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Research Papers
The Caring Experience of Family Caregivers for Patients of Living Donor Liver Transplantation from the Family Members
Bang, Miseon , Kwon, Suhye
J Korean Acad Nurs 2022;52(4):435-450.   Published online August 31, 2022
DOI: https://doi.org/10.4040/jkan.22043
AbstractAbstract PDF
Purpose
The purpose of the study was to understand the care experiences of the family of living donor liver transplantation (LDLT) patients where the donation had occurred within the family.
Methods
Participants were eight family caregivers who cared for recipients and donors of LDLT. Data were collected through individual in-depth interviews from November, 2020 to April, 2021. Data analysis was performed through a cyclical process of data collection and analysis by applying Giorgi’s phenomenological research method.
Results
The five main components extracted from the experiences of the family caregivers were: "A double-edged choice to save the family", "The harsh daily life of liver transplantation care", "The yoke of double care on both shoulders", "The power to withstand the adversity of caring", and "The recovery and growth of life pursued by trusting each other".
Conclusion
The participants tried to do their best in their daily lives, while providing reassurance and care to the LDLT patients in the family; however, they expressed some worry and hardship while doing so. The results of this study provide a deeper understanding of the caring experience of the family caregivers, which may contribute to the development of nursing interventions that will aid these caregivers in providing care to their LDLT family members. Furthermore, the development and application of an integrated management program for LDLT patients in the family is required.
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Influence of Self-care on Burnout in Primary Family Caregiver of Person with Dementia
Kwon, Jeong Hwa , Hong, Gwi-Ryung Son
J Korean Acad Nurs 2021;51(2):217-231.   Published online April 30, 2021
DOI: https://doi.org/10.4040/jkan.20274
AbstractAbstract PDF
Purpose
The purpose of this study was to identify the influence of self-care on burnout experienced by primary family caregivers of persons with dementia.
Methods
The subjects of the study were 156 primary family caregivers of persons with dementia at home in Korea. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and hierarchical multiple regression using IBM SPSS Statistics ver. 24.0 for Windows.
Results
The mean scores for self-care and burnout were 42.35 and 61.60, respectively. Self-care, subjective health status, living with a person with dementia, and behavioral and psychological symptoms of dementia were significant factors affecting burnout in family caregivers. Self-care was identified as the strongest factor affecting burnout, explaining 13.9% of burnout with controlling factors in caregivers and care receivers.
Conclusion
To prevent burnout in primary family caregivers of persons with dementia, self-care of family caregivers should be emphasized. In nursing education, family caregivers should be recognized and approached as nursing clients who are responsible for taking care of their health. In nursing practice and research, digital self-care or self-care improvement intervention programs should be designed to help family caregivers, and further studies on self-care centered on health of family caregivers should be conducted.
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Original Articles
Factors Influencing Psychosocial Well-Being in Family Caregivers of People with Amyotrophic Lateral Sclerosis
Hyeon Sik Chu, Young Ran Tak, Seung Hyun Kim
J Korean Acad Nurs 2018;48(4):454-464.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.4.454
AbstractAbstract PDF
Abstract Purpose

The purpose of this study was to identify factors influencing psychosocial well-being in family caregivers of patients with amyotrophic lateral sclerosis (ALS).

Methods

A descriptive correlational design was used. The transactional model of stress and coping was used to investigate the psychosocial well-being of 137 family caregivers of patients with ALS. Data were collected through self-reported questionnaires from January to November 2016. Data were analyzed using an independent t-test, one-way ANOVA, Pearson's correlation, and hierarchical multiple regression analysis with the SPSS WIN 21.0 program.

Results

The regression model had an adjusted R2 of .49, which indicated that meaning-focused coping, social support, ALS patient-family caregiver relationship (especially a spousal relationship), and tracheostomy were significant predictors of caregivers’ psychosocial well-being.

Conclusion

Meaning-focused coping and social support significantly influenced caregivers’ psychosocial well-being. Therefore, interventions to improve caregivers’ psychosocial well-being must focus on increasing meaning-focused coping and social support resources.

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A study on the Experience of the Life of Caregivers with Mentally Ill Children
Kyoung Soon Lee
Journal of Nurses Academic Society 1997;27(4):953-960.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1997.27.4.953
AbstractAbstract

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.

