• 대한간호학회지
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• 제24권4호
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• pp.666-677
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• 1994

In comparison with the long and continuous his-tory of research in the general area of stress and coping, theoretical and clinical interest in family stress and adaptation is a recent phenomenon. To understand the phenomena of family behavior, a comprehensive theoretical framework is needed to us provide an adequate background to for research. This study was designed to develop and test a hypothetical model for family stress and adaptation in families with handicapped children. A hypothetical model was constructed on the basis of the family stress theory developed by McCubbin etc. The model included six paths. For the purpose of model testing, empirical data was collected from May to August, 1992. The subjects of the study were 190 parents of chidren in five special schools and one private institute in Seoul and Choong Nam. An SPSS P $C^{+}$ and PC-LISREL 7.13 computer programs were used for descriptive and covariance structure analysis. The results of the study are as follows. (1) Family Stress(${\gamma}$$_{3l}$=-.288, T=-4.942) had a direct effect on Family Adaptation. (2) Family Functioning ($\beta$$_{21}$=-.373, T=5.595) had a direct effect on Situational Definition. (3) Family Functioning ($\beta$$_{31}$ =.334, T=5.375) had a direct effect on Family Adaptation. (4) Situational Definition( a2=.270, T=4.285) had a direct effect on Family Adaptation The model was supported by the empirical data. Thus it is suggested that the model could be adequately applied to family nursing care of families with a mentally handicapped child. In particular, the nursing interventions that enhance family functioning and the situational definition would improve family adaptation in families with mentally handicapped children.n.n.

• 여성건강간호학회지
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• 제10권1호
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• pp.32-41
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• 2004

Purpose: The purpose of this study was to explore and describe the process of life adaptation in women with cervical cancer. Method: A grounded theory method with guided data collection and analysis was used. Fifteen women with cervical cancer who had some kind of treatment at the hospital were asked open-ended and descriptive questions with a guideline. All interviews were tape-recorded and transcribed verbatim. Result: The core category that emerged from the comparative analysis was "overcoming cancer" named as a process of life adaptation in the participants. The process of overcoming cancer evolved three stages - "admitting reality", "attempting health-care" and "continuing health-care". Depending on the paradigm model, the central phenomena of the experiences was "powerlessness". The internal factors motivating women to overcome cancer were "denial of cancer" and "desire for life". Strategies of overcoming cancer included "living as a cancer patient," "selective food eating," "steady exercising," "getting rid of stress," and "preparing for death". The intervening conditions, "supportive system," "forms of life," and "burden on family," influenced overcoming cancer. Conclusion: The results of this study could help clinical nurses to understand life adaptation in cervical cancer patients and establish efficient coping strategies in dealing with the problems they face.

• 한국아동복지학
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• 제36호
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• pp.133-163
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• 2011

본 연구는 미국 저소득 미혼모가구의 사회적 지지가 아동의 문제행동과 인지능력에 미치는 영향을 분석하였다. 스트레스-대응모델과 가족과정모델, 사회적 지지에 관한 이론적 관점을 기초로 사회적 지지가 아동발달에 영향을 제공하는 직접효과와 미혼모의 양육스트레스를 매개로 한 간접효과를 분석하였다. 본 연구를 위해 미국 취약가족아동복지연구의 종단패널자료를 사용하였으며, 전체 1,315명의 저소득 미혼모가구와 빈곤아동이 분석에 사용되었다. 분석결과, 사회적 지지는 아동문제행동에 직접적인 영향을 제공하는 것으로 분석되었으며, 양육스트레스를 매개로 한 간접효과도 발견되었다. 반면에 사회적 지지는 아동인지능력에 직접적으로 유의미한 영향을 제공하지는 않으나 양육스트레스와 아동문제행동을 매개로 한 간접효과를 제공하는 것으로 나타났다. 본 연구결과를 토대로 저소득 미혼모가구의 경제적 환경을 개선하고 양육스트레스를 완화하기 위한 정책적 함의와 서비스방안에 대해 논의하였다.

