to fear of death", "Various interpretations of death", "Limitations in their nursing practice", "Resentment of lack of nurses", "Longing to better understand death", and "Motivation for inner growth". Conclusion: Through their first encounter with death of a patient, nursing students experienced various emotions and viewed their role as hospice caregiver by projecting themselves as fully trained nurses in future. Participants considered terminal care as a part of nursing care. The result of this study indicates the need to include education of death in the nursing school curriculum.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.1
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• pp.56-65
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• 2004

Objectives: The aim of this study was to investigate the quality of life of caretaking family members who have a patient with psychiatric disorders. The results will be served as a basic data of ameliorating the quality of life of caregivers. Methods: 78 caretaking family members who have a patient with schizophrenia and 54 caretaking family members who have a patient with alcohol dependence, a total of 132 persons completed the questionnaire, and analyzed. The Korean version of the SmithKline Beecham Quality of Life Scale and the Family Burden Scale were applied. Results: There was no statistically significant correlation between burden and sex, age, income, and duration of living with patients before onset. The male caregiver showed higher quality of life than that of female. It showed statistically significant correlation between age and factor physical well-being and factor activity. 41% of variance of quality of life of caregivers were explained by the stress response, burden, and overall merits of the field of psychiatry, and the tension had the most explanatory power. Conclusion: The chronic illness may give a burden on caregivers, and that decrease the quality of life of caregivers. The longer duration of illness of patients, the lower quality of life of caregivers on competence factor. Therefore, the authors recommend the therapeutic modality must be offered to the caregivers who may experience the stress and burden.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.837-840
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• 2015

Background: The disclosure of a diagnosis of cancer is complex, particularly in older patients. The aim of this study was to investigate the association between age and not knowing the diagnosis, and its impact on mood. Materials and Methods: The study included 70 patients with various types of solid and hematologic cancer in early stages, which were followed up in an outpatient oncology/hematology clinic in Turkey between January, 2014 and June, 2014. Initially the caregivers of patients were asked whether the patients knew their diagnosis or not. A questionnaire for the Geriatric Depression Scale was then administered to the patients. Patient age, gender, marital status and education level were noted and analyzed with respect to knowing the diagnosis and depression. Results: Of the 70 patients, 40% of them were female. The mean age was $68.2{\pm}8.9$. The rate of the patients who does not know their diagnosis was 37.1% (n=26). The overall depression rate with GDS was found 37.1% (n=26) among the participants. There was no association with knowing the diagnosis (p=0.208) although the association between not knowing the diagnosis and age was significant (p=0.01). Conclusions: In this study we revealed no association between not knowing the diagnosis and depression in elderly patients. Contrary to what some has thought, the patient is not protected from psychological distress by not being informed about the diagnosis. We believe this study and similar ones will help to discuss and further explore patient autonomy, the principle of respect to self-determination and end of life issues in different cultures.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.373-379
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• 2013

Background: Although caregiving to patients with terminal illness is known to be a stressful burden to family members, little attention has been focused on work-related problems. We aimed to investigate employment status and work-related difficulties of family caregivers of terminal cancer patients, comparing with the general population. Methods: Using structured questionnaires, we assessed family caregivers of 481 cancer patients determined by physicians to be terminally ill, from 11 university hospitals and the National Cancer Center in Korea. Results: Among 381 family caregivers of terminal cancer patients (response rate, 87.6%), 169 (43.9%) were not working before cancer diagnosis, but currently 233 (63.7%) were not working. Compared with the general population (36.5%), the percentage of not working among the family caregivers was higher (OR=2.39; 95%CI=1.73-3.29). A major reason for not working was to provide assistance to the patients (71.6%). 40.6% of those who continued working and 32.3% of those who not working family members reported extreme fatigue. Caregivers of old age, those who were female, those with a lower household income, and those caring for patients with a low performance status were not working at a more significant rate. Conclusion: Family caregivers of terminal cancer patients suffer job loss and severe work-related difficulties, probably due to caregiving itself and to fatigue. We need to develop supportive programs to overcome the burden of caregivers of the terminally ill.

