• Title/Summary/Keyword: Caregiver(s)

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The Moderate Effect of Social Support on Family Caregivers' Burdens and Health and Quality of Life with Demented Patients (치매환자 가족부양자의 부양부담과 건강 및 삶의 질에 대한 사회지원의 중재효과)

  • Kyung-Hyun Suh ;Kyung-Im Chun
    • Korean Journal of Culture and Social Issue
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    • v.15 no.3
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    • pp.339-357
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    • 2009
  • As quickly becoming an ageing society in Korea, this study aims to investigate how family caregivers' burden with demented patients and social supports are related to their health and quality of life, and the interaction of caregiving burden and social supports on caregivers' health and quality of life. The participants were 207 family caregivers (106 females) of demented patients lived in Seoul, Kyunggi, and Chungcheong areas, whose average of age were 51.62 ( SD=9.25). The psychological tests used in this research included the following: Multidimensional Caregiver Burden Inventory, Chon's Physical Symptom Questionnaire, Hahn & Jang's Perceived Health Inventory, Negative Affect Self-Statement Questionnaire, and the Korean Version of Cambell's Subjective Well-being Scale, Social Support Survey in Medical Outcomes Study, and Kwon's Questionnaire for Maladjusted Problems of Demented. Results indicated that caregivers' burden with demented patient related to physical symptoms and depression positively, and perceived health and subjective well-being negatively. Social supports showed moderate effects on influences of caregiving burden in perceived health, depression, and subjective well-being of family caregivers with demented patients. It was identified the possibility of their buffering effect on negative results of caregiving burden with demented patients. Since caregiving burden accounted for the 34% of the variances for family caregivers' physical symptoms and depression, researchers discussed the promotion and intervention of their health and quality of life. Beside of different effects of social supports with level of caregiving burden, with previous studies it was discussed some saliant findings such as family caregivers with patients who showed severe dementia symptoms were perceiving even less supports from others.

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The Relationship of Social Support, Stress, Health Status and Quality of Life in Caregivers of Home-stay Cancer Patient in a Comminity (지역사회 재가 암환자 가족의 사회적 지지 스트레스, 건강상태 및 삶의 질과의 관계)

  • Kim, Boon-Han;Kim, Tae-Su;Kim, Eui-Sook;Jung, Yun
    • Journal of Hospice and Palliative Care
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    • v.3 no.2
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    • pp.144-151
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    • 2000
  • Purpose : This investigation was to identify the relationship of social support, stress, health and quality of life in caregivers of home-stay cancer patient. Method : We used a questionnaire and obtained data from the records of 79 caregivers of home-stay cancer patient in a community. Window SPSS-PC was used for the data analysis and the statistical method used were the t-test, ANOVA and Pearson's correlation coefficient. Result : The mean score of family support(3.24) was higher than nurse's support(3.03). The mean score of stress was 3.52 and that of health status was 2.98. The mean score of quality of life was 2.34. The health status of caregivers of cancer patient was influence by age(F=3.17, p=0.018) and education(F=3.59, p=0.032). There was a correlation between nurse's support and family support(r=.263, p<0.05). There was a correlation between stress and health status(r=0.597, p<0.01). The quality of life was correlated with stress(r=-.678, p<0.01) and health status(r=-0.741, p<0.01). Conclusion : The above result indicate that we must consider of social support, stress and health status to promote of quality of life of the caregiver of cancer patient.

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The Hope of the Stroke Patients (뇌졸중환자의 희망)