• 대한간호학회지
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• 제31권2호
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• pp.221-231
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• 2001

This study was conducted by analyzing all 33 articles based on the LISREL, published from January 1991 to March 1999 in Korea. The analyses consisted of the publication date of articles, principal dependent variables, subjects of the research, adequacy of sampling, adequacy of research purposes and results, accordance between theoretical model and hypothetical model, fit measures, theoretical base of model modification, and adequacy of conclusion. The results were as follows : . The thesis of 33 articles in total were outnumbered as 25 (75.8%) to 8 (24.2%) research articles. As for a sex classification of the subjects, 45.5% of the research were conducted around a female group of subjects, while 54.5% were done for both sex, The range of the sample size was 105 to 803, and the average was 259 subjects. . A single theoretical variable was measured for each measurement variable, any difference between variables was hardly found in 8 articles (24.2%), and 19 articles (57.6%) did not consider any measurement error. To analyze if the representative has been articles (21.2%) were seen with a sign of a representative. Questionnaires were used in a majority (31 articles) of the data collecting process. Only 2 articles (6.1%) were measured with a physiologic index simultaneously. . 14 articles (42.2%) were centered on theory development, 10 articles on theory synthesis, and 9 articles on theory test. The research purposes and results were consistent in 25 articles (75.5%) and 8 articles (24.2%) were inconsistent. The quality of life and health promotion behavior were the concepts most frequently studied as a dependent variable, and 7 articles centered on them. In applied theories a health promotion model was used on 4 articles (12.1%), while role theory and stress-coping models were in 3 articles respectively. . The articles were analyzed to see if the hypothetical model was elaborated and tested by the theoretical model. Twenty-five articles proved to be rationale for the inconsistencies. Also, 56.5% proposed hypotheses were supported among the subject articles, and 30 articles (90.0%) suggested a revised model. Path coefficient (17 articles) and theoretical adequacy (17 articles) were the standards mostly used. In conclusion, the principal factors were obtained from the research are to be considered as the principes of LISREL application. First, a model has to be established on a theoretical base rather than empirical results dependent on the data. The results are also required to be globally interpreted. Secondly, at least 200 samples are necessary to satisfy the need. Third, more than 3 measurement variables are to be adjusted to a single theoretical variable; the measurement errors must be suggested as well. Finally, normal distribution characteristics of the data and the estimation method need to be reported. Based on the research result, the follows are suggested; . Systematic criteria on the LISREL application and procedure need to be developed . Agreement form is required to report the results of research using the LISREL

• 한국보건간호학회:학술대회논문집
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• 한국보건간호학회 2002년도 제27회 보건종합학술대회
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• pp.224-227
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• 2002

Alcoholism affects not only the individuals who depend on it, but also their families. Children who have an alcohol dependent parent have various problems and need help, but little attention has been given to them. Many references report only negative characteristics of these children. In order to help the children of alcohol dependent parents, health professionals need more information. A wholistic understanding and analysis of these children is needed as a basis for the development of suitable programs of help them. A phenomenological methodology was used to identify the experience of children whose fathers were addicted to alcohol. The findings portray the essence of the lived experience of children of alcohol dependent fathers. Nine adolescents participated in in-depth inverviews and observation with the researcher, done between October and December 2001. The data were recorded on audio tape and transcribed. Sampling was continued until the data were theorectically saturated. The Colaizzi's method was used for data analysis. The results of this study are as follows. Three themes and twenty six meanings were identified. The first theme is Living Alone: living abusively as partner to an alcohol dependent father, living dangerously like an explosive fury, living as an object that ha no self, living with rejection of fatherly being, living with felt responsibility but having no power to help mother who suffers patiently with pain and abuse, living along with no shoulder to lean on, and living with the prejudice of sex discrimination. The second theme is Paradoxical Coping in Life. The meanings are obsessive behavior as a way to control father's behavior, always on the defensive due to anxiety and tension, being afraid of life alone due to paranoid thoughts, contradictory expectation about father's drinking behavior due to life with chronic tension, stress becoming familiar and life being boring and tendious without stimulation, life that is fake and filled with misinterpretations about reality, affection sought from others due to loneliness, compensatory life within peer group, negative expectation about the future due to negative experiences, controling others to protect ego, denial of real emotion to protect self from hurt, life of regretting self, and strong need for approval from others. The third theme is sustaining life. The meanings are ambivalence between revenge on father and pity, struggle for desirable self against fear of gather-like image, understanding father through self reflection, hope to find fatherly being through father's recovery, being able to stand through emotional control and cognitive restructuring, nurturing the seed of hope for the future while in a situation of desperation. The contribution of this study is to give a wholistic understanding of the empirical reality of children of alcohol dependent parents and to develop substantive theory in nursing knowledge. In nursing practice, the results of this study can provide a foundation for the development of programs for children of alcohol dependent parents.