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Health Promotion Behavior, Self-Efficacy and the Role Stress of Family Caregivers Who Care for Hospitalized Cancer Patients
Hye Sook Jang, Jeong Ran Lee, Moung Sil Lee, Yeon Sun Yun, Young Hee Kim
Journal of Korean Academy of Nursing 2000;30(2):402-412.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.2.402
AbstractAbstract PDF

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.

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The Comparison of the coping Patterns of Cancer Patients and Their Caregivers According to the Phases of Illness
Young Hee Yang
Journal of Korean Academy of Nursing 1998;28(4):970-979.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.4.970
AbstractAbstract PDF

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.

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Actual Physical Symptom and Stress in Caregivers of Patients with Cerebrovascular Disease
Hee Seoung Kim, Hyeoun Ae Park, Mi Jeong Oh
Journal of Korean Academy of Nursing 1998;28(3):695-704.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.3.695
AbstractAbstract PDF

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.

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A Model for Quality of Life of Family Caregivers with a Chronically Ill Patient
Eun Sook Park, Sook Ja Lee, Young Joo Park
Journal of Korean Academy of Nursing 1998;28(2):344-357.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.2.344
AbstractAbstract PDF

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.

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The Effects of a Support Group Intervention on the Burden of Primary Family Caregivers of Stroke Patients
Eun Kwang Yoo, Sanghee Jeon, Jeong Eun Yang
Journal of Korean Academy of Nursing 2007;37(5):693-702.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2007.37.5.693
AbstractAbstract PDF

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.

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A Study on the Related Factors of the Wellbeing of Family Caregivers in Elderly with Stroke
Yeon Hwan Park, Su Jeong Yu, Shin Mi Kim, Yun Jung Lee
Journal of Korean Academy of Nursing 2006;36(2):373-380.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2006.36.2.373
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the factors related to the wellbeing of the family caregivers of the elderly with a stroke.

Methods

The subjects of this study were 199 elderly treated in four oriental hospitals in Korea, and their primary family caregivers. The data was collected by interviewsand a self reported questionnaire, during the period from October, 2003 to April, 2004.

Results

The results of this study were as follows. The mean score of wellbeing of family caregivers was 60.6412.63. The factors related to wellbeing of family caregivers were sex, age, education, depression, illness severity, ADL, paralysis, and speech disability in elderly characteristics. Among family caregivers characteristics, education, relation, and burden were significantly related. In situational variables, family income and the previous relationship between the elderly and family caregivers were related to wellbeing. Stepwise multiple regression analysis revealed that the most powerful predictor of wellbeing was the burden of family caregivers. A combination of the depression of elderly and age of family caregivers accounted for 50.3% of the variance of wellbeing.

Conclusions

On developing the nursing intervention for improving wellbeing of family caregivers, many factors should be considered, especially caregiver burden, and elderly depression.

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Influencing Factors that Affect the Psychological Well-being in Family Caregivers of Stroke Patients
Jung Hee Kim, Ok Soo Kim
Journal of Korean Academy of Nursing 2005;35(2):399-406.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.2.399
AbstractAbstract PDF
Purpose

The purpose of this study was to investigate the factors that affect the psychological well-being in family caregivers of stroke patients.

Method

The General Health Perception, short form 36, Health Survey Questionaire was used to measure health perception. The Caregiving Mastery Scale was used to assess the mastery, while the Psychological General Well-Being Index was used to examine the level of well-being.

Result

Subjective health, caregiving mastery, patient's ADL and caregiving duration influenced on caregiver's psychological well-being. Subjective health had effect on psychological well-being both directly and indirectly. Caregiving duration and patient's ADL had indirect effect on psychological well-being through caregiving mastery.

Conclusion

It is need to develop a health program for the caregivers of stroke patient's and to provide nursing intervention to improve the caregiver's ability, thereby improving the well-being of the family caregivers.

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The Effects of the Day Care Service Program for the Elderly and Family with the Stroke: Compared with the Elderly and Family in Home
Yeon Hwan Park
Journal of Korean Academy of Nursing 2003;33(7):990-998.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.7.990
AbstractAbstract PDF
Purpose

The purpose of this study was to identify the effects of the day care service for the elderly and family with the stroke.

