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"Burden"

Original Articles
Purpose
The purpose of this study was to investigate caring self-efficacy and social support, and their mediating effects on the relationship between caring burden and caring behavior in family caregivers of elderly with dementia in the community-dwelling.
Methods
A sample of 210 participants was used in a cross-sectional study. Data were collected from July 15th to November 22nd, 2019 through structured questionnaires and analyzed using descriptive statistics, multiple linear regression analysis, and the bootstrapping method with SPSS/WIN 25.0 and PROCESS macro program.
Results
The mean score for caring behavior was 3.14±0.81 (range 1~5). Caring behavior was significantly associated with caring burden (r=-.54, p<.001), caring self-efficacy (r=.68, p<.001), and social support (r=.69, p<.001). Using Baron and Kenny's approach and PROCESS macro model 4, caring behavior was found to be directly affected by caring burden (β=-.55, p<.001). Caring self-efficacy (β=-.36, p<.001) and social support (β=-.34, p<.001) were directly affected by caring burden. The partial mediating effects of caring self-efficacy (β =-.18, p=.007, 95% confidence interval -0.44~-0.14) and social support (β=-.23, p<.001, 95% confidence interval -0.38~-0.13) on the impact of caring burden on caring behavior were confirmed.
Conclusion
The impact of caring burden on caring behavior was mediated by caring self-efficacy and social support in family caregivers of elderly with dementia in the community-dwelling. The results suggest that caring self-efficacy and social support need to be considered in developing nursing interventions to reduce caring burden and improve caring behavior for family caregivers of elderly with dementia.

Citations

Citations to this article as recorded by  
  • Care burden, depression, quality of life, and institutionalization factors among family caregivers of long-term care recipients: A secondary data analysis
    Eun-Jeong Han, Yeongwoo Park, Heejung Kim, Myonghwa Park
    Journal of Korean Gerontological Nursing.2025; 27(1): 57.     CrossRef
  • Factors influencing the caring behaviors of primary family caregivers of older adults with dementia: A cross-sectional study
    Da-Mi Kim, Hye-Young Jang
    Journal of Korean Gerontological Nursing.2024; 26(2): 146.     CrossRef
  • Effect of perceived chronic illness management support, health literacy, and social support on the care burden of families caring for older people with multiple chronic conditions at home: A cross-sectional study
    Eun Sil Lee, Mi Young Kim
    Journal of Korean Gerontological Nursing.2023; 25(1): 76.     CrossRef
  • Influence of Gratitude and Sense of Meaning in Life on Caregiving Self-Efficacy of Family Caregivers of Persons With Mental Illness
    Won Hee Jun
    Western Journal of Nursing Research.2023; 45(12): 1104.     CrossRef
  • Resilience of family caregivers of people with dementia in South Korea: protocol for a scoping review
    Hyun-Ju Seo, Min-Jung Choi, Song-I Park, Jeong-hwan Park
    BMJ Open.2022; 12(7): e056739.     CrossRef
  • Positive Changes in Caregiving Experiences of Family Caregivers for Long-Term Care Recipients after a Family Counseling Support Program
    Eun-Jeong Han, Myonghwa Park, Jihye Jung
    Journal of Korean Gerontological Nursing.2022; 24(1): 85.     CrossRef
  • Health Promotion Behavior among Older Korean Family Caregivers of People with Dementia
    Aram Cho, Chiyoung Cha
    International Journal of Environmental Research and Public Health.2021; 18(8): 4123.     CrossRef
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  • 7 Crossref
  • 7 Scopus
Factors Affecting Caregiver Burden in Caregivers of Patients with Parkinson's Disease
Dong Won Kim, Eun Sook Bae
Korean J Adult Nurs 2015;27(3):283-293.   Published online June 30, 2015
DOI: https://doi.org/10.7475/kjan.2015.27.3.283
PURPOSE
Depression is a common sign of suffering among the patients with Parkinson's disease (PD). Frequent and severe neuropsychiatric symptoms lead to high levels of distress in patients and their caregivers, which results in the high levels of caregiver burden. The aim of this study was to determine the predictors of caregiver burden in caregivers of the patients with Parkinson's disease (PD).