• 한국간호교육학회지
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• 제8권1호
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• pp.61-71
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• 2002

purpose : The purpose of this study was to find out the influencing factors of smoking-cessation behavior of patients with coronary heart disease and to suggest the model of smoking-cessation behavior which was based on the relationship between influencing factors and then to test its fitness empirically. method : This study was based on the Theory of Reasoned Action and a hypothetical model was constructed with fifteen paths in consideration of main predictive factors of smoking-cessation behavior such as biological factor, disease-related characteristics, self-efficacy, supportive factor, environmental factor, disease-related perception factor, intention-to-quit, and psychological factor. The validity of a smoking- cessation model was tested to 264 patients with coronary heart disease by using SPSS 8.0 and Window LISREL 8.12a. results : 1. Seven of the 15 paths of smoking-cessation behavior proved to be significant. 2. The final model excluded three paths in the hypothetical model was demonstrated to be improved by $x^2$=44.31 (df=38, p=.22), Goodness of Fit Index (GFI)=.98, Adjusted Goodness of Fit Index (AGFI)=.96, Non-Normed Fit Index(NNFI)=1.00, Normed Fit Index(NFI)=1.00, and Root Mean Square Residual(RMR)=.24. 3.The smoking-cessation behavior was influenced directly by biological factor, self-efficacy, supportive factor, environmental factor, intention-to-quit, and psychological factor. The smoking-cessation behavior was accounted for 82% of variance by these factors. conclusion : although the adolescents' smoking behavior can be predicted by only smoking intention, it is hard to predict the adults' smoking-cessation behavior by only this factor. Therefore, intention-to-quit, self-efficacy, supportive factor should be improved because these are promotive factors for smoking-cessation behavior. Biological factor, environmental factor, and psychological factor are inhibitive factors, so nicotine replacement therapy is helpful to the high nicotine-dependents, and ex-smokers avoid other smokers in their environment and also patients should learn and practice the stress coping-skills.

• 대한간호학회지
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• 제30권1호
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• pp.122-136
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• 2000

Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.

• 한국사회복지학
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• 제61권2호
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• pp.325-348
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• 2009

암은 우리나라의 사망원인 1위로, 환자뿐 아니라 가족의 삶에도 큰 영향을 미친다. 특히, 돌봄책임을 맡고 있는 가족원의 삶의 질은 사회적 지지, 돌봄 부담에 대한 평가, 재평가에 의해 영향을 받는다. 암환자 가족의 삶의 질을 향상시키기 위해서는 이들 요인들 간의 유기적인 관계를 밝혀 사회복지 실천 방법을 발전시킬 필요가 있다. 본 연구에서는 국립암센터를 이용하는 암환자 가족 295명의 사회적 지지, 돌봄 부담감, 내적 성장, 삶의 질을 파악하고, 이들 변수간의 관계를 구조방정식모형을 통해 검증하였다. 연구결과 첫째, 연구모형의 적합성을 검증하였을 때 적합도 지수가 CFI(.951), TLI(.940), RMSEA(.062)으로 좋은 적합도를 보였다. 둘째, 직접효과에 대한 검증결과 사회적 지지의 돌봄 부담감, 내적 성장에 대한 직접효과, 돌봄 부담감의 내적 성장, 삶의 질에 대한 직접효과, 내적 성장의 정신적 삶의 질에 대한 직접효과가 통계적으로 유의하였다. 셋째, 돌봄 부담감, 내적 성장의 매개효과에 대한 검증 결과, 사회적 지지가 삶의 질에 미치는 영향에 대한 돌봄 부담감의 매개효과, 사회적 지지와 돌봄 부담감이 정신적 삶의 질에 미치는 영향에 대한 내적 성장의 매개효과가 통계적으로 유의하였다. 이러한 결과에 따라 암환자 가족의 삶의 질에 영향을 미치는 사회적 지지, 돌봄부담, 내적성장간의 관계에 대하여 논의하고 사회복지 실천 및 연구를 위한 함의를 제언하였다.