• Title/Summary/Keyword: family caregiver's burden

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A Ethnographic Field Study for a Model Development of the Chronic Bed-ridden Patient s Home-ward (만성 재가 기동장애자의 가정병실 모델 개발을 위한 현장 연구)

  • 김태연;정연강
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.597-615
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    • 1994
  • This study is designed to facilitate the creation of home environment conducive to the family taking care of chronic bed-ridden patients with more effective method. The need for this study has emerged against the background of marked changes in the structure of ailments and causes of death, resulting in the number and plights of chronic bed-ridden patients as well as of a rapid increase in demand for medical care and resulting premature discharge. Keeping these in mind, this study focused on home-wards where the majority of chronic bed-ridden patients are being cared for. Despite. their overriding importance, home-words are less than efficient in caring (or chronic bed-ridden patients. These circumstances require the designing of home-wards that can offer greater comfort to patients and at the same time make things easier for caregivers, on the basis of an overall analysis of patients' life and home - ward situation. According1y this study adopted a Participant Observation Method derived cultural anthropology, Toward this end, 3 patients were chosen as subjects of this study for intensive interviewing and participant observation. In the process of this field re-search efforts were made to collect emprical data, that is, to faithfully record the words of the subjects and their caregivers for analysis and interpretation. The findings of these analyses are as follows. Firstly, the chronic bed-ridden patients are mostly being taken care by close family members. Secondly, a room for the exclusive use of the patient, floor, kitchen, bathroom and multipurpose space were found to be necessary for proper caring of the patient. These spaces were respectively used with a view to 1) accomodating the patient as well as caregivers' activities, 2) keeping general and medical supplies and other appliances for patient's care and drying the patient's washing, 3) preparing and keeping the patient's foods and beverages, 4) keeping the supplies necessary for cleaning the patient's body and treating the patient's eliminations, 5) washing the patient's clothes, underwears and bedclothes. The patient's room in turn is subdivided into six portions in terms of uses : specifically the places for accomodating 1) the patient, 2) medical supplies, 3) medicines, 4) linens St clothes, 5) bedclothes and, 6) diapers. Thirdly, the activities of the caregiver are subdivided into seven key areas : hygiene, exercise, diet, elimination, therapeutic nursing, prevention of sore, and other activities. Each area is further classified into several different activities of caring. These activities we mainly carried out in the patient's room. Fourthly, the supplies for caring the chronic bed-ridden patient is divided into two large domains : medical and general supplies. Finally, three main problems areas were found in this study on the part of caregivers, that is, sore prevention, hygiene problem related frequent urination / defecation, the caregiver's physical, psych ological and emotional burden. In consideration of the aforesaid problem areas, a model home-ward was developed in this study. The newly-developed model has been found to have the following six advantages. Firstly, the time and effort required for maintaining the patient's hygiene are reduced, thus relievins the caregiver's physical and psychological bur-den. Secondly, the patient's hygiene can be maintained in satisfactory conditions, because the patient's eliminations are more easily removed. Thirdly, skin irritations caused by the patient's eliminations were remarkably reduced and so were the patient's sores due to moisture and bacteria. Fourthly, the home-ward have a tilt-table ef-fect thanks to the inclining room floor. This improves the patient's cardiovascular function as well as constantly changes pressed skin areas and thus prevents sores. Fifthly, improved shelf arrangements help make the best use of patient's supplies. Sixthly, the trouble of continuously changing clothes, underwears, diapers & bedclothes is remarkably reduced simply by covering the patient with cotton sheets when laid in bed. This is espected to cut down expenses by reducing the comsumptions of diapers and other disposable supplies.

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The Reaction and the Supporting Need for the Mother in Caring for their Chronicly III Child after Discharge (퇴원에 따른 만성 질환아 어머니의 반응과 환아 돌보기 지지 요구)

