• Title/Summary/Keyword: Spouses Support

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A Study on Community-dwelling Elders with Dementia, their Primary Caregiver, and Living Environments (재가 치매노인의 주 수발자와 환경 실태)

  • Kim Nam Cho;Kim Jung Hee;Lim Young Mi
    • Journal of Korean Public Health Nursing
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    • v.16 no.1
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    • pp.13-29
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    • 2002
  • The purpose of this study was to describe about elders with dementia, their families, and their living environment by visiting the households where demented elders resided. The findings will be used as a basis to develop future individualized adjustment programs for demented elders and their families living in communities. The study participants were 64 demented elders and their families who were registered to a dementia counseling center at Nam-Gu community health center located in Inchon, Korea. Data were collected for two months, from May to June 2001. The length of data collection for each home visit ranged from 1.5 to 2.5 hours. Conclusion are as follows based on these study findings: Those demented elders had more than one chronic health problem in addition to their pre-existing dementia condition. Two thirds of the demented elders were not receiving any specific treatment for dementia. They showed a moderate level of independence in basic ADL, but were mostly residing at home because of lack of ability to perform more delicate and complicate routine daily activities by themselves. In addition, the primary caregivers were not well adjusted to the care-giving activities for their demented family members due to the lack of knowledge and information about dementia. The caregivers were mostly women including daughters-in-law, woman spouses and daughters, over a half of whom perceived their physical and mental health status as poor. Their image toward the demented elders was considerably negative. while their level of knowledge on dementia was moderate. The burden for the care-giving was high, whereas their coping method was passive. As the difference in image toward elderly before and after the onset of dementia in their family member increases, the caregiver burden also increased. The main resource of social support for the caregivers was their children. The caregivers showed high level of needs for knowledge and information on dementia, and day care service was the most preferred type of service by the caregivers. There was lack of safety in the living environments for the demented elders and their families, and in the surrounding environments to prevent dementia-related symptoms. Considering that home-based family care-giving is the most culturally appropriate model of providing care for the demented elders in Korea, we need to develop and apply an individualized adjustment program for the demented elders and their families.

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Family Solidarity between Old Parents and Adult Children, Welfare Distribution, and Suicidal Ideation of Elderly (노부모와 성인자녀간의 가족결속도가 노인의 자살생각에 미치는 영향 연구: 복지유통관점 중심으로)

  • Jung, Myung-Hee;Kim, Eun-Jeong
    • Journal of Distribution Science
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    • v.12 no.8
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    • pp.91-102
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    • 2014
  • Purpose - Today, the importance of the service industry has increased. Social welfare businesses that follow the non-profit principle have neglected the distribution of the service. However, an intangible service, when produced and consumed, has a similar service delivery system to common service distribution and social welfare. Therefore, the author has assumed the efficiency of the service delivery system of social welfare to be equivalent to the service distribution industry. Hence, various kinds of social welfare services for the prevention of elderly suicide, from the perspective of distribution, are discussed. Studies on generational relations have thus far investigated depression from parent-children conflict, and satisfaction with their lives. Studies on the relationship between family solidarity and elderly suicide by analyzing existing social problems are rare. This study investigated the effects of family solidarity between old parents and adult children upon elderly suicide by analyzing serious psychological and social problems. This study revealed basic measures for elderly suicide prevention through services that could elevate family solidarity from the perspective of social welfare service distribution. Research design, data, and methodology - The subjects were 468 elderly, 65 years or older, at 18 senior welfare centers and halls for the elderly at Seoul and Gyeonggi-do. Questionnaire surveys, excluding invalid answers, were analyzed. Convenience sampling was used from February 5, 2014 to March 5, 2014. The findings were: First, women and those having spouses with advanced educational backgrounds and social activities had primary solidarity such as contact solidarity, affectionate solidarity, functional solidarity (giving help), and functional solidarity (receiving help). In addition, those who had good health, from a subjective point of view, had more solidarity. Second, the elderly who were men and single, and who had poorer educational backgrounds thought of suicide, lacked social activities, and had poor health, from a subjective point of view. Third, family solidarity between old parents and adult children had significantly negative influence on the suicidal ideation of the elderly. Results - The study revealed the following implications. First, the preparation for old age should consider not only economic welfare but also the psychological welfare due to the relationship with children. Second, the phenomenon of elderly suicide because of a lack of family solidarity could increase national loss and have great influence upon welfare in old age. Therefore, planning of welfare services for the elderly should consider the value of relationships with children to improve the psychological welfare of the elderly. Third, the social expenses of government-oriented support for parents should be discussed from the people's point of view. Conclusions - The subjects of the study comprised the elderly at Seoul and Gyenggi-do; therefore, it would be difficult to extrapolate the findings to all the elderly in the nation. The subject visited senior welfare centers as well as halls for the elderly; therefore, it would be difficult to assume that the trends were representative of the elderly in the nation.