Method

Data were collected from September 2002 to March 2003 by self report questionnaires and interview. 50 elderlies and families(Gr I) who used day care center were compared with 51 elderlies and families (Gr II) who didn't used. The data were analyzed using independent sample t test and chi square test.

Result

The general characteristics, stressors, and situational variables related to outcome variables were homogeneous between two groups. The caregiver burden(t=-2.287, p=.024) score in the Gr I was significantly lower than in the Gr II. However there was no evidence of an effect day care center attendance on the depression of the elderly, the relationship between elderly and caregiver, and the family functioning.

Conclusion

Findings indicate that day care service was effective in reducing the caregiver burden of the elderly, however more day care service programs(elderly health management, rehabilitation...)will be added.

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Predictors of Depression among Family Caregivers of Older Adults with Dementia
Hae Jung Lee, Young Sook Kim, Ki Ryeon Kim, Ju Sung Kim, Ji Min Seo
Journal of Korean Academy of Nursing 2003;33(7):936-944.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.7.936
AbstractAbstract PDF
Purpose

This study was to identify important predictors of depression among characteristics of caregiving situation and utilized resources in order to provide basic information for effective nursing interventions to reduce depression experienced by family caregivers of older adults with dementia.

Method

Seventy one family caregivers were identified from community service centers and face-to-face interviewed using structured questionnaires. Data were analyzed with descriptive statistics, Pearson correlation and hierarchical multiple regression using SPSS WIN 10.0 program.

Result

Family caregivers reported high levels of depression, moderate levels of social support, and moderate utilization of coping strategies. Female caregivers who (β=.22) utilized ‘negative’ coping strategies more often (β=.48) and ‘cognitive reconstructuring’ coping strategies less often (β=-.23) were more likely to report higher depression (R2=0.63).

Conclusion

Nursing interventions increasing family caregivers' utilization of positive coping strategies such as problem solving, existential growth, and help seeking and decreasing their utilization of negative coping strategies such as self-blaming are needed to decrease their depression levels.

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The Role of Social Support in the Relationship between Stress and Depression among Family Caregivers of Older Adults with Dementia
Hae Jung Lee, Ji Min Seo, Suk Hee Ahn
Journal of Korean Academy of Nursing 2003;33(6):713-721.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.6.713
AbstractAbstract PDF
Purpose

This study was to determine the mediator or moderator role of social support in the relationship between stress and depression among family caregivers of older adults with dementia.

Method

Sixty nine family caregivers were randomly selected from health care centers in P city and a face-to-face interview was conducted using questionnaires from January to May of 2002. Data were analyzed with descriptive statistics, Pearson correlation, and hierarchical multiple regression using SPSS program.

Result

Family caregivers of older adults with higher dependency in ADLs and higher problematic behaviors, provided care to the older adults for a longer period of time, and perceived less social support reported higher depression. Social support showed mediating effects between stress and depression, while did not show moderating effects. Elderly dependency on ADLs and caregiving duration decreased perceived social support and decreased social support increased depression.

Conclusion

To increase family and social support to the caregivers of more functionally impaired elderly, family education to increase emotional support and physical assistance to the caregivers and broader and flexible application of social support such as increasing accessibility to the elderly daycare service with lower price may prove beneficial.

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Hermeneutic Phenomenological Study on Caring Experience of Spouses of Elderly People with Dementia at Home
Hye-Young Jang, Myungsun Yi
J Korean Acad Nurs 2017;47(3):367-379.   Published online January 15, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.3.367
AbstractAbstract PDF
Abstract 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.

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Effects of Home Care Services Use by Older Adults on Family Caregiver Distress
Jiyeon Kim, Hongsoo Kim
J Korean Acad Nurs 2016;46(6):836-847.   Published online December 30, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.6.836
AbstractAbstract PDF
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, χ2 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 (β=-.89, p=<.001) and home helper visits (β=-.53, p=.014). Level of caregiver distress was also significantly associated with days of nurse visits (β=-.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.

