• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.4
• /
• pp.1779-1784
• /
• 2016

Background: Western physicians tend to favour complete disclosure of a cancer diagnosis to the patient, while non-Western physicians tend to limit disclosure and include families in the process; the latter approach is prevalent in clinical oncology practice in India. Few studies, however, have examined patient preferences with respect to disclosure or the role of family members in the process. Materials and Methods: Structured interviews were conducted with patients (N=127) in the medical oncology clinic of a tertiary referral hospital in Bangalore, India. Results: Patients ranged in age from 18-88 (M=52) and were mostly male (59%). Most patients (72%) wanted disclosure of the diagnosis cancer, a preference significantly associated with higher education and English proficiency. A majority wanted their families to be involved in the process. Patients who had wanted and not wanted disclosure differed with respect to their preferences regarding the particulars of disclosure (timing, approach, individuals involved, role of family members). Almost all patients wanted more information concerning their condition, about immediate medical issues such as treatments or side effects, rather than long-term or non-medical issues. Conclusions: While most cancer patients wanted disclosure of their disease, a smaller group wished that their cancer diagnosis had not been disclosed to them. Regardless of this difference in desire for disclosure, both groups sought similar specific information regarding their cancer and largely favoured involvement of close family in decision making. Additional studies evaluating the influence of factors such as disease stage or family relationships could help guide physicians when breaking bad news.

• Journal of Hospice and Palliative Care
• /
• v.15 no.3
• /
• pp.147-154
• /
• 2012

Purpose: The purpose of this study is to understand family members' experience of deciding to withdraw life-sustaining treatments for terminally-ill patients in an unconscious state. Methods: Data were collected by performing an in-depth interview with eight terminally-ill patients' family members who decided to withdraw life-sustaining treatments. Colaizzi's phenomenological method was used for data analysis. Results: Questions were classified into 12 groups and finally into five categories. The five categories were about family members' frustration with patient's condition, emotional preparation for the patient's death upon medical professionals' recommendation, patient's wishes, exhaustion due to caring and past experiences related to life-sustaining treatment. Conclusion: Using the five categories, hospice and palliative professionals could better understand family members' decision making experience of withdrawing life-sustaining treatments for terminally-ill patients. Based on that, the family members could be provided with appropriate counseling and care, which in turn could improve hospice and palliative care intervention.

• Korean Journal of Occupational Health Nursing
• /
• v.8 no.1
• /
• pp.84-91
• /
• 1999

Pneumoconiosis is a pathological change which is caused by coal dusts. It is a chronic disease that is not cured thoroughly but need treatment and nursing care through all lifetime of the patient. The family of the patient will be suffered from the physical and mental difficulties in the consequence of pneumoconiosis. The study is to find out the characteristics of the families with pneumoconiosis patients. The subjects of the study were 300 families with pneumoconiosis patients who were under medical treatment in Taeback, Donghae, Jeongsun Occupational Medical Center. The period of the study was from the 8th to the 31st of August, 1998. The data were collected by the structured questionnaires included the family intensity measurement which was translated by "Oh". The general properties of the subjects were calculated by frequency and percentage with SAS program. The followings are the summaries of the study. 1) The mean age of the pneumoconiosis patients was 62.3 years. The mean duration of diseases was 11 years and 7 months and the mean duration of hospital stay was 6 years and 4 months. 2) The mean age of the primary care giver was 55.7 years. The proportion of highschool education was 9.6% and it was quite low level compared to other primary care giver groups. 3) The average number of family members were 1.76 person(2.76 persons included patient). The economic status was somewhat high compared to other families with chronic patients. 4) The mean score of family intensity was 41.2(item mean=3.4). With the result, it is recommended to develop a program to improve the quality of family life. For example, there will be social support program for pneumoconiosis patients family sponsored by Social Insurance for Occupational Diseases.