Successful Factors of Smoking Cessation for Male Workers from Small and Medium Enterprises Registered with Local Tobacco Control Center (일개 지역금연지원센터에 등록된 중소규모 사업장 남성 근로자의 금연 성공 요인)

  • Ryu, Il-Hwa;Park, Ki-Soo
    • Journal of agricultural medicine and community health
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    • v.46 no.4
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    • pp.253-265
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    • 2021
  • Objectives: The aim of the study is to identify the success factors of 6 months of smoking cessation targeting male workers in small and medium-sized businesses. Methods: The subjects of this study were smoking male workers who had got the visiting services at a tobacco control center to stop smoking from January 2018 to December 2020. Total number of the participants was 767. Results: The male workers in small and medium enterprises had a success rate of 20.2% for smoking cessation for 6 months. With multiple logistic regression, the factors causing the differences in the success rate for 6 months of the workers were as follows. - The odds ratios (ORs)(95% confidence interval, CI) of the age group of under 29 and 40-49 years were 0.10 (0.03-0.29) and 0.43 (0.24-0.76), respectively, compared to the 50 years and older group. The ORs (95% CI) of the daily average of smoking group of 11-20 and more than 21 were 0.52(0.34-0.80) and 0.46(0.24-0.90), respectively, when compared to the group of 1-10. The ORs (95% CI) of the supporting persons for quitting smoking group of with spouse and other family were 1.99(1.18-3.34), compared to the group with no one. Conclusions: This study showed that the chance of success for smoking cessation for 6 months is higher when the subjects have spouses and other family Supporting persons for quitting smoking. And it also shows that the less they smoke a day and the older they are, the more likely it is to succeed in quitting smoking.

Needs of Patients and their Families in Hospice Care Unit (일 호스피스 병동 입원 환자와 가족의 요구도)

  • Kim, Hyung-Chul;Kim, Eun-Sook;Park, Kwang-He
    • Journal of Hospice and Palliative Care
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    • v.10 no.3
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    • pp.137-144
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    • 2007
  • Purpose: The purpose of this study is to identify and assess the needs of the cancer patients and their families and provide basic data to meet with their needs. Methods: This is a descriptive study using questionnaire method. Questionnaire were collected by mail from 76 discharged patients from a hospice ward from May until the end of October, 2004, and data were analyzed by SPSS 10.0. Results: Admitted patients had needs of pain control (85.5%), non-pain symptoms (63.2%) such as vomiting, dyspnea, ascites, etc, and emotional and spiritual problem solving (28.9%, 14.5%). Interests of patients were health care of himself/herself (65.8%), concern for their spouses left alone (32.9%), and future of their children (15.8%). In families' needs of care of 5 areas, "information on patient's status and treatment/nursing care" was shown most high score ($3.48{\pm}0.62$). In detailed questions, they request most 'to inform the prognosis of patients' and the next is 'to inform the reasons that nursing care was required'. The next highest score was to 'inform family roles' ($3.39{\pm}0.64$), and next was spiritual support ($3.11{\pm}0.79$), and emotional support ($3.08{\pm}0.72$). Expectations of family on the treatment were comfortable dying (73.4%) scored the highest. Patients' families were satisfied with volunteer service most in service area (97.4%). The next was pain control (89.5%) and nursing service (77.6%). Conclusion: Health care staff should identify the actual needs of families caring cancer patients and they should operate realistic programme which can give continuous and assistance by reflecting individual needs and characteristics. With these srategies, the quality of life of patients and families can be improved. And then the intervention programme should be developed to measure subjective nursing care needs of terminally ill cancer patients and their families.

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Ethnography of Caring Experience for the Senile Dementia (노인성 치매 환자의 돌봄경험에 대한 문화기술지)

  • 김귀분;이경희
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.1047-1059
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    • 1998
  • Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the fomer is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. These differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoetical model of nusing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants (4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure" . At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. They, also, experience indifference such as being upset and left alone. The forth is "acceptance" They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning others' recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequences enable us to summarize the principles of cue experience such as, in the early stage, negative response such as physical·psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is an initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above : however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encouraged if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses and positive responses are constantly being converted. I would like to suggest the following based on the above conclusions : First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.