METHODS
The study included 183 consecutive PD patients and their caregivers. Patients were assessed using the Hoehn and Yahr scale, Mini Mental State Examination (MMSE), Beck Depression Inventory (BDI), and Schwab and England Activities of Daily Living Scale. Caregivers' depressive symptoms were evaluated using the Caregiver Burden Inventor (CBI), BDI, and World Health Organization Quality of Life Scale.
RESULTS
All of the patients reported one or more neuropsychiatric symptoms. Patients' and caregivers' depressive symptoms, caregivers' age and education, time for caregiving, and quality of life were significantly associated with the increased caregiver burden. After controlling the level of education as a potential confounding variable, depression in both patients and caregivers, time for caregiving, and quality of life explained 45.6% of the variance in caregiver burden.
CONCLUSION
Substantial attention needs to be given to the early identification of depression in PD patients and their caregivers to improve caregivers' quality of life and burden.

Citations

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  • Factors influencing caregiver burden in families of hospitalised patients with lung cancer
    Ye Ji Seo, Heeok Park
    Journal of Clinical Nursing.2019; 28(9-10): 1979.     CrossRef
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  • 1 Crossref
The Factors affecting Burdens and Quality of Life of the Family Caregivers of Patients with Rare and Incurable Diseases Using Home Ventilators
Moon Sook Hwang, Mi Kyoung Lee, Jeong Rye Song
Korean J Adult Nurs 2014;26(2):191-202.   Published online April 30, 2014
DOI: https://doi.org/10.7475/kjan.2014.26.2.191
PURPOSE
This study was aimed to survey the actual caregiving conditions of family caregivers who are caring patients with rare and incurable diseases using home ventilators at home, and to clarify any factors affecting their burdens and quality of life.
METHODS
A questionnaire survey was performed by the 159 subjects, and the questionnaires contained the actual conditions of caregiving activities, and caregiver's burdens and quality of life. The collected data was analyzed by ANOVA, Pearson's correlation, and stepwise linear regressions.
RESULTS
The mean of burden scores was 3.55 out of 5, and influencing variables included the relationships with patient (spouse), respite (moderate), health status, and diagnosis (non ALS), with the explanatory power of 30.0%. The mean of the quality of life was 2.58 point, and the influencing variables included burdens, health status, and respite (enough), with the explanatory power of 39.0%.
CONCLUSION
In order to improve the quality of life among family caregivers caring for patients with using a home ventilator, it is required to develop strategies for reducing caregiving burdens as well as to introduce family respite welfare systems to family caregivers.

Citations

Citations to this article as recorded by  
  • Burden, social support, and coping strategies in family caregivers of individuals receiving home mechanical ventilation: a cross-sectional study
    Lucyna Płaszewska-Żywko, Izabela Fajfer-Gryz, Jakub Cichoń, Maria Kózka
    BMC Nursing.2024;[Epub]     CrossRef
  • Factors Affecting Quality of Life in Family Caregivers of Patients in Intensive Care Units
    Kyeong Mi Kong, Sunjoo Boo, Youngjin Lee, Jeong-Ah Ahn
    Journal of Korean Critical Care Nursing.2024; 17(2): 12.     CrossRef
  • Effects of the Discharge Education Program on Family Caregivers Caring for Patients on Mechanical Home Ventilation in Korea: A Pilot Test
    Hyang Sook Kim, Gwang Suk Kim, Hyangkyu Lee, JiYeon Choi, Young Sam Kim, Eui Geum Oh
    Home Health Care Management & Practice.2022; 34(4): 258.     CrossRef
  • NADİR HASTALIĞI OLAN ÇOCUKLARIN AİLELERİNDE BAKIM YÜKÜNÜN İNCELENMESİ
    Merve Deniz PAK GÜRE, Cemre PAK
    Turkish Journal of Family Medicine and Primary Care.2021; 15(2): 269.     CrossRef
  • Factors associated with caring behaviors of family caregivers for patients receiving home mechanical ventilation with tracheostomy: A cross-sectional study
    Hyang Sook Kim, Chung Eun Lee, Yong Sook Yang, Tai-Heng Chen
    PLOS ONE.2021; 16(7): e0254987.     CrossRef
  • Factors Influencing Psychosocial Well-Being in Family Caregivers of People with Amyotrophic Lateral Sclerosis
    Hyeon Sik Chu, Young Ran Tak, Seung Hyun Kim
