Purpose: The aim of the study was to explore nurses' experience of person-centered relational care in the context of critical care. Methods: Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through indepth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data. Results: Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced 'balancing emotions' and 'authenticity' in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory. Conclusion: The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.
The Journal of Korean Academic Society of Nursing Education
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v.7
no.1
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pp.68-80
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2001
This study is aimed to evaluate the effects of the educational program that is designed to help the patients of T.K.R.A. to improve their self-nursing ability. The research will show how well this program can contribute to raising of their adaptability of everyday life by decreasing the difficulties that the patients had before in their daily life. The sample persons for this research were 40 adult patients who had T.K.R.A. in our hospital, and the data were collected through the questionnaires which were given to them. For the surveying tool, Jette's scale was applied to measure the degree of uncomforting that the patients experienced in their daily life. The materials of report had been gathered from May 1st to December 10th. The collected data were analyzed with real numbers, percentage, average, the standard deviation, TorF test and Pearsons correlation. The results of this study can be summarized like follows: The survey of self-caring exercise part were processed with two groups containing experiment group and contrast group. The exercise which took the highest points in experiment group was repetition of stretching and bending knees with laid down position while taking a walk, repetition of stretching and bending knees with seated on chair position and repetition of stretching and bending knees with laid down position got high points in contrast group. There were distinctive differences in statistics between repetition of stretching and bending knees in laid down position and taking a walk. There was no significant statistical gap between the degrees of inconveniences of daily life that each two groups experienced when we compared the average of the two groups, but 12 out of 20 questions got considerable differences. According to common characters of self-caring, there was a distinctive gap in the group who left the hospital in 14days and the ones who spend more than 30 minutes with exercise. The patient group who left the hospital in fourteen days after T.K.R.A. spent more time doing self-caring exercise. In the relationship between common characters and the degree of difficulties of daily life, Exercising is effective and Spending more that 30 minutes for exercise showed visible differences. The patients who answered that exercise are effective and put more time for it experienced less pain in their everyday life. The data proved by Pearson's correlation showed the relationship between self- caring and the degree of pain of daily life. According to the result, the increasing of self-caring activities helped to down the degree of inconveniences of daily life. This data show that T.K.R.A. reduced self-caring exercise ability and daily life activities. Therefore, the medical staffs who would take care the T.K.R.A. patients should offer stable nursing through well scheduled and education materials for patients. It is also important to encourage the patients to participate to the exercise by showing them how exercise after T.K.R.A. The education program is expecting to guarantee not only the right of patients to get enough information but also effective result to decrease uncomfortable of daily life.
Journal of the Korean Applied Science and Technology
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v.36
no.4
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pp.1373-1384
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2019
This study is a descriptive research to analyze the factors affecting the care burden of dementia patients in the community. The data was collected from 223 dementia patients in the community for 10 days from November 30 to December 9, 2018. The results showed that there was a statistically significant difference in caring burden according to demographic characteristics according to the age group of the main caregivers, the relationship with dementia patients, the duration of caring for dementia patients, and the difficulty of caring for dementia patients. Had a negative correlation with dementia knowledge(r=-.145, p=.030). The factors affecting the care burden of dementia patients were as follows: dementia care period(β=.408, p=.006), difficulty in caring for dementia patients(β=-.307, p=.023), relationship with dementia patients(β=-.299, p=.013), and age group of primary caregivers of dementia patients(β=-.265, p=.007). Therefore, in order to alleviate the burden of caring for dementia patients in the community, a practical and continuous care intervention program is needed
Journal of Korean Academic Society of Home Health Care Nursing
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v.11
no.1
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pp.5-13
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2004
The home health care industry has grown rapidly and can be expected to continue to grow in the foreseeable future. Home health care refers to the practice of nursing applied to clients with a health condition in the clients place of residence. clients and their designated care givers are the focus at home health nursing practice. The goal of care is to initiate. manage and evaluate the resources needed to promote the clients optimal level of well-being and function. Nursing activities necessary to achieve this goal may warrant preventive maintenance and restorative emphases to prevent potential problems from developing. Many project program were suggested home health care model for Korea's health care system and policy direction for expansion and establishment of home health care .But the aim of this paper is to provide on overview for theoretical frame work in home health care. Theories and conceptual frameworks or models are important nursing because they define and guide the boundaries of professional practice and identify key nurse-patient-caregiver relationships that emerge with caring. Following is the research with an investigation of the literature review in the University of Arizona international medline database, In conclusion, are as followers: First, many nursing theorists have had a tremendous impact on nursing practice. the following highlights those nursing theorists that are particularly helpful in understanding home health care. 1. Florence Nightingale : Our earliest theoretical legacy. Nightingale's believes are reflected in basic infection control practice such as hand washing and infectious waste disposal and are key nursing interventions in home care. 2. Martha Roger's :Science of unitary human beings theory. Rorger's believed that the focus of shared. non invasive healing modelities is the human environmental field rather than direct physical care. These modelities continue to evolve as our awareness (reflecting greater diversity, faster rhythms, motions, and ways of knowing) transcends time and space, allowing individuals to get in touch with their integral nature of unbroken wholeness. On people as ever changing energy fields have special relevance in home care especially with hospice and palliative care applications. 