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A Prediction Model for Unmet Needs of Elders with Dementia and Caregiving Experiences of Family Caregivers
Sora Choi, Myonghwa Park
J Korean Acad Nurs 2016;46(5):663-674.   Published online October 31, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.5.663
AbstractAbstract PDF
Purpose

The purposes of this study were to develop and test a prediction model for caregiving experiences including caregiving satisfaction and burden in dementia family caregivers.

Methods

The stress process model and a two factor model were used as the conceptual frameworks. Secondary data analysis was done with 320 family caregivers who were selected from the Seoul Dementia Management Survey (2014) data set. In the hypothesis model, the exogenous variable was patient symptomatology which included cognitive impairment, behavioral problems, dependency in activity of daily living and in instrumental activity of daily living. Endogenous variables were caregiver's perception of dementia patient's unmet needs, caregiving satisfaction and caregiving burden. Data were analysed using SPSS/WINdows and AMOS program.

Results

Caregiving burden was explained by patient symptomatology and caregiving satisfaction indicating significant direct effects and significant indirect effect from unmet needs. The proposed model explained 37.8% of the variance. Caregiving satisfaction was explained by patient symptomatology and unmet needs. Mediating effect of unmet needs was significant in the relationship between patient symptomatology and caregiving satisfaction.

Conclusion

Results indicate that interventions focusing on relieving caregiving burden and enhancing caregiver satisfaction should be provided to caregivers with high levels of dementia patients' unmet needs and low level of caregiving satisfaction.

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The Effect of Patient-centered CPR Education for Family Caregivers of Patients with Cardiovascular Diseases
Hyun Sun Kim, Hyun-Jin Kim, Eunyoung E. Suh
J Korean Acad Nurs 2016;46(3):463-474.   Published online June 30, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.3.463
AbstractAbstract PDF
Purpose

For cardiovascular patients, family caregivers play a vital role in daily nursing and cardiac emergencies. This study aimed to evaluate the effect of patient-centered CPR education (PCE) for family caregivers of patients with cardiovascular diseases.

Methods

Fifty-four participants were randomly assigned to the PCE or control group. The PCE group received tailored counseling on overall cardiovascular disease information and CPR followed by interactive instructor-guided CPR training and re-education follow-up by telephone 2 weeks later. The control group received only video-based CPR self-education and booklets. Cardiovascular disease and CPR knowledge and self-efficacy were measured before (pre-test), immediately after (post-test 1), and 4 weeks after the PCE (post-test 2). CPR skills and performance were measured pre-test and at post-test1.

Results

The PCE group demonstrated significant improvements in knowledge (F=91.09, p<.001), self-efficacy (F=15.19, p<.001) and CPR skills and performance (F=8.10, p=.008), as well as significant differences over time (knowledge: F=364.25, p<.001; self-efficacy: F=1162.28, p<.001; CPR skills and performance: F=1798.81, p<.001). There were significant group-by-time interactions for knowledge (F=8.10, p=.001), self-efficacy (F=4.30, p=.019) and CPR skills and performance (F=4.81, p=.036) by repeated measures ANOVA.

Conclusion

This is the first study to demonstrate the effects of a patient-centered intervention with CPR education tailored for patients' and family caregivers' preferences, needs, and lifestyles. The results of this study encourage the use of tailored, patient-centered interventions in cardiovascular nursing practice.

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Invited Article
Psychological and Physical Health in Family Caregivers of Intensive Care Unit Survivors: Current Knowledge and Future Research Strategies
JiYeon Choi, Michael P. Donahoe, Leslie A. Hoffman
J Korean Acad Nurs 2016;46(2):159-167.   Published online April 29, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.2.159
AbstractAbstract PDF
Purpose

This article provides an overview of current knowledge on the impact of caregiving on the psychological and physical health of family caregivers of intensive care unit (ICU) survivors and suggestions for future research.

Methods

Review of selected papers published in English between January 2000 and October 2015 reporting psychological and physical health outcomes in family caregivers of ICU survivors.

Results

In family caregivers of ICU survivors followed up to five years after patients' discharge from an ICU, psychological symptoms, manifested as depression, anxiety and post-traumatic stress disorder, were highly prevalent. Poor self-care, sleep disturbances and fatigue were identified as common physical health problems in family caregivers. Studies to date are mainly descriptive; few interventions have targeted family caregivers. Further, studies that elicit unique needs of families from diverse cultures are lacking.