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Follow-up study on Activities of Daily Living of the Elderly in Rural Community (농촌지역노인의 일상생활 동작능력에 관한 추적연구)

  • Lee, Sung-Kook;Baek, Eun-Jung;Chun, Byung-Yeol;Yeh, Min-Hae;Jung, Jin-Wook;Kim, Hye-Kyung;Kai, Inchiro
    • Journal of agricultural medicine and community health
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    • v.23 no.1
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    • pp.65-78
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    • 1998
  • This study was conducted to find out the factors which have an effect on the rural aged's natural history by disability in Activities of Daily Living(ADL) and ADL decline with 475 old people which were chosen except the dead 90 and unconfirmable 56 old people by performing follow-up survey for 4 years since 1993 on the basis of presurveyed data about 621 home old people over 60 years residing in 13 villages at Kangdong-myon, Kyongju-city, Kyongsangbuk-do Province, Korea. Such activities of daily living as bathing, dressing, going to toilet, transfer, feeding and continence were examined. 1. In the follow-up survey for 4 years, the ADL distribution of the dead was remarkably lower than the subject group. 2. It was also shown in the 4-year follow-up survey that 82.1% of high ADL group maintained high ADL while 77.8% of low ADL group died within 4 years. 3. The occurrence percentage of disabilities of each group by ADL item for 4 years appeared high in such an order as bathing, continence, dressing, going to toilet, transfer and feeding. 6.7%(8.1% for female and 4.6% for male) of the old people who were the high ADL group at the time of the first survey had disabilities that occurred after 4 years. 4. In the change of ADL according to general characteristics used to analyse the factors which have an effect on ADL decline, there was a significant difference in age and job, that is, the jobless old people had the higher degree of ADL decline. In the change of ADL according to behavioral pattern, for the male old people there was a significant difference in support of living expenses and subjective health condition. In this case, the degree of ADL decline was higher if they depended on their sons & daughters or spouses and felt that they were not healthy.

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The Effect of Objective and Subjective Social Isolation and Interpersonal Conflict Type on the Probability of Cognitive Impairment by Age Group in Old Age (노년기 연령집단별 객관적·주관적 사회적 고립과 대인관계갈등 유형이 인지기능에 미치는 영향)

  • Lee, Sang Chul
    • 한국노년학
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    • v.38 no.4
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    • pp.811-835
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    • 2018
  • Social relations and cognitive function in old age are closely related to each other, and social relation is classified into structural characteristics and qualitative characteristics reflecting cognitive and emotional evaluation. The concept of social isolation is the focus of attention in relation to the social relations of old age. Social isolation has a multidimensional theoretical structure that is divided into objective dimension such as social network, type of furniture, social participation, and subjective dimension such as lack of perceived social support and loneliness. There is also a close relationship between cognitive function and interpersonal conflict in old age. In this study, we examined the effect of subjective social isolation, which shows the structural characteristics of social relations, and subjective social isolation and interpersonal conflict on the dementia occurrence by age group in the elderly. The data were analyzed by applying a random effect panel logit model using 1,740 panel data from the first year to the third year of KSHAP. The results of the analysis are summarized as follows. First, the cognitive impairment increased sharply with age. Objective and subjective social isolation were both U-shaped distribution with an inflection point of 80 years old. Second, the main effect on the probability of cognitive impairment was statistically significant with objective and subjective social isolation, but the type of interpersonal conflict did not appear to be significant. Third, the results of two-way interaction effect analysis on the probability of cognitive impairment are as follows. The relationship between subjective social isolation and the probability of occurrence of cognitive impairment was significantly different according to the level of conflict with spouse. In addition, the higher the subjective social isolation, the higher the probability of cognitive impairment in the elderly(over 85) than in the young-old(65~74). In addition, as the level of conflict with spouses increases, the probability of cognitive impairment of the oldest-old(aged 85 or older) is drastically lower than that of the young-old(aged 65~74). Based on the results of this study, policy and practical implications for reducing the cognitive impairment of the elderly age group were suggested, and limitations of the study and suggestions for future research were discussed.

Study of The Area of Nursing Need by the Family Developmental Stage (가족발달단계에 따른 간호요구영역에 관한 연구)

