• Journal of Korean Academy of Nursing
• /
• v.28 no.2
• /
• pp.344-357
• /
• 1998

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 was developed based on the findings from past studies on quality of life and on the family with a chronically ill patient. Data were collected by self-reported questionnaires from 200 family caregivers in Seoul & 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 [X$^2$=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 effects 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.

• Journal of Korean Academy of Nursing
• /
• v.23 no.3
• /
• pp.467-486
• /
• 1993

Today, more chronically ill and handicapped people are being cared for at home by a family member caregiver. The task of caring for a family momber may mean that the caregiver has less time and money and more work which may result in increased fatigue and symptoms of illness. This study was done to examine the well-being of family caregivers. Fifty three family caregivers were interviewed. Concepts were measured using existing tools and included : Burden(25 item 5 point scale), Social sup-port (21 item 7 point scale), Health status defined by a symptom checklist(48 item S point scale), and Well -being defined by a quality of life scale (14 item 7 point scale) and caregiving activities. Data collection was done by interview and Q-sort. Social support and well - being were positively correlated as were symptoms and burden. Symptoms and burden were negatively correlated with social support and well-being. Items on the quality of life scale had a mean score range from 3.09 to 4.96. Quality of life related to income was lowest (3.09) but the desire to use more money for the patient was rated 2.90 on the burden scale where the item means ranged from 0.73 to 3.55. The high mean of 3.55 was for obligation to give care and the low 0.73 was (or not feeling that this was helping the patient. Mean scores for symptoms ranged from 0.26 to 2.15 with the 2.15 being for “worry about all the things that have to be done.” Over half of the patients were dependent for help with some activities of daily living. The caregivers reported doing an average of 3.40 out of five patient care activities including bathing (77.4%), shampooing (67.9%), and washing face and hands (49.1％), and 3.74 out of seven home maintenance activities including laundry (98.1％), cooking (83.0%), and arranging bed-ding(75.5%). The caregivers reported their spouse as one of the main sources of social support, including in times of loneliness and anger The mean score for loneliness as burden was 2.15 and ranked fourth and 31 (58.5％) of the sample reported being lonely recently and not being satisfied with the support received. Similarly anger caused by the patient was given a mean score of 2.13, and anger was reported to have been present recently by 38 (71.7%) of the sample and satis-faction with the support given was low. Having someone to help deal with anger ranked twelfth out of 21 items on the social support scale and had a mean score of 3.98 (range 3.49 to 5.98). Spouses were reported as a major source of social support but the fact that 50% of the caregivers were caring for a spouse, may account for the quality of this source of social support having been affected. These caregivers faced the same problems as others at the same stage of life. but because of the situation, there was a strain on their resources, particularly financial and social. In conclusion it was found that burden is correlated negatively to quality of life and positively to symptoms, but in this sample, symptoms and bur-den were scored relatively low. Does this indicate that the caregivers accept caregiving as part of their destiny and accept the quality of their lives with burden and symptoms just being a part of caregiving\ulcorner Does the correlation between the bur-den and symptoms indicate they are a measure of the same phenomenon or that the sample was of a more mobile, less burdened group of caregivers\ulcorner Quality of life was the one variable that was significant in explaining the varience on burden. Further study is needed to validate the conclusions found in this study but they indicate a need for nurses to ap-proach these caregivers with a plan tailored to each individual situation and to give consideration to interventions directed at improving quality of life and expanding social support networks for those caring for spouses.

• Journal of Korean Academic Society of Home Health Care Nursing
• /
• v.3
• /
• pp.86-97
• /
• 1996

The traditonal inpatient acute hospital setting is organized primarily for the intensive management of disease, but not well-suited for continuity of care for the chronically ill patients after being discharged from hospital. For the planning of the continuity of care, firstly, it is necessary to assess the home care needs of the discharged pateints in the context of the nursing diagnosis. Therefore, this study is designed to identify the home nursing care need trajectory of the patients with chronic illness after discharged from one of the the General Hospitals in Seoul, Korea. The subjects are the patients with chronic illness such as stroke, musculoskeletal disease, hypertension, cancer etc., in average age of 52. 2 years old. The findings of this study are as follows : 1) The limitaion of ADL has been constantly facing to the subjects and has not been changed 4 weeks after being discharged. And the sense of with-drawal was getting worse at 4th weeks than the 1st week after being discharged. 2) The lists of the patient's problems are the impairment of mobility, elimination pattern, inactivity, impairment of skin integrity, ineffective airway clearance, and potential anxiety, self concept deficit, ineffective family coing, etc. Those problems were diminished in quantity at the first week after discharged, but at the 4th week, those problems were getting worse. 3) The need of specialized nursing care such as tube feeding, ostomy care, $O_2$ inhalation, IV therapy, teaching and exercise are considered as the most consisting problems facing to the subjects. 4) In general, the chronically ill patients and their caregivers have not been adapted well even at the 4th weeks after being discharged. 5) Considering those findings, the basic care for patients should be given and the trainging for process of the adaptation after discharged should be encouraged prior being discharged from hostital. For this suggestion, the systematic discharge planning should be carried and the hospital based home nursing model should be implemented at the general hospital for the chronically ill patients.