• Journal of Hospice and Palliative Care
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• 제2권2호
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• pp.138-143
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• 1999

Accurately estimating survival times in terminal cancer patients is very difficult for palliative care clinicians. But a reasonably accurate estimate of survival would permit the medical team to : Plan the ideal therapeutic strategy between overtreatment and too early discontinuation of specific therapy. Answer any questions asked by the patient or family. Organize adequate assistance for the patient concerned. Decide on the eligibility of the patient for clinical trials and whether to begin a treatment, the effects of which will not be immediate. This case was a 79 year-old male patient with colon cancer. He complained of dry mouth, anorexia, weight loss and showed KPS $40{\sim}50$ on admission day. 40 days later he died. To improve patient/family quality of life, it is necessary to improve the ability to estimate accurately a patient's length of survival.

• 한국사회복지학
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• 제41권
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• pp.173-200
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• 2000

The purpose of this study is to examine the variables that may influence the level of family adaptation to schizophrenic patients using the Family Resiliency Model. The Family Resiliency Model is the most current extension of family stress Model. According to the Family Resiliency Model, The level of family adaptation in the face of a crisis situation is determined by a number of interacting components. The subjects are 151 family members with schizophrenic patient. The result from the research were as follows: 1) The following variables significantly correlated with the family adaptation: income of the family, educational level of the family, intimacy between family and patient, knowledge on schizophrenia, recognition of prognosis on schizophrenia. 2) The factors that compose the Family Resiliency Model significantly correlated with the level of family adaptation. 3) The result of stepwise multiple regression analysis indicated that factors which predict the level of family adaptation were the family control, the quality of family communication, and the support from the extended family, these findings give us significant practical implications for social work intervention.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제21권3호
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• pp.37-45
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• 2015

Purpose: The main objective of this paper is, to evaluate the unit design for patient-centered care and to draw lessons-learned for further improvement. Methods: This study conducted a case study of the intensive care unit, designed to fulfill patient-centered care in the US. It evaluated the effectiveness of the unit by incorporating several study methods such as plan analyses, direct observations through nursing tracking and behavior mapping, and focus group interviews. Results: The major design decision made in this patient-centered unit was the use of patient rooms with designated family areas and distributed nursing stations. Both design features appeared to be a success on a variety of research metrics and outcomes. The study identified that the patient rooms ultimately help family members to spent more time with their loved ones, which leads to increased satisfaction of family members and nurses also report that they generally enjoy the distributed nurses' stations, which provide a comfortable environment to complete their regular lines of work such as charting, monitoring patients, and collaborating with their colleagues. Implications: Certain design features in intensive care units such as patient rooms with designated family areas and distributed nursing stations could appropriately support hospitals to fulfill patient-centered care.

• 가정∙방문간호학회지
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• 제2권
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• pp.19-34
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• 1995