    Journal of Korean Academy of Nursing.2018; 48(4): 454.     CrossRef
  • The Effect of the Activity of Daily Living of Adult People with Physical Disabilities on Spouse's Caregiving Stress and Depression
    Deok Ju Kim
    Journal of the Korea Academia-Industrial cooperation Society.2016; 17(12): 371.     CrossRef
  • Influencing Factors on Stress in Caregivers of Stroke Patients Being Admitted in Rehabilitation Centers
    Nam-Hee Kim, Young-Sook Tae, Yooun-Sook Choi, Joo-Hee Bae
    Journal of the Korea Academia-Industrial cooperation Society.2016; 17(2): 188.     CrossRef
  • 101 View
  • 3 Download
  • 8 Crossref
  • 4 Scopus
Effects of Burden and Family Resilience on the Family Adaptation of Family Caregivers of Elderly with Dementia
Hye Young Jang, Myungsun Yi
Korean J Adult Nurs 2013;25(6):725-735.   Published online December 31, 2013
DOI: https://doi.org/10.7475/kjan.2013.25.6.725
PURPOSE
The purpose of this study was to investigate the levels of burden, family resilience and adaptation of caregivers of elderly patients with dementia, and further to identify factors influencing their adaptation.
METHODS
A cross-sectional descriptive study was designed. Data were collected from questionnaires distributed to 131 family caregivers of elderly patients who visited at the Centers for Dementia in Seoul during 2012~2013. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation analysis, and stepwise multiple regression.
RESULTS
The average age of the care giving subjects was 63.58, and 31.3% were male, and 41.2% were the spouses. Statistically significant relationships were found between burden and adaptation (r=-.38, p<.001), and between family resilience and adaptation (r=.52, p<.001), and between burden and family resilience (r=-.35, p=.001). Thirty percent of adaptation was explained by burden and family resilience. The most influencing factor to adaptation was family resilience which explained about 27% of the variance.
CONCLUSION
The results of the study clearly indicate that family resilience explains better than burden on adaptation of family caregivers. Thus, to develop more effective nursing intervention for family caregivers of elderly patients with dementia, it would be necessary to integrate family resilience in the programs. 27% is not that much and I wonder if we have to do more work to identify the factors that influence care giving.
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A Comparative Study of the Factors Influencing Burden of Primary Family Caregivers according to the Degree of Serious Illness of Elderly Patients Admitted in an Intensive Care Unit
Kwuy Bun Kim, Kyung Suk Han, Sohyune R Sok
J Korean Acad Adult Nurs 2009;21(2):187-198.   Published online April 30, 2009
PURPOSE
This study was to compare and examine the factors influencing burden of primary family caregivers according to the severity of illness of elderly patients admitted in an intensive care unit.
METHODS
Subjects were the families of elderly patients in intensive care units of K, S and Y hospitals in Seoul. Data were collected from March to October 2007. Subjects were 108 persons over age 65. Data were analyzed by SAS statistics.
RESULTS
First, groups 5 and 3 showed higher burden than that of group 4. Second, high correlation was found between stress and burden, stress and anxiety, and burden and anxiety. Third, factors influencing family burden were found to be stress for group 5, stress, anxiety, and monthly income for group 4, and stress and patient age for group 3.
CONCLUSION
Specific nursing interventions to decrease the stress of primary family caregivers of serious ill elderly patients in an intensive care unit are needed. Additionally, more effective and systematic activation of a long-term medical insurance system for seriously ill seniors is considered necessary to mediate the burden of primary family caregivers.
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Quality of Life and Family Burden in Cancer Patients
Il Soon Sung, Ji Youn Kim, Gie Ok Noh, Ki Duck Ahn, Eun Jung Ryu, In Gak Kwon
J Korean Acad Adult Nurs 2007;19(4):603-613.   Published online September 30, 2007
PURPOSE
The purpose of this study were to investigate the self-reported quality of life and family burden and to examine the factors associated with the quality of life in patients with cancer.