  • 최부옥
    • Journal of Korean Academy of Nursing
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    • v.7 no.2
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    • pp.43-59
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    • 1977
  • The Community Health Service considers the family as a service unit and places the emphasis of its service on the health problems and the nursing needs of the family rather than the individual. From the conceptual point of view that tile community health service is both health maintenance and health promotion of the family, the community health nurse should have a knowledge of the growth and development of the family and be responsible for the comprehensive support of normal family development. The community health nurse often is in a position to make a real contribution to normal family development. In order to investigate the relationship between the areas of nursing need and family development, the following objectives were established 1. To discover the general characteristics of the study population by the stage of family development. 2. To discover specific nursing needs in relation to the family developmental stage, and to determine the intensity of the nursing needs and the ability of the family to cope with these needs. 3. To discover overall family health nursing problems in relation to the family developmental stage and determine the intensity of the nursing need and the problem solving ability of family. Definitions : The family developmental stages as classified by Dually were used stage 1. Married couples(without children) stage 2. Childbearing Families (oldest child birth to 30 months of age) stage 3. Families with preschool children (oldest child 2½-to 6 years) stage 4. Families with schoolchildren (oldest child 6 to 13 years). stage 5. Families with teenagers (oldest child 13 to 20 years) stage 6. Families as launching centers (first child gone to last child′s leaving home). stage 7. Middle- aged parents (empty nest to retirement) stage 8. Aging family member (retirement to death of both spouses) The areas of nursing need were defined as those used in the study, "A Comprehensive Study about Health and Nursing Need and a Social Diagram of the Community", by tile Nursing research Institute and Center for population. and Family Planning, July 1974. The study population defiled and selected were 260 nuclear families ill two myron of Kang Hwa Island. Percent, mean value and F- test were utilized in tile statistical analysis of the study result. Findings : 1. General characteristics of the study population by tile family developmental stage ; 1)The study population was distributed by the family developmental stage as follows : stage 1 : 3 families stage 2 : 13 families stage 3 : 24 families stage 4 : 41 families stage 5 : 50 families stage 6 : 106 families stage 7 : 13 families stage 8 : 10 families 2) Most families had 4 or 5 members except for those in stage, 1, 7, and 8. 3) The parents′ present age was older in the higher developmental stage and their age at marriage was also younger in the higher developmental stages. 4) The educational level of parents was primarily less than elementary school irrespective of the developmental stage. 5) More than half of parents′ occupations were listed as laborers irrespective of the developmental stage, 6) More than half of the parents were atheists irrespective of the developmental stage. 7) The higher the developmental stage(from stage 2 to stage 6 ), the wider the distribution of children′s ages. 8) More than half of the families were of middle or lower socio-economic level. 2. Problems in specific areas of nursing need by family developmental stage, the intensity of nursing need and the problem solving ability of the family : 1) As a whole, many problems, irrespective of the developmental stage, occurred in tile areas of Housing and Sanitation, Eating Patterns, Housekeeping, Preventive Measures and Dental care. Problems occurring ill particular stages included the following ; stage 1 : Prevention of Accident stage 2 : Preventive Vaccination, Family Planning. stage 3 : Preventive Vaccination, Maternal Health, Family Planning, Health of Infant and Preschooler. stage 4, 5 : Preventive Vaccination, Family Planning, Health of School Children. stage 6 : Preventive Vaccination, Health of School Children. 2) The intensity of the nursing need in the area of Acute and Chronic Diseases was generally of moderate degree or above irrespective of the developmental stages except for stage 1. Other areas of need listed as moderate or above were found in the following stages: stage 1 : Maternal Health stage 3 . Horsing and Sanitation, Prevention of Accident. stage 4 . Housing and Sanitation. stage 5 : Housing and Sanitation, Diagnostic and Medical Care. stage 6 : Diagnostic and Medical care stage 7 : Diagnostic and Medical Care, Housekeeping. stage 8 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical Care, Dental Care, Eating Patterns, Housekeeping. 3) Areas of need with moderate problem solving ability or less were as follows : stage 1 : Diagnostic and Medical Care, Maternal Health. stage 2 : Prevention of Accident, Acute and Chronic Disease, Dental Care. stage 3 : Housing and Sanitation, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measure, Dental Care, Maternal Health, Health of Infant and preschooler, Eating Patterns. stage 4 : Housing and Sanitation, Prevention of Accident, Diagnostic and Medical Care, Preventive Measure, Dental Care, Maternal Health, Health of New Born, Health of Infant and Preschooler, Health of school Children, Eating Patterns, Housekeeping. stage 5 . Housing and Sanitation, Prevention of Accident, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measure, Dental Care, Preventive Vaccination, Maternal Health, Eating Patterns. stage 7, 8 : Housing and Sanitation, Prevention of Accident, Acute and Chronic Disease, Diagnostic and Medical Care, Preventive Measures, Dental Care, Preventive Vaccination, Eating Patterns , Housekeeping. Problem occurrence, the degree of nursing need and the degree of problem solving ability 1 nursing need areas for the family as a whole were as follows : 1) The higher the stages(except stage 1 ), the lower the rate of problem occurrence. 2) The higher the stage becomes, the lower the intensity of the nursing need becomes. 3) The higher the stages (except stages 7 and 8), the higher. the problem solving ability. Conclusions ; 1) When the nursing care plan for the family is drawn up, depending upon the stage of family development, higher priority should be give to nursing need areas ① at which problems were shown to occur ② where the nursing need is shown to be above moderate degree and ③ where the problem solving ability was shown to be of moderate degree. 2) The priority of the nursing service should be Placed ① not on those families in the high developmental stage but on those families in the low developmental stage ② and on those areas of need shown in stages 7 and 8 where the degree nursing need was high and the ability to cope low.

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