• Korean Journal of Adult Nursing
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• v.18 no.3
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• pp.457-467
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• 2006

Purpose: The purpose of this study was to identify the main factors influencing family functioning of caregivers in families with stroke. Method: A Convenient sample of 173 primary family caregivers who take care of a stroke patient at an Oriental medicine hospital in Jeonbuk. Interviews were done with a standardized questionnaire including family functioning by nurses. Results: In Pearson's correlation analysis, the influencing factors related to family functioning were ADL(p=.017), level of paralysis(p=.019) as stressors, Quality of relation(p=.000) as situational variables, and family caregivers' burden(p=.000). Stepwise multiple regression analysis showed 29.9% of the variance family functioning was significantly accounted for by the quality of relationship between stroke patient and caregiver(26.8%), and caregiver burden(3.1%). Conclusions: Findings indicate that families of stroke patients need family-focused nursing intervention as supported care to improve the relationship between patient and primary caregiver and relieve caregiver burden by culturally tailoring to Korean.

• Journal of Korean Academy of Nursing
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• v.29 no.6
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• pp.1419-1433
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• 1999

Little is known about the impact of family caregiving for the demented elderly in Korea. The purpose of this study was to identify the current state of development of family caregiving research for the demented elderly in Korea and to identify correlates of caregiver or health problems and burdens within the socio-political contexts of Korea. A critical review of 17 family caregivers was carried out. The review revealed that various caregiving impacts and correlates of caregiver burden or health problems have been studied in relation to demented elderly family caregiving. Family caregiving for the demented elderly is a very complex phenomenon and various factors were related to caregiver burden, or their emotional and physical health. Findings from studies reviewed have shown inconsistent, inconclusive, and contradictory results. Furthermore, several conceptual and methodological problems were identified in the studies reviewed: restricted conceptualization, unrepresentative study samples, inadequate sample size, inappropriate study design, absence of comparison groups, inappropriate psychometric properties, and uncontrolled confounding factors. More research, as well as directions for further research, is recommended to identify family caregiving the impact of for the demented elderly, and to clarify the factors that explain results.

• International Journal of Human Ecology
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• v.17 no.2
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• pp.1-15
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• 2016

This is a descriptive study that introduces programs that support family caregivers looking after the elderly, by focusing on the case of Georgia, in the United States. The U.S. is one of the few countries that support family caregivers by law. In this study, we focus on the evidence-based interventions implemented through the Alzheimer's Disease Supportive Services Program (ADSSP), a federal policy that complements the National Family Caregiver Support Program (NFCSP). Our findings show that one-on-one evidence-based programs (EBPs) for family caregivers are both economical and effective in assisting caregivers. In our discussion, we highlight how the implementation of the latest EBPs can build an infrastructure to support family caregivers. ADSSP funding is useful as it constructs a caregiver support through the implementation of programs in the local community. The result is the creation of a well-coordinated division of labor among government agencies, academia and NGOs, which produces a synergetic effect in funding, research and development, translation and implementation of programs, and staff training. We conclude that the implementation of EBPs funded by the government is a useful reference for Korea and other rapidly aging countries, if we are to create an infrastructure for caregiver support, which can effectively prevent a crisis in caregiving.

• Health Policy and Management
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• v.22 no.3
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• pp.383-402
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• 2012

The purpose of this study is to investigate the factors affecting family caregiver financial burden of out-of pocket expenses for the nursing home service under Long-term Care Insurance System. We conducted a national cross-sectional descriptive survey from July to September 2010 to collect data based on the long-term care benefits cost specification. Total 1,016 family caregivers completed questionnaires. 185 subjects of total were excluded from the data analysis due to being answered by user(18 cases), or caregivers not to pay for services expenditures(122 cases), having a missing data on family caregivers characteristics(45 cases). Finally, 831 subjects were included in the study. The average financial burden was 3.18(${\pm}0.71$). We divided subjects into two groups by level of burden, high-burden group and low-burden group. In the result of the multiple logistic regression analysis, family caregiver financial burden was significantly higher in family caregivers with ages 40 to 49 compared to less than 40, lower educational level, unsatisfaction for long-term care service, high percentage(more than 50%) of cost-sharing and high total out-of pocket expenses(more than 300,000 won) for long-term care services. Also, Family caregivers who are spouse felt higher financial burden compared to son. This study is meaningful as the first attempt to measure family caregiver financial burden for long-term care service and to identify factors affecting the financial burden. Family caregivers felt financial burden of out-of pocket expenses for the nursing home service. The policy makers, the insurer, and the providers need to pay attention to ease family caregiver financial burden.

• The Korean Journal of Community Living Science
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• v.22 no.1
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• pp.35-51
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• 2011

This study examined how caregiving experiences of spouses and adult children were different to each other in terms of caregiver characteristics, the impairment level of the elderly, caregiving time, caregiver burden, the effects of long-term care services, etc. Data were collected from 321 spouses and 324 adult children who cared for the functionally and/or cognitively impaired elderly using long-term care services. The main results are as follows. (1) Caregiver characteristics differed significantly between spouses and adult children. (2) Adult children cared for the more severely impaired elderly in terms of IADL, cognitive impairment, and behavior problems while spouses spent more time helping in ADL activities. (3) Spouse caregivers experienced greater overall burden, worry and strain, and financial burden compared to adult child caregivers. (4) Long-term care services were effective in reducing caregiver burden and improving family relations. Additionally, relations between adult child caregivers and the elderly was more improved than relations between spouse caregivers and the elderly after using long-term care services. Based on these findings, the differential experiences between spouse caregivers and adult child caregivers were discussed.