• Journal of Korean Academy of Nursing
• /
• v.46 no.3
• /
• pp.463-474
• /
• 2016

Purpose: For cardiovascular patients, family caregivers play a vital role in daily nursing and cardiac emergencies. This study aimed to evaluate the effect of patient-centered CPR education (PCE) for family caregivers of patients with cardiovascular diseases. Methods: Fifty-four participants were randomly assigned to the PCE or control group. The PCE group received tailored counseling on overall cardiovascular disease information and CPR followed by interactive instructor-guided CPR training and re-education follow-up by telephone 2 weeks later. The control group received only video-based CPR self-education and booklets. Cardiovascular disease and CPR knowledge and self-efficacy were measured before (pre-test), immediately after (post-test 1), and 4 weeks after the PCE (post-test 2). CPR skills and performance were measured pre-test and at post-test1. Results: The PCE group demonstrated significant improvements in knowledge (F=91.09, p<.001), self-efficacy (F=15.19, p<.001) and CPR skills and performance (F=8.10, p=.008), as well as significant differences over time (knowledge: F=364.25, p<.001; self-efficacy: F=1162.28, p<.001; CPR skills and performance: F=1798.81, p<.001). There were significant group-by-time interactions for knowledge (F=8.10, p=.001), self-efficacy (F=4.30, p =.019) and CPR skills and performance (F=4.81, p=.036) by repeated measures ANOVA. Conclusion: This is the first study to demonstrate the effects of a patient-centered intervention with CPR education tailored for patients' and family caregivers' preferences, needs, and lifestyles. The results of this study encourage the use of tailored, patient-centered interventions in cardiovascular nursing practice.

• Proceedings of the KAIS Fall Conference
• /
• 2009.12a
• /
• pp.934-936
• /
• 2009

This study was to identify the correlation between the degree of burden, stress and social support of family caregivers in ICU patient. The subjects were 146 family care givers observed at a general hospital at D city. The level of stress that family caregivers experience the average points of 2.18, which is considered less than average. The level of burden that average point of 2.51. Points for level of subjective feeling ranged from 1.74 to 3.90. The average point of 3.03 is higher than that for objectively recognized feeling. The points for social support that average point of 3.03 for social support proves that families feel positive about the social support they are receiving. The level of stress which shows that the lower the income, the higher the stress. The effect on stress shows significance in subjective feelings of burden, social support, and employment, indicating that they have correlations with stress. Both the feeling of burden and social support have an impact upon the stress that patient families experience.

• The Journal of Korean Physical Therapy
• /
• v.14 no.4
• /
• pp.75-86
• /
• 2002

The patients with a central nervous impediment and a sequela caused by a Stroke are continuously increasing, and the burden of family and society for Stroke patients are also increasing. Since Stroke patients are required to receive a long time medical treatment and care. It adds a economical burden as well as a mental and physical burden of patient's family. In addition, it is a primary factor which deepens the disparity of medical resources in social aspect. But the social concern for these patients are very insufficient and are entirely left to the patient's family The mediation of Skilled Nursing Facility for Stroke patients enable to receive more special and proper medical treatment and recuperation service in the middle of time when they return to home from hospital. It also contributes to the settlement of the charge of patient's family and the serious disparity of medical resources. Therefore, this study will summon the social understanding of the necessity of Skilled Nursing Facilities through the above debate.

• Journal of Korean Academic Society of Home Health Care Nursing
• /
• v.15 no.2
• /
• pp.115-121
• /
• 2008

Purpose: The purpose of this study was to identify the needs of family caregivers of home care patients. Methods: A total of 40 caregivers had been selected from a hospital-based home care agency in Gyunggi province. The instrument developed by Hileman, Lackey, & Hassanein(1992) was modified to 55 items and used in this study. The instrument consists of 6 categories: informational, household, patient care, personal, spiritual, and psychological needs. Out of 29 analysed with descriptive statistics, Mann-Whitney U test, and Spearman correlation test using SPSS 14.0. Results: Most caregivers were females, with a mean age of $60.0{\pm}15.5$, 32.1% were spouses, and 92.9% were living with patients. Patient's activities of daily living score was very low, and 44% of patients had cerebrovascular disease. Caregiver's needs were moderate, and the greatest being personal need. There was a significant difference between caregiver's monthly income and needs. Conclusion: Home care nurses need to teach and support family caregivers with specific programs and services to meet the identified and unmet needs of caregivers of home care patients. In-home respite and institutional respite are recommended for family caregivers taking care of patients with chronic disease.

