• 제목/요약/키워드: Patient's family

검색결과 703건 처리시간 0.06초

구조화된 재활교육이 뇌졸중환자 가족의 스트레스에 미치는 영향 (A Study of the Effect of Structured Rehabilitation Education on the Stress of the Family with Stroke Patients)

  • 김병은;이정민;이향련
    • 동서간호학연구지
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    • 제1권1호
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    • pp.22-39
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    • 1997
  • Purpose: The purpose of this study is to evaluate the effect of rehabilitation education on the reduction of the stress of family members who have patients suffering from stroke and to find a new way to nurse the patients and their family. Subjects & Methods: The subjects were sixty-one family members with the patients who had been hospotalized in K hospital of oriental medicine from september the 9th, 1996 to september the fourteen, 1996. This study was performed by simulated control group pretest-posttest design; pretest was done on the control group through a questionnaire, counselling and observation while posttest was done on the experimental group 1-2 days after systemic rehabilitation education. To teach the patients and their family, the amended version of a book written by Lee Hae-jin was used as a tool for systemic rehabilitation education. As a method to estimate ADL score, modified Kang's method was applied and ADL score was measured by well-trained technician. As for the tool to estimate the degree of family stress, Choi's method adjusted to this study was applied. In the analysis of the data, social property of the patient and the characteristic of the disease were surveyed in $X^2$ examination to confirm the consistency between the experimental group and the control group. The diffrence in the degree of the stress, which is a dependent factor, was examined by t-test. The difference in ADL score between the experimental group and the control group was examined by t-test. The difference in the degree of the stress according to the general feature of the family with stroke patient, social property of the patients and the characteristic of the disease were surveyed by F examination. The difference in family stress according to the degree of ADL was surveyed by F examination. RESULTS: 1. After hypothetically-examined systemic rehabilitation education, the total of the score of family stress surveyed in 34 items of three domains was compared between the experimental group and the control group. There was no statistically significant difference between two groups; mean score of experimental group=2.28, that of control group=2.93(t=.17, df=59, p=. 66). 2. In the survey on family stress in 34 items, the items over mean score 3.0 were firstly the anxiety of possible disability and relapse of the disease and secondly to watch the patient's suffering without doing anything in the domain of the change of the disease and the difficulty in caring. And the items of the lowest stress with less than mean 2.0 score were little chance to meet the relative and friends, inconsistent treatment and attitude of the medical workers and the change of the attitude of the relative due to the patient orderly in the domain of social and personal relation and the responsibility as the family. The items which showed the difference between two groups were aggravation of neighboring patient(t=3.36, df= 59, p=.001) and the possibility of patient's death(t=2.19, df=58.38, p=.033) in the domain of the change of the disease and the difficulty in caring. 3. In the study on the stress difference according to general features of the family with the stroke patient, the score of family stress with the occupation was higher with mean 2.49 than that of the family stress without occupation with mean 2.16, but there was no significant difference. (F=5.21, df=1/59, p=.026). 4. In the study on the stress difference according to social property of the patient and the characteristic of the disease, there was significant difference in the age of the patients (F=2.98, df=3/57, p=.039). These results show that even if there is no statistically significant difference between two groups, sixteen of the experimental group are less than 3.0 in ADL score(standard 6 score)while eight of the control group are less than 3.0 and that ten of the experimental group are in the year range of 39-49 while four of the control group are in the year range of 39-49 which showed significant difference in family stress. These imply that there is a possibility that the experimental group have serious and fundamental stress resulting in high pretest stress compared with the control group. It might be due to the characteristic of simulated control group pretest-posttest design that the psychologic-supportive effect by the education was not observed. On the basis of these results, the followings are suggested. 1) A study on the nursing-mediated method to reduce the stress in the items which are not resolved by rehabilitation education, a study on nursing according to the patient's age and a study on the supportive nursing toward the family with occupation are required. 2) More than two times consecutive nursing-mediated rehabilitation education to measure the family stress is required. 3) Comprehensive and multilateral systemic education program including the instruction on western-eastern medicine, physical therapy, exercise and diet through collaboration of the experts in each field is required. 4) Family stress at home as well as in the hospital needs to be estimated and home rehabilitation and home-nursing needs to be continued.

