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Cost Analysis of Long Term Care Services (장기요양보호서비스의 비용분석)

  • Park, Changje;Kim, Soo-Young;Joo, Soo-Hyeon
    • 한국노년학
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    • v.29 no.3
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    • pp.1043-1061
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    • 2009
  • The purpose of this study is to evaluate cost side by type of long term care services economically, and then to discuss the findings and implications for the results of analysis. For this research, primary caregivers that provide care the elderly requiring long term care services sanctioned by National Health Insurance Corporation were drawn and surveyed. Among collected data, data for 422 primary caregivers were used for this study. The subjects used in this study consisted of family caregivers from various settings that give care to the elderly. The results of this study can be summarized as follows. First, caregiver's household income level is low. Therefore, caregiving families with the elderly are likely to have financial difficulties. Second, under coverage of long term care insurance system, the direct cost caregiving households pay for the elderly is still very high. Third, indirect cost of caregiving households accounted for the larger proportion caregiving costs. Fourth, social cost burden for caregiving the elderly is very high. This cost amount is appropriately equal to household income of caregivers surveyed in the research. Fifth, service use cost of caregiving households is differentiated by type of long term care service. Sixth, direct cost of caregiving households is statistically significantly differentiated by type of long term care service, but is differentiated less than service use cost. Seventh, social indirect cost for caregiving the elderly is statistically significantly differentiated by type of long term care service. Eighth, social cost amounts for the elderly utilizing long term care service is very high, total social cost per capita by types of long term care service tend to converge on average social cost per capita of total service.

Relationship between Preschool Child-Mother Interaction, Child's Health Status, Health-Related Quality of Life, and Social Development (학령전기 아동과 어머니의 상호작용, 아동 건강 상태, 건강 관련 삶의 질 및 사회적 발달 간의 관계)

  • Park, Sunghee
    • Child Health Nursing Research
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    • v.20 no.4
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    • pp.255-263
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    • 2014
  • Purpose: The purpose of this study was to examine relationship of preschool child and mother interaction, child's health status, health-related quality of life and social development. Also, it was intended to provide a basis for development of mother-child interaction programs. Methods: The present study was a descriptive research. Participants in this study were a convenience sample of 230 preschool children and their mothers. For the final analysis 209 questionnaires were used after eliminating questionnaires with incomplete responses. Data were analyzed using the SPSS 18.0 program. Results: The mean score for interaction between preschool child and mother was $3.96{\pm}0.55$ out of 5 points, for child health status, $3.75{\pm}0.62$ out of 5 points, for child's health-related quality of life, $83.89{\pm}10.20$ out of 100 points and for child's social development, $19.66{\pm}3.57$ out of 24 points. Positive correlations were found between interaction of preschool child and mother, child's health status, health-related quality of life, and social development. Conclusion: The results demonstrate the importance of the quality of the relationship between mother, the child's primary caregiver, and her child for the healthy growth and development of preschool children. It is suggested that intervention programs for preschool child-mother interaction should be developed using evidence based data.

Study on Spiritual Well-being and Family Support of Cancer Patients (암 환자가 지각한 가족 지지와 영적 안녕에 관한 조사 연구)

  • 김정순;전성숙;황보선;김은영
    • Korean Journal of Health Education and Promotion
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    • v.16 no.2
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    • pp.67-80
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    • 1999
  • This study was designed to provide the basic data of nursing intervention for alleviation of effective adjustment of cancer patients by identifying the correlation between the spiritual well-being and family support. The subjects for this study were 69 patients who were diagnosed as cancer and were admitted to a university hospital in Pusan. Data were collected during the period between December 1, 1998 and January 20, 1999 by interviewing with questionnaires. Family support questionnaire consisted of 11 questions answerable on a 5 point Likert scale developed by Kang Hyun Suk(1985). Spiritual well-being questionnaire consisted of 20 questions answerable on a 4 point Likert scale modified by Kang Jeong Ho(1996). The data were analyzed by in descriptive statistics, Pearson correlation coefficient, t-test and ANOVA using SPSS/WIN program. The results of this study were as follows. 1. The mean score for family support in cancer patients was 49.48, which indicated that cancer patients perceived their state of family support as high level. The mean score for spiritual well-being in cancer patients was 55.87, which indicated that cancer patients perceived their state of spiritual well-being as moderate level. Among the components of spiritual well-being, the mean score for religious well-being was 26.94 and for existential well-being 28.93. From the above, the mean score for existential well-being was higher than that of religious well-being. 2. There were statistically significant differences in family support according to the types of primary caregivers(F=3.48, p=0.008). The spouse caregiver showed the highest family support among the caregivers. There were statistically significant differences in spiritual well-being according to the job(F=2.20, p=0.046) and the level of perceived health status(F=2.71, p=0.05). There were statistically significant differences in religious well-being according to the religion(F=2.42, p=0.004) and the number of family members(F=3.38, p=0.040). And there were statistically significant differences in existential well-being according to the job(F=2.48, p=0.026) and the level of perceived health status(F=2.74, p=0.048). 3. There were positive correlation between spiritual well-being and the family support(r=0.481, p=0.000), between religious well-being and family support(r=0.336, p=0.008) and existential well-being and family support(r=0.519, p=0.000).