• Research in Community and Public Health Nursing
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• v.9 no.1
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• pp.181-199
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• 1998

This study was designed to examine Home Nursing Care in Hospital-based and Community-based programs. This study investigates actual conditions of nursing needs and demands of clients and their family and the state of home nursing services. We hope that this study will improve upon the current home nursing care system. In Korea Home-Nursing Care programs are still developing and only now becoming a part of the health care delivery system. The data was collected by a questionaire the clients developed and modified through literature review by this writer and through 10 nurses who are members of 4 hospital and 3 community- based agencies. In this study 173 clients were selected. The study lasted from Oct. 1997 to March of 1998. The results show that the average age was 64.3, years older than most women clients (63.0%), the average age of a caregiver was 50.9 years old and most were female(77%). Two types of agency clients with a significant difference between social conditions [25.7%] used some form of insurance; 54.3% had the spouse pay expenses; pay 58.5% son and daughters of Hospital-based agencies: patients of social workers were 24.0%, the highest in the community agency. The condition of patients was 63.2% of the foley and nelaton catheter insertion at hospital based agencies. The range of nursing services offered is one of the highest among the 34 kinds of servies including nasogastric tube management basic nursing, ROM exercise, bladder irrigation, wound and sore dressing. For an effective care service factors that disturb each program such as a non-cooperatative family as well as patients themselves need to be lessened. Further more, the following must be emphasized, supportive counsel 27.0%, steady care for patient, 13.3%maintain a sense of security(11.7%), dressing sores and nutrition(10.0%). Although there were a large number of home nursing care services in the community, policy changes have gathered momentum. Fortunately, the scope and level at legal support will be increased in the future. The program should intergrate and link the district or community together. A project to develop a community based home nursing system as soon as possible should be developed. In conclusion, home nursing care nurses training curriculum should be strengthened.

• Journal of Hospice and Palliative Care
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• v.9 no.1
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• pp.35-39
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• 2006

A 77-year-old female presented panperitonitis due to advanced gastric ranter during palliative care. In the case of panperitonitis following obstruction or perforation, surgical treatment is vital to avoid fatal sepsis and dehydration. However, the risk of surgery and the residual life of a patient must be carefully considered because of high mortality and complication rate in those patients with advanced disease due to the poor condition. The therapeutic value of aggressive hydration, nasogastric tube insertion, and the use of antibiotics is also questionable. Palliative surgery was not performed on this case, and she passed away peacefully in the presence of family after 4 days of palliative medical care. Here is the appropriate management for this kind of patients we would like to recommend through review of relevant references and long discussions. Firstly, we need to predict survival time using clinical variables. Secondly, considering patient status and risk of surgery, non surgical palliative care such as pain control, transient nasogastric tube insertion, and parenteral hydration is recommended. Minimal use of fluid is desirable to minimize complications such as edema and dyspnea if massive hydration in the beginning of treatment is not proved to be effective. Even though started earlier in the course of disease, discontinuation of antibiotics could be discussed with patients and their caregiver if patient status is not improved.

• Korean Journal of Health Psychology
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• v.16 no.1
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• pp.169-187
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• 2011

The present study explored psychosocial characteristics of infants with genital anomalies (GA) and their caregivers against normal controls. Participants were female caregivers and infants between the ages of 6to38months diagnosed with hypospadias(HS;n=103) or cryptorchidism (CR;n=49). Normalcontrols(n=131) were recruited and selected via Internet. Caregivers completed measures on parenting stress, coping style, social support, and infant temperament. Within the GAgroups, HScaregivers reported their greatest parental concerns as infant urination/bodily functioning difficulties whereas CRcaregivers reported worries related to surgical anesthesia issues. Both groups reported concern about their children's potential reproductive problems. Per caregiver report, infants with GA had lower ability to self-soothe. HS infants in particular were perceived as exhibiting greater negative emotion. Compared with controls, HS and CRcaregivers overall employed coping strategies more frequently and had lower interpersonal sensitivity and parental distress. However, HScaregivers emerged as experiencing higher stress when compared to the CRgroup. There were no differences in to tal parenting stress and social support scores between groups. Further, CRcaregivers reported lower levels of family discord than controls. Despite temperament-related differences between infants with GA and normal controls, HS and CRcaregivers reported lower parental distress and greater use of coping skills as compared to controls. Clinical implications are discussed.