METHODS
216 patients participated in the cross-sectional study. The European Group of Research and Treatment of Cancer Quality of life Questionnaire (EORTC QLQ-C30) and the Family Burden Scale were sent by mail to 2,000 cancer patients. Two hundred and sixteen patients answered the questionnaire. The stepwise multiple regression was conducted to analyze predictors of overall quality of life.
RESULTS
All subscales of EORTC QLQ-C30 were significantly correlated with family burden. The regression analysis of patients with cancer revealed some variables as significant predictors; performance, perceived severity, family burden, time since diagnosis, and sex.
CONCLUSION
The results offer a number of recommendations for future research and nursing practice focused on primary care for patients with cancer and their family for improving quality of life.
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Influencing Factors on Family Functioning of Caregivers in Families with Stroke Patients
Su Jeong Yu, Yeon Hwan Park
J Korean Acad Adult Nurs 2006;18(3):457-467.   Published online August 31, 2006
PURPOSE
The purpose of this study was to identify the main factors influencing family functioning of caregivers in families with stroke.
METHOD
A Convenient sample of 173 primary family caregivers who take care of a stroke patient at an Oriental medicine hospital in Jeonbuk. Interviews were done with a standardized questionnaire including family functioning by nurses.
RESULTS
In Pearson's correlation analysis, the influencing factors related to family functioning were ADL(p=.017), level of paralysis(p=.019) as stressors, Quality of relation(p=.000) as situational variables, and family caregivers' burden(p=.000). Stepwise multiple regression analysis showed 29.9% of the variance family functioning was significantly accounted for by the quality of relationship between stroke patient and caregiver(26.8%), and caregiver burden(3.1%).
CONCLUSIONS
Findings indicate that families of stroke patients need family-focused nursing intervention as supported care to improve the relationship between patient and primary caregiver and relieve caregiver burden by culturally tailoring to Korean.
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A Study on the Burden, Health Status and Well-being in Spouse Caregivers of Patients with Stroke
Soo Yeon Ahn, Young Eun Kwon, Jeong Ju Hong
J Korean Acad Adult Nurs 2005;17(2):287-297.   Published online June 30, 2005
PURPOSE
The purpose of the study is to investigate the correlation between burden, health status and well-being in spouse caregivers of patients with stroke. METHOD: The subjects of this study were 160 spouse caregivers registered at general hospital in Seoul and Seongnam. The data were collected from July 2th to October 30th, 2003. The Suh & Oh's burden scale, Yang's health status scale and Park's well-being scale were employed to measure burden, health status and wellbeing respectively. Collected data were analyzed using SPSS 12 version to obtain summary statistics for the descriptive analysis, Pearson Correlation, and Stepwise Multiple Regression. RESULTS: 1. The mean score of the degree of burden, health status and well-being were 3.52, 5.92 and 3.64 points. 2. The burden of the subjects were significantly negative correlated with psycho- logical health status(r=-.482. p<.01) and wellbeing(r=-.455, p<.01). 3. With the result of stepwise multiple regression, psychological health status and wellbeing were the main variables which could explain burden by 27.1%. CONCLUSION: The findings of this study will provide practical guidelines for developing emotional nursing interventions for the spouses taking care of CVA patients who would experience a heavy burden and distress.
