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Research Paper
A Concept Analysis of Quality Nursing Care
Juanamasta, I Gede , Aungsuroch, Yupin , Gunawan, Joko
J Korean Acad Nurs 2021;51(4):430-441.   Published online August 31, 2021
DOI: https://doi.org/10.4040/jkan.21075
AbstractAbstract PDF
Purpose
This study aimed to perform a concept analysis of quality nursing care.
Methods
Walker and Avant’s concept analysis method was used to carry out this study.
Results
The defining attributes identified were as follows: caring, the nurse-patient relationship, and patient needs. Antecedents included patient characteristics, individual factors (age, education, knowledge, competence, and experience), job position, and environmental factors. The consequences of quality nursing care have significant influence on both patients and nurses.
Conclusion
The findings can aid researchers in obtaining a better understanding of quality nursing care, and stakeholders can consider the factors related to quality nursing care and its consequences to improve the nursing process.
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Original Articles
Shifting of Centricity: Qualitative Meta Synthetic Approach on Caring Experience of Family Members of Patients with Dementia
Young Mi Ryu, Mi Yu, Seieun Oh, Haeyoung Lee, Haejin Kim
J Korean Acad Nurs 2018;48(5):601-621.   Published online January 15, 2018
DOI: https://doi.org/10.4040/jkan.2018.48.5.601
AbstractAbstract PDF
Abstract Purpose

This study aimed to synthesize the caring experiences of Korean family members of patients with dementia through a qualitative meta-synthesis method.

Methods

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).

Results

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.

Conclusion

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.

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Development of a Measurement Tool of Caring to Evaluate Quality of Nursing Care
Byoung Sook Lee
Journal of Nurses Academic Society 1996;26(3):653-667.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.3.653
AbstractAbstract PDF

It is important to find indicators of quality nursing care to establish the excellence of nursing practice and for the development of nursing as a profession. Caring is one of the indicators which can represent professional nursing care. The purpose of this study was to develop a measurement tool of caring that could be used as an instrument for the evaluation of quality of nursing care. The Target population for the developed tool of caring is the adult patient. The mearsurement tool of caring was developed through the following steps. (1) A list of caring behaviors was made using qualitative researches on caring that has been done in Korea. (2) Caring behaviors in nurses were selected using the list of caring behaviors developed from Watson's 10 factors of caring, (3) Items for the measurement tool of caring were developed using the caring behaviors of nurses (4) Content validity of the developed items was evaluated by an expert panel. (5) The mearsurement tool of caring was developed after a pilot study (6) Internal consistency, and construct validity of the developed tool were verified. (7) The mearsurement tool of caring with the items verified for the internal consistency and construct validity was confirmed. As a result of the study, a mearsurement tool of caring, composed of 27 items with 3 factors, was developed. The Reliability coefficient of the tool was . 9578. The tool is a 5 point Likert scale. The factors of the tool and the number of items for each factor are, 1) accessibility and availablility, 15 items; 2) emotional support and giving information, 8 items; 3) providing a protective environment, 4 items.

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Concept Analysis of Caring
Byoung Sook Lee
Journal of Nurses Academic Society 1996;26(2):337-344.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.2.337
AbstractAbstract PDF

Caring is being rediscovered as a central and unifying concept of the nursing. Traditionally, nursing profession has emphasized spirit and activities of caring. But there is little efforts to study the caring phenomena scientifically and systematically in nursing, and then the concept of caring is still remained unclear and ambiguous. Changes of social, and health care environment are threatening the philosophy and practice of caring, so it is urgent to identify caring more scientifically and to rediscover the nature of nursing discipline. Knowledge of the caring is essential component for the development of nursing as a science and a profession. The first thing to study a concept is thought to be the analysis of the concept. So in this study, concept analysis of caring was perfomed to clarify the concept of caring as a basis for the study of caring afterward. The approach used for the concept analysis of caring was the approach presented by Walker and Avant. The defining (or critical) attributes of caring identified in this study were (1) a series of activities for helping others, (2) concern and devotion, (3) interpersonal relationship, and (4) scientific and systematic process. The identified antecedents of caring were (1) awareness of other's needs for help, and (2) moral and cognitive motivation for helping others. The identified consequences of caing were (1) healing, (2) satisfaction, and (3) growth. And the consequences of caring were revealed to both of the care giver and the care receiver. The empirical referents of caring could be the behaviors of interpersonal relationship through scientific and systematic process with concern and devotion for others.