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The Effect of Group Sensory Integrative Intervention for Play Skill and Social Interaction (그룹감각통합치료가 아동의 놀이와 또래 상호작용에 미치는 영향)

  • Hong, Eun-Kyoung;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.7 no.1
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    • pp.13-25
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    • 2009
  • Objective : The purpose of the study is to find out how group sensory integrative (SI) intervention enhances play skill and social interaction of the children with sensory integration disorders. Method : Three children who were showing problems related in sensory integration received 12 SI intervention sessions. The Sensory Profile (SP) and The Social Maturity Scale (SMS) were accomplished by the subject's primary caregiver. Test of Playfulness (ToP) and Peer Social Interactions Rating Scale (PSIRS) were utilized to investigate the children's play skills and social interactions with their friends. Goal Attainment Scale (GAS) is applied to assess the children's play skill, social interactions with peer, and sensory processing at each session. Data was collected before- and after the intervention and analyzed by the Wilcoxon matched-pair signed rank test with SPSS/WIN version 10.0 and Microsoft Excel. Results : The average scores of ToP, PSIRS, and SMS were increased after the sensory integrative intervention. However, there is no significant difference in the play skills and social interactions between data of pre-intervention and the one of post-intervention. The score of the GAS was frequently increased in terms of the play skills and sensory processing throughout the whole sessions. Conclusions : This study reveals a possibility of that the group sensory integrative intervention may affect not only sensory processing ability, but also play skills and social interactions of children experiencing difficulties of sensory processing. Future research should supplement limitations of this study regarding insufficient number of the subject and the short period of the experiment.

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Activities of a Home Hospice Organization (가정호스피스기관의 활동에 관한 연구)

  • Kim, Jung-Hee;Choi, Young-Soon
    • Journal of Hospice and Palliative Care
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    • v.3 no.1
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    • pp.28-38
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    • 2000
  • Purpose : This study examined characteristics of, problems of and services provided to hospice recipients and their family members at a home hospice organization. Methods : The subjects were 113 people who were discharged from one free-standing home hospice organization between November, 1994 and lune, 1999. Since the opening of the organization in November of 1994, it has provided hospice services at patients' homes with no charge. Data were collected from those subjects' records. Results : The average age of the subjects was 57.1 years; those aged 60 and over were 54%. Spouse was the most frequent(50.9%) primary caregiver followed by daughter-in-law and daughter. All the subjects were diagnosed as having cancer. Of those 41 subjects who did not know their terminal stage in the beginning, 31 subjects came to know their states. Of the subjects, 72.7% were referred from their physicians. On the average, the service duration and the number of home visits were 6.8 weeks and 7.2 times, respectively. Pain was the most prevalent problem of the subjects(89.4%). Medication management was the most frequently provided service followed by psychological supports. The reasons for discharge were death(88.5%) and refusal(8%). Home was the most frequent place of death(60%). Conclusion Home hospice service providers should be trained particularly in working with elders and in managing cancer pain. People need to be referred at an appropriate time for achieving goals of hospice. Community recognition of hospice services needs to be promoted.

