The purpose of this study was to explore and describe the experience of caregivers with mentally ill children. The sample consists of 4 participants who care for their children with mentally ill. They were asked open-ended questions in order for them to talk about their experiences. With permission of the subjects, the interviews were recorded and transcribed. The methodology utilized was the Colaizzi's phonomenological approach. The interview data was organized by themes into 5 categories : anguish, positive emotion, maturation, acceptance of the disease, and seeking information. These 5 themes were further categorized into 4 main groups : emotional impact, spiritual maturation, adapting to the illness, and seeking support needs. The results of this study have clinical and theoretical implications not only for psychiatric nursing in Korea but also for all clinicians working with the families of the mentally ill.

PURPOSE: It was identified that how many homebound bedridden elderlies and their primary caregivers were depressed, and which factors affected the bedridden elderly's depression. METHOD: The subjects were 191 homebound bedridden elderlies and their primary caregivers. The affecting factors were classified into two categories: bedridden elderly and their primary caregiver related factors. Then bedridden elderly's factors were classified demographic and disease-related factors again. The stepwise regression was used to identify significant factors. RESULT: The prevalence of bedridden elderly's and caregiver's depression was 77.8% and 67.0%, respectively. And the model explained 33.3% of variance of bedridden elderly's depression. Cognitively-impaired female elderlies who had depressed caregivers were found to be more depressed. And caregivers who perceived burden were identified to be more depressed. CONCLUSION: It is recommended that the health professionals need to identify bedridden elderlies and caregivers at risk of depression. Especially elderlies who is in poor cognition, those who are female, and those whose caregivers were depressed might be considered carefully in all counseling or follow-up. Also the primary caregivers must be helped to access already available formal and informal support.

PURPOSE: The purpose of this study was to identify the burden, health promotion behavior and health status and to describe the relationship of the burden, health promotion behavior and health status of the family caregivers of intensive care unit patients. METHOD: The subjects were 48 family caregivers of ICU patients in a University Hospital. Data were collected between June, 1 and July, 31, 2000 using structured questionnaires. Research tools used were Suh and Oh's Burden Scale, Revised Walker, Sechrist, and Pender's HPLP(1987) ; Revised Nam's Health State Scale(1965). RESULT: The mean score of burden of family caregiver was 3.01(full score was 5). The mean score of health promotion behavior of family caregiver was 2.52 (full score was 4). And the mean score of health status of family caregiver was 0.68(full score was 1.00). The score of psychological health state was a little higher than the physiological one. In correlational analysis, the burden and the health status of caregivers were reversely correlated . The correlation between the burden and the health promotion behavior, and the health behavior and health status were not significant. CONCLUSION: The more burden caregivers of ICU patients felt, the worse their health status. So nurses need to understand the family caregiver's burden and apply nursing care that can reduce burden, in order to improve the health status of family caregivers.

This was a descriptive study clarifying the factors affecting family caregivers' sense of well-being. This study was conducted with 131 caregivers using structured self-reporting questionnaires and directly interviewing adult patients who had been under treatment in two general hospitals. The hospitals were located in M city from Aug. 10, 2000 until Sep. 2, 2000. The collected data were analyzed using SAS PC+ program, and the data were tested using descriptive statistics, t-tests, ANOVA, Pearson's Correlation Coefficient, and Stepwise Multiple Regression. The results of this study are as follows; 1) The variables affecting the caregivers' sense of burden were age (F=3.76, p=.0063), education level (F=4.67, p=.0015), monthly income (F=2.49, p=.0466), amount of assistance provided (F=4.19, p=.0037), and the relationship with patient before disease (F=9.49, p=.0001). 2) The variables affecting caregivers' sense of well-being were age (F=9.54, p=.0001), residing with patient (t=11.38, p=.0010), the period of caregiving (F=10.52, p= .0001), education level (F= 2.79, p=.0290), monthly income (F=3.04, p=.0196), and relationship with patient before disease (F= 10.51, p=.0001). Also, all of the variables which showed statistical significance. 3) In viewing the relationship between activities of daily living (ADL) and the senses of burden and well-being, a negative relation- ship between activities of daily living (ADL) and a sense of burden was found (r=-.640, p=.000). However, the relationship between activities of daily living (ADL) and a sense of well-being had a positive correlation (r= .232, p=.008). Also the relationship between the sense of burden and the sense of well-being was revealed to have a negative correlation (r=-.614, p=.000). 4) A sense of burden was the most important indicator to the well-being of the caregivers who took care of stroke patients (R2 =.36). In addition to this, living with the patient (45%), activities of daily living (51%), relationship with patient before disease (53%), and the family's monthly income accounted for 56% of the sense of well-being of the caregivers.

