In comparison with the long and continuous history of research in the general area of stress and coping, theoretical and clinical interest in family-stress and adaptation is a recent phenomenon. To understand the phenomena of family behavior, a comprehensive theoretical framework is needed to us provide an adequate background to for research. This study was designed to develop and test a hypothetical model for family stress and adaptation in families with handicapped children. A hypothetical model was constructed on the basis of the family stress theory developed by McCubbin etc. The model included six paths. For the purpose of model testing, empirical data was collected from May to August, 1992. The subjects of the study were 190 parents of chidren in five special schools and one private institute in Seoul and Choong Nam. An SPSS PC+ and PC-LISREL 7.13 computer programs were used for descriptive and covariance structure analysis. The results of the study are as follows. (1)Family Stress(tau31= -.288, T=-4.942) had a direct effect on Family Adaptation. (2)Family Functioning(beta21=-.373, T=5.595) had a direct effect on Situational Definition. (3)Family Functioning(beta31=.334, T=5.375) had a direct effect on Family Adaptation. (4)Situational Definition(beta32=.270, T=4.285) had a direct effect on Family Adaptation. The model was supported by the empirical data. Thus it is suggested that the model could be adequately applied to family nursing care of families with a mentally handicapped child. In particular, the nursing interventions that enhance family functioning and the situational definition would improve family adaptation in families with mentally handicapped children.

This study was designed to develop and test a structural model for maternal adaptation and family stress in families with mentally handicapped children. A hypothetical model was constructed on the basis of the family stress theory developed by McCubbin etc. The model included 6 theoretical concepts and 11 paths. For the purpose of the model testing, empirical data were collected from May to August, 1992. The subjects of the study constituted 190 mothers of children in five special schools and one private institute in Seoul and Choong Nam. An SPSS PC+ and PC-LISREL 7.13 computer programs were used for descriptive and covariance structure analysis. The results of the study were as follows. (1) The hypothetical model showed itself a good fit to the empirical [Chi-square=18.35 (df=7, P=0.005), Goodness of Fit Index=0.991, Adjusted Goodness of Fit Index=0.959, Root Mean Square Residual=0.042), Non Normed Fit Index=0.90, Normed Fit Index=0.93]. (2) The results of Hypothesis testing indicated : 1) Social support(gamma11=.238, T=2.352), Family functioning(gamma12=.729, T=5.957) and Family life event stress(gamma13=.125) had direct effects on situational definition. 2) Life event stress(gamma23=.319, T=3.872) had direct effects on the effect of the handicapped child on the family. Family functioning(gamma22=-.245) and situational definition(beta21=-.335, T=3.227) had direct effects on the effect of the handicapped child on the family. 3)Situational definition(beta31=-.273, T=3.493), family life event stress(gamma33=.124, T=2.169) and the effect of the handicapped child on the family(beta32=.264, T=-3.227) showed the direct effect on the maternal adaptation. The model was supported by the empirical data. Thus it was suggested that model could be applied to family nursing care with the families with the mentally handicapped. The construction and testing of the comprehensive model seem to be the first trial in Korea.

The purpose of this study was to investigate the residents' opinions about community mental health in the Taegu-Kyungpuk area for the future development of a community mental health program and model appropriate for Korea, Yhe subjects were 152 residents in the Taegu-Kyungpuk area. In July 1999, the data was collected using a convenience sample technique. Mental health status was significantly different for the level of occupational advantage(x2=15.684, p<.05) and physical health(x2=39.262, p<.000). Factor structure for mental health problems with the percentage of variance was as follows: optimistic view(27.581). dark view(10.758). mastery(6.200), discomfiture(6.101) and life style(5.641). Most of the respondents(92.1%) took the mental health problems seriously. The serious aspects of the mental health problem were found to be epilepsy, mental retardation, neurosis and schizophrenia respectively. Concerning about the view of community mental health, most of the respondents answered that the a C.M.H.C. was 'useful and urgent' concering the need for C.M.H.(77.6%). They answered positively on the utilization of C.M.H.C(75.7%) and preferred the separately new community mental health center. A psychiatrist was preferred as the key person in charge(44.1%). If community mental health centers were established in a community health center, they answered that the expected major problem would be quality control of care(44.7%). They preferred the psychiatrist's office as the recommended agency for the insane(44.7%). Opinions of the asylum system were found very negative in respect to psychiatric therapy and humanitarianism. The results of this study will help establish a relevant model for this community as the primary site for a community-based mental health model.

Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the former is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. these differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoretical model of nursing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants(4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure". At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. they, also, experience indifference such as being upset and left alone. The forth is "acceptance". They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning other recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequence enable us to summarize the principles of care experience such as, in the early stage, negative response such as physical, psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above; however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encourage if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses are constantly being converted. I would like to suggest the following based on the above conclusions: First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.