3. Madeline Leininger's; Transcultural nursing theory. Home care nurses move through a variety of communities and often care for patients from different cultural back grounds. Therefore Leininger's work has a good that with home care because home care nursing practice is very culturally focused. 4. Dorothea Orem's : Self care deficit theory. Orem's theory views care as something to be performed by both nurses and patients. The role of the nurse is to provide education and support that help patients acquire the necessary activities to perform self-care. Orem's theory is foundational to have care because it begins to truly acknowledge the role of the patient in managing his or her own health. which is referred to as self-care. 5. Margaret Neuman's; Health as expending consciousness theory. Neuman believes that health compasses disease and reflects an underlying pattern of person-environment interaction. A key application of 'Neuman's work to home care is for nurses to understand that health and illness do not necessarily exist at opposite ends of a continuum. 6. Jean Watson's: Theory of human caring. Watson's theory of human caring in nursing proposes human caring as the moral ideal of nursing. Nurses participate human caring to protect, enhance and preserve humanity by assisting individuals to fing meaning in illness. pain and existence and to help others gain self knowledge. self control. and self healing such thinking lends richness to theory development. as well as clinical practice in home care. Second, Robin Rice : Dynamic self determination for self care. (A theoretical framework for home care) Dynamical self determination for self care can be useful to home care nurses in a variety of ways. As research tool it can be reflected in the interview process when the home visit. The home care nurse's role is that of facilitator of patient self-determination for self care through numerous strategies. including patient education and case management.
Journal of Korean Academy of Fundamentals of Nursing
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v.4
no.2
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pp.175-192
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1997
The purpose of this study was to identify the care needs of family-caregivers to the patients with stroke. Subjects were 115 family-caregivers caring for the patients while they were in-patients or out-patients with stroke in two general hospitals and one oriental medicine hospital located in Seoul and Kwang-Ju. The instrument used for this study was made by the researcher on the basis of results of literature review and interviews with family-caregivers, composed of 35 items. Internal validity by calculation of cronbach's alpha with data of respondents was 0.91, which was regarded as high. The Data were analyzed by SAS program, with percentage, mean, t-test, and ANOVA. Factor structures of care needs of family-caregivers were elicited by factor analysis(PCA, Varimax rotation). Datum collection had been from July 1 to August 14, 1997. The results of this study were as follows : 1. The mean score of the sum of the care needs of family-caregivers was 3.96 and the highest-mean item was 'need for immediate care(M=4.77)', and the lowest-mean item was 'need for chaplian's visit (M=2.82)'. 2. Care needs of the family-caregivers were : Need to be informed of the disease, treatment and care ; need of education and assistance related to physical functional level ; need of social support and consultation ; need of management of nursing problem related to immobility ; need of appreciation ; need of the way to communicate with patients ; need of immediate care and help. The highest mean factor was the 'need for immediate care and help(M=4.74)', and the lowest mean factor was the 'need of appreciation(M=3.58)'. 3. The variables influencing the degree of care needs perceived by family-caregivers to the patients with stroke were as follows : There were significant differences between need to be informed of the disease, treatment and care and general characteristic factors, which were family caregiver's sex (p=.0178), caring period(p=.0223) and patient's suffering period(p=.0244). There were significant differences between need of education and assistance related to physical functional level and general characteristic factors, which were patient's paralysis(p=.0177), patient's ADL dependency(p=.0032). There were significant differences between need of social support and consultation and general characteristic factors, which were family caregiver's sex(p=.0055), occupation(p=.0159), religion(p=.0093) and patient's sex(p=.0134). There was significant difference in the degree of need of management of nursing problem related to immobility, according to the patient's ADL dependency(p=.0493). There were significant differences between need of appreciation and general characteristic factors, which were family caregiver's age(p=.0107), sex(p=.0133), and patient's age(p=.0338). There were significant differences between need of the way to communicate with patient and general characteristic factors, which were patient's paralysis(p=.0002) and aphasia(p=.0001). There were significant differences between need of immediate care and help and general characteristic factors, which were family caregiver's caring period(p=.0162) and patient's suffering period(p=.0116). 4. The mean score of patient's ADL dependency was 3. 38 and the highest-mean item was 'ascending and descending stairs(M=4.12)', and the lowest-mean item was 'drinking(M=2.60)'. There was no significant difference in the degrees of care needs related to the patient's ADL dependency. 5. The highest information source of family-caregivers was from the doctors about the disease, treatment and care(26.1%). The second highest one was from mass media(20.8%), and the third one was from the nurses. The above findings may be used as the basic data to seek more efficient way of elevating nursing practice and quality for family-caregivers to the patients with stroke.
Objectives: This study evaluated the effects of traditional Korean medicine treatment on a patient with asthma. Methods: A patient was treated with acupuncture, herbal medicine, and cupping. The effect of treatment was evaluated via the quality of life questionnaire for adult Korean asthmatics (QLQAKA), the visual analog scale (VAS), and night awakening frequency. Results: After treatment, improvements were observed. The total QLQAKA score increased from 36 to 50. Conclusions: This study observed that traditional Korean medicine treatments are effective in caring for a patient with asthma.