In this paper, we examined the depression of stroke patient's caregivers and analyzed influencing factors of the depression. The subjects were 215 caregivers who have takencare of stroke survivors in their home. The conceptual model of this study consisted of the caregiver's depression, perceived burden, illness intrusiveness, and patient's ADL. Modified Korean CES-D, modified subjective and objective Burden Scale, Illness intrusiveness(II), and Instrumental Activity of Daily Living(IADL) were used to measure concepts. Path analysis was used to test the model of this study. The results were as follows: 1. The mean depression score was 11.6 which was below the cut-off score of the CES-D. This score indicates that the subjects were higher than normal adults' mean score but not depressive. Eighty-six out of 215 caregivers(40%) were above the cut-off score. This finding was different from previous research results, and the reason might be the patients' capability of ADL. In a group of low capability patient's activities of daily living, caregiver's depression score was 15.5. 2. Caregiver's depression was positively related to caregiver's burden and illness intrusiveness, but negatively related to patient's activities of daily living. 3. The caregiver's perceived burden and illness intrusiveness directly influenced on their depression. Furthermore, the and caregiver's illness intrusiveness led to depression indirectly through their burden. A patient's activities of daily living didn't influence directly on depression but indirectly through caregiver's illness intrusiveness and burden.

The sample of this study consisted of 140 informal caregivers who provided care to the older adults(over 60 years of age) in Great Cleveland, USA. Self-rated questionnaires were utilized to collect information. The purpose of the study was to identify coping strategies most frequently utilized by informal caregivers of older adults and to examine predictors of the caregivers' health responses to the caregiving situation applying Lazarus and Folkman stress model(1984). Stepwise multiple regression was used to identify significant predictors among caregivers' demographic-socio-economic factors, older adult's dependency of activities of daily living(ADLs), caregiver's appraisal to the caregiving situation, and coping strategies. Informal caregivers (N=140) included in the study utilized help-seeking and problem-solving coping strategies more than self-blame and minimization of threat coping strategies. Caregivers' responses to the caregiving situation were observed by caregivers' perceived physical health, depression and life satisfaction. For perceived physical health, threat appraisal, older adult's dependency on ADLs, existential growth coping strategy, and monthly income accounted for 25% of the variance. Caregivers who appraised the caregiving situation as more threatening, reported higher dependency on ADLs, used more existential growth coping strategy, and had higher monthly income reported better physical health. For depression, threat appraisal, stress appraisal, existential growth coping strategy, self-blame coping strategy, and monthly income accounted for 48% of the variance. Caregivers who used more existential growth coping and less self-blame coping, appraised the situation as less threatening, less stressful, and had higher monthly income reported less depression. For life satisfaction, self-blame coping, existential growth coping, monthly income, stress appraisal accounted for 49% of the variance. Caregivers who used more existential growth coping, less self-blame coping, less stress appraisal, lower monthly income reported better life satisfaction. In conclusion, informal caregivers in this study utilized positive coping strategies such as problem-focused, existential growth, help-seeking, rather than negative coping strategies including self-blame. When they utilized positive coping strategies more often, caregivers experienced higher perceived physical health, higher life satisfaction and lower depression. Therefore, nursing intervention which utilized positive coping strategies is needed to enhance informal caregivers to have positive health responses to the caregiving demands.

The purpose of this study was to describe the perceived burden of the stroke patient's caregiver and related factors to analyze relationships between perceived burden and social supports. A convenient sample of 225 caregivers who take care for a stroke patient at home participated in this study. Caregiver's perceived burden was measured by the objective and subjective burden scale developed by Montgomery (1985). Related factors of burden were studied in terms of the patient's instrumental activties of daily living, cognitive function, caregiver's demographic variables and caregiver's illness intrusiveness. The results were as follows: (1) The mean of objective burden score was 4.5, and subjective burden score was 3.1. These scores show that caregivers perceive moderate level of burden. (2) Caregivers' objective burden was significantly related to caregivers's illness intrusiveness (r=.62), patient's IADL (r=-.33), and patient's cognitive function (r=-.15). The subjective burden was related to the caregiver's illness intrusiveness (r=.29), the patient's IADL (r=.24), and the caregiver's age(r=.23). (3) The percentage of stroke caregivers who perceived physical support was 49.1%. The percentage of those who perceived emotional support was 61.0%, and those who perceived financial support totaled 37.6%. (4) Caregivers who received any type of social supports perceived lower subjective burden, and caregivers who received physical or psychological support perceived lower objective burden. These results emphasized the necessity of a rehabilitation programs for stroke patients and support program for family caregivers.

