• 제목/요약/키워드: Informal caregivers

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노인대상자의 비전문 간호제공자가 경험하는 소진예측요인 : Discriminant Analysis를 이용한 분석 (Predictors of Burnout among Informal Caregivers of Older Adults ; Using Discriminant Analysis)

  • 이해정;송라윤
    • 대한간호학회지
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    • 제29권3호
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    • pp.585-595
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    • 1999
  • The purpose of this study was to examine the predictors of burnout among informal caregivers of older adults. One hundred thirty seven caregivers who had provided care to older adults over 60 years of age for more than one month were included in the study. Most of the caregivers were white (91%) and female (78%). Mean ages of the caregivers were 64 years and 78% of them were married. Seventy percent of the older adults suffered from Alzheimer and related disease. In this study, caregivers reported that they experienced burnout once a month. The scores of emotional exhaustion and reduced personal accomplishment of the caregivers were in the moderate burnout range. To examine the predictors of burnout, discriminant analysis was used. Caregivers were divided by two groups based on the sum of scores (cutpoint=6) on three dimensions of burnout after each dimension was categorized into high(3), moderate(2), and low(1). Nine predictors were included in the analysis : Caregiver's age, employment status, Instrumental Activities of Daily Living (IADL) of the older adult, presence of dementia of the older adult, caregiver's empathy toward the older adult (emotional and cognitive), and 3 coping strategies (negative, problem-focused, cognitive reconstructioning). Caregivers who reported high burnout showed higher cognitive empathy toward the older adults than those who showed low burnout. Caregivers who experienced high burnout used negative coping more often, and cognitive reconstructioning coping and problem focused coping less often than their counterparts. Wilks' Lambda was .78 indicating that differences between the two groups were significant. Cognitive empathy and cognitive reconstructioning coping showed high standardized canonical discriminat function coefficients over .40. Discriminant function with 9 predictors correctly classified 71% of the sample. In conclusion, informal caregivers also experienced certain level of burnout. Cognitive empathy and coping strategies predicted burnout experience of the caregivers. Based on this study, nursing intervention to the informal caregivers to improve their cognitive empathy toward the older adults and to modify their coping strategies in a way to reduce burnout experience can be applied. Further research to develop effective nursing interventions for the purpose of reducing burnout experience by modifying predictors was suggested.

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노인대상자를 돌보는 비전문 간호제공자의 대응기전과 건강반응 예측요인 (Coping Strategies Utilized in the Caregiving Situation and Predictors of Health Responses among Informal Caregivers of Older Adults)

  • 이해정;송라윤
    • 대한간호학회지
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    • 제30권4호
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    • pp.893-904
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    • 2000
  • The sample of this study consisted of 140 informal caregivers who provided care to the older adults(over 60 years of age) in Great Cleveland, USA. Self-rated questionnaires were utilized to collect information. The purpose of the study was to identify coping strategies most frequently utilized by informal caregivers of older adults and to examine predictors of the caregivers' health responses to the caregiving situation applying Lazarus and Folkman stress model(1984). Stepwise multiple regression was used to identify significant predictors among caregivers' demographic-socio-economic factors, older adult's dependency of activities of daily living(ADLs), caregiver's appraisal to the caregiving situation, and coping strategies. Informal caregivers (N=140) included in the study utilized help-seeking and problem-solving coping strategies more than self-blame and minimization of threat coping strategies. Caregivers' responses to the caregiving situation were observed by caregivers' perceived physical health, depression and life satisfaction. For perceived physical health, threat appraisal, older adult's dependency on ADLs, existential growth coping strategy, and monthly income accounted for 25% of the variance. Caregivers who appraised the caregiving situation as more threatening, reported higher dependency on ADLs, used more existential growth coping strategy, and had higher monthly income reported better physical health. For depression, threat appraisal, stress appraisal, existential growth coping strategy, self-blame coping strategy, and monthly income accounted for 48% of the variance. Caregivers who used more existential growth coping and less self-blame coping, appraised the situation as less threatening, less stressful, and had higher monthly income reported less depression. For life satisfaction, self-blame coping, existential growth coping, monthly income, stress appraisal accounted for 49% of the variance. Caregivers who used more existential growth coping, less self-blame coping, less stress appraisal, lower monthly income reported better life satisfaction. In conclusion, informal caregivers in this study utilized positive coping strategies such as problem-focused, existential growth, help-seeking, rather than negative coping strategies including self-blame. When they utilized positive coping strategies more often, caregivers experienced higher perceived physical health, higher life satisfaction and lower depression. Therefore, nursing intervention which utilized positive coping strategies is needed to enhance informal caregivers to have positive health responses to the caregiving demands.