Conclusion

Studies to date have described the impact of caregiving on the psychological and physical health in family caregivers of ICU survivors. Few studies have tested interventions to support unique needs in this population. Therefore, evidence for best strategies is lacking. Future research is needed to identify ICU caregivers at greatest risk for distress, time points to target interventions with maximal efficacy, needs of those from diverse cultures and test interventions to mitigate family caregivers' burden.

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Original Article
Development of a Measurement Instrument for Parenting Behavior of Primary Caregivers in Early Childhood
Sun-Jung Park, Kyung-Ah Kang
J Korean Acad Nurs 2015;45(5):650-660.   Published online October 30, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.5.650
AbstractAbstract PDF
Purpose

The purpose of this study was to develop an instrument to measure the parenting behavior of primary caregivers of children in early childhood.

Methods

An instrument was developed according to Devellis's instrument development process. The participants in this study who completed the main survey were 370 mothers and grandmothers. The survey was conducted from June 1 to July 30, 2014, and collected data were analyzed using item analysis, half-split reliability and Cronbach's α coefficient, exploratory and confirmatory factor analysis, convergent validity.

Results

The factor structure of the instrument showed the cumulative variance as 55.7% in the factor analysis. As a result of a confirmatory factor analysis, a four-factor structure was found to be appropriate, and the construct validity and convergent validity of the instrument were thereby confirmed. The finalized parenting behavior instrument consisted of 26 items and four independent factors: affectionate, laissez-faire, educational and impulsive. A five-point Likert scale was employed, and a higher score in a particular factor showed that most of the behaviors belonged to the factor.

Conclusion

The instrument developed in this study was found to be reliable and valid, and can be used to develop parent-child relationship building.

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Review Article
Effects of Family Support Programs for Caregivers of People with Dementia - Caregiving Burden, Depression, and Stress: Systematic Review and Meta-analysis
Seyeon Park, Myonghwa Park
J Korean Acad Nurs 2015;45(5):627-640.   Published online October 15, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.5.627
AbstractAbstract PDF
Abstract Purpose

The objective of this systematic review was to assess the effects of family support programs on caregiving burden, depression, and stress in family caregivers of people with dementia.

Methods

A literature search was conducted of electronic databases to identify randomized controlled studies with family support programs done between 2000 and 2014. Studies published in English and/or Korean were included for the analysis with search strategies adapted from the Cochrane Dementia and Cognitive Improvement Group. Studies were rated for quality assessment by two independent reviewers using the appraisal checklist developed by Cochrane Reviews and Dissemination. Of 8,334 articles identified in the literature search, full texts of 76 articles that met the inclusion criteria were reviewed and 38 were found to include relevant outcomes.

Results

Results from selected studies were pooled in statistical meta-analysis using Review Manager Software and heterogeneity between combined studies was assessed using the Chi-square test. Meta-analysis showed that the effect sizes of family caregiver support programs were small to medium for categories of caregiving burden (Hedge's g= - 0.17, 95% CI= - 0.30~ - 0.04), depression (Hedge's g= - 0.30, 95% CI= - 0.40~ - 0.20), and stress (Hedge's g= - 0.39, 95% CI= - 0.52~ - 0.25).

Conclusion

The review results indicate that a support programs can assist family care-givers in reducing their psycho-emotional distress.

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Original Articles
Depression and Caregiving Burden in Families of Patients with Amyotrophic Lateral Sclerosis
Juyeon Oh, Ji Won An, Ki-Wook Oh, Seong-Il Oh, Jung A Kim, Seung Hyun Kim, Jeong Seop Lee
J Korean Acad Nurs 2015;45(2):202-210.   Published online April 30, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.2.202
AbstractAbstract PDF
Purpose

The purpose of this study was to describe depression, caregiving burden and the correlation of the two variables in the families of patients with amyotrophic lateral sclerosis (ALS) and to clarify factors predicting caregiving burden.