  • Chai, Hyun-Yi
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.8 no.1
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    • pp.50-61
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    • 2001
  • With the improvement of current medicine, the number of the chronicly ill children are increasing. The illness of the child drives all of the family to despair. especially it is a burden on the mother who takes care of the ill child. She's faced with many emergencies and feels powerless. The home care for a child is for finding a child's problems early and mediating them. The purpose of this study was to investigate the mother's reaction following their chronicly ill child's discharge and to investigate the supporting needs for caring for an ill child. The subjects of this study were mothers with a chronicly ill child being discharged from a general hospital in Seoul and the data was collected from July 20 to September 30. Data was collected by using questionnaires which were developed by the researcher. (The questionnaires were composed of the average 5 points - Likert's method). The Mother's reaction means that the higher the score, the more negative the mother's thoughts about discharge are. Supporting need for caring for ill an child means that the higher the score, the higher the demand of nursing is. The statistical analysis used the SPSS program for t-test. ANOVA, and Pearson Correlation. The results of this study were as follows: 1. The mother's reaction scores following discharge were the lowest. 19 and the highest 72 so that the total average was 43.15. The answer, 'I worry that my baby will be troubled with illness again after discharge gained the high points (3.94 of 5 points). The answer. 'The discharge of my baby makes me gloomy' gained 2.05-it was the lowest points. Their were significant differences according to religion (p=.006). salary (p=.050). the burden of the medical fee (p = .005) and caregiver (p=.027). 2. Supporting Need for caring for ill an child was the lowest 15 and the highest 67. the total average was 47.87. The answer. 'I'd be glad to get a person whom I could always get counsel about the health of my baby with' scored the high point (average 4.04 of 5). The answer. 'Caring for my baby at home makes me exhausted' gained the lowest point. 2.49. Their were significant differences according to religion (p=.019) and diagnosis (p=.019). 3. The relationship between the reaction of the mother and supporting need for caring for an ill child was a positive correlation (r=0.585). In conclusion. this study revealed that mothers weren't positive about their chronicly ill child's discharge and they wanted to get support for caring for an ill child. Through this study. I proposed that the program to support the chronicly ill child at home and home care by continuous counselling after discharge should be develop.

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The Experience of the Stroke Patients about the Use of Oriental Medicine (뇌졸중 환자의 한방의료 이용 경험)

  • Kim Lee Sun
    • Journal of Korean Public Health Nursing
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    • v.11 no.1
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    • pp.82-92
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    • 1997
  • Cerebrovascular diseases in Korea is an important health problem since mortality and mobidity have been increased rapidly. It marked the 2nd cause of specific death rates in 1993. The subjects of the study were seventeen citizens who are using to the Oriental Medicine. The data were collected from Apr. to Oct. 1996. The researcher as a caregiver and volunteer made confidence of them and asked for their agreement on the purpose of the study. The subjects expressed their experience as openheartedly as possible. The researcher described closely the experiences of using to the Oriental Medicine with there words themselves and under the observation of the reseacher. A tape-recorder was used under the permission of the subjects to prevent the leakage of the spoken information and communication. The analysis of the data was made through the phenomenological analytic method suggested by Van Kaam, which is as follows; as an unit of description which include the subject' expressions and the researcher's observation. The conclusions of this study was as follows : one hundred eighteen descriptive expression found and they were grouped eighteen common factors. These are ${\ulcorner$to effect needle${\lrcorner}$ ${\ulcorner$to effect Chinese medicine${\lrcorner}$ ${\ulcorner$treatment method${\lrcorner}$ ${\ulcorner$attitude of herb doctor${\lrcorner}$ ${\ulcorner$recommendation of family and other person${\lrcorner}$ ${\ulcorner$what one sold to${\lrcorner}$ ${\ulcorner$traditional custom${\lrcorner}$ ${\ulcorner$experience of the past use${\lrcorner}$ ${\ulcorner$to be desolate${\lrcorner}$ ${\ulcorner$negative recognition${\lrcorner}$ ${\ulcorner$Ineffective drug${\lrcorner}$ ${\ulcorner$Unfaithful of doctor${\lrcorner}$ ${\ulcorner$positive recognition${\lrcorner}$ ${\ulcorner$Oriental medical hospital surroundings${\lrcorner}$ ${\ulcorner$to build up one's health${\lrcorner}$ ${\ulcorner$to be clear blood${\lrcorner}$ ${\ulcorner$economic burden${\lrcorner}$ ${\ulcorner$deficit of profession${\lrcorner}$ Finally. eighteen common factors were grouped under six highter categories. These are ${\ulcorner$Belief to oriental medicine${\lrcorner}$ ${\ulcorner$motivation of use${\lrcorner}$ ${\ulcorner$distrust to western medicine${\lrcorner}$ ${\ulcorner$stability of emotion${\lrcorner}$ ${\ulcorner$Alteration of positive physical function${\lrcorner}$.

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Cost Analysis of Long Term Care Services (장기요양보호서비스의 비용분석)

  • Park, Changje;Kim, Soo-Young;Joo, Soo-Hyeon
    • 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.