A Theory Construction on the Care Experience for Spouses of Patients with Chronic Illness (만성질환자 배우자의 돌봄 경험에 대한 이론 구축)
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- Journal of Korean Academy of Nursing
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- v.30 no.1
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- pp.122-136
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- 2000
Chronic illness requiring attention and management during a long period of time puts great burden onto patients, their family and society. For patients with chronic illnesses, providing social support is the most important, and the fundamental support comes from their spouses. Amount and quality of support from spouses seems to differentiated according to the sex of patients. Female patients tend to believe that their spouses are not very supportive. Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the factors that result in greater burden. Also, they developed a theoretical model of husbands′ care for their wives through a qualitative research into husbands′ experience. Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The questionnaire about the disease experience of female arthritis patients and the burden of husbands were sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers. The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis was 9.1 years. Education level was varied from primary school to graduate school, and average income/month was 1,517,300 won. Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183 responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and telephone interviews. The mean age of participants was 58 years, and the educational level and socioeconomic status also varied. Result: 1. Husbands′ burden: The average burden was 57.68 with a range of 6-96. 2. Burden and general characteristics: The husband′s burden correlated with the age of the patients, numbers in the family, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and the husband′s understanding of the level of severity. 3. Linear correlation analysis on burden: The husbands′ burden is explained in 22.5% by husband′s recognition of level of severity and husbands′ age. 4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was high but subjective burden was low(pattern III), objective burden was low but subjective burden was high(pattern IV). The pattern was correlated with the family income, educational level of the patients and their husbands, therapy methods, patient′s level of discomfort, patient′s disease severity, patient′s level of dependence and husband′s understanding of level of severity. 5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The causal factor was the patients′ experience due to symptoms : physical disfigurement, pain, immobility, limitation of house chores, and limitation of social activities. Contextural factors are husbands′ identification of housework and husbands′ concern about the disease. The mediating factors are economic problems, fear of aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve emotional stress. The "companionship" resulted from caring activities, participation of household activities, helping patients′ to coping with emotional experience. 6. Companionship is established through the process of entering intervention, and caring state of mind. Entering intervention is the phase of participation of therapy and involvement of houseworks. The caring phase consists of decision on therapy, providing therapy, providing direct care, and taking over the household role of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands′ companionship is enhanced. In conclusion, nursing care of chronic illnesses should include a family member especially the spouse. All information on disease shoud be provided to patients and whole family member. Strong support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of life of patients and families will be much improved.
1. Background Women's health and their involvement in health care are essential to health for everyone. If they are ignorant, malnourished or over-worked, the health &-their families as well as their own health will suffer. Women's health depends on broad considerations beyond medicine. Among other things, it depends upon their work in farming. their subordination to their families, their accepted roles, and poor hygiene with poorly equipped housing and environmental sanitation. 2. Objectives and Contents a. The health status of rural women : physical and mental complaints, experience of pesticides intoxication, Farmer's syndrome, experiences of reproductive health problems. b. participation in and attitudes towards housework and farming c. accessibility of medical care d. status of maternal health : fertility, family planning practice. induced abortion, and maternal care 3. Research method A nationwide field survey, based on stratified random sampling, was conducted during July, 1986. Revised Cornell Medical index(68 out of 195 items). Kawagai's Farmers Syndrome Scale, and self-developed structured questionnaires were used to rural farming wives(n=2.028). aged between 26-55. 4. Characteristics of the respondents mean age : 40.2 marital status : 90.8% married mean no. of household : 4.9 average years of education : 4.7 yrs. average income of household : \235,000 average years of residence in rural area : 36.4 yrs average Working hours(household and farming) : 11 hrs. 23 min 5. Health Status of rural women a. The average number of physical and mental symptoms were 12.4, 4.7, and the rate of complaints were 22.1%, 38.8% each. revealing complaints of mental symptomes higher than physical ones. b. 65.4% of rural women complained of more than 4 symptoms out of 9, indicating farmer's syndrome. 11.9 % experienced pesticide overdue syndrome c. 57.6% of respondents experienced women-specific health problems. d. Age and education of respondents were the variables which affect on the level of their health 6. Utilization of medical services a. The number of symptoms and complaints of respondents were dependent on the distance to where the health-care service is given b. Drug store was the most commonly utilized due to low price and the distance to reach. while nurse practitioners were well utilized when there were nurse practitioner's office in their villages. c. Rural women were internalized their subordination to husbands and children, revealing they are positive(93%) in health-care demand for-them but negative(30%) for themselves d. 33.0% of respondents were habitual drug users, 4.5% were smokers and 32.3% were alcohol drinkers. and 86.3% experienced induced-abortion. But most of them(77.6%) knew that those had negative effects on health. 7. Maternal Health Care a. Practice rate of contraception was 48.1% : female users were 90.9% in permanent and 89.6% in temporary contraception b. Induced abortions were taken mostly at hospital(86.3%), while health centers(4.7%), midwiferies(4.3%). and others(4.5%) including drug stores were listed a few. The repeated numbers of induced abortion seemed affected on the increasing numbers of symptoms and complaints. c. The first pre-natal check-up during first trimester was 41.8%, safe delivery rate was 15.6%, post-natal check-up during two months after delivery. Rural women had no enough rest after delivery revealing average days of rest from home work and farming 8.3 and 17.2. d. 86.6% practised breast feeding, showing younger and more educated mothers depending on artificial milk 8. Recommendations a. To lessen the multiple role over burden housing and sanitary conditions should be improved, and are needed farming machiner es for women and training on the use of them b. Health education should begin at primary school including health behavior and living environment. c. Women should be encouraged to become policy-makers as well as administrators in the field of women specific health affairs. d. Women's health indicators should be developed and women's health surveillance system too.