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Caring related to Health in Korea: Ethnography centered Wichon-ri, Kangwon-do
Hye Yeon Hwang
Journal of Korean Academy of Nursing 2000;30(1):194-201.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.1.194
AbstractAbstract PDF

The propose of the study is to try to support the practice of caring suitable for our cultural emotion by cognating the meaning of caring related to health which is melted in korean culture. Concrete purposes were as followings; to first, confirm the caring of civilian in Kangwon-do, to secondly search the caring in the traditional culture idea, and to thirdly present the conceptual frame about the caring. The methodology of this research is the ethnography to use the depth interview and the participative observation. The geographical area of this research was in Wichon-ri, Songsan- myon, Kangnung-shi, Kangwon-do. Study participants were, 6men and 18women, totally 24 persons. Their average age was 72.6 years old. The period of data collection was from January, 1998 to April, 1999, which original data became saturation. Data collection was done after accept allowance of the participants, their stories were recorded in cassettee, by the way of the Spradley analysis was applied and adjusted. The results which was analyized as domain, category and property were as following; First, the category was the life serving other persons, which is the for mind, the benefiting one, the comprehensive one, the respective one, on soon. Second, the category was the controling life, and its property was the moderate mind, that is, vegetables were tried to be fed moderately, pleasantly and comfortable. Thirdly, the category was the eagerness life, and the properties were diligent mind, and mind which accomplished the complete resposibility. Fourth, the category was a happy life, and the properties were positive mind, satisfying one, thankful one, one of their ancestors benefit, and supplicatory one. Fifth, the category was the accepting life, and the properties were the submissive mind, resign one. Sixth, the category was the joint life all together and the properties were the harmonized mind, and the mutual helping one. Seventh, the category was the ruling life, and the properties were the pure mind, the ones which controls the body, the mind, the nature; which could surely confirmed the source of the life that lived with the nature, the native idea of our people. Eighth, the category was the retaining life, and the properties were the inherits the native custom, and the one that keep public morals. According to the result of examining the caring in ethnography, the general caring was performed the conceptual frame about the caring which is related to health was found in the principle of consideration, harmony, compliance, and transcendence.

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The Notion of Death and Caring Behaviors in one Community
Sung Hee Ko, Young Hee Lee
Journal of Korean Academy of Nursing 1999;29(3):688-699.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1999.29.3.688
AbstractAbstract PDF

This study was to find out the perception of toward death and caring behavior of lay parsons in one community : One Island in Pusan County, Chonbuk. The methodology of this study was ethnography. For this study, The fieldwork was conducted from October 1997 to July 1998. Data collected by in-depth interview and participant observations. The participants consisted of were 17 persons of both sexes. The key informants were four specific people. The result of this study is as follows; The people perceived two different kinds of death. Normal death, which means death from old age. The person was respected as an ancestor God and was believed to exist forever with their offspring. Abnormal death was regarded as negative, many had fears toward this king of death. The causes of abnormal death were supernatural phenomena and had absolute holy meanings. Whether death was good or bad, The death was not personal, but collective events as family or community affairs and was interpreted as death and birth for their offsprings. Funeral rites were family-centered and/or community-centered. The did normal procedures for normal deaths for abnormal deaths, there were many protective ceremonies(BuJungmagi : the prevention of the taboo of uncleanliness) for the remaining people. These ceremonies combined confucism and shamanism. Caring behavior for dying persons was ruled as community-centered, reciprocal and reality-centered principles.

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Ethnography of Caring experience for the Senile Dementia
Kwuy Bun Kim, Kyung Hee Lee
Journal of Korean Academy of Nursing 1998;28(4):1047-1059.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.4.1047
AbstractAbstract PDF

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.