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The Correlation Among Health Status, Burden and Quality of Life of the Adult Stroke Patient's Family and the Elderly Stroke Patient's Family
Kwuy Bun Kim, Kyung Ho Lee
J Korean Acad Adult Nurs 2001;13(2):262-276.   Published online June 30, 2001
The purpose of this study is to investigate the correlation among the stroke patient family's health, burden and quality of life which is based upon the comparative appreciation of the adult stroke patient's family and elderly stroke patient's family. For this purpose, data were collected from the family care-givers for two groups of stroke patients under sixty years old and over sixty years of age, admitted at K Hospital and H Hospital in Seoul. The instruments for this research are based on the tool for measuring physical health and psychological health developed by Yang, Young-hee(1992), the tool for measuring the sense of burden by Seo, Mee-hae and Oh, Ga-sil(1993), and the tool for the quality of life by Noh, Yoo-ja(1988). The sampling for this study was done from December, 2000 until February, 2001. Questionnaire data were drawn up by personal interviews aided by the staff nurses. The analysis of collected data are based on general characteristics calculated at the rate of 100 percent of the average, t-test, ANOVA(some difference on a level with p<.05 being subsquently confirmed by DMR) for Health Status, Burden, Quality of Life and Pearson Correlation to verify the hypothetical correlation among the subjects. The results of this study are as follows: 1. In the adult stroke patient family, the factors influencing the physical health proved to be age, present occupation and family-formation. Here, the factors influencing psychological health turned out to be age, matrimonial status, present occupation and family-formation. In the elderly stroke patient family, the factors influencing physical health proved to be age, gender, final academic status, matrimonial status, present occupation, and relation with the patient. Here, the factors influencing the psychological health were age, final academic status, matrimonial status, present occupation, relation with the patient and family-formation. In the former case, the influencing factors upon the burden were shown to be age, final academic status, matrimonial status, relation with the patient and family-formation. In the latter case, the influences upon the burden were age, gender, final academic status, matrimonial status, present occupation and relation with the patient. In the former case, the influences on the quality of life were gender, and economic situation. In the later case, the influencing factors on the quality of life were age, final academic status, matrimonial status, present occupation, and relation with the patient. 2. The rate of the physical condition in the former case turned out to be 2.83, and the psychological condition 2.37. The physical condition of the latter case was 2.76, and the psychological condition 2.46. The rate of the burden in the former case was 3.14, and that of the latter case was 3.04. The rate of quality of life in the former case proved to be 2.46, and that of the latter case 2.55. 3. The rate of correlation between the burden and the quality of life appeared to be the high counter-correlation (r= -.573). The rate of correlation between the psychological health and the burden of a simialr (r= -.565). The rate of correlation between the physical health and the psychological health proved to be a moderate correlation (r= .372), The rate of correlation between physical health and the burden turned out to be a low counter-correlation (r= -.276). According to this study, there proved to be a very close correlation among the stroke patient family's health, the burden and quality of life. Thus, it would be necessary to find out various nursing interventions in order to mitigate the stroke patient family's burden in the process of caring for the patients.
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Study on Family Caregiving Burden Scale of Dementia-Korea(FCBSD-K)
Nam Ok Cho
J Korean Acad Adult Nurs 2000;12(4):629-640.   Published online December 31, 2000
The purpose of this study was to develop and validate the scale to measure dementia patient's caregiver burden of Korea. In the first phase of the study, 15 caregivers of dementia patients were interviewed to provide narrative data from which items were developed. Initially 65 items were generated from the interview data of 15 caregivers. Content validity was judged by two separate panels of experts with 27 professionals and 30 family caregivers. These items were analyzed through the Index of Content Validity and 33 items were selected which met .80 or more of the CVI. This preliminary FCBSD-K was tested with 207 adult caregivers for reliability and construct validity including item analysis and orthogonal(Varimax) factor analysis. Eight items were deleted because of high or low item-item correlation. The result of the second factor analysis produced six factors that coincided with the conceptual framework posed for the scale developed. The six factors were labeled as 'physio social factor' 'emotional factor' 'family cultural factor' 'role obligation' 'guilt feeling' and 'financial & supportive system factor'. The alpha coefficient relating to internal consistency was .9264 for reliability. In conclusion, cultural factor is related to dementia patient's caregiver burden and FCBSD-K was useful in assessing the dementia patient's caregiver burden in Korea.