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The Experiences and Challenges of Caregivers of Frail or Chronically Ill Elderly: An Integrative Review

  • Han, Hae-Ra
    • Perspectives in Nursing Science
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    • 제3권1호
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    • pp.47-60
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    • 2006
  • BACKGROUND: Social, legal, and economic factors have changed the delivery of care to elderly who are frail and/or chronically ill. Increasing number of the elderly are now treated in the community, while living with or in close proximity to their family. It is evident that families play a major role of support for elderly persons in our society. This paper provides a review and analysis of studies that have investigated informal caregiving issues encompassing physical, psychological, emotional, and social domains. RESULTS OF THE REVIEW: Family caregiving often interfered with workplace and other responsibilities, creating physical, emotional, and financial stress for caregivers. Relatively high volumes of research addressed caregiving issues in the families of Alzheimer patients and in the areas of emotional and psychological impact of caregiving. Few studies explicitly investigated the role of informal caregivers in the management of other chronic conditions such as stroke or depression or physical consequences of long-term caregiving. While most studies were focused on negative aspects of caregiving, a few studies found it rewarding. Often the burden, stress, and socio-economic effects on the family caregiving for an elderly person were not sufficiently appreciated. CONCLUSIONS: Positive outcomes for both the caregiver and the care recipient are more likely to occur when effective levels of collaboration exist between health professionals and caregivers. As a first step, a better understanding of the caregiving experience such as caregiver characteristics, care recipient characteristics, and social stigma is important for nurses to minimize the burden of care so that appropriate interventions can be developed. In addition, further studies are needed to examine the role and needs of informal caregivers in the care of increasing number of frail and/or chronic ill elderly treated in the community.

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중증장애노인의 비공식 보호 제공량과 유형의 결정요인 연구 (The Factors that Influence Amount and Types of Informal Caregiving to the Severely Disabled Elderly)

  • 박창제;김기태
    • 한국사회복지학
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    • 제54권
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    • pp.203-220
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    • 2003
  • 본 연구의 목적은 비공식 부양자가 기능제안이 있는 중증 장애노인에게 제공하는 노인보호의 양과 유형에 영향을 미치는 요인을 파악하는 데 있다. 이를 위해 65세 이상 중증장애노인을 수발하고 있는 주부양자들을 대상으로 설문조사를 하여 회수된 설문지 중에서 사용 가능한 211부를 본 연구의 분석 표본으로 선정하였다. 연구목적에 따라서 부양상태에 대한 확률 추정과 보호제공시간량에 미치는 요인을 분석한 결과, 부양상태와 부양결정에 관련된 요인들에 대하여 유의미안 결과를 얻을 수 있었다. 보호제공시간 시간량에 OLS분석을 실시한 결과에 따르면, 첫째 소득은 총가족보호시간에 회귀한 모형 1에서만 효과가 있는 것으로 나타났다. 둘째, 부양생산기술의 구성요소들 중 일상생활동작제한과 수단적 일상생활동작제안, 부양팀원수, 공식서비스 이용이 보호제공량에 유의미한 영양을 주는 것으로 나타났다. 셋째, 가계생산기술을 구성하는 요소들은 부양시수에 유의한 영양을 미치지 않는 것으로 나타났다. 넷째, 부양자 선호의 구성요소에서는 부양자의 경제활동 여부, 노인보호 구입을 위해 지불할 용의가 있는 금액이 유의한 것으로 나타났다.

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노인간병가족의 부담요인 및 부담완화를 위한 사회복지서비스와 실천방법의 효과에 관한 연구 (Factors of Caregiving Burden and the Effectiveness of Social Welfare Services for the Family Caregivers of the Impaired Older Persons)