  • 김이순
    • Journal of Korean Academy of Nursing
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    • v.27 no.1
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    • pp.212-227
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    • 1997
  • Cerebrovascular diseases in Korea is an important health problem since mortality and mobidity have been increased rapidly. It marked the 2nd cause of specific death rates in 1993. The stroke causes physical function disorder due to hemiparalysis and emotional disorder, and stroke patients experience helplessness, powerlessness. sense of alienation and loss of hope. These feelings make the rehabilitation difficult because they lose the will of life. The subjects of the study were seven citizens who live in Pusan, are over 50 years old and belong to low income-level. The data were collected from Jan. to Sep. 1995. The researcher as a caregiver and volunteer made confidence of them and asked for their agreement on the purpose of the study. The subjects expressed their experience as openheartedly as possible. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi, which is as follows ; as an unit of description which include the subject' expressions and the researcher's observation, it is examined the theme that express the hope experience with the subject's language(underlining), and the focal meanings are identified. The focal meaning is the crystalization of the theme, which is written in the language of the researcher. After intergrating the focal meaning and make the situated structural description as the meaning of the hope experience identified on each subject's point. After intergrating the situated structural description and make the general structural description as the meaning of the hope experience identified on total subject's point then the systemizing of the structure of the hope experienced phenomena and the flowing of the conciousness was researched. The conclusions of this study was as follows : The ten sources of hope which the subjects experienced were sorted as under 〈mutual relations to others : spouse, children, relatives, fellow believer. health professioner. associate patient group〉, 〈spiritual dependence〉. 〈recovery of physical function〉. 〈rumination of the past life〉, 〈expectation of the future〉. 〈economic power〉, 〈belief〉, 〈ability〉. 〈spontaneous participation〉 and 〈recovery of roles〉. Their hope was spoken out by the following two kinds of linguistics. First. the hope was expressed in the affirmative expression as follows : 〈 to be dependable〉, 〈to make efforts〉, 〈to keep under control〉, 〈to desire〉, 〈to be pleasant〉, 〈to be peaceful〉, 〈to be grateful〉, 〈to give help〉, 〈self-confidence. Courage〉, 〈to be happy〉, 〈to satisfy oneself〉, 〈to share with others〉, 〈to understand〉 and 〈to be affected, be impressed〉 Second, the hope was expressed in the negative on pression as under : 〈to be distressed〉, 〈to be uneasy〉, 〈to be sorry, be unsatisfied〉 〈despair〉, 〈to abandon〉, 〈to be fearful〉, 〈to suffer〉, 〈to bear a burden〉 〈to be confused〉, 〈to be solitary〉, 〈chest trouble〉, 〈to feel heavy〉 〈grief〉, 〈to be daunted〉, 〈to get angry〉, 〈to be uncomfortable〉, 〈to have something regretable〉 and 〈to feel guilty〉. And their hope was expressed by the following four behavioral expressions : 〈physical sphere〉, 〈psychological sphere〉, 〈social support sphere〉 and 〈spiritual sphere〉. The reaction patterns of their hope experience appeared in the following 4 coping method : 〈conquest type〉, 〈dependence type〉, 〈adaptation type〉 and 〈fate type〉. Finally, in the hope structure the sense of certainty don't always coexict with the sense of uncertainty, When the stroke patients try to search for the best quality of life, the senses of certainty and uncertainty make a continual cyclic system in the hope structure.

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A Study on Factors Influencing Dementia Management Strategies and Their relationships with Primary Caregivers' Burden (치매주간호자의 치매관리전략 영향요인과 부양부담 관계 연구)

  • Lee, Hyeon-Sun;Oh, Jin-Joo
    • Research in Community and Public Health Nursing
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    • v.13 no.4
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    • pp.629-638
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    • 2002
  • The impact of chronic diseases on patients and their families depends on how well the family members cope with it. Therefore, research on strategies for facilitating the coping of the families in a desirable manner is very important. Dementia management strategies refer to specific means families of dementia patients use to cope with dementing illness of their family members. This study was designed to examine type of dementia management strategies utilized by families and to identify factors influencing them. The subjects in this study were 103 conveniently selected demented patients and their primary caregivers who were registered to a public health center located in Chungcheong Province. The subjects were visited by 20 home visiting nurses, and the data were collected using a structured questionnaire. The data were collected form May 2, 2001 to June 2, 2001. The findings of this study were as follows. 1. The most frequently used types of dementia management strategies were active management (M=3.36, S.D=.96), and encouragement (M=2.94, S.D=.99). Criticism was least used type of dementia management strategy (M=2.71, S.D=.99). 2. The factors influencing each management strategy were as follows; 1) The criticism management strategy was most frequently used by the primary caregivers who graduated elementary school (F=3.21, p<.05). 2) The encouragement strategy was most frequently used by the primary caregivers in a case when the patients were in the mild stage of dementia (F=2.76, p<.05), when the patients never had any treatment experiences (F=2.01, p<.05), when the family could afford the provision of treatment for the patients (F=-2.44, p<.050), and when the primary caregiver had a job (t=2.90, p<.01). 3) The active management strategy was most widely used by the primary caregivers who could afford the provision of treatment for the patients (F=-2.31, p<.05) and were in their 70s (F=3.04, p<.05). This type of management strategy was significantly more used by those who discussed the difficulties of caring with their family members (F=3.46, p<.05). 3. The use of criticism management strategies was significantly correlated with the total level of burden of the primary caregivers. But the types of encouragement and active management strategies had negative correlations with the caregivers' burden although they were not significant. Since the findings of this study showed that the criticism management strategy had a significant positive relationship with caregivers' burden, those who are more likely to use the negative management strategy should be identified in future studies. The primary caregivers who are more likely to use negative strategy should be more closely monitored and be focused as the group who should be intervened in future studies.