• Journal of the Korean Home Economics Association
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• v.29 no.3
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• pp.71-83
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• 1991

This study examines a pattern of family caregiving and its effect on life satisfaction of disabled elderly people. Data were gathered through the use of face-to-face interview method from a sample of 135 elderly aged over 60. One-third of the elderly respondents have no family caregiver. Most of caregivers provide routine household chores and physical help, but persnal care such as bathing and changing clothes was taken by elderly people themselves. The caregiver in an elderly couple is most likely the wife. When a spouse is unavailable, daughters-in law usually assume the role of a primary caregiver. Sex difference has been found in the most comfortable caregiver for the elderly. The most comfortable caregiver for the elderly men is shown to be their spouse, whereas the one for the elderly women is show to be their daughter-in-law. Most of the disabled elderly are emotionally dependent on their son(usually their eldest son), but physically dependent on their spouse, daughter-in-law, or daughter. The caregivers are dominated by women. Among those elderly receiving care from their children, the relationship between the aged their caregiver is found to be closer than the past when the aged were healthy: however, this relationship is found to be almost the same as the past among those elderly receiving care from their spouse. Finally, the degree of family solidarity, satisfaction with received cares, and the relationship with caregivers are found to be closely related to life satisfaction of the elderly respondents.

• Korean Journal of Adult Nursing
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• v.14 no.1
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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.

• Asian Oncology Nursing
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• v.2 no.1
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• pp.5-16
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• 2002

Purpose: This study was to develop a stress-adaptation model for family caregivers of cancer patients that could provide the basis of planning nursing intervention. Method: A hypothetical model was developed using the family adaptation model proposed by Haley et al. (1987). In the literature, the stressor was identified as patient's characteristics, caregiver's characteristics, duration of illness, and family life events. It affected stress appraisal, family resources, family coping and finally caregiver's adaptation. In this model, 18 paths were constructed. Data were collected from 241 caregivers, whose family members were in treatment between June and August 2000, at 3 university hospitals and were analyzed by SPSS and LISREL programs. Results: 1) The overall fitness indices of the hypothetical model were x 2=267.78 (P= .0), GFI= .92, AGFI= .87, NFI= .93, NNFI= .93, PNFI= .64, PGFI= .55, and RMR= .43. Ten of the eighteen paths proved to be significant. 2) To improve the model fitness, the hypothetical model was modified considering modification indices and the paths proved not significant. Final model excluded 3 paths demonstrated to be improved by x2=161.96 (P= .00), GFI= .95, AGFI= .91, NFI= .96, NNFI= .96, and RMR= .23. Twelve of fifteen paths proved to be significant. 3) Stress appraisal was influenced by disease related characteristics and duration of illness and was explained 22% of the variance. Family resources were influenced by stress appraisal and was explained 57% of variance. Family coping was influenced by disease related characteristics, caregiver's characteristics, duration of illness, family life event, and stress appraisal and was explained 57% of variance. Family caregiver adaptation was influenced by disease related characteristics, caregiver's characteristics, stress appraisal, and family coping and was explained 31% of variance. Twelve of fifteen paths were significant. Conclusion: Based on this study, to help family caregivers to adapt, individual intervention is necessary with consideration of disease related and caregiver's characteristics and duration of illness. The intervention should include efforts to raise the family resources and to identify positively the stress they encounter, and there is a need to establish an adaptation model that considers emotional aspects of family caregivers. Since there is a difference in emotional status depending on the disease stage, a study needs to be done to analyze the differences among the disease stages (diagnosis, treatment, recurrence, and terminal stages).

• Korean Journal of Adult Nursing
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• v.12 no.3
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• pp.384-395
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• 2000

This study examined burdens of primary family caregivers, and family functioning of patients with cancer. In addition, the relationship between two concepts was assessed to develop nursing intervention to reduce the burdens of caregiving, and to improve family functioning. Ninety-two primary family caregivers of patients with cancer at a general hospital in Seoul participated in this study. The patients with cancer aged from 19 to 84 years with a mean age of 51 years, and sixty-one percent were male. About 30 percent of the patients suffered liver and billiary tract cancer. Fifty-six percent of the primary family caregivers were spouses of the patients and 70.7 percent were women. Primary family caregivers' burdens were assessed by the Burden Scale originally developed by Zarit (1980) and Novak & Guest(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales: time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financial burden. Family functioning was assessed by the Family APGAR developed by Smilkstein(1978). The results were as follows: 1. The average burden score was 86.1, indicating a moderate level of burden. The time-dependent burden scored highest followed by developmental, physical, social, financial, and emotional burdens. The mean score of family APGAR was 9.71; among subjects 82.6% were included in dysfunctional families. 2. Of the characteristics of patients, age, gender, number of admissions, and job were found to be associated with the level of burden. There was no significant difference between patient characteristics and family functioning. Of the characteristics of primary family caregivers, caregiver's perception of patient prognosis was significantly related to the level of burden, and family functioning. Caregiver's sex and age were also related to family functioning. The quality of relationship between a patient and a caregiver was significant situational factors affecting the level of burden, and family functioning. In addition, the income of family, and help from other family members were related to the level of burden. Given the results, it is essential to develop nursing intervention to reduce burden and to improve family functioning, such as support groups.

• Journal of Korean Academy of Nursing
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• v.46 no.6
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• pp.836-847
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• 2016

Purpose: The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. Methods: A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, $x^2$ test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Results: Presence of family caregiver distress was significantly associated with days of nurse visits (${\beta}$=-.89, p=<.001) and home helper visits (${\beta}$=-.53, p=.014). Level of caregiver distress was also significantly associated with days of nurse visits (${\beta}$=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. Conclusion: The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.