The purpose of this study is to identify health promotion behavior, self-efficacy and role stress of family caregivers who care for hospitalized cancer patient, The results would be used to provide the necessary basic data for promoting healthy behavior of the family caregivers to the cancer patient. The results were as follow : 1) The level of health promotion behavior was significantly different depending on the existence of care givers religion and type of help from family members. There was a positive relationship between the performance level of health promotion behavior and perceived health status or age. There was a negative correlation between the performance level of health promotion behavior and time cared for. 2) The level of self-efficacy was significantly different depending on gender and if the subject was employed. There was a positive relationship between perceived health status and intimacy with patient. 3) The level of role stress was significantly different in genders and relationships with patients. 4) There was a positive relationship between health promotion behavior and self-efficacy.

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.

The concept of empathy was examined in the professional caregiving relationship and its application was extended to the context of informal caregiving. Using the Lazarus and Folkman model. the influence of empathy on the caregiver's experience in the caregiving relationship was illustrated. The effects of the caregiver's empathy on his/her own caregiving outcomes were investigated by examining the relationship between empathy and burnout experience and life satisfaction. Empathy increased emotional exhaustion while increased personal accomplishment and personalization. indicating conflicting relationship between empathy and burnout. This conflict relationship between empathy and burnout can be explained by suggesting the distinct roles of two dimensions of empathy: emotional and caregiving context and to examine the definite roles of two dimensions of empathy were suggested.

The purpose of this study was to investigate the relationship between the burdent on families who live with an elderly person suffering from senile dementia, and the degree of their depression. There were 400 participants in this study, staying in the Seoul and Kyonggi areas from August, 1, 1997 to February 28, 1998. Among the group, 100 participants took care of their patients at home, and another 300 participants left 100 patients at a day-care center, 100 sanatorium for senile dementia(asylum for helpless elderly people), 100 an infirmary for elderly people. Eventually 242 subjects out of the 400 were selected for the data analysis. The Zarit(1980) tool was employed to measure the degree of burden and Zung's(1965) "Self-Rating Depression Scale" was employed for the data analysis. The data was analyzed, and the percentage, t-test, ANOVA, and Pearson's Correlation Coefficient were calculated. The results are as follows. 1. The average degree of burden that care-giving families felt was 49.13, which is somewhat high. 2. The average degree of depression that-giving families felt was 51.95, which is relatively high. 3. The degree of burden was directly affected by the relation with the patient(F=2.48, P<.05), and the socio-economic status of the family(F=5.17, P<.05). It's also affected by the patient's educational status(F=2.17, P<.05). 4. The degree of depression of the family was significantly dependent on sex(t=-2.05, P<.05), age(F=2.99, P<.05), the relationship with the patient(F=3.65, P<.01), socio-economic status(F=7.74, P<.001), occupation(t=2.82, P<.01), health status(F=4.42, P<.01), and the place of residence(F=4.30, P<.01). The patient characteristics was significantly dependent on his/her educational status(F=3.85, P<.01), the period of suffering from senile dementia(F=2.47, P<.05), and smoking habit(F=6.17, P<.001). 5. The relationship between the degree of burden and that of depression reads r=0.43, which is statistically positive correlation in the high significant level. Upon analyzing the entire summation, most care-giver for elderly patients suffering from senile dementia lack time in caring for themselves. They also experience chronic fatigue and mental discomfort caused by the isolation from society, curtailment of certain activities, a sense of responsibility of certain activities, a sense of responsibility for their patients, and limits of their endurance in taking care of their patients over time. In conclusion, this study emphasizes the necessity for the following propositions : 1. In order to measure the degree of burden that Korean care-giving families undergo, a new tool must be developed on the basis of Korean culture. 2. An educational program based on the demands that care-giving families undergo must e developed, and its clinical effect also has to be examined.