The purpose of this study was to analysis level on family caregiver's burden for the elderly with chronic disease in a rural area and to choose priority care group, thereby facilitating the development of interventions to reduce the caregiver's burden. For this purpose, data were collected by questionaire from June 10 to October 8, 1994. The instruments for data collection were Caregiver Burden Inventory by Novak(1989) and Zarit et al(1982), severity of dementia by Hughes Scales(1982), ADL by Lawton(1971), patients' family caregiving activity by pre-survey and reference review(Lee, 1993 ; Jang, 1990 ; Yoo, 1982). The subjects were 213 family caregiver of elderly with chronic disease in a rural area. The data was analysed by the use of t-test, ANOVA, correlation and multiple regression. The results were as follows ; 1. Total burden was evaluated below average, the mean of family burden was 46.98. By the diagnostic classification, Hypertension was 27.37, DM 32.46, CVA 62.96, Dementia 61.24. 2. Significant variables which were correlated to the family caregiver's burden were the patient's disease diagnosis (F=33.82, p<0.001), severity of dementia(F=30.52, p<0.001), the status of disease management(F=11.53, p<0.001), ADL(F=10.54, p<0.001), PADL(F=7.50, p<0.001), income(F=7.17, p<0.001), caregiver's health status(F=24.53, p<0.001), a view of patient's prognosis (F=22.17, p<0.001), relationship with the patient(F=33.82, p<0.001), the number of hours per day spent on caregiving(F=77.52, p<0.001), level of intimacy of caregiver and patients(F=8.75, p<0.001), level of helping(F=4.90, p<0.01), the frequency of caregiving activity(F=3.80, p<0.01), the number of admission(F=5.54, p<0.01), the length of caregiving(F=4.43, p<0.01), other chronic patient in family(t=2.81, p<0.01), caregiver's job(F=3.11, p<0.01), the duration of illness(F=2.98, p<0.05), caregiver's religion(F=2.93, p<0.05), medical security(F=3.89, p<0.05), caregiving's helper(t=2.42, p<0.05). 3. PADL was the most important predictor to family caregiver burden(R2=0.6611). In addition to this, IADL, caregiver's health status, the length of caregiving. level of intimacy of caregiver and patients, patient's age, the patient's disease diagnosis and patient's job accounted for 76% of family caregiver burden. 4. The criteria of priority care group were as follows ; the mean of family caregiver burden was above 58, above of moderate ADL, the number of hours per day spent on caregiving above of 8 hours, above of moderate dementia. By the diagnostic classification, number of priority care group, Hypertension was 4 (8.0%), DM 4(8.0%), CVA 34(64.1%), Dementia 45(75.0%).

• 지역사회간호학회지
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• 제14권4호
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• pp.686-698
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• 2003

Purpose: This is a descriptive correlation study purposed to provide basic data for comprehensive nursing care by analyzing the relationship between the burden and the quality of life of family caregivers of cancer patients treated with chemotherapy. Methods: As for the subjects of this study, 66 family caregivers who take care of cancer patients hospitalized and treated with chemotherapy participated in the research. The tool of this study was a structured questionnaire including questions concerning burden(19 items) and the quality of life(33 items). Collected data were analyzed using SPSS PC+ program through descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and stepwise multiple linear regression. Results: 1) The mean score of burden was 2.6383. The mean score of quality of life was 3.3034. These score show that family caregivers perceive a moderate level of burden and the quality of life. 2) Family caregivers' burden was significantly related to symptoms in the cancer patient (r= 0.3501, P=0.0042) and family caregivers(r= 0.5340, P=0.0001). Family caregivers' quality of life was significantly related to symptoms in the cancer patient(r= -0.3528, P=0.0039) and family caregivers(r= -0.5472, P=0.0001). According to the result of examining' the relationship between burden and the quality of life, there was a statistically negative correlation(r= -0.6326, P=0.0001). 3) 'Family income after the onset of the patient' was the most important predictor of the burden of family caregivers($R^2$=0.158). 'Usual relationship with the patient' was the most important predictor of the quality of life of family caregivers($R^2$=0.138). Conclusions: The results presented above indicate that we must consider burden of family caregivers and symptoms experienced by them in order to improve the quality of life of family caregivers of cancer patients treated with chemotherapy.

• 대한간호학회지
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• 제29권6호
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• pp.1324-1335
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• 1999

The purpose of this study was to explore the educational needs of patients with, kidney transplants and their family members to develop a rehabilitational and educational program. Data were collected from January 29, 1999 to April 20, 1999 with interviews using a structured questionnaire. There were 184 subjects in this study. of them, 107 were patients who had kidney transplants and had visited at the out-patient department of three general hospitals located in Seoul and 77 were family members. The questionnaire used for this study was developed by the investigator through a literature review and from data collected from 11 professional personnel and three kidney transplant patients and their families. The data were analyzed using the SAS program with t-test, ANOVA, Scheff test, Pearson correlation coefficient. The results are as follows; 1) In the patient group, total mean score for educational needs was 154.61 and the item mean score was 3.96. For the family group, total mean score for educational needs was 168.84 and the item mean score was 4.15. So in the family group, educational needs were scored higher than by the patient group. With regard to domains, both patient and family groups had as the highest educational needs, the domain of physical health and the top ten items in the educational needs were also in the domain of physical health. 2) In the patient group, women and the divorce/ bereavement group had higher educational needs in the domain of nutritional management, those who had been admitted longer than four weeks from their kidney transplant had higher educational needs in the domain of physical health and those who were less than 4 years from their transplant had higher educational needs in the domain of follow-up care. In the family group, those who were Catholics and had high school education had higher educational needs in the domain of nutritional management. 3) In the patient group, academic background was positively correlated(r=.208, p=.031) to educational needs.