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Caring Experience of Mothers with IDDM Children
Mi Hye Choi
Journal of Korean Academy of Nursing 1998;28(1):81-92.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.1998.28.1.81
AbstractAbstract PDF

This study is to define the caring experience of mothers with insulin-dependent diabetes mellitus children, by finding core category, contextual factors, intervening factors, and the patterns of caring, and to develop a practice theory on it. Research method followed grounded theory methodology by Strauss and Corbin. Subjects were six mothers, whose children have had insulin-dependent diabetes mellitus for 4 months to 14 years by the interview time. They were selected by theoretical sampling. Data were collected from September, 1995 to January, 1996. Interview were done by long interview took 50 minutes to 2 hours. Content of interview was recorded and transcribed later. Based on the results of previous interview, content of next interview was planned until data reached to the saturation point. Results were as follows : One hundred and forty concepts were found. These concepts were grouped into thirty-three categories, and then to ten categories. Mothers with diabetic child were revealed to face "being overwhelmed by burden". Overwhelming by burden is found to be progressed through the cycle production-coping-decrease or in crease process. Mothers showed four patterns of adaptation in caring the diabetic children. 1) If mothers felt large amount of overwhelming by burden because of difficulty of caring and unsympathizing but they had sufficient support, no condition of the child, and their coping mechanism was positive, most of them overcome with strong will, but some fell into burnout. 2) If mothers felt large amount of overwhelming by burden because of difficulty of caring, unsympathizing, insufficient support, serious condition of the child, and their coping mechanism was negative, they fell into burnout by coping with feeling. 3) In mothers felt small amount of overwhelming by burden because of little difficulty of caring and sympathizing, sufficient support, no serious condition of the child, but their coping was negative, most of them fell into burnout by coping with feeling, but some overcome. 4) If mothers felt small amount of overwhelming by burden because of little difficulty of caring and unsympathizing, sufficient support, no serious condition of the child, and their coping was positive, they overcome with strong will. On the basis of the above result, in order to help mothers take good care of their children, nursing assesment and intervention on life readjustment, and getting support should be required. Especially, through understanding mothers' personalities, individual support consistent with each of them should be required. Therefore education, counseling, mutual support and exchange of information will have to be accomplished.

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A Philosophical Inquiry into Caring in Nursing: Based on Ricoeur's Narrative Ethics
Byung Hye Kong
Journal of Korean Academy of Nursing 2005;35(7):1333-1342.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.7.1333
AbstractAbstract PDF
Purpose

This paper was aimed to inquire into Ricoeur's self -hermeneutics and narrative ethics, and apply it to personal identity constituting caring and care ethics in the practice of nursing. Its purpose is to provide a philosophical foundation for caring in nursing.

Methods

According to Ricoeur's narrative identity, ontological caring was interpreted as personal identity constituting caring. His ethics were described as care ethics, which contributed to preserving and promoting the personal dignity of the client, as self in search for the good life in the nursing practice.

Results

Narrative understanding of the client pointed to the ontological role of care in the constitution of personal identity. From an ethical aspect of the narrative, respect for personal identity and personal dignity of the client was crucial to an ethical caring attitude, promoting self-esteem in the nursing practice.

Conclusion

This paper suggested that Ricoeur's ethics could provide a philosophical basis for understanding ontological and ethical caring in nursing. This contributed to protection of the client from the threat of personal identity, as well as respecting their personal dignity.

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Exploring the Nature of Caring in Hwa-Byung: Transpersonal Caring-Healing Model
Soon Yong Khim, Cho Sik Lee, Byung Hye Kong, Joo Young Shin
Journal of Korean Academy of Nursing 2005;35(2):225-238.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2005.35.2.225
AbstractAbstract PDF

Hwa-Byung(HB) has been categorized as a Korean culture-bound syndrome that is prevalent in married women of low socioeconomic status.

Purpose

The Purpose of the study was to search for the essence of HB and a caring-healing process of HB. Then the research result discusses whether the Transpersonal Caring-Healing Model has been congruent with it.