The purse fo this study was to examine the predictors of burnout among informal caregivers of older adults. One hundred thirty seven caregivers of who had provided care to older adults over 60 years of age for more than one month were included in the study. Most of the caregivers where white (91%) and female (78%). mean ages of the caregivers were 64 years and 78% of them were married. Seventy percent of the older adults suffered from Alzheimer and related disease. In this study, caregivers and related disease. In this study, caregivers reported that they experience burnout once a month. The scores of emotional exhaustion and reduced personal accomplishment of the caregivers were in the moderate burnout rang. To examine the predictors of burnout, discriminant analysis was used. Caregivers were divided by two groups based on the sum of score (cutpoint=6) on three dimensions of burnout after each dimension was categorized into high(3), moderate(2), and low(1). Nine predictors were include in the analysis: Caregiver's age, employment status, Instrumental Activities of Daily Living (IADL) of the older adult, presence of dementia of the older adult, caregiver's empathy toward the older adult(emotional and cognitive), and 3 coping strategies (negative, problem-focused, cognitive reconstructioning). Catefgivers who reported high burnout showed higher cognitive empathy toward the adults than those who showed low burnout. Caregivers who experienced high burnout used negative coping more often, and cognitive reconstructioning coping and problem focused coping less often than their counterparts. Wilks' Lambda was .78 indicating that their differences between the two groups were signigicant. Cognitive empathy and cognitive reconstructioning coping showed high standardized canonical discriminant function coefficients over .40. Discriminant function with 9 predictors correctly classified 71% of the sample. In conclusion, informal caregivers also experienced certain level of burnout. Cognitive empathy and coping strategies predicted burnout experience of the caregivers. Based on this study, nursing intervention to the informal caregovers to improve their cognitive empathy toward the older adults and to modify their coping strategies in way to reduce burnout experience can be applied. Further research to develop effective nursing interventions for the purpose of reducing burnout experience by modifying predictors was suggested.

Cancer has been considered a life-threatening disease and coping patterns could have a string impact the physical and psychological health of patients and their family. The purpose of this study was to identify the change of coping patterns according to the phases of illness in the patients with cancer and their family caregivers and to compare the coping patterns of patients with those of their caregivers. The phases of illness consisted of 1st(initial) stage, 2nd(metastatic or recurred) stage and 3rd(terminal) stage based on literature. The coping methods were measured using the modified Ways of Coping Questionnaire by Lazarus and Folkman(1984). Seventy-nine patients(35 in stage 1,31 in stage 2, and 13 in stage 3) and ninety-two caregivers(38 in stage 1,30 in stage 2 and 24) agreed to participate from two general hospitals in Seoul and Choongnam. No significant changes were found in the coping patterns according to the phases of illness in both groups. Patients in stage 2 and caregivers in stages 2 and 3 problem-focused coping methods were significantly used more than emotion-focused coping methods. Patients in stage 1 significantly used two coping strategies that were cognitive reconstruction and emotion expression more than caregivers. Patents in stage 2 significantly used emotion-focused coping methods including minimizing threat, blame, and emotion expression excepting wishful thinking more than caregivers. We need more research to identify the relationship between the coping methods and their efficiencies through long-term observation and attempt to develop the nursing interventions that could have an improvement on positive coping methods and provide guidance on the problems the patients experience.

This study amis for examines the actual physical symptom and stress in caregivers of patients with cerebrovascular disease. The data were collected by a survey conducted from August to September, 1997 which included 65 caregivers of cerebrovascular disease patient in 4 hospitals located in Seoul. The caregiver's stress was measured by Choi(1992)'s instrument and the actual physical symptoms were investigated. The data were analyzed using ANOV, Scheffe test, pearson correlation coefficient and stepwise multiple regression. The results were as follows : 1. The mean number of caregiver's physical symptom was 3.5. There were significantly higher number of physical symptom in women, those of who have a religious affiliation, those of two perceive their own health status perceived s bad, and those of two perceived their patients disease condition as serious than in their counterparts. Also, the number of caregiver's physical symptom was significantly higher in caregivers whose patients have a paralysis symptom and the disease onset as spontaneous. 2. The average of caregiver's stress was 57.9. The caregiver's stress was the highest in between the ages of 50 and 59. There were also significantly higher level of stress in women, those of two perceived the disease condition of their patient as serious than in counterparts. 3. The most common caregiver's physical symptom was fatigue(87.7%). This was followed by insomnia(58.5%) and muscle (47.4%). 4. Caregiver's physical symptom was positively correlated with caregiver's stress and negatively correlated with patient's activity of daily life. 5. The most important variable affecting the caregiver's physical symptom was patient's activity of daily life which accounted for 12.7% of the total variance in stepwise multiple regression analysis. The most important variable affecting the caregiver's stress was the patient disease condition perceived by the caregiver that accounted for 12.1% of the total variance.