Green or an environmental consciousness has been a major issue for businesses and government offices, as well as consumers, worldwide. In response to this movement, the Korean government announced, in the early 2000s, the era of "Green Growth" as a way to encourage green-related business activities. The Korean fashion industry, in various levels of involvement, presents diverse eco-friendly products as a part of the green movement. These apparel products include organic products and recycled clothing. For these companies to be successful, they need information about who are the consumers who consider green issues (e.g., environmental sustainability) as part of their personal values when making a decision for product purchase, use, and disposal. These consumers can be considered as eco-sumers. Previous studies have examined consumers' purchase intention for or with eco-friendly products. In addition, studies have examined influential factors used to identify the eco-sumers or green consumers. However, limited attention was paid to eco-sumers' disposal or recycling behavior of clothes in comparison with their green product purchases. Clothing disposal behaviors are ways that consumer can get rid of unused clothing and in clue temporarily lending the item or permanently eliminating the item by "handing down" (e.g., giving it to a younger sibling), donating, exchanging, selling, or simply throwing it away. Accordingly, examining purchasing behaviors of eco-friendly fashion items in conjunction with clothing disposal behaviors should improve understanding of a consumer's clothing consumption behavior from the environmental perspective. The purpose of this exploratory study is to provide descriptive information about Korean eco-sumers who have ecologically-favorable lifestyles and behaviors when buying and disposing of clothes. The objectives of this study are to (a) categorize Koreans on the basis of clothing disposal behaviors; (b) investigate the differences in demographics, lifestyles, and clothing consumption values among segments; and (c) compare the purchase intention of eco-friendly fashion items and influential factors among segments. A self-administered questionnaire was developed based on previous studies. The questionnaire included 10 items of clothing disposal behavior, 22 items of LOHAS (Lifestyles of Health and Sustainability) characteristics, and 19 items of consumption values, measured by five-point Likert-type scales. In addition, the purchase intention of two eco-friendly fashion items and 11 attributes of each item were measured by seven-point Likert type scales. Two polyester fleece pullovers, made from fabric created from recycled bottles with the PET identification code, were selected from one Korean brand and one US imported brand among outdoor sportswear brands. A brief description of each product with a color picture was provided in the survey. Demographic variables (i.e., gender, age, marital status, education level, income, occupation) were also included. The data were collected through a professional web survey agency during May 2009. A total of 600 final usable questionnaires were analyzed. The age of respondents ranged from 20 to 49 years old with a mean age of 34 years. Fifty percent of the respondents were males and about 58% were married, and 62% reported having earned university degrees. Principal components factor analysis with varimax rotation was used to identify the underlying dimensions of the clothing disposal behavior scale, and three factors were generated (i.e., reselling behavior, donating behavior, non-recycling behavior). To categorize the respondents on the basis of clothing disposal behaviors, k-mean cluster analysis was used, and three segments were obtained. These consumer segments were labeled as 'Resale Group', 'Donation Group', and 'Non-Recycling Group.' The classification results indicated approximately 98 percent of the original cases were correctly classified. With respect to demographic characteristics among the three segments, significant differences were found in gender, marital status, occupation, and age. LOHAS characteristics were reduced into the following five factors: self-satisfaction, family orientation, health concern, environmental concern, and voluntary service. Significant differences were found in the LOHAS factors among the three clusters. Resale Group and Donation Group showed a similar predisposition to LOHAS issues while the Non-Recycling Group presented the lowest mean scores on the LOHAS factors compared to the other segments. The Resale and Donation Groups described themselves as enjoying or being satisfied with their lives and spending spare-time with family. In addition, these two groups cared about health and organic foods, and tried to conserve energy and resources. Principal components factor analysis generated clothing consumption values into the following three factors: personal values, social value, and practical value. The ANOVA test with the factors showed differences primarily between the Resale Group and the other two groups. The Resale Group was more concerned about personal value and social value than the other segments. In contrast, the Non-Recycling Group presented the higher level of social value than did Donation Group. In a comparison of the intention to purchase eco-friendly products, the Resale Group showed the highest mean score on intent to purchase Product A. On the other hand, the Donation Group presented the highest intention to purchase for Product B among segments. In addition, the mean scores indicated that the Korean product (Product B) was more preferable for purchase than the U.S. product (Product A). Stepwise regression analysis was used to identify the influence of product attributes on the purchase intention of eco product. With respect to Product A, design, price and contribution to environmental preservation were significant to predict purchase intention for the Resale Group, while price and compatibility with my image factors were significant for the Donation Group. For the Non-Recycling Group, design, price compatibility with the factors of my image, participation to eco campaign, and contribution to environmental preservation were significant. Price appropriateness was significant for each of the three clusters. With respect to Product B, design, price and compatibility with my image factors were important, but different attributes were associated significantly with purchase intention for each of the three groups. The influence of LOHAS characteristics and clothing consumption values on intention to purchase Products A and B were also examined. The LOHAS factor of health concern and the personal value factor were significant in the relationships with the purchase intention; however, the explanatory powers were low in the three segments. Findings showed that each group as classified by clothing disposal behaviors showed differences in the attributes of a product, personal values, and the LOHAS characteristics that influenced their purchase intention of eco-friendly products. Findings would enable organizations to understand eco-friendly behavior and to design appropriate strategic decisions to appeal eco-sumers.