• 제목/요약/키워드: Lazarus-Folkman Stress Model

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초기 유방암 환자의 심리사회적 적응 구조모형 (A Structural Model for Psychosocial Adjustment in Patients with Early Breast Cancer)

  • 김혜영;소향숙
    • 대한간호학회지
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    • 제42권1호
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    • pp.105-115
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    • 2012
  • Purpose: This study was done to propose a structural model to explain and predict psychosocial adjustment in patients with early breast cancer and to test the model. The model was based on the Stress-Coping Model of Lazarus and Folkman (1984). Methods: Data were collected from February 18 to March 18, 2009. For data analysis, 198 data sets were analyzed using SPSS/WIN12 and AMOS 7.0 version. Results: Social support, uncertainty, symptom experience, and coping had statistically significant direct, indirect and total effects on psychosocial adjustment, and optimism had significant indirect and total effects on psychosocial adjustment. These variables explained 57% of total variance of the psychosocial adjustment in patients with early breast cancer. Conclusion: The results of the study indicate a need to enhance psychosocial adjustment of patients with early breast cancer by providing detailed structured information and various symptom alleviation programs to reduce perceived stresses such as uncertainty and symptom experience. They also suggest the need to establish support systems through participation of medical personnel and families in such programs, and to apply interventions strengthening coping methods to give the patients positive and optimistic beliefs.

발달장애 성인자녀를 둔 부모의 돌봄 스트레스와 삶의 만족도 -가족탄력성, 대처방식의 매개효과- (The caregiving stress and life satisfaction of parents of adult children with developmental disabilities: The mediating effects of family resilience and coping styles)

  • 이원남;김경신
    • 한국가족관계학회지
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    • 제21권4호
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    • pp.27-50
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    • 2017
  • Objectives: This study was carried out in order to evaluate the overall process that the caregiving stress of parents of adult children with developmental disabilities affected their life satisfaction through the levels of family resilience, and coping styles on the basis of stress-coping-adaptation model of Lazarus and Folkman(1984). Method: For this purpose, the structured survey was conducted by 394 parents of adult children with developmental disabilities. The data was analysed by AMOS 20.0 version. Results: The findings can be summarized as follows: First, the structural equation model(SEM) analysis was conducted in order to examine the various paths that parents' caregiving stress affected their life satisfaction. The model's goodness-of-fit was fine($x^2=225.20$, df=95, p=000. RMSEA=.06, TLI=.95). There were significant relationships between caregiving stress and family resilience(${\beta}=-.36$, p<.001), emotion-focused coping style(${\beta}=.47$, p<.001), life satisfaction(${\beta}=-.53$, p<.001). Second, family resilience and emotion-focused coping showed mediating effects on the relationship between caregiving stress and life satisfaction. Conclusions: The strategies for enhancing family resilience and social services for applying effective coping methods should be expanded in order to diminish the caregiving stress of parents of adult children with developmental disabilities.

집단지지 중재가 뇌졸중 환자 가족원의 제 적응에 미치는 효과 (The Effect of Support Group Intervention on Various Adaptations of Primary Family Caregivers Caring for Cerebro-Vascular Accident Patients)

  • 김복랑
    • 성인간호학회지
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    • 제12권3호
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    • pp.334-344
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    • 2000
  • The purpose of this research was to examine the effect of support group intervention on the various adaptations of primary family caregivers caring for Cerebro- Vascular Accident patients. The nonequivalent control group pretest-posttest design within the framework of Lazarus & Folkman's stress-adaptation model was used for this experimental study. The subjects were 86 primary family caregivers caring for Cerebro- Vascular Accident patients at K hospital in Taegu, D herbal hospital in Kyung Ju, H hospital in Pohang from March, 1998 to July, 1998. Among 86 subjects, 43 were placed in an experimental group and 43 in a control group. The experimental group was treated by researcher who administered informational and emotional support group intervention once a week over a five weeks period. The data were collected through interviews. Collected data was analized by means of a chi-square test, t-test, ANCOVA, and Pearson correlation coefficient. The results of this research were as follows: 1. Physical, emotional, and social adaptation scores in the experimental group were revealed to be significantly higher than those of the control group. 2. There was significant positive correlation among physical health, subjective burden, depression and objective burden. Accordingly, it is concluded that informational and emotional support group intervention was a useful nursing intervention on the various adaptations of primary family caregivers caring for Cerebro-Vascular Accident patients.

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대처 개념의 국내 간호연구 분석 (Analysis of Nursing Studies of Coping Conducted in Korea from 1978 to 1995)

  • 소향숙;조복희;홍미순
    • 대한간호학회지
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    • 제26권3호
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    • pp.709-729
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    • 1996
  • This study was done to analyze the trends of research on coping in Korea, to suggest future direction, for research on coping, and ultimately to contribute to an increase in explanation of adaptation. This article reviewed 79 nursing research papers on coping done since 1978 by examining them according to the period of publication or presentation, research design, type of subjects, measurement instruments, research for a degree or not, range of reliability, and association of coping and related variables. The results are as follows : The number of studies on coping increased rapidly from the mid-1980's and decreased slowly from the mid-1990's. The maority of the studies were surveys, comparative studies, or correlational studies. The subects of the 46 studies were healthy people, while those in the remaining studies were patients with a variety of illnesses. Thirth-eight studies on coping were done for master's thesis, three for dissertion, and 38 were not degrees. The Bell and Jalowiec coping scales have not been used since the early 1990's. In contrast, Lazarus and Folkman's W.C.C.L. has been used increasingly since that time. The reliabilities of the coping scale were reported in 37 cases and the Cronbach's alpha coefficients were .71 to .86. All subjects reported using more problem-oriented coping than emotion-oriented coping in short-term or emotion-oriented coping and healthy groups did more long-term coping. It was difficult to describe consistently the relationship between stress and coping according to the type of coping scale or research subjects, but generally moderate relationships were found. This was due to instrumental problems and no consideration of situational context. The subject group who used more short-term coping and less long-term coping reported poorer mental status, and higher scores in burnout and state anxiey than others. That is, the relationship between stress and adaptation increased the power of explanation with intervening the mediating effect of coping. The association of locus of control, mastery, social support, and self-concept with coping showed positive relationships : those of uncertainty and severity in illness with coping showed negativerelationships ; those of state anxiety and depression with short-term coping were positive, and those of self-esteem with long-term coping or problem-oriented coping were negative. There were significant differences in the scores of types of coping according to religion, level of education, and socio-economic status. That is, Presbyterians and Catholics, those with higher education levels and higher socio-economic status used more long-term or problem-oriented coping. On the basis of the above findings the following recommendations are made : 1. There is a need to test the mediating effect of coping variable in order to clarify the concept. 2. Longitudinal studies are needed to determine the patterns of change in coping strategies when stressful events are encountered. 3. It's necessary to develop a reliable and variable measurement tool for coping. 4. There is a need to identify subscales of coping to increase explanation of variance 5. It's necessary to consider personal, situational, and antecedent variables : the characteristics of subject populations, the natures of illness and treatment situations. 6. The power of explanation of studies designed to identify the stress-adaptation process should be increased using the combination model of process-oriented coping and cognitive-structural model.

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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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