Journal of Korean Academy of Nursing Administration
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v.14
no.1
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pp.13-25
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2008
Purpose: The study aimed at providing better understanding of the way of carrying out nursing practice tailored to meet patient's individuality, and types of customized care in home care settings. Method: This study was conducted with qualitative design, using a grounded theory method. The directors of the home care department at three general hospitals nominated 12 staff nurses who had the experience of customized care. The data were collected using interview and field observation, and analyzed line-by-line with steps of coding. Result: The core category of customized care was 'caring in a precise manner suited to patient's individuality'. The central phenomenon was 'desire to do more for patient'. The action and interactions were: (a) knowing a patient all the more, (b) making a special relationship to a patient, (c) designing care alternatives reflecting individuality, and (d) performing the care alternatives reflecting individuality. Three types of customized care were the following: (a) completion of customized care, (b) an attempt to customized care, and (c) abandonment of working for customized care. Conclusions: The knowledge of customized care would be based on development of nursing practice program focusing on patient' individuality, and instrument development necessary for further research on care customization.
Kim, Hyo Min;Koh, Su-Jin;Hwang, In Cheol;Choi, Youn Seon;Hwang, Sun Wook;Lee, Yong Joo;Kim, Young Sung
Journal of Hospice and Palliative Care
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v.20
no.3
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pp.188-193
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2017
Purpose: There has been very little study on the associations between patient's symptoms themselves and family caregiver (FC)'s depression in the palliative phase. This cross-sectional study was to investigate the relationship between symptom features of terminally ill cancer patients and their FC's depression. Methods: We performed a multicenter survey using the MD Anderson symptom inventory and the Hospital Anxiety and Depression Scale. A total of 293 patient-FC pairs were recruited from seven tertiary medical centers. A multivariate regression analysis was applied for identifying the relevant factors associated with FC depression and for estimating adjusted depression score of FCs. Results: Among various psychosocial factors, low FC quality of life, low social support, spouse, and more caregiving time were significantly associated with FCs' depression. According to the presence of FCs' depression, there were significant differences in some symptom characteristics of patients. Even after adjusting for the relevant confounders, depression scores were lower in FCs caring for patients who had negative symptoms (loss of appetite, P=0.005; drowsiness, P=0.024; and dry mouth, P=0.043) than in FCs caring for patients who had not. FCs caring for patients with severe appetite loss had lower depression scores than those with not severe one (P=0.039). Conclusion: Our result suggests that patient's symptom characteristics might be helpful when evaluating a FC's depression.
Purpose: The purpose of this study was to describe depression, caregiving burden and the correlation of the two variables in the families of patients with amyotrophic lateral sclerosis (ALS) and to clarify factors predicting caregiving burden. Methods: A descriptive and cross-sectional study was conducted with 139 family members who provided care to patients with ALS. The characteristics of patients and families, Korean-Beck Depression Inventory (K-BDI), Korean version of Zarit Burden Interview (K-ZBI) and Korean-Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised (K-ALSFRS-R) were used as study measures. Results: The mean score for K-BDI was 19.39 out of 63 suggesting sub-clinical depression and 38.2% of the family members exhibited depression. The mean score for K-ZBI was 66.03 out of 88. The predictors for K-ZBI were K-BDI, age of family member, length of time spent per day in caring, relationship to patient and K-ALSFRS-R. Conclusion: The results of this study suggest that levels of depression and caregiving burden are high among family members caring for patients with ALS. As depression is associated with caregiving burden, screening and emotional supports should be provided to reduce the burden of care for these family. Support programs to alleviate the care burden are also needed, considering family demographics, time per day in caring giving and K-ALSFRS-R.
Kim, Geun Myun;Lee, Ok-Kyun;Lee, Jeoung-Ran;Kang, Ok-Hee;Jeong, Young-hwa;Chang, Soo Jung
Journal of Korean Academic Society of Home Health Care Nursing
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v.27
no.3
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pp.306-320
/
2020
Purpose: This study aimed to explore the subjective perception structures and types of empathy among nurses caring for patients with behavioral and psychological symptoms of dementia (BPSD) using Q-methodology. Methods: Thirty-eight Q-samples (statements) were derived from in-depth interviews with 10 nurses working in long-term care hospitals and nursing homes. The Q-sorting was conducted in rank order (the responses obtained by each of the 30 nurses working at 3 long-term care hospitals and 4 nursing homes) into a normal distribution grid (from -4 to +4). The types of empathy among participants were analyzed using the PC-QUANL program. Results: Five types of empathy accounting for 48.5% of the total variance were categorized as follows: (1) taking the patients' personality into consideration while helping, (2) interacting closely and emotionally, (3) supporting the patient as a companion, (4) performing the duty in a defensive manner, and (5) resolving patients' problems by focusing on their needs. Conclusion: This study shows that there are various types of empathy in nurses caring for patients with BPSD. Therefore, it is necessary to develop strategies and educative programs to enhance empathy competency and deal with burnout based on the type of empathy.
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