• Journal of Korean Academy of Nursing
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• v.28 no.4
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• pp.958-969
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• 1998

In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.

• Research in Community and Public Health Nursing
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• v.9 no.1
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• pp.143-162
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• 1998

This is a study for the construction of nursing care based upon the Korean attitude toward medicine. Factors which were investigated include the source of nursing care, the reason for choosing care, the type of heath care chosen, the accessability of caregivers, and the desired location of death. The population examined in this study consisted of 517 adults distributed in six large cities and 191 adults from five rural communities. Data was analyzed using frequency, percent, Cronbach alpha, $X^2$ - test, t - test, F - test and scheffe post hoc contrast with an SAS program. The results of this study are summarized as follows: 1. Among sources of nursing care used, first rank rated-pharmacy(54.4), private hospital(18.2), general hospital(8.4), folk remedies in house (5.0), chinese hospital(2.8), prayer(2.8) and others(8.4), and the reasons for choosing nursing care rated 'the easiest method' (63.6), 'the best method'(15.7), 'reliable'(10.8) and 'lower cost burden'(4.6) in order of preference. 2. The type of nursing care chosen rated western medicine(6.80), chinese medicine(6.15), folk remedies(5.46), faith remedies(3.51) and divination remedies (1.41). There were significant differences in the effect recognition degree to various kinds of medicine. 3. The difference of the type of nursing care chosen according to general characteristics showed that urban residents were higher than rural community residents(t=2.15, p=0.0320) in western medicine, and urban residents, women, and singles were higher than rural community residents(t=2.04, p=0.0414), men (t= -2.89, p=0.0039), and married(t=2.50, p= 0.0126) on folk remedies. With repect to age and education those 21-30, under 20 and 31-40, graduated from college and graduate school were higher than above 51, above 61 (F = 7.76, p = 0.0001), graduated from elementary school(F=4.39, p=0.0006) on folk remedies. In other categories, rural community residents, women, younger people. Christians were higher than urban residents ( t = -2.73, p=0.0305), men(t= -4.15, p=0.0001), older people (F=2.48, p=0.0307), Catholic, Buddhist, or atheist (F= 70.18, p=0.0001) on faith remedies. Those graduated from high school and Buddhist were higher than unschooled, graduated from middle school(F=3.18, p= 0.0075), atheist, Catholic or Christian(F=18.32, p=0.0001) on divination redemies. There were significant differences concerning age and education level. 4. The accessibility of caregivers rated 'caregivers should be nearby if the patients need them' (50.0), 'caregivers must be there all day (24 hours)' (39.6), 'caregivers must be there at night only'(5.0), 'caregivers must be there during the day only'(2.6), 'caregivers always should visit during visiting hours' 0.4), 'caregivers don't need to be there at all' (1.2). The frist rank of suitable caregivers were rated as spouse(66.6), mother(24.2), daughter (3.6), daughter-in-law(1.9), and the reasons of thinking thus were rated as 'the most comfortable' (81.5), 'people should correctly with regards to family they'(7.1), 'the easiest' (5.4), 'take good care of the patient' (5.1) and 'lower cost burden' (0.4). 5. The desired location of death rated as the following: his/her house (91. 6) to the hospital(8. 4). A person going to encounter death in the hospital wanted his house(78.5) over the hospital(21.5), and a person dieing in the hospital prefered his house(52.9) over the hospital(47.1) as a funeral ceremony place. The following suggestions are made based on the above results. 1. A sampling method that enhances the re presentativeness should be used in regional and/or national related research and replicated to confirm the result of this study. 2. This study should be used to understand the Korean view of medical centers and to meet the expectations of patients in Korean nursing. 3. Research on the Korean traditional view of humans and expectations of the sick, health and illness, and health behavior, the perception of dying, the decision to heal, and the view of general medicine should continue to be conducted continuosly so that Korean nursing theory can be advanced on these concepts.