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The Effect of a Multidisciplinary Team Approach on the Rehabilitation of Stroke Survivors (뇌졸중 환자를 위한 팀접근 재활프로그램의 효과)

  • Cho, Bok-Hee
    • The Korean Journal of Rehabilitation Nursing
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    • v.6 no.2
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    • pp.137-151
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    • 2003
  • The purpose of this study was to develop a multidisciplinary team approach program for stroke survivors, and to identify its effects on their rehabilitation. The team was composed of 7 members: a rehabilitation nurse, a physician, a physical therapist, an occupational therapist, a therapeutic recreational therapist, a nutritionist, and a researcher. A quasi-experimental study was performed with 36 subjects: 18 in the experimental group and 18 in the control group, using a noneqivalent control group pretest-posttest design. The experimental group participated 4 times in rehabilitation programsfocused on information and emotional support provided by the rehabilation team-and received telephone counseling from the researcher. The control group did not receive any treatment. The selection criteria for the subjects in this study were: (a) patients who were diagnosed as having had an ischemic stroke within the last year, (b) patients free of any communication disorder, (c) and those having a primary caregiver who could assist in filling out the form assessing the level of ADL. The data were collected from patients who had been discharged from a tertiary hospital, between October 1st, 1999 and September 30th, 2000. The data were analysed by $X^2$ test, Fisher's exact test, ANCOVA, Wilcoxon's rank sum test, and Wilcoxon's signed rank test using an SAS program. The results were as follows: 1. In terms of physical variables (blood pressure, grasp power, and ADL) 1) There was a significant difference in blood pressure between the two groups (systolic pressure P= .012, diastolic pressure P= .050). 2) There was also a significant difference in grasp power between the two groups (affected side : P= .012, unaffected side : P= .010). 3) There was no significant change in the level of ADL between the two groups. 2. In terms of psychosocial variables (depression, self-efficacy, self-esteem, and social activities) 1) There were no significant differences between the two groups. However, all four psychosocial variables showed a tendency to improve in the experimental group, while only two variables (depression and self-efficacy) showed a simalar tendency in the control group. 2) The level of social activities in the control group decreased significantly after a month (P= .050). 3. The level of life satisfaction improved in both groups, but no significant difference was found. Stroke has high recurrence rate and requires considerable follow-up care. The program used in this study was developed and designed for stimulting the rehabilitation process of stroke survivors. Through the program period of one month (meetings were held weekly), a positive effect was detected in physical variables, although the psychosocial variables did not improve significantly. In retrospect, a one month period may not be an adequate length of time to improve the psychosocial variables, as the stroke survivors were complicated cases, and most of them were elderly. Further research is therefore recommended by increasing the length of program, so that its effect can be more noticeable.

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DENTAL TREATMENT IN A PATIENT WITH METACHROMATIC LEUKODYSTROPHY UNDER GENERAL ANESTHESIA : A CASE REPORT (이염성 백질 이영양증 환아의 치아우식 치료 증례 보고)

  • Ryu, Jiyeon;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Young Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Kim, Chong-Chul;Lee, Sang-Hoon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.2
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    • pp.96-100
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    • 2016
  • Metachromatic leukodystrophy (MLD) is a progressive and degenerative neurological disease caused by a deficiency of the catabolic enzyme arylsulfatase A. Deficiency of arylsulfatase A results in accumulation of sulfatide in the white matter of the peripheral and central nervous system and it occurs demyelination as a result. The patient gradually goes through mental and motor failure. General symptoms of MLD include gait disturbance, mental deterioration, muscle rigidity and impaired swallowing. Inheritance of the disease is autosomal recessive. We report a dental caries treatment of a 3-year old boy with MLD. The patient underwent hematopoietic stem cell transplantation (HSCT) to slow the progression of the disease. He was suffered from difficulties of mastication and swallowing from the degenerative neurological symptom. He was ingesting food by both oral feeding and tubal feeding after he took percutaneous endoscopic gastrostomy (PEG). The cause of multiple caries was mainly presumed as patient's prolonged time of meal. The treatment was performed under general anesthesia considering patient's incompliance. Severely affected lower primary molars were treated with pulp treatment and restored with stainless steel crown. Others were restored with composite resin. There were no postoperative complications. MLD is life threatening progressive disease and also has an impact on unfavorable condition for oral health. Routine home oral care and periodic professional dental care should be emphasized to the caregiver of patient considering the susceptibility of dental caries. Not only the medical care, but periodic dental office visit would benefit the quality of life of the patient.