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The Homecare Needs of Cancer Patients (암환자의 퇴원 후 가정간호 요구)

  • Kwon, In-Soo;Eun, Young
    • Journal of Korean Academy of Nursing
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    • v.29 no.4
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    • pp.743-754
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    • 1999
  • The purpose of this descriptive study was to identify the homecare needs of patients with cancer and to provide a basis of interventions. One hundred and two patients at one general hospital in Gyeongnam responded to a questionnaire developed on the basis of care needs perceived by nurses caring for hospitalized patients with cancer. The questionnaire was a Likert type 5 point scale with 56 items on five need categories ; 1) informational 2) physical care : 3) emotional care 4) socioeconomic care and 5) special care needs. Internal consistency of this questionnaire was Cronbach's $\alpha$=.9101 for total items. The data was collected from March 1st to May 31th, 1998, by two graduate nurses. In the data analysis, mean & standard deviation were calculated to identify the degree of care need of each item, and the t-test & ANOVA were done to determine the effects of patients' demographic background on their care needs. The findings are summarized as follows ; 1) The mean score of total of need items was 3.048. Of the four need categories the highest score was informational at 3.4, followed by emotional care, 3.063, physical care, 2.623, and socioeconomic care, 2.599. 2) In the informational need category there were four subcategories with 19 items. Medication and pain control had the highest score, 3.755 ; second was diet and exercise, 3.613 ; third was disease and treatment process, 3.337 ; and last was personal hygiene and infection prevention at 2.687. 3) In the physical care need category there was nine items, IV infusion for nutrition and management of treatment complication was above 3.2 points and the remaining items were in the 2.847-2.070 score ranges. 4) In the emotional care need category there were seven items. The highest need was in support for relationships with health personnel, 3.673. The need for support of religions beliefs and support for having a religion were low at about 2 points. 5) In the socioeconomic care need category there were six items. Support for medical insurance expansion and financial support were above 3 points. Legal support and support for caring of children were low in the care needs. 6) In the special care need category the there were 15 items. Informational need about immunization and informational need about effects of disease on growth and development were high, above 4.1 points. Need for decubitus care and prevention, sitz bath and incontinence care were low, below 2 points. 7) There were significant differences in degree of care need according to admission rate, education level, marital status, religion and caregiver's religion. In conclusion, homecare needs perceived by hospitalized patient's with cancer was moderate, but informational need was higher than direct care need, leading to the conclusion that the provision of sufficient information to patients with cancer at discharge is needed. Nursing interventions should be developed considering the patient's background.

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A Study on the Burdens and Depressive Reactions on Families who Cared for Patients Suffering from Senile Dementia (치매노인을 돌보는 가족의 부담감과 우울반응에 관한 연구)

  • 김영자;이평숙
    • Journal of Korean Academy of Nursing
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    • v.29 no.4
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    • pp.766-779
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    • 1999
  • The purpose of this study was to investigate the relationship between the burden on families who live with an elderly person suffering from senile dementia, and the degree of their depression. There were 400 participants in this study, staying in the Seoul and Kyonggi areas from August 1, 1997 to February 28, 1998. Among the group, 100 participants took care of their patient at home, and another 300 participants left 100 patient at a day-care center, 100 sanatorium for senile dementia(asylum for helpless elderly people), 100 an infirmary for elderly people. Eventually 242 subjects out of the 400 were selected for the data analysis. The Zarit (1980) tool was employed to measure the degree of burden and Zung's(1965) “Self-Rating Depression Scale” was employed for the data analysis. The data was analyzed, and the percentage, t-test, ANOVA and Person's Correlation Coefficient were calculated. The results are as follows : 1. The average degree of burden that care-giving families felt was 49.13, which is somewhat high. 2. The average degree of depression that care -giving families felt was 51.95, which is relatively high. 3. The degree of burden was directly affected by the relation with the patient(F=2.48, P<.05), and the socio-economic status of the family(F=5.17, P<.05). Its also affected by the patient's educational status(F=2.17, P<.05). 4. The degree of depression of the family was significantly dependent on sex(t=-2.05, P<.05), age (F=2.99, P<.05), the relationship with the patient(F=3.65, P<.01), socio-economic status (F=7.74, P<.001), occupation(t=2.82, P<.01), health status(F=4.42, P<.01), and the place of residence(F=4.30, P<.01), The patient characteristics was significantly dependent on his/her educational status(F=3.85, P<.01), the period of suffering from senile dementia(F=2.47, P<.05), and smoking habit(F=6.17, P<.001). 5. The relationship between the degree of burden and that of depression reads r=0.43, which is statistically positive correlation in the high significant level. Upon analyzing the entire summation, most care-givers for elderly patients suffering from senile dementia lack time in caring for themselves. They also experience chronic fatigue and mental discomfort caused by the isolation from society, curtailment of certain activities, a sense of responsibility for their patients, and limits of their endurance in taking care of their patients over time. In conclusion, this study emphasizes the necessity for the following propositions : 1. In order to measure the degree of burden that Korean care-giving families undergo, a new tool must be developed on the basis of Korean culture. 2. An educational program based on the demands that care-giving families undergo must be developed, and its clinical effect also has to be examined.

