This study aimed to synthesize the caring experiences of Korean family members of patients with dementia through a qualitative meta-synthesis method.
By searching through nine Korean and English databases, we compared 37 qualitative studies on caring experiences of family members of patients with dementia. The selected studies were synthesized through meta-synthesis, proposed by Sandelowski and Barroso (2007).
The meta-synthesis elicited four themes: tough life due to care for patients, changes in relationships, adaptation to caregiver's roles, and new perspectives of life through personal growth. Caregivers were shocked when a sudden diagnosis of dementia was made prior to any preparation on their part. They were tied to their patients all the time and their mind and body got exhausted. Their relationship with patients began to change and they looked at them differently. They experienced conflicts with the other non-caring family members and were alienated from them. They were also socially isolated. However, by building their own care strategies and utilizing social resources, they gradually adapted to their caregiver roles. Finally, they experienced personal growth and acquired a new perspective toward life by accepting their roles and finding meaning in their lives. Shifting the caregiver's centricity from themselves to the patient was the process of becoming human beings who actively constructed their realities while giving meaning to their painful lives and interacting with the environment.
The results of the study can be useful for nurses in understanding the experiences of caregivers of the patients with dementia and in providing them with practical interventions.
The purpose of this study was to identify factors influencing psychosocial well-being in family caregivers of patients with amyotrophic lateral sclerosis (ALS).
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.
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.
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.
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: 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 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.
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.
The purpose of this study was to explore and describe the experiences of the family caregivers using a nursing home for their elderly family members.
Participants for this study were 1 man and 9 women caregivers. Data was collected through in-depth interviews from October, 2005 to April, 2006 and analyzed using Strauss and Corbin's grounded theory methodology.
“Finding a way to live together” emerged as a core category and it reflected expanding consciousness allowing them to see each other in a more positive view. The basic social process of “finding a way to live together” includes 3 phases: 1) recognizing the problems, 2) finding solutions to the problems, and 3) accepting the changes in their surrounding. Lack of privacy, family troubles, extreme distress, and unavailable caregivers are reflected in the process of recognizing the problems. The process of finding solutions was making a decision, obtaining family agreement, choosing the best nursing home, and enduring the financial burden. Possible outcomes of the last phase include recovering peace of mind and continuing conflict.
Findings from this study offer suggestions for developing a strategy to help not only the elderly but also the family caregivers.
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.
The purpose of this study was to identify the factors related to the wellbeing of the family caregivers of the elderly with a stroke.
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.
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.
On developing the nursing intervention for improving wellbeing of family caregivers, many factors should be considered, especially caregiver burden, and elderly depression.
The purpose of this study was to explore women caregivers' lived experiences in caring at home for a family member with dementia and to identify conditions that oppress women in the context of family caregiving.
This study was conducted within the feminist perspectives using qualitative secondary data. Ten secondary data conveying self reflective contents were selected from the 25 original data obtained in 1999 to 2000.
Six themes that emerged from the qualitative thematic content analysis were; androcentric view of family caregiving, undervalued family caregiving by the family members, Self rationalization in the context of family caregiving, family-centric care mechanism, exemplary caring within the family context, and inter-familial relationships among women.
The main focus of feminist research is to provide empowerment for the women research participants and to bring about social change of oppressive constraint through some actions. On the basis of the research findings, therefore, action strategies from feminist perspectives were suggested in some aspects of health care delivery sectors, nursing education and research sectors, and administrative sectors.
The purpose of this study was to identify the effects of the day care service for the elderly and family with the stroke.
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.
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.
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.
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.
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.
Presence of family caregiver distress was significantly associated with days of nurse visits (β=-.89,
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.
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.
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.
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.
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.
The purpose of the study was to explore and describe the experience of adult Korean children who are caregivers for parents institutionalized with dementia.
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.
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.
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.
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?"
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.
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.
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.
The purpose of this study was to evaluate a Self-efficacy-based Basic Life Support (SEBLS) program for high-risk patients' family caregivers on cardiac arrest. The SEBLS program was constructed on the basis of Bandura's self-efficacy resources as well as the International Liaison Committee on Resuscitation's “2000 Guidelines for CPR and ECC”.
The effect of the SEBLS program on emergency response self-efficacy and emergency response behavior such as BLS(Basic Life Support) knowledge and BLS skill performance was measured by a simulated control group pretest-posttest design. Study subjects were38 high-risk patients' family caregivers(20 experimental subjects and 18 control subjects) whose family patients were admitted to a general hospital in Incheon, Korea.
1. Emergency response self-efficacy was significantly higher in the experimental subjects who participated in the SEBLS program than in the control subjects. (t=8.3102, p=0.0001). 2. For emergency response behavior, BLS knowledge (t=5.6941, p=0.0001) and BLS skill performance (t=27.8281, p=0.0001) was significantly higher in experimental subjects than in control subjects.
A SEBLS program can increase emergency response self-efficacy and emergency response behavior, and could be an effective intervention for high-risk patient's family caregivers. Long-term additional studies are needed to determine the lasting effects of the program.