• 한국노년학
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• v.31 no.3
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• pp.831-848
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• 2011

The purpose of this study is to analyse the family caregivers' stress pathways by types of long term care services for the elderly, and then to discuss the findings 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 258 primary caregivers by type of long term care services were used for this study. The results of this study can be summarized as follows. First, on average, the elders that utilize care service in institutions for the elderly were higher proportion of women, older, higher rate of bereavement, more children than the elders that utilize in-home care service, but some cases were vice-versa. Second, the elders that utilize care service in institutions more ADL dependency, higher proportion of severe dementia or severe stroke, higher care rank by National Health Insurance Corporation than the elders that utilize in-home care service on average. Third, primary caregivers with elders that utilize in-home care service were higher proportion of women, older, lower education level, higher rate of spouse and daughter-in-law in relationship with care recipient, less health, lower income than primary caregivers with elders that utilize care service in institutions. Fourth, subjective indicators representing caregivers' reactions to caregiving for the elderly significantly impact on caregivers' stress(ie, depression), and pathway of caregivers' stress are differentiated by type of long term care services. Fifth, stressors that have direct impacts on depression as caregiving family are differentiated by type of long term care services. Therefore, policies or programs to reduce negative mental health or stress of caregivig families should be designed differently by reflecting pathway of various stressors and stress by use types of long term care services for the elderly.

• Korean Journal of Adult Nursing
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• v.24 no.6
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• pp.615-626
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• 2012

Purpose: The purpose of this study was to investigate caregiver burden and health related quality of life (HRQoL) among male spouses who cared for partners with a stroke. Methods: The subjects were spouses of 121 female patients who visited the neurology outpatients department in one tertiary hospital located in Seoul between February and April in 2011. Results: The mean age of the male caregivers was $71.25{\pm}5.51$ years. The mean score of caregiver's burden was moderate ($63.28{\pm}9.85$). The average reported caregiving time was $58.48{\pm}5.51$ min/day with the male spouses spending more time in house-working than with caregiving activities. The reported depression and care giving time, plus the cognitive status and functional dependencies of the spouse were significantly related to male caregiver's burden. The mean scores of 'physical health' and 'mental health' for quality of life for the male caregivers was moderate (47.49 and 47.33 respectively). Overall, caregiver's burden has a negative effect on the HRQoL of male spouses. Conclusion: Caregiver's burden and HRQoL are important problems which are in need of nurses' attention. It is suggested that intervention programs for male spouses be developed with a focus on emotional and social support as well as education about the caregiving role.

• Journal of Korean Academy of Nursing
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• v.47 no.3
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• pp.367-379
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• 2017

Purpose: This study aimed to understand and describe the caring experiences of spouses of elderly people with dementia. Methods: The hermeneutic phenomenological method was used and participants were 12 spouses aged 65 and over who were taking care of their husbands or wives with dementia at home. Data were collected from individual in-depth interviews on participants' actual caring experiences. Additionally, novels, movies, and memoirs on elderly couples with partner who had dementia were included as data for the analysis. The qualitative data analysis software program was used to manage and process the collected qualitative data. Data were analyzed using hermeneutic phenomenological analysis based on four fundamental existentials including lived body, lived space, lived time, and lived others. Results: Five essential themes emerged from the analysis: 1) body moving like an old machine, 2) swamp of despair filling with hope, 3) sweet time after bitterness, 4) disappointed elderly couple in the empty nest, and 5) unappreciation vs. empathetic feelings. These essential themes were comprehensively summarized as "the road leading to the maturation of life with dedication and hope while bearing the weight of caring based on the couple's relationship." Conclusion: The findings indicate that the nature of the caring experience of spouses of elderly individuals with dementia is filled with many dynamic and paradoxical dimensions. Thus, results of the study would help with developing interventions tailored specifically for elderly spouse caregivers to support their role adaptation and ultimately improving their quality of life.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.184-190
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• 2021