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The Effect of Adding Kami-guibi-tang to Acetylcholinesterase Inhibitor Treatment on the Cognitive Function of Mild Alzheimer's Disease Patients: Study Protocol of a Randomized, Placebo-Controlled, Double-Blind Pilot Trial

  • Yang, Seung-bo;Kim, Ha-ri;Shin, Hee-yeon;Kim, Jeong-hwa;Lee, Chang-woo;Jahng, Geon-ho;Park, Seong-uk;Ko, Chang-nam;Park, Jung-mi
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.326-338
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    • 2020
  • Background: Alzheimer's disease (AD) is a chronic neurodegenerative disease that causes disorientation, mood swings, problems with language, and difficulty remembering recent events. Acetylcholinesterase inhibitors (AchEIs) and memantine have been used to slow the course of the disease, but they can neither modify its progression nor prevent disease onset. Previous studies have suggested that Kami-guibi-tang (KGT) could be beneficial for supporting cognitive function in AD patients, but few clinical trials have been published. This pilot study aimed to evaluate the effect of KGT in improving cognitive function in AD patients. Methods: The study will be a randomized, placebo-controlled, double-blind, single-center trial conducted using subjects diagnosed with mild AD by neurologists. Study subjects will be randomly assigned to either a treatment or control group. The treatment group will receive KGT granules for 24 weeks, while the control group will receive placebo granules. AchEI administration will be maintained in both groups during the entirety of the study. Subjects will be assessed using the following exams: the Seoul Neuropsychologic Screening Battery (SNSB) for cognitive function; brain magnetic resonance imaging (MRI) for brain metabolite, neurotransmitter, and cerebral blood flow (CBF) measurements; the Korean version of Quality of Life-Alzheimer's Disease (KQol-AD) for quality of life; the Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI) for neurobehavioral symptoms; blood tests for amyloid and tau proteins and general blood parameters; and electrocardiography (ECG) before and after taking the medication. Discussion: Our findings will provide insight into the feasibility of large-scale trials to consolidate evidence for the efficacy of KGT for dementia treatment. Registration ID in CRIS: KCT0002904 (Clinical Research Information Service of the Republic of Korea).

The Need for Rehabilitation Day Care Program Service of Stroke Survivors (재가 뇌졸중환자의 주간재활간호 프로그램 서비스 요구조사)

  • Jeong, Seong-Hee;Suh, Moon-Ja
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.1
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    • pp.29-44
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    • 1999
  • This study was carried out to obtain basic data required to plan and develop Rehabilitation Day Care Program for the stroke Survivors at home in Korea. The subjects comprised of 118 stroke survivors who discharged from 4 hospitals in Seoul during the past 2 years. The data were collected from August 3, 1998 to September 18, 1998, through interviews with questionnaires about general characteristics, activities of dally living, depression and service need of rehabilitation day care program at the outpatient clinics by trained nursing graduates. Data were analyzed with descriptive analysis, Pearson's correlation analysis, and Stepwise multiple linear regression analysis using SPSS/WIN program. The results obtained are as follows ; 1. The mean score of the general need of rehabilitation day care program of stroke survivors was 2.78(range 1-4). The highest need among the service categories of the rehabilitation day care program was self-care and restorative activities category, and health services referral category, recreation category, psychosocial activities category in order. The needs of each category are as follows ; 1) In the health services referral category, the need for speech therapy was highest, followed by the need for physical therapy and occupational therapy. 2) In the psychosocial activities category, the need for self-help group was highest. 3) In the self-care and restorative activities category, the need for bathing was highest, followed by bowel training, and ambulation training. 4) The need for the recreation category was 2.62. 2. Among the need for the effect related to the utilization of day care program, the need for survivors' physical and psychological well-being was highest and was followed by the need for caregiver's physical and psychological wellbeing. Pearson's correlation analysis revealed following results ; 1. The need for rehabilitation day care program service displayed a correlation with the level of education, ADL, and the level of depression, and a reverse correlation with age. 2. The need for the effect related to the utilization of rehabilitation day program displayed a correlation with the level of education, ADL, and the level of depression. The stepwise multiple linear regression analysis revealed following results : 1. For the need for rehabilitation day care program service, 28.4% of the variance was initially explained by one variable, level of depression. The level of depression plus two variables, survivors' age and ADL, explained 34.2% of the variance in the need for rehabilitation day care program service. 2. For the need for the effect related to the utilization of rehabilitation day care program, 12.4% of the variance was initially explained by one variable, level of depression. The level of depression plus one variable, level of education, explained 20.4% of the variance in the need for the effect related to the utilization of rehabilitation day care program. In conclusion, above characteristics should be considered when we are planning to develop stroke survivors' rehabilitation day care program.