DENTAL TREATMENT UNDER GENERAL ANESTHESIA IN A PATIENT WITH LOWE SYNDROME : A CASE REPORT (로웨 증후군 환아의 치아우식 치료 증례 보고)

  • Ryu, Jiyeon;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Young Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Kim, Chong-Chul;Lee, Sang-Hoon
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.2
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    • pp.82-86
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    • 2016
  • Lowe syndrome is X-linked gene disorder, characterized by cataracts, renal dysfunction and brain abnormalities. Oral healthcare of young patients with Lowe syndrome could be easily neglected due to the uncooperative behavior or other systemic condition of the child. We are presenting a case of successful treatment under general anesthesia with uncooperative child with Lowe syndrome. A 3-year old boy with Lowe syndrome visited Seoul National University Dental Hospital for multiple caries. He had been suffering from congenital cataract, medullary nephrocalcinosis and hypotonia. Multiple caries were observed from clinical and radiographic examination. Concerning behavior management problem and possibility of aspiration due to hypotonia, dental treatment under general anesthesia was planned. Left upper primary first molar was extracted to prevent further infection. Other teeth were treated with Stainless steel crown or composite resin restoration based upon the extent and the severity of dental caries. Under general anesthesia, dental procedure was carried out successfully and safely. Considering uncooperative behavior and other medical conditions of the patient, general anesthesia could be effective. Home oral care and periodic visit to dental clinic should be emphasized to the caregiver of patient with Lowe syndrome, considering the susceptibility of dental caries and other oral manifestation.

A study on the factors influence on the family function of persons with mental illness - Comparison of the persons with recent onset and chronic mental illness - (정신질환자 가족기능에 영향을 미치는 요인연구: 발병초기와 만성 정신질환자의 비교)

  • Jo, Eun Jung;Kim, HyunSoo;Kim, Jong Chun
    • Korean Journal of Family Social Work
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    • no.57
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    • pp.99-124
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    • 2017
  • The primary objective of this study is to examine differences between the persons with recent onset and chronic mental illness in their family function; and analyze factors influence on the family function. The independent variables are divided into four sets: socio-economic, clinical, familial, and social characteristics. The subjects of this study are the 628 with mental disorders, and the sample was selected in Pusan and Gyeong-nam area. The findings of this study can be summarized as followed: The family with chronic mental illness showed higher family function in comparison with recent onset. Result of hierarchical multiple regression analysis show that age of onset, difference between ideal and reality in family function variable only influenced family function for the recent onset group, and activities of daily living, difference between ideal and reality in family function, caregiver's health, community support variables influenced family function for the chronic group. The results suggest a need for using different treatment approaches for recent onset versus chronic mentally disabled families. Implications for mental health social work practice for family with disabled are suggested.

Caregiving Rewards and Costs of Grandmothers Raising Grandchildren (조손가족 조모가 경험하는 손자녀 양육의 보상과 비용)

  • Han, Gyoung-hae;Joo, Ji-hyun;Lee, Jeong-hwa
    • 한국노년학
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    • v.28 no.4
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    • pp.1147-1164
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    • 2008
  • There has been a sharp increase in the number of grandmothers raising grandchildren in contemporary Korean society. However, little is known about the complexity of the experiences of the custodial grandparenting. Most of the studies mainly examined burden/cost and have paid little attention to the positive aspects of custodial grandparenting. In order to overcome this limitation of previous research, this study aims 1) to examine not only the costs but also the rewards of custodial grandparenting and to explore related factors, 2) to develop the typology based on relative rewards-burden perception of grandmothers about custodial grandparenting and explore the group differences. The data were gathered from 449 grandmothers raising their grandchildren as a primary caregiver, using a structured questionnaire. The data were analyzed using descriptive statistics, correlation, hierarchical multiple regression and ANOVA, with SPSS WIN 12.0 program. Main findings are as follows: First, custodial grandmothers report not only care-giving burden such as physical burnout and economic burden but also various rewards such as joy of watching their grandchildren grow and feeling good about themselves to be a help with their adult children, i.e. grandchildren's father or mother. Second, factors related to the level of perceived cost of grandparenting are different from the factors affecting the positive aspects of grandparenting. Third, results of the two by two cross-tab analysis based on the level of rewards and burden show that about 32 percent of the grandparents belong to Type II group(high rewards-low cost). This result is quite contrary to the assumption of previous research focusing mostly on cost and burden of custodial grandparenting. Fourth, four groups were different in terms of grandmother & grandchildren's characteristics. Implications of these results are discussed.