Objectives : Dementia is one of the most distressing mental health problems in the older population. Caregivers also experienced physical, psychological, and emotional stress from taking care of dementia patients. So, we developed program for supporting dementia caregiver and evaluated its efficacy on reducing caregiver burden. Methods : We provided 5 sessions of dementia caregiver supporting program to 30 caregivers who were taking care of dementia patient in their home. Program was held in Cheonan Center for Alzheimer's disease and other dementia that was established by Cheonan city government for supporting dementia patients and their caregivers. We evaluated caregiver burden using short Zarit burden inventory consisted of 12 items scoring 0 (no burden) to 4 (everyday burden) before and after program. We evaluated satisfaction of caregiver about program using satisfaction survey consisted of 10 items scoring 0 (very dissatisfy) to 4 (very satisfy) after program. Results : Mean age of caregiver was 61.9. 40.0% (n=12) of caregivers were spouse. 53.3% (n=16) of caregivers were son or daughter. Caregiver burden that was estimated by short Zarit burden inventory were significantly decreased after program (p<0.001). When each item was compared, 4 items (7, 10, 11 and 12) were significantly decreased after program (p=0.036, p=0.018, p=0.01, p=0.024). All mean scores of 10 items about satisfaction were over 3 meaning that participants generally satisfied to program. Conclusions : Our study suggested that dementia caregiver supporting program could reduce caregiver burden and provide satisfaction. Therefore, programs for supporting dementia caregivers might be important as well as treating dementia patients. So, we should be interested in developing and providing efficiently this kind of program to reduce caregiver burden.

• Journal of Haehwa Medicine
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• v.6 no.1
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• pp.555-566
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• 1997

This study was undertaken to identify the degree of burden and depression according to level of self-care activity and variables to which affect that in family caregivers of patients with stroke. The data were collected from October 23th to November 20th, 1995 The subjects in this study were 80 caregivers, that is, one family member and 80 patients with stroke who were hospitalized in one oriental medicine hospital in D city. The questionnaires consisted of questions regarding burden(13 items, 6 point scale), depression(20 items, 4 point scale), and self-care activity(15 items, 5 point sacle) Data were analyzed using percentages, means, t-test and ANOVA with the SAS program. The results of this study are as follows: 1) The mean score for client's self-care activity was 2.58. The highest score of the self-care activity item was 'returning'(M=3.604), and the lowest score of the self-care activity item was 'shower or tubbathing'(M=1.925). 2) the degrees of self-care activity according to the general characteristics of patients were tested. It was significantly different by sex(P<0.01), occupation(P<0.05), and relationships with patients(P<0.05). That is, the degree of self-care activity was higher in men than that of women, and caregiver with job than caregiver without that. In the case that caregiver was a patient's spouse, the degree of self-care activity was higher than other case. 3) The score for family caregiver's burden was higher than the mid level for the 13 items and caregiver's depression was relatively low. 4) According to the degree of self-care activity, the group was divided to 3, that is, A( 15-33), B(34-56), and C(57-75). The score of total burden was the highest in group A(M=55.257) and the lowest in group C(M=51.928), but there were no statistically significant differences between groups. The score of objective burden was the highest in group A(M=30.400), and the lowest in group C(M=25.214), and there were statistically significant differences between groups. The score of subjective burden was the highest in group B(M=26.000) and the lowest in group A(M=24.783), but there were no statistically significant differences between groups. The degree of depression was the highest in group A(M=44.750) and the lowest in group C(M=40.751), but there were no statistically significant differences between groups.