This study was designed to construct a model that predicts the quality of life of family caregivers with a chronically ill patient. The hypothetical model wad developed based on the findings from past studies on quality of life and on the family with a chronically ill patients. Data were collected by self-reported questionnaires from 200 family caregivers in Seoul and Kyung Gi-Do, from May 1 to July 21, 1997. Data were analyzed using descriptive statistics and correlation analysis. The Linear Structural Relationship(LISREL) modeling process was used to find the best fit model which predicts causal relationships among variables. The results are as follows: 1. The overall fit of the hypothetical model to the data was moderate [X2=31.54(df=23, p=.11), GFI=.96, AGFI=.91, RMR=.04]. 2. Paths of the model were modified by considering both its theoretical implication and the statistical significance of the parameter estimates. Compared to the hypothetical model, the revised model has become parsimonious and had a better fit to the data expect chi-square value(GFI=.95, AGFI=.91, RMR=.04). 3. Some of predictive factors, especially economic status, physical ability to perform daily-life activity, period after disease-onset, social support and fatigue revealed indirect effect on the quality of life of family caregivers with a chronically ill patient. 4. The factors, burden and role satisfaction revealed significant direct effects on the quality of life of family caregivers with a chronically ill patient. 5. All predictive variables of quality of life of family caregivers with a chronically ill patient, especially economic status, physical ability to perform daily-life activity, period after disease-onset, social support, fatigue, burden and role satisfaction explained 38.0% of the total variance in the model. In conclusion, the derived model in this study is considered appropriate in explaining and predicting quality of life of family caregivers with a chronically ill patient. Therefore it can effectively be used as a reference model for further studies and suggests direction in nursing practice.

PURPOSE: This qualitative study aimed to identify the common, lived experiences of grandmothers who cared for their grandchildren as the primary caregivers. METHODS: This study was based on the phenomenological method described by Colaizzi (1978). RESULTS: Seven theme clusters emerged from the data as follows: "grandmother caregivers accept the parenting role of the incessant responsibilities and the distrust of non-kin caregivers.", "grandmother caregivers have a double maternal roles; an instrument-oriented maternal role to their own child and relationship-oriented maternal role to their grandchild.", "grandmother caregivers are partially authorized to make decisions in the matters of their grandchild.", "grandmother caregivers suffer a deterioration in their health by an acceleration of the aging process.", "caregiving causes grandmother caregivers to feel a sense of social isolation, and persue various coping strategies to control this feeling.", "grandmother caregivers have a greater feeling of self-esteem, but they often conflict with their adult children if they don't feel appreciated by them.", "grandmother caregivers have limited social support and their health issues are often overlooked in the family context." CONCLUSION: The results of this study can guide nurses and health care workers to understand the experiences of grandmother caregivers and to implement individualized nursing interventions suited for them.

PURPOSE: The purpose of this study was to develop and evaluate the effects of a support group intervention on the burden of primary family caregivers of stroke patients. METHOD: A nonequivalent control group pretest-posttest design was used. The subjects were 36 primary family caregivers of stroke patients [experimental(N=18) and control(N=18) groups] in a neurosurgery ward of a university hospital. The experimental group members participated in six sessions of a support group intervention for two weeks and the degree of their caregiving burden was evaluated. Data was analyzed by Chi-square tests, t-tests, and paired t-tests using SPSS 10.0. RESULT: The experimental group had a significantly lower total burden score (t=2.061, p= .047)and sub-scales of emotional(t=-3.319, p= .002), time-dependent(t=-2.045, p= .049) and developmental(t=-2.656, p= .012) burden scores than the control group, while no significant differences were found in physical, social or financial burden scores between the two groups. Within the experimental group, there was a significant decrease in physical(t=2.507, p= .023), emotional(t=4.754, p= .000), social(t=2.932, p= .009), time- dependent(t=5.015, p= .000) and developmental(t=7.541, p= .000) burden scores but not the financial burden score. CONCLUSION: The results suggest that a support group intervention can be utilized as an effective nursing program to reduce the burden of primary family caregivers of stroke patients.