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The Effect of a Multidisciplinary Team Approach on the Rehabilitation of Stroke Survivors (뇌졸중 환자를 위한 팀접근 재활프로그램의 효과)

  • Cho, Bok-Hee
    • The Korean Journal of Rehabilitation Nursing
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    • v.6 no.2
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    • pp.137-151
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    • 2003
  • The purpose of this study was to develop a multidisciplinary team approach program for stroke survivors, and to identify its effects on their rehabilitation. The team was composed of 7 members: a rehabilitation nurse, a physician, a physical therapist, an occupational therapist, a therapeutic recreational therapist, a nutritionist, and a researcher. A quasi-experimental study was performed with 36 subjects: 18 in the experimental group and 18 in the control group, using a noneqivalent control group pretest-posttest design. The experimental group participated 4 times in rehabilitation programsfocused on information and emotional support provided by the rehabilation team-and received telephone counseling from the researcher. The control group did not receive any treatment. The selection criteria for the subjects in this study were: (a) patients who were diagnosed as having had an ischemic stroke within the last year, (b) patients free of any communication disorder, (c) and those having a primary caregiver who could assist in filling out the form assessing the level of ADL. The data were collected from patients who had been discharged from a tertiary hospital, between October 1st, 1999 and September 30th, 2000. The data were analysed by $X^2$ test, Fisher's exact test, ANCOVA, Wilcoxon's rank sum test, and Wilcoxon's signed rank test using an SAS program. The results were as follows: 1. In terms of physical variables (blood pressure, grasp power, and ADL) 1) There was a significant difference in blood pressure between the two groups (systolic pressure P= .012, diastolic pressure P= .050). 2) There was also a significant difference in grasp power between the two groups (affected side : P= .012, unaffected side : P= .010). 3) There was no significant change in the level of ADL between the two groups. 2. In terms of psychosocial variables (depression, self-efficacy, self-esteem, and social activities) 1) There were no significant differences between the two groups. However, all four psychosocial variables showed a tendency to improve in the experimental group, while only two variables (depression and self-efficacy) showed a simalar tendency in the control group. 2) The level of social activities in the control group decreased significantly after a month (P= .050). 3. The level of life satisfaction improved in both groups, but no significant difference was found. Stroke has high recurrence rate and requires considerable follow-up care. The program used in this study was developed and designed for stimulting the rehabilitation process of stroke survivors. Through the program period of one month (meetings were held weekly), a positive effect was detected in physical variables, although the psychosocial variables did not improve significantly. In retrospect, a one month period may not be an adequate length of time to improve the psychosocial variables, as the stroke survivors were complicated cases, and most of them were elderly. Further research is therefore recommended by increasing the length of program, so that its effect can be more noticeable.

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An Integrated Review on Main Caregiver's Burden of Elderly in Korean Nursing Home (한국 요양시설 노인의 주 돌봄자 부담감에 대한 통합적 고찰)

  • Kim, Eun Jeong;Sung, Kyung Mi
    • Journal of Digital Convergence
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    • v.17 no.6
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    • pp.267-277
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    • 2019
  • The purpose of this study is to investigate the burden of caring for the care-givers of the elderly in Korea by using an integrated literature review method. A total of 23 studies were analyzed using a search database. When care-givers had higher sense of filial and guilt or more than two diseases, they showed high level of feeling of burden. Also, they had high level of feeling of physical burden by their oldness, service period (especially at the period of 1-3 years). In the feeling of economic burden, they had high level of feeling of burden by their oldness, or elderly's disease periods. The feeling of burden by psychological condition was found in elderly in aged and the beginning of admission of nursing home. The feeling of burden by environment situation was found when the functional status of the elderly was bad. Therefore, we need to concern care-givers's feeling of burden with elderly people in the nursing home. In the future, I believe that the findings of this study will be helpful for development of the intervention program for alleviate burden for the care-giver.