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중환자가 지각한 가족지지와 절망감과의 관계연구 (Family Support and Hopelessness in Patients Admitted to Neuro-Surgical Intensive Care Unit)

  • 김현실;조미영
    • 대한간호학회지
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    • 제22권4호
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    • pp.620-635
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    • 1992
  • This study identified correlations between perceived family support and hopelessness in patients admitted to Neuro - surgical Intensive Care Units. The purpose was to enhance theoretical understanding of the relationships of these two variables. The subjects of this study were 51 patients admitted to N-lCU, at three general hospitals in Seoul. Data were collected by researcher in structured interviews from Aug. 12 to Oct. 13, 1992. The research tools were parts of the Moos Family Environment Scale and the Beck Hopelessness Scale. The general characteristic data were analyzed for frequency and percentage ; the hypothesis was tested by the pearson product Moment Correlation Coefficient. After normality tests by using Kolmogorov - Sminorvtest, and T- test, ANOVA and Mann-Whitney U test, Kruskal -Wallis test were used on the Family Support and the Hopelessness about general charcteristics. The results of the above analysis were as follows 1) The average family support score for the group was 63.61 (tool average 51) and item average was 3.74 (tool item average 3) : the family support score of this sample was higher than average. The average family cohesion score of family support was 35.25 (tool average 27) and item average was 3.91 (tool item average 3). The average family expression score of family support was 28.35 (tool average 24) and item average was 3.57 (tool average 3). In this sample, perceived family expression was lower than family cohesion. 2) The average hopelessness score was 45.88 (tool average 60) and item average was 2.29 (tool item average 3) : the hopelessness score of this sample was low in comparison to the average. 3) The hypothesis in this study was supported. The main hypothesis that the higher the perceived family support level, the lower the level Of the hopelessness, was Supported (r=-.3869 p=.003). The sub-hypothesis that the higher the perceived family cohesion level, the lower the level of hopelessness, was supported(r=-.3688 p=.004). The sub-hypothesis that the higher the perceived family expression level, the lower the level of hopelessness, was supported (r=-.3068 p=.014). 4) General characteristics of the objects related to family support were ‘economic status’(p=.025) and ‘helping person’(P=.044) : the higher the economic status, the greater the family support. When the patient identified the helping person as a spouse, family support was rated more highly. The only general characteristic related to family cohesion was ‘helping person’(p=.041). No general characteristics were related to family expression. 5) The one general characteristic related to hopelessness was ‘education’(p=.002) : the higher their education, the lower their hopelessness. For these ICU patients, were related perceived family support and hopelessness, and family expression level was low in comparison to family cohesion level. The perceived family support of these seriously ill patients in situational crisis may have influenced the patient's emotional reaction of hopelessness. This study concluded that nurses in the ICU confirm the family support of the patient, and involve the family as the most intimate support systems in the care of the patient to help reduce the patient's hopelessness.

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파킨슨병 환자 가족의 삶의 질에 미치는 영향요인 (Factors Affecting the Quality of Life of Family Caregivers of Patients with Parkinson Disease)

  • 김규리;김민주
    • 근관절건강학회지
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    • 제26권2호
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    • pp.102-110
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    • 2019
  • Purpose: The purpose of this study was to investigate the factors affecting the quality of life of family caregivers of patients with Parkinson disease in Korea. Methods: A total of 162 family caregivers of patients with Parkinson disease who were visiting the D hospital in B city completed questionnaires, including general and disease-specific characteristics, family burden, patient-caregiver relationship satisfaction, family support and quality of life. Data were analyzed with t-test, ANOVA with $Scheff{\acute{e}}$ test, Pearson's correlation coefficient, and multiple regression analysis using SPSS 23.0. Results: The average score of the quality of life was $85.54{\pm}17.74$ (range: 26~130) among family caregivers of patients with Parkinson disease. Stepwise multiple regression analysis revealed that fifty percent of the quality of life was explained by family support, family burden, and patient-caregiver relationship satisfaction. Conclusion: Family support, family burden, and patient-caregiver relationship satisfaction were identified as factors affecting the quality of life of family caregivers of patients with Parkinson disease. Therefore, it is necessary to develop a program to enhance family support and reduce family burden to improve the quality of life of family members caring for patients with Parkinson disease.