• 종양간호연구
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• 제8권1호
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• pp.32-39
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• 2008

Purpose: This study was to identify the relationship between perceived family support and quality of life in hospitalized patient with terminal cancer. Method: Study subjects were 104 patients with terminal cancer who were hospitalized and treated at K university hospital, in Busan. Perceived family support and quality of life were measured using the Kang's Revised Family Support Scale and Youn's Quality of Life scale for terminal patients. Results: 1) The mean score of perceived family support was $4.23{\pm}0.61$. The mean score of quality of life was $5.83{\pm}1.37$. 2) The perceived family support was significantly different with primary care giver, food type, medical period after diagnosis. 3) The levels of quality of life was significantly different by number of children, effect of religion on the one' life, perceived state of disease and pain. 4) There was moderate positive correlation between perceived family support and quality of life. Conclusions: Increase in perceived family support was associated with increase in quality of life in hospitalized patients with terminal cancer. It is necessary that the development of nursing education program for family which help to support the patient with terminal cancer for increasing the quality of life of patient with terminal cancer.

• 한국융합학회논문지
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• 제10권6호
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• pp.365-379
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• 2019

본 연구의 목적은 환자-가족중심 의료서비스의 특성과 성과를 체계적 문헌고찰 방법으로 분석하여 서비스의 융합적 유효성을 평가하는 것이다. 15개 전자 데이터 베이스에서 환자-가족중심 의료서비스의 성과를 연구한 RCT 문헌 검색, 선정, 자료 추출, 질 평가를 시행하였다. 선정된 21편 문헌의 환자-가족중심 의료서비스의 공통적 특성은 정보제공과 교육, 의사소통, 가족 및 친구의 참여였다. 환자-가족중심 의료서비스의 성과 측정 변수는 89개였고, 환자 성과는 사망률, 재원기간 등으로 측정되었으며 18편의 문헌에서 환자 성과가 유의하게 향상되었다. 본 연구는 환자-가족중심 의료서비스의 성과를 통합적으로 제시하여 서비스의 유효성을 증명함으로써 의료기관과 지역사회의 지속적인 의료질 향상 활동을 위한 당위성을 제공하였으며 향후 의료의 질 향상과 환자안전을 위한 환자-가족중심 의료서비스의 융합적 적용과 이에 대한 근거기반 연구가 필요함을 제언한다.

• 기본간호학회지
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• 제4권2호
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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.

• The Journal of Korean Physical Therapy
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• 제20권2호
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• pp.25-32
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• 2008

Purpose: The purpose of this study was to provide the basic data to decrease the stress of the family caregivers. Methods: The questionnaire was administrated to the family caregivers of 156 patients with stroke who consented to be interviewed. Among 156 caregivers, we analyzed 120 caregivers. We evaluated on the stress of the family caregivers. Results: First, the general characteristics of patient with CVA were high at 82.55% in male, 55.83% in infarction, 53.33% in the left hemiplegia, 47.50% in sixties, 80.83% in 1 recurrence rate, 27.50% in 1-2 years of disease period. Second, the general characteristics of family caregivers were high in above sixties, female in gender, existence in religion, married in marital status, high school in educational level, below 1 million-won in monthly income, spouse in relationship with patient, below 1 years in total caring period. Third, it showed that stress of family caregivers above 3.0 score has 8 items. Forth, the patient's characteristic that have the influence on the stress was significant in the period of disease(p<0.05). Finally, the characteristics of family caregivers that have the influence on the stress were the monthly income, caring period(p<0.05). Conclusion: These findings indicated that the stress of the family caregivers was correlated with the time in hospital, the income and nursing period.