• The Korean Journal of Rehabilitation Nursing
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• v.8 no.1
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• pp.50-58
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• 2005

Purpose: The purpose of this study was to increase our understanding of the terminal cancer patients and their families concerns. I analyzed the counseling contents of terminal cancer patients and their relatives who referred to hospice office. Method: Data was collected from January 2004 to November 2004. During the counseling, I took notes the key points and contents. 109 patients and/or their families's counseling records were analyzed with the descriptive statistics and content analysis. Result: 73.4% of patients knew their current terminally ill status. The mobility of 86.2% of the patients was worse than ECOG 3 level. Patients have uncontrolled pain(28.4%), emotional distress(55.0%), and physical distress(49.5%). Caregivers of the patients were spouse(46.8%), sons and daughters(24.8%). Family members had problems to tell the bad news to their family cancer patient. 95.4% of the patient and family members was informed about the hospice and palliative care services, and 35.8% of them was referred to the hospice and palliative organizations. Frequently asked questions were 'what is hospice?', 'how much is the cost of hospice services?' etc. Conclusion: Care planning for terminal cancer patients must include patient. Also, professionals should consider and offer accessible, effective and empathetic counseling services to patients and families.

• Journal of Hospice and Palliative Care
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• v.20 no.3
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• pp.188-193
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• 2017

Purpose: There has been very little study on the associations between patient's symptoms themselves and family caregiver (FC)'s depression in the palliative phase. This cross-sectional study was to investigate the relationship between symptom features of terminally ill cancer patients and their FC's depression. Methods: We performed a multicenter survey using the MD Anderson symptom inventory and the Hospital Anxiety and Depression Scale. A total of 293 patient-FC pairs were recruited from seven tertiary medical centers. A multivariate regression analysis was applied for identifying the relevant factors associated with FC depression and for estimating adjusted depression score of FCs. Results: Among various psychosocial factors, low FC quality of life, low social support, spouse, and more caregiving time were significantly associated with FCs' depression. According to the presence of FCs' depression, there were significant differences in some symptom characteristics of patients. Even after adjusting for the relevant confounders, depression scores were lower in FCs caring for patients who had negative symptoms (loss of appetite, P=0.005; drowsiness, P=0.024; and dry mouth, P=0.043) than in FCs caring for patients who had not. FCs caring for patients with severe appetite loss had lower depression scores than those with not severe one (P=0.039). Conclusion: Our result suggests that patient's symptom characteristics might be helpful when evaluating a FC's depression.

• Korean Journal of Health Education and Promotion
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• v.16 no.2
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• pp.67-80
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• 1999

This study was designed to provide the basic data of nursing intervention for alleviation of effective adjustment of cancer patients by identifying the correlation between the spiritual well-being and family support. The subjects for this study were 69 patients who were diagnosed as cancer and were admitted to a university hospital in Pusan. Data were collected during the period between December 1, 1998 and January 20, 1999 by interviewing with questionnaires. Family support questionnaire consisted of 11 questions answerable on a 5 point Likert scale developed by Kang Hyun Suk(1985). Spiritual well-being questionnaire consisted of 20 questions answerable on a 4 point Likert scale modified by Kang Jeong Ho(1996). The data were analyzed by in descriptive statistics, Pearson correlation coefficient, t-test and ANOVA using SPSS/WIN program. The results of this study were as follows. 1. The mean score for family support in cancer patients was 49.48, which indicated that cancer patients perceived their state of family support as high level. The mean score for spiritual well-being in cancer patients was 55.87, which indicated that cancer patients perceived their state of spiritual well-being as moderate level. Among the components of spiritual well-being, the mean score for religious well-being was 26.94 and for existential well-being 28.93. From the above, the mean score for existential well-being was higher than that of religious well-being. 2. There were statistically significant differences in family support according to the types of primary caregivers(F=3.48, p=0.008). The spouse caregiver showed the highest family support among the caregivers. There were statistically significant differences in spiritual well-being according to the job(F=2.20, p=0.046) and the level of perceived health status(F=2.71, p=0.05). There were statistically significant differences in religious well-being according to the religion(F=2.42, p=0.004) and the number of family members(F=3.38, p=0.040). And there were statistically significant differences in existential well-being according to the job(F=2.48, p=0.026) and the level of perceived health status(F=2.74, p=0.048). 3. There were positive correlation between spiritual well-being and the family support(r=0.481, p=0.000), between religious well-being and family support(r=0.336, p=0.008) and existential well-being and family support(r=0.519, p=0.000).