  • 이인정
    • 한국사회복지학
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    • 제46권
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    • pp.319-348
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    • 2001
  • The primary purpose of this study is to examine the buffering effect of social welfare services on the relationship between the level of older persons' impairment and burden experienced by the family caregivers. It also assessed the level of caregiving burden as well as the effect of both older person's impairment and the characteristics of the caregivers on burden. The survey data collected from 150 community residing family caregivers was used for analyses. Findings are as follows. First, the caregivers are more burdened in the deterioration of mental health, scarce time for oneself, and the suffering of social life than in other areas of burden. Second, the more severe the physical and the mental impairment of the elder, the more burden the caregivers experience. The caregivers' characteristics such as the worse mental health, the lower level of attachment to the elder, the longer caregiving hours are also related to the higher level of caregiving burden. Third, the caregivers' use of adult day care and respite care services buffer the relationship between the level of impairment of older persons and the caregiving burden. However, social work counselling, visiting nurse, homemaker services do not have such buffering effects. Among informal support, instrumental support buffers the relationship between the elder's physical impairment and burden, while emotional support buffers the relationship between the elder's mental impairment and burden. According to the results, implication for social welfare services and practice methods for the family caregivers was discussed.

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재가 와상 노인의 우울에 영향을 미치는 요인 (Affecting Factors of Homebound Bedridden Elderly′s Depression)

  • 김인자;김금순;서문자;조남옥
    • 대한간호학회지
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    • 제32권5호
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    • pp.665-672
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    • 2002
  • It was identified that how many homebound bedridden elderlies and their primary caregivers were depressed, and which factors affected the bedridden elderly's depression. Method: The subjects were 191 homebound bedridden elderlies and their primary caregivers. The affecting factors were classified into two categories : bedridden elderly and their primary caregiver related factors. Then bedridden elderly's factors were classified demographic and disease-related factors again. The stepwise regression was used to identify significant factors. Result: The prevalence of bedridden elderly's and caregiver's depression was 77.8% and 67.0%, respectively. And the model explained 33.3% of variance of bedridden elderly's depression. Cognitively-impaired female elderlies who had depressed caregivers were found to be more depressed. And caregivers who perceived burden were identified to be more depressed. Conclusion: It is recommended that the health professionals need to identify bedridden elderlies and caregivers at risk of depression. Especially elderlies who is in poor cognition, those who are female, and those whose caregivers were depressed might be considered carefully in all counseling or follow-up. Also the primary caregivers must be helped to access already available formal and informal support.

장기요양 재가서비스 이용자를 돌보는 가족주부양자의 부양부담감에 영향을 미치는 요인 (Factors Related to Family Caregivers' Burden with the Community-Dwelling Disabled Elderly under the Long-Term Care Insurance System)

  • 한은정;이정면;권진희;신슬비;이정석
    • 보건행정학회지
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    • 제24권1호
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    • pp.71-84
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    • 2014
  • Background: Informal care is increasingly recognized as placing a significant burden on the lives of family caregivers. The purpose of this study is to investigate factors related to family caregivers' burden with the community-dwelling disabled elderly under the long-term care insurance system, using the Stress Process Model developed by Pearlin (1990). Methods: Total 1,233 family caregivers with the disabled elderly, using the long-term care services in their home from May to June 2009, completed questionnaires finally. The questionnaire of this study consists of a total of 32 questions, including 11 questions related to background and context, 17 questions related to objective stressors, and 4 questions related to coping resourses. Family caregivers' burden is measured by the Korean Revised Caregiving Appraisal Scale (K-RCAS, Cronbach's alpha=0.86). To investigate factors related to family caregivers' burden, multiple regression analysis was conducted. Results: The average score of caregivers' burden was 22.0 (${\pm}6.12$). In multiple regression analysis, there were statistically significant factors affecting on the family caregivers' burden, that are related to background and context (region, living status, education level, relationship with beneficiary), objective stressors (duration of caregiving), coping resourses (caregiver's health status). Conclusion: This study found that family caregivers experience a considerable burden. The findings suggest that policies must be taken to relieve family caregivers of their duties temporarily, and to support them with counselling and education.

한국 성인 남녀의 부양지원 제공 실태와 특성 (Prevalence and Characteristics of Informal Caregiving in Korea)

  • 한경혜;윤성은
    • 가정과삶의질연구
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    • 제20권1호
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    • pp.65-73
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    • 2002
  • The purpose of this study was to describe 1) the prevalence of caregiving among adult men and women in Korea and 2) the characteristics of caregiving context. The main results were as follows: 1) About 1 in 6 adults reported that they provided care for the relatives and friends during the previous year. 2) The proportion of male to female caregivers was similar, indicating a higher prevalence of male involvement than previous studies indicated. Yet, the relationships to care recipients and types of care were found to be different by gender of caregiver 3) Adult caregivers are most likely to provide care for the elderly, but continue to provide care for younger persons as well. 4) A nontrivial proportion of the respondents reported providing care for more than one person, suggesting the need to pay special attention to these multiple caregivers.