Method

Case examples resulted from in-depth telephone counseling over a period of time at the Women's Hot Line with a client who is a housewife with HB. The counseling content was analyzed through Giorgi's method of descriptive phenomenology.

Result

The core meaning of the essence of HB was ‘ injustice’; and essential themes were ‘ lack of reciprocity’, ‘ infidelity’ ‘ suppressed aggression and powerlessness’ and ‘ need for recognition’. The core meaning of the essence of the caring-healing process was ‘ caring-healing experience(maintaining a trust relationship)’; and essential themes were ‘ active listening’, ‘ empathy’ and ‘ forming a therapeutic relationship’. According to Watson, ‘ active listening’, ‘ empathy’ and ‘ forming a therapeutic relationship’ were identified as intentionality, intersubjectivity and transpersonal.

Conclusion

Transpersonal caring can release inner power and strength and help the person to gain a sense of inner harmony. Transpersonal caring is as important to healing as are conventional treatment approaches and even more powerful in the long run.

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Nurse's Perception of Technological Development, Caring Attributes and Professional Self-Concept in YanBian
Choon Hee Noh, Kyoung Ae Kim, Chun Yu Li, Jin Sook Lee, Su Sie Kim, Kyeong Yae Sohng
Journal of Korean Academy of Nursing 2003;33(3):356-364.   Published online March 28, 2017
DOI: https://doi.org/10.4040/jkan.2003.33.3.356
AbstractAbstract PDF
Purpose

The purpose of this study was to describe technological development, caring attributes and professional self-concept as perceived by nurses in YanBian.

Method

Data were collected using an instrument containing 137 Likert items was administered to 477 RN's working in general hospitals in YanBian. The instrument contained sections which examined technological influences questionnaire(TIQ), caring attributes questionnaire(CAQ), and professional self-concept nursing inventory(PSCNI).

Result

Descriptive and inferential statistics revealed by marital status and position. Married, working special ward nurses reported a higher TIQ score than that of unmarried and working general ward and OPD. PSCNI and CAQ score of head or supervisor nurses were higher than that of staff nurses. Subjects revealed very low score of CAQ, while PSCNI score was higher than that of other Asian countries such as Korea, Beijing China, HongKong China and Japan as proved in former study.

Conclusion

Useful information for educators and nurse administrators is provided from this results. Further study needs to be done to discuss in the light of cultural and environmental differences between YanBian(Korean-Chinese) and Korean nurses.

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Hermeneutic Phenomenological Study on Caring Experience of the Mothers of Children with Epilepsy
Woo Joung Joung, Myungsun Yi
J Korean Acad Nurs 2017;47(1):71-85.   Published online February 28, 2017
DOI: https://doi.org/10.4040/jkan.2017.47.1.71
AbstractAbstract PDF
Purpose

The purpose of this study was to develop a deeper understanding of the experience of mothers caring for children with epilepsy.

Methods

Data were collected through individual in-depth interviews and observation from 12 mothers of children with epilepsy. Data were collected from December, 2014 to February, 2015 and analyzed using van Manen's hermeneutic phenomenological methodology to identify essential themes of their experience.

Results

The essential themes that fit into the context of the 4-existential grounds of time, body, other people, and space were: Lived time-ongoing influence of the past, living in insecure present, fearful future with no answer; Lived body-bonded body, burned out state; Lived other-burden but also support, shrunken down; Lived space-narrowed range of activity, widened horizon.

Conclusion

The findings in this study show in-depth understanding of the hardships of mothers who are caring for children with epilepsy. The beauty and greatness of these mothers are revealed through the analysis of various phenomenological materials such as literary and artistic work reflecting socio-cultural context, as well as vivid care experiences of mothers of children with epilepsy. This will be helpful in increasing understanding of the nature of caregivers' experience for medical professionals dealing with patients and caregivers. Also it helps to improve the understanding of the disease among the general public, followed by a more warming and caring attitude towards patients and family members. Finally, it will enhance psychological well-being and overall quality of life of the epileptic children and their families.

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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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