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Caregiver burden and family functioning of cancer patient
Yeon Hwan Park, Hye Jin Hyun
J Korean Acad Adult Nurs 2000;12(3):384-395.   Published online September 30, 2000
This study examined burdens of primary family caregivers, and family functioning of patients with cancer. In addition, the relationship between two concepts was assessed to develop nursing intervention to reduce the burdens of caregiving, and to improve family functioning. Ninety-two primary family caregivers of patients with cancer at a general hospital in Seoul participated in this study. The patients with cancer aged from 19 to 84 years with a mean age of 51 years, and sixty-one percent were male. About 30 percent of the patients suffered liver and billiary tract cancer. Fifty-six percent of the primary family caregivers were spouses of the patients and 70.7 percent were women. Primary family caregivers' burdens were assessed by the Burden Scale originally developed by Zarit (1980) and Novak & Guest(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales: time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financial burden. Family functioning was assessed by the Family APGAR developed by Smilkstein(1978). The results were as follows: 1. The average burden score was 86.1, indicating a moderate level of burden. The time-dependent burden scored highest followed by developmental, physical, social, financial, and emotional burdens. The mean score of family APGAR was 9.71; among subjects 82.6% were included in dysfunctional families. 2. Of the characteristics of patients, age, gender, number of admissions, and job were found to be associated with the level of burden. There was no significant difference between patient characteristics and family functioning. Of the characteristics of primary family caregivers, caregiver's perception of patient prognosis was significantly related to the level of burden, and family functioning. Caregiver's sex and age were also related to family functioning. The quality of relationship between a patient and a caregiver was significant situational factors affecting the level of burden, and family functioning. In addition, the income of family, and help from other family members were related to the level of burden. Given the results, it is essential to develop nursing intervention to reduce burden and to improve family functioning, such as support groups.
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A Longitudinal Study on the Burdens of Caregivers in Families with Stroke Patients
Sue Jin Kang, Smi Choi-Kwon
J Korean Acad Adult Nurs 2000;12(2):209-221.   Published online June 30, 2000
This longitudinal study examines the burdens and related factors for stroke patient's primary family caregivers. Sixty-one patients treated for stroke at a general hospital in Chung-nam province and family member caregivers participated in this study from July 28, 1998 to August 1, 1999. Family caregivers' burdens were assessed by the burden scale originally developed by Zarit(1980) and Novak &Geust(1989) and modified by Oh's(1993) for use in Korea. The burden scale instrument consists of five subscales.: financial burden, social burden, physical burden, dependency burden, and emotional burden. Repeated ANOVA and Stepwise multiple regression were used in the data analyses. The results were as follows: The burden mean score was 3.23 in the hospital, 3.26 after hospital release, and 3.27 in the home environment. In the hospital, a patient's degree of cognition, and social support for family caregivers were significant factors affecting the sense of burden felt by family caregivers. After hospital release, the significant factors affecting the sense of burden were the degree to which stroke patients could participate in daily living activities, social support for family caregivers, and changing to a second caregiver. In the home environment, the most significant factor affecting the sense of burden was social support for family caregivers.
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Effect of Social Support Group on Quality of Life and Burden of Primary Family Caregivers of Patients with Brain Injury
Young Mi Lee, Jeong Sook Park
J Korean Acad Adult Nurs 1999;11(3):413-424.   Published online September 30, 1999
The aim of the present study is to assess the effect of social support group, in improving the quality of life and alleviating the burden of primary family caregivers of patients with brain injuries. The group consisted of the 34 concerned family members, who were identified as the primary family caregivers of patients with brain injuries. Data were collected from July 1st. to September 25th. 1998. Four social support group(consisting of 6-11 members) were involved over a 5-week period. During this period, each support group met the primary family caregivers once a week for an hour. A burden scale and quality of life scale were used to obtain the pre-test and post-test data. The data analysis (paired t-test, and Pearson correlation) was done using SPSS 7.0. The findings of the present study are as follow: 1. Hypothesis 1 ; "Caregivers burden will be decreased by participation of social support group compared to before" was suppoted( t=2.71, P<.011). 2. Hypothesis 2 ; "Caregivers quality of life will be increased participation of social support group compared to before" was rejected(t=1.98, P<.056). 3. Statistically significant negative correlation was found in the relationship between the burden and quality of life(r=-.5911, P= .000). In conclusion, it can be said that the participation of social support group in alleviating the burden of primary family caregivers of patients with brain injury is an effective nursing intervention.
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