Methods

A descriptive and cross-sectional study was conducted with 139 family members who provided care to patients with ALS. The characteristics of patients and families, Korean-Beck Depression Inventory (K-BDI), Korean version of Zarit Burden Interview (K-ZBI) and Korean-Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised (K-ALSFRS-R) were used as study measures.

Results

The mean score for K-BDI was 19.39 out of 63 suggesting sub-clinical depression and 38.2% of the family members exhibited depression. The mean score for K-ZBI was 66.03 out of 88. The predictors for K-ZBI were K-BDI, age of family member, length of time spent per day in caring, relationship to patient and K-ALSFRS-R.

Conclusion

The results of this study suggest that levels of depression and caregiving burden are high among family members caring for patients with ALS. As depression is associated with caregiving burden, screening and emotional supports should be provided to reduce the burden of care for these family. Support programs to alleviate the care burden are also needed, considering family demographics, time per day in caring giving and K-ALSFRS-R.

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Structural Equation Model for Caregiving Experience of Families Providing Care for Family Members with Mental Disorders
In Ohg Oh, Sunah Kim
J Korean Acad Nurs 2015;45(1):97-106.   Published online February 27, 2015
DOI: https://doi.org/10.4040/jkan.2015.45.1.97
AbstractAbstract PDF
Purpose

This study was done to develop and test a structural model for caregiving experience including caregiving satisfaction and caregiving strain in families providing care for family members with a mental disorder.

Methods

The Stress-appraisal-coping model was used as the conceptual framework and the structural equation model to confirm the path that explains what and how variables affect caregiving experience in these families. In this hypothesis model, exogenous variables were optimism, severity of illness and uncertainty. The endogenous variables were self efficacy, social support, caregiving satisfaction and caregiving strain. Data were collected using structured questionnaires.

Results

Optimism and caregiving self-efficacy had significant direct and indirect effects on caregiving satisfaction. Optimism, severity of illness and uncertainty had significant direct and indirect effects on caregiving strain. The modified path model explained effects of optimism on caregiving self-efficacy with social support in the path structure as a mediator. Also, there were direct and indirect effects of optimism and uncertainty on caregiving satisfaction with social support and caregiving self-efficacy in the path structure as a mediators.

Conclusion

Results suggest the need to improve caregiving self-efficacy of these families, establish support systems such as a mental health professional support programs for caregiving self-efficacy. Optimism, severity of illness and uncertainty perceived by families need to be considered in the development of support programs in order to increase their effectiveness.

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The Experience of Adult Korean Children Caring for Parents Institutionalized with Dementia
Suhye Kwon, Young-Sook Tae
J Korean Acad Nurs 2014;44(1):41-54.   Published online February 28, 2014
DOI: https://doi.org/10.4040/jkan.2014.44.1.41
AbstractAbstract PDF
Purpose

The purpose of the study was to explore and describe the experience of adult Korean children who are caregivers for parents institutionalized with dementia.

Methods

Participants were fourteen adult children caregivers of elders institutionalized with dementia. Data were collected through in-depth unstructured interviews with individual participants from August to November, 2012. Theoretical sampling was used to the point of theoretical saturation. Data were analyzed using Strauss and Corbin's Grounded Theory Method.

Results

From open coding, 67 concepts, 29 sub-categories, and 14 categories were identified. Analysis revealed that the core category of the experience of adult children caring for their parents institutionalized with dementia was 'enduring the role of a prop' consisting of four phases: initial turmoil, exploration, role adjustment, and acclimation. To manage the role of a prop, participants utilized various action/interactional strategies such as overcoming the unfamiliarity, overseeing the nursing home care, and counterbalancing the caring roles. As a result, participants experienced ambivalence towards the existence of parents with dementia, changes in family relationships, altered viewpoint towards nursing homes, and restructuring of life.

Conclusion

In-depth understanding of the experience will guide nurses to promote effective interventions in order to better support the Korean family caregivers of parents institutionalized with dementia.

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Structural Relationship of Burnout and Related Variables among Family Caregivers of Cancer Patients
Min Joo Hong, Young Sook Tae
J Korean Acad Nurs 2013;43(6):812-820.   Published online December 31, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.6.812
AbstractAbstract PDF
Purpose

The purpose of this study was to construct a structural equational model to explain and predict burnout in family caregivers of patients with cancer. The study was based on the Stress-Appraisal-Coping Model of Lazarus and Folkman (1984) and Family Stress Theory (Hill, 1958).