뇌졸중 환자를 돌보는 가족의 심리적 안녕감에 영향을 미치는 요인 (Influencing Factors that Affect the Psychological Well-being in Family Caregivers of Stroke Patients)

  • 김정희;김옥수
    • 대한간호학회지
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    • 제35권2호
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    • pp.399-406
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    • 2005
  • Purpose: The purpose of this study was to investigate the factors that affect the psychological well-being in family caregivers of stroke patients. Method: The General Health Perception, short form 36, Health Survey Questionaire was used to measure health perception. The Caregiving Mastery Scale was used to assess the mastery, while the Psychological General Well-Being Index was used to examine the level of well-being. Result: Subjective health, caregiving mastery, patient's ADL and caregiving duration influenced on caregiver's psychological well-being. Subjective health had effect on psychological well-being both directly and indirectly. Caregiving duration and patient's ADL had indirect effect on psychological well-being through caregiving mastery. Conclusion: It is need to develop a health program for the caregivers of stroke patient's and to provide nursing intervention to improve the caregiver's ability, thereby improving the well-being of the family caregivers.

영화 '마빈스룸' 가족간호중재 -시나리오 접근법- (The Scenario Approach Method for Family Nursing Intervention Based on the Movie 'Mabin's Room')

  • 박경민;김정남
    • 지역사회간호학회지
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    • 제12권3호
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    • pp.627-638
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    • 2001
  • Caring is an essential element of nursing. In a family with a patient. a critical situation may happen not only for the patient but also for the members of the family. Therefore, a caring service from the healthcare providers can also be requested for the family members. The movie 'Mabin's Room' deals with family problems. In this study, the assessment, problem, diagnosis and planning for the family nursing situation for family problems were made focusing on the role of characters in the movie 'Mabin's Room'. Regarding family nursing intervention, the framework of the story 'Mabin's Room' was reorganized to solve the problems based on the role of community health nurse. In this scenario approach method, the situation in the movie is used without change but the scenario related to the roles (or communication) of community health nurse for solving the family problems is added. It is a problem solving oriented method by reorganizing the scenario in a movie story situation. The reorganized scenario in this study is just an example of scenario approach method. Community Health Nurses can cultivate their creativity by solving various problems in the community by adopting or modifying this simple scenario in practice.

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암환자를 돌보는 가족원의 스트레스, 대처방식과 소진의 관계 (Relationships between Stress, Ways of Coping and Burnout of Family Caregivers of Cancer Patients)

  • 홍민주;태영숙;노미영
    • 종양간호연구
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    • 제12권1호
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    • pp.92-99
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    • 2012
  • Purpose: The study was to examine the relationships between stress, ways of coping and burnout among family caregivers of cancer patients. Methods: Data were collected by self-reported questionnaires from 207 family caregivers of cancer patients at one university hospital and one general hospital in Busan, Korea. The instruments included a Stress Scale, a Ways of Coping Scale and a Burnout Scale. The collected data were analyzed using frequency, percentage, t-test, ANOVA, Scheffe's test, and Pearson's correlation coefficients with the SPSS WIN 19.0 program. Results: Stress was found to have significant relationships with age, relation to the patient, education, monthly income, degree of care-giving, financial burden and activities of daily living of patient. In active coping, there were significant differences according to education and religion. Passive coping was significantly related to gender. In burnout, there were significant differences according to age, relation to the patient, education, occupational status, monthly income, degree of care-giving, financial burden and activities of daily living of patient. Stress and burnout showed a positive correlation, while there was a negative correlation between burnout and active coping. Conclusion: These results suggest that promoting active coping would better support family caregivers of cancer patients in managing burnout effectively.

말기 대장암환자에서 중상을 통한 예후 측정 및 증상조절 (Predicting Life Span for Terminal Colon Cancer using Clinical Symptoms)

  • 이도행;최윤선;홍명호;김준석;이경진;김영수
    • Journal of Hospice and Palliative Care
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    • 제2권2호
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    • pp.138-143
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    • 1999
  • Accurately estimating survival times in terminal cancer patients is very difficult for palliative care clinicians. But a reasonably accurate estimate of survival would permit the medical team to : Plan the ideal therapeutic strategy between overtreatment and too early discontinuation of specific therapy. Answer any questions asked by the patient or family. Organize adequate assistance for the patient concerned. Decide on the eligibility of the patient for clinical trials and whether to begin a treatment, the effects of which will not be immediate. This case was a 79 year-old male patient with colon cancer. He complained of dry mouth, anorexia, weight loss and showed KPS $40{\sim}50$ on admission day. 40 days later he died. To improve patient/family quality of life, it is necessary to improve the ability to estimate accurately a patient's length of survival.