노인장기요양보험제도의 노동공급효과 분석 - 부양가구원과 여성가구원을 중심으로- (The Effect of Long-Term Care Insurance on Labor Supply)

  • 권현정;고지영
    • 한국사회복지학
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    • 제67권4호
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    • pp.279-299
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    • 2015
  • 본 연구의 목적은 노인장기요양서비스를 이용하는 부양가구원과 여성가구원의 노동공급효과를 확인하는데 있다. 노인장기요양보험제도의 공식적 돌봄 서비스가 부양가구원들의 비공식적 돌봄을 대체한다면, 이는 부양가구원들의 시간제약을 변화시켜 노동공급을 증가시킬 것이다. 따라서 이러한 노동공급효과는 각국의 공적 돌봄 서비스의 제도적 수준에 따라 달라질 수 있다. 지금까지 서구국가들에서는 이에 대한 연구가 활발히 전개되어 왔으나, 이러한 실증분석들은 혼재된 결과를 보인다. 선행연구들에서는 무엇보다 방법론상 내생성의 문제가 지속적으로 제기되어 왔다. 본 연구는 이러한 문제를 해결하고자 유사실험설계인 PSM(Propensity Score Matching)과 DD(Double Difference) 결합모형을 활용하여 선택편의를 최소화하였다. 한국복지패널 3차, 9차 데이터를 활용한 분석 결과, 한국의 노인장기요양보험제도의 노동공급효과는 나타나지 않았다. 단순이중차이분석에서는 노동시간과 근로소득이 유의미하게 증가한 것으로 나타났지만, 더 엄격하다고 볼 수 있는 이중차이 고정효과모형분석에서는 그 효과가 나타나지 않았다. 이를 서구의 경험적 연구결과에 비춰보면, 한국의 공적 돌봄서비스인 노인장기요양보험제도가 비공식적 돌봄을 대체하지 못하고 일부만을 보완하는 수준에 머물러 있는 것이라고 해석할 수 있다. 본 연구의 분석결과는 그동안 제기되어온 노인장기요양서비스의 급여불충분성에 대한 증거가 될 수 있으며, 노인장기요양서비스의 제도적 배열이 대상자 및 부양가족의 욕구에 맞도록 선택되어져야 한다는 함의를 가진다.

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노인의 민간 돌봄에 대한 연구 - 중국 연변지역 조선족을 중심으로 (Study on Folk Caring for the Elderly - Focus on Korean minority Yanbian, Chian -)

  • 고성희
    • 대한간호
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    • 제34권3호
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    • pp.69-84
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    • 1995
  • The purpose of this study was to identify caregivers of the elderly, the pattern of the caregivers' caring behaviors, and the cultural principles of patterns of caring behaviors practiced in a Korean minority community, Yanbian. To clarify these, an ethnographic approach was used. The fieldwork for this study was conducted from Aug. 24, 1993 to May 20, 1994. The informants were 16 natives, age 60 or more, who were members of a large family of three generations. The results of the study are as follows. The caregivers for the elderly were family, kinship and community groups. Family caregivers for the elderly were spouses, sons, daughters-in-law, grandchildren, sons of former wives, sons of former husbands, adopted sons. daughters and sons-in-law. The elderly had caregivers who were part of the kinship group. Three community groups provided care for the elderly. The three community groups were Dokbozo. a formal large organization for the elderly. the same age group as an informal small meeting for the elderly, and other community younger groups. The findings of this study indicated that family caregivers, especially spouses and sons, are the significant others of the elderly, and comminuty groups are better caring groups than kinship relatives. This study identified forty-three different kind of caring behaviors. They were divided into fifteen behavior patterns. These patterns integrated into five categories : soo-bal(¼?¹ß), protecting, respect, support, jung(?×). For physical comfort, soo-bal and protecting were conducted. For the comfort of mind, respect. support, and jung were conducted. The comfort of mind are better than physical comfort for the elderly. Cultural principles of caring behaviors were group membership, reciprocity, and harmony. But there was no hierarchy priciple. And these three principles provide best caring together at the same time. This study provides significant data for nursing research, theory and practice.

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