Methods

Data were collected from July 10 to September 30, 2012 through direct interviews and a self-report questionnaire survey. Participants in this study were 206 family caregivers providing care for patients with cancer in In-patient or Out-patient departments of three different general hospitals located in Busan. Measured variables were exogenous variables (social support and perceived health status) and endogenous variables (perceived stress, hope and burnout).

Results

Goodness of fit in the hypothetical model was χ2=174.07, TLI=.95, CFI=.97, RMSEA=.08. Perceived health status, perceived stress, and hope showed statistically significant direct effects on burnout of family caregivers. Social support affected burnout of family caregivers indirectly. These variables explained 68.5% of total variance in burnout.

Conclusion

The results from this study suggest that perceived stress, perceived health status, and hope should be considered as major influential factors when developing nursing interventions to control burnout of family caregivers (of patients with cancer).

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Overcoming Experiences of Family Members Caring for Elderly Patients with Dementia at Home
Mi Ra Sung, Myungsun Yi, Dong Young Lee, Hye Young Jang
J Korean Acad Nurs 2013;43(3):389-398.   Published online June 28, 2013
DOI: https://doi.org/10.4040/jkan.2013.43.3.389
AbstractAbstract PDF
Purpose

The purpose of the study was to understand and describe the overcoming experiences of family members caring for elderly patients with dementia at home.

Methods

Data came from autobiographies on the overcoming experiences of caregiving from 31 participants, who had submitted the autobiographies to a public contest held by the Seoul Metropolitan Center for Dementia in 2012. Data were analyzed using qualitative content analysis.

Results

Four overcoming stages emerged from the analysis: confronting stage; challenging stage; integrating stage; and transcendental stage, representing transformation of experiences from frustration and suffering to happiness and new hope in life. The confronting stage illustrates severe negative feelings and exhaustion occurring after the diagnosis of dementia. The challenging stage signifies major driving forces in taking good care of their patients. It includes tender loving memories about the patients as well as family and social supports. The integrating stage shows genuine empathy for the patients' situation and the happiness of 'here and now', while the transcendental stage represents new hope in the future.

Conclusion

Health professionals need to support caregivers to find true meaning of caring and happiness in everyday life, while providing specific information on dementia care and relieving various negative feelings.

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Experiences of Family Caregivers of Patients with Terminal Cancer
Eun Sook Choi, Keum Soon Kim
J Korean Acad Nurs 2012;42(2):280-290.   Published online April 30, 2012
DOI: https://doi.org/10.4040/jkan.2012.42.2.280
AbstractAbstract PDF
Purpose

This study done to identify the experiences of families caring for patients with terminal cancer. The question was, "What is the caregiving experience of a family who has a member with terminal cancer?"

Methods

Grounded Theory was applied and in-depth interviews were done with 11 family members. Interviews were recorded with the interviewees' consent and were transcribed and analyzed. Participants' relationships to patients were 6 spouses, 4 daughters, and 1 mother. The ages of the participants were between 32 and 62, with an average of 47.5.

Results

The study showed "enduring with bonds" as the main category and the main factor affecting this category was the "patients' diagnosis of terminal cancer." The caregiving experience was divided into four stages: shock, confusion, struggle, and acceptance. Mediating factors were relationship with the patient, intimacy with the patient, social support, communication, and trust. Conclusively, participants underwent internal maturity, and changes occurred in family and social and personal life.

Conclusion

The families took care of the patients with responsibility and love. The study results should help with the understanding of a family with a member with terminal cancer and should be used to develop nursing, mediating, and consulting programs for these caregivers.

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The Effects of Oral Care Education on Caregivers’ Knowledge, Attitude, & Behavior toward Oral Hygiene for Elderly Residents in a Nursing Home
Myung Sook Park, Smi Choi-Kwon
J Korean Acad Nurs 2011;41(5):684-693.   Published online October 12, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.5.684
AbstractAbstract PDF
Abstract Purpose

To investigate the effects of oral care education on knowledge, attitudes & behavior of caregivers in oral care and oral hygiene for residents in nursing homes.