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중환자 가족의 부담감, 건강증진행위 및 건강상태에 관한 연구 (A Relation Study on Burden, Health promotion Behavior and Health Status of the Family Caregiver of Intensive Care Unit Patient)

  • 김은실;박정숙;박청자
    • 대한간호학회지
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    • 제32권5호
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    • pp.654-664
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    • 2002
  • The purpose of this study was to identify the burden, health promotion behavior and health status and to describe the relationship of the burden, health promotion behavior and health status of the family caregivers of intensive care unit patients. Method: The subjects were 48 family caregivers of ICU patients in a University Hospital. Data were collected between June, 1 and July, 31, 2000 using structured questionnaires. Research tools used were Suh and Oh's Burden Scale, Revised Walker, Sechrist, & Pender's HPLP(1987) ; Revised Nam's Health State Scale(1965). Result: The mean score of burden of family caregiver was 3.01(full score was 5). The mean score of health promotion behavior of family caregiver was 2.52(full score was 4). And the mean score of health status of family caregiver was 0.68(full score was 1.00). The score of psychological health state was a little higher than the physiological one. In correlational analysis, the burden and the health status of caregivers were reversely correlated . The correlation between the burden and the health promotion behavior, and the health behavior and health status were not significant. Conclusion: The more burden caregivers of ICU patients felt, the worse their health status. So nurses need to understand the family caregiver's burden and apply nursing care that can reduce burden, in order to improve the health status of family caregivers.

의학적 충고에 반한 퇴원의 특성과 퇴원결정 요인에 관한 연구 - 사회사업가의 개입사례와 역할을 중심으로 - (A Study on the Characteristics of DAMA(Discharge Against Medical Advice) Case and Causal Factors of DAMA - Perspective of Medical Social Worker's Role and Intervention -)

  • 강흥구;이상진;조경기
    • Journal of Korean Neurosurgical Society
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    • 제29권12호
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    • pp.1620-1627
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    • 2000
  • Objectives : DAMA cases were analyzed to examine what the main casual factors of DAMA were and how to deal with these cases effectively in hospital with the DAMA interdisciplinary team including medical social worker whose role is to perform psycho-social assessment, family counsel, to evaluate family's DAMA need. Patients and Methods : The content analysis of medical record and social work record were reviewed in 37 cases referred by medical doctor to DAMA team. These cases were reported by patients' self discharge request or family's request for discharge from September 1998 to February 2000. The DAMA team consists of Assistant Director of Hospital as team leader, medical staff in-charge, social worker, QI nurse, other staff members who are not involved in direct treatment for patient, and administrative clerk. Results : The results of content analysis are as follows : 1) The most causal factors of DAMA consist of combination of more than 2 factors. 2) The major decision-maker is revealed to be son and daughter of patient. 3) In 59.4% of cases, family was not informed of patients' prognosis, alternatives, the consequence of DAMA at all. 4) In cases of DAMA report, the rapid intervention of social worker is carried out. Conclusion : In this study, we propose the interdisciplinary team approach to make decision legitimately and ethically for DAMA. The suggestions from this study are as follows : 1) To deal with DAMA case properly, the interdisciplinary team approach should be considered. 2) The criteria for DAMA case should be formed carefully. For the explicit selection of DAMA case, preliminary system for high-risk patient screening is recommended. 3) The medical social worker is available for the psycho-social problems of the patient once family members. For the effective family counselling, discharge planning and nursing home placement, the participation of medical social worker should be mandatory.

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암환자의 일차간호제공가족의 스트레스 인지평가 영향 요인 분석 (Factors Influencing Stress Appraisal of Cancer Patients' Primary Caregivers)

  • 신계영;김매자
    • 성인간호학회지
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    • 제14권1호
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    • pp.125-134
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    • 2002
  • Purpose: The objectives for this study were to identify the factors that correlate with appraisal of illness and to explore what variables are predictive of cancer patients primary caregivers' cognitive appraisal for stress. Method: The subjects were selected by convenient sampling and 130 caregivers who completed a questionnaire. Measures used in this study included the Family Inventory of Resources for Management, Social Support Index, Family Crisis Oriented Personal Evaluation Scales and Family Coping Coherence Index. Pearson correlation was used to identify the relationship among factors and multiple regression was used to determine the individual and cumulative effect of potential predictors on the caregivers' appraisal. Results: Patient's level of activity, severity of the disease, quality of relation between patient and caregiver, caregiver's subjective health status, economic status, family resources and coping were significantly correlated. Among the variables, coping, family resources, economic status and quality of relation between caregiver and patient predicted 49.2 percent of the variance in appraisal of caregivers' stress condition. Conclusion: These findings suggest that coping mechanisms and family resources are important for positive appraisal. Nurses should provide adequate nursing care for the primary caregiver about professional care information and supportive counseling.

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