• Korean Journal of Social Welfare
• /
• v.45
• /
• pp.374-399
• /
• 2001

Experiences of the subjective burden and its determinants were analyzed in a sample of 110 primary family caregivers of adult schizophrenic patients. The subjects reported varying amount of subjective burden and its mean score was 17.84 that meant considerably high level of subjective burden. Reports of subjective burden were high in the items of 'pity', 'frustration and resentment', 'regret'. The result of factor analysis revealed that subjective burden consisted of four factors such as 'hopelessness', 'frustration and resentment', 'fear', and 'pity and anxiety'. The results about the determining variables of subjective burden indicated that the prognosis of patient, perceived stigma, the number of previous hospitalization, the availability of secondary caregiver, primary caregiver's age, and family income were predictive of primary caregivers' subjective burden. The result examining the multivariate relationship among subjective burden, stressors, social support, family demographic and socioeconomic characteristics revealed that the more important determinants of subjective burden were the prognosis of patient, perceived stigma, and the number of previous hospitalization, Implications for intervention to help with primary caregivers' subjective burden were discussed.

• Journal of Korean Academy of Nursing
• /
• v.29 no.3
• /
• pp.639-655
• /
• 1999

An explanatory design was employed to identify the relationship of physical, emotional & social readjustment and social support of post hospitalized stroke patients and their caregivers. A convenient sample of 254 patients who given follow-up care at the outpatient department after discharge and 225 caregivers were recruited. Mental Status Questionnaire (MSQ), Social Support Inventory Stroke Survivors (SSISS), Illness intrusiveness(II), Instument Activity of Daily Living(IADL), Center of Epidemilogic Studies-Depression(CES-D), social activity and caregiver burden were used for measurement in this study. Results showed patient's physical level measured by IADL and psychological level measured by depression were high. But social activity was low. Cognitive function, depression & social activity were not significantly different by the posthospitalized period, but IADL was. The source of professional support was mostly the physician at the outpatient department. The family support was found significantly related to patient's depression & social activity and caregiver's subjective burden. Professional support was found significantly related to patient's IADL & depression. Illness intrusiveness as a mediating variable was a sig nificantly predicting power on patient's IADL & depression. The path analysis was used to identify the variables to predict the physical, emotional, and social status of patients. As a result, patient's age, cognitive function, illness intursiveness and professional support significantly predicted the level of IADL ; patient's cognitive function, illness intrusiveness and family support significantly predicted the level of depression ; and patient's age and family support significantly predicted the level of social activity of posthospitalized stroke patients. Based upon these results, the rehabilitation programs to reduce the illness intrusiveness and improve cognitive funtion were recommended for the readjustment of the stroke patients. This model of the readjustment of the posthospitalized stroke patients is recommended as the framework for care of the stroke patients.

• The Korean Society of Law and Medicine
• /
• v.9 no.2
• /
• pp.11-52
• /
• 2008

Based on foreign examples and past debates, the minimal conditions for passive euthanasia can be suggested as following; (1) The patient is incurable by modem medical practice and his death is impending (less than 6 months), (2) Euthanasia is practiced solely to relieve physical pain of the patient, (3) If the patient can express his will, there should be a clear and sincere request or consent, (4) More than 2 doctors including doctor in charge should consent, (5) Euthanasia should be practiced in ethical way, (6) Patient family should agree(when the patient will is assumed.) It is hard to resolve issues regarding euthanasia based on past rulings and cases without concrete law. As in United States and Germany, clear and objective provisions of euthanasia and definitive method for patient's advanced directive should be legislated to resolve medical conflict and to relieve patient and family from agony. And death with dignity debate will not be able to proceed if it is only substantively approached because of unclear definition of euthanasia and benefit comparison way of thinking. Thus it is important to establish definitive process to decided legislation of euthanasia act and resolving conflicts arising from each step of the process among interested parties exchanging medical/ethical opinions.