• Health Policy and Management
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• v.33 no.3
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• pp.311-324
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• 2023

Background: Long-term care insurance for the elderly has been stably established along with the quantitative expansion of long-term care facilities. Indeed, the need for a paradigm about human rights-based service approach is being raised throughout society from a service perspective. Therefore, this study aimed to analyze the association between elderly human rights awareness and quality of service by considering human rights education as a moderate variable. Methods: This study conducted surveys with 138 caregivers working in long-term care facilities located in Seoul and Gangwon. General characteristics, awareness of human rights, and the level of service quality were examined using descriptive statistics, frequency analysis, and correlation analysis. And multi-variable linear regression with a hierarchical framework was employed. These analyses were performed using IBM SPSS ver. 25.0. Results: Of the 138 caregivers, 97.1% were female, 87.7% were more than 50 years old, and most of their education level was high-school graduates. Their length of employment ranged from more than 5 years to less than 10 years. The level of awareness regarding elderly human rights of the elderly was below normal (mean=2.21), but the quality of service was high (mean=4.21), and the need for human rights education was also high (mean=4.28). Among the general characteristics, the length of employment was significantly associated with awareness of elderly human rights. Moreover, political rights awareness, included as sub-domains of human rights, was positively associated with quality of service. However, the moderating variable, human rights education, was not significantly associated with the quality of service. Conclusion: In this study, human rights education, as a moderating variable, did not have a statistically significant effect on caregivers' human rights awareness in relation to service quality. This finding is inconsistent with previous research results. These results can be explained by the fact that the frequency of education in long-term care facilities was a significant factor in the practice of protecting the human rights of the elderly. Therefore ongoing encouragement for the frequency of current human rights education and improvements in the educational approach appear to be necessary. In addition, these findings reveal the need for strength of education policies and effective in-depth research about human rights and quality of service to respect the human rights of the elderly.

• Clinical and Experimental Pediatrics
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• v.50 no.5
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• pp.436-442
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• 2007

Purpose : To promote awareness and efforts by pediatricians to identity and prevent child abuse by investigation of characteristics of victim and types of injury caused by abuse. Methods : A retrospective study was performed with 20 patients who had been diagnosed or suspected as child abuse at Hallym University Hospital from January 1999 to December 2005. The medical records, radiologic documents, and social worker's notes were reviewed to investigate age, sex, visiting time, form of abuse, perpetrator, risk factor, and type of injury. Results : The mean age of the subjects was 2.8 years. Fourteen patients were between 0-1 years old, 2 patients between 1-6 years old, 3 patients between 7-12 years old, and 1 case over 13 years old. The ratio of male to female was 1:1. The majority of these patients (70%) visited via emergency department. Eight five percent of these patients reported with physical abuse, 5% psychological abuse, 5% sexual abuse, and 5% neglect respectively. The suspected perpetrator was the biological father in six cases, the biological mother in three cases, the stepmother in two cases, caregiver in one case, relatives in one case and "unknown" in six cases. Bruise and hematoma (80%) were the most common physical findings. Skull fractures were diagnosed in six cases, long bone fractures in two cases, hemoperitoneum in two cases, subdural hemorrhage in 10 cases, epidural hemorrhages in two cases, subarachnoidal hemorrhages in two cases, and retinal hemorrhages in five cases respectively. Seventeen cases required hospitalization and surgical operations performed were in nine cases. Four patients died and three patients had sequalae such as developmental delay and quadriplegia. Conclusion : Child abuse results in high mortality and morbidity in victims. Therefore early recognition and prevention is very important. Pediatricians should always suspect the possibilities of abuse in cases of fracture, intracranial hemorrhage, abdominal injury, or even any injury to the body. We recommend that the clinical investigation of suspicious children should include a full multidisciplinary social assessment, a skeletal survey and CT or MRI.