Methods

In this quasi-experimental study, the intervention group (n=27) of residents received oral care from intervention group caregivers (n=28) who had received 6 weeks of oral care education. The control group (n=27) of residents received usual oral care from control group caregivers (n=26). Data on knowledge, attitude, and behavioral change in oral health care by the caregivers and plaque index & halitosis of the residents were collected. Data were analyzed using SPSS WIN 16.0.

Results

1) Scores on caregivers’ knowledge (p<.001) and behavior (p<.001) for oral care were higher in the intervention group 6 and 12 weeks. The caregivers’ attitude (p<.001) score for oral care was higher in the intervention group 12 weeks. 2) The plaque index (p=.004) and halitosis (p=.002) of the nursing home residents were lower in the intervention group than the control group at 6 and 12 weeks.

Conclusion

Oral care education programs for caregivers are effective in improving the oral hygiene of elderly residents in nursing homes through enhancement of caregiv-ers’ knowledge, attitude, and behavioral change.

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Correlation between Severe ALS Patient-Caregiver Couples' Characteristics and Caregivers' Health Related Quality of Life
Myoung Soo Kim, Hyung-Ik Shin, Yusun Min, Jung Yoon Kim, Jung Soon Kim
J Korean Acad Nurs 2011;41(3):354-363.   Published online June 13, 2011
DOI: https://doi.org/10.4040/jkan.2011.41.3.354
AbstractAbstract PDF
Purpose

The purpose of this cross-sectional study was to examine the relationship between characteristics of severe ALS patient-caregiver couples and health related quality of life (HRQoL) in family caregivers.

Methods

The participants in this study were 89 pairs of ALS patients using ventilators and a family caregiver. The characteristics of the ALS patients and caregivers, Korean-Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised, Zarit Burden Interview and SF-36 were measured in this study. The data were collected from August 2008 to April 2009. Descriptive statistics, Pearson correlation coefficients, and canonical correlation were used for data analysis.

Results

The physical component summary and mental component summary of the HRQoL score for family caregivers were 147.49±31.63 and 129.09±35.83, respectively. HRQoL for caregivers was related to characteristics of the ALS patient-caregiver couples, such as patient's gender, caregiver's age, gender, marital status, daily time spent in caregiving and burden with one significant canonical variable. The significant variate showed that the lower the age, the time spent in caregiving and the burden of caregivers, the higher the HRQoL of caregivers.

Conclusion

The support systems for caregivers considering caregiver characteristics such as demographics and burden should be implemented to improve the HRQoL of caregivers.

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An Analysis of the Meaning of Respite for Family Caregivers of Elderly with Dementia
Mi Ryeong Song, Yong-Mi Lee, Suk-Hee Cheon
J Korean Acad Nurs 2010;40(4):482-492.   Published online August 31, 2010
DOI: https://doi.org/10.4040/jkan.2010.40.4.482
AbstractAbstract PDF
Purpose

This study was a qualitative research study in which focus group interviews were used to collect data on the meaning of respite for family caregivers who are taking care of elders with dementia.

Methods

The focus group interviews and participants consisted of 2 family caregiver groups, for a total of 8 people taking care of their elders and 5 professional caregivers working in a geriatrics hospital or social welfare institutions. Content analysis was used and debriefing notes were referred in order to analyze the data.

Results

The meaning of respite in this research was measured using 4 main categories: 'Temporary break from routine', 'direct help', 'psychological comfort', 'valuables which cannot be taken easily' and 9 subcategories: 'Temporary diversion of attention', 'temporarily free from my duty', 'taking care of oneself', 'receiving economic help', 'empathize with others', 'comfort based on trust', 'resting together with the elder', 'no time to rest', 'cannot get out of one's obligatory duty'.

Conclusion

The findings of the study show that rest means not only a temporary relief from caretaking, but also a real respite based on the patients' stable state and comfort. These results indicate a new meaning for respite, that the first step of respite program has to begin even when the caregivers do not recognize the need for respite.

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J Korean Acad Nurs : Journal of Korean Academy of Nursing
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