Purpose This study aims to explore the relationship between the discharge process and two-year prognosis in patients with Heart Failure (HF) who were hospitalized because of HF exacerbation.
Methods Medical records were reviewed to identify patients admitted for HF exacerbation. Information regarding the following discharge processes was collected: follow-up visits, discharge educational contents, and the presence of family caregivers during patient education. HF-related events, including emergency department visits, readmissions, or death because of HF, were defined as a composite of events. A multivariate Cox proportional hazards regression model was used after adjusting for covariates to explore the association between the discharge process and HF-related events.
Results A total of 201 patients were included in this study. In the two-year follow-up periods, 41 patients (20.4%) experienced at least one HF-related event. Follow-up visits were scheduled at an average of 8.11±2.92 days after discharge. Approximately 95.0% of the patients received discharge education with an average of 1.66±1.04 topics, and 69.7% of the families participated in this educational activity. In the multivariate Cox regression model, not having family members during education was associated with a longer time to HF-related events (hazard ratio: 2.09; 95% confidence interval: 1.001~4.346). However, follow-up visits and the amount of educational content received were not associated with time to HF-related events.
Conclusion The presence of family caregivers during education appears to be a protective factor against adverse prognosis in patients with HF. Our results highlight the importance of family engagement during discharg
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Purpose This study aimed to evaluate distress, family resilience, and Quality of Life (QoL) among family caregivers of cancer patients undergoing chemotherapy and explore whether family resilience moderates the association between distress and QoL. Methods This is a cross-sectional study. One hundred seventeen family caregivers of cancer patients undergoing chemotherapy were recruited through the oncology outpatient clinic and two oncology wards at a tertiary university hospital. The participants completed self-reported questionnaires, including the Hospital Anxiety and Depression Scale, Family Resilience Scale-Cancer, and Caregivers’ Quality of Life Index-Cancer. Descriptive statistics, independent t-tests, one-way Analysis of Variance (ANOVA), and hierarchical regression analysis were used for statistical analysis. Results The mean distress score was 15.31±6.91, the mean family resilience score was 112.71±14.11, and the mean QoL score was 71.19±18.90. After controlling for potential covariates, distress was found to be negatively associated with QoL (β=-.45, p<.001), whereas family resilience was positively associated with QoL (β=.49, p<.001), explaining 62.8% of the variance. However, family resilience did not moderate the association between distress and QoL in this study. Conclusion Distress and family resilience are crucial factors associated with QoL in the caregivers of cancer patients undergoing chemotherapy. This finding indicates that oncology nurses should develop interventions to relieve distress and enhance family resilience to improve family caregivers’ QoL. Further studies are required to confirm the moderating role of family resilience.
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PURPOSE There is limited available research about the experiences of family caregivers and their care of family members with cancer. The purpose of this study was to explore the experience of distress among family caregivers. Further, this study explored what aspects of caring for family member contributed to the distress. METHODS Data were collected through in-depth interviews with thirteen family members primarily responsible for the care of the member with cancer. All interviews were audio-taped, transcribed, and analyzed with qualitative content analysis. RESULTS The findings showed that the patients' physical, psychological, socio-relational, and spiritual symptoms influenced their caregivers' distress. The four categories that emerged from the data included “focusing attention only on the patient battling with cancer,â€â€œbeing trapped in turmoil of complex emotions and feelings,â€â€œhaving had to endure alone,†and “hanging in there at the crossroads of life and death.†With respect to these categories, fourteen sub-categories were ultimately identified. CONCLUSION Based on this study, researchers need to focus more attention on, and explore such co-existing distress to develop an adequate support program for the family caregivers of cancer patients.
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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.
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PURPOSE The purpose of this study was to explore and identify the role adaptation processes of family caregivers with patients transferred from intensive care unit to general ward. METHODS Using a grounded theory methodology, in-depth individual interviews were conducted. Data were collected from 11 participants. The participants were asked about their experiences of role adaptation considering situational contexts and interactional strategies. Transcribed data and field notes were analyzed using constant comparative analysis. RESULTS The core category was 'becoming almost a nurse with hope and fear.' The identified phenomena by the participants were the joy of being alive, having hope for a full recovery, anxiety and fear of uncertain future, feeling burdensome on a given role. The results included both role adaptation and mal-adaptation of caregivers. CONCLUSION The role adaptation processes of family caregiver with patients transferred from intensive care unit to general ward can be explained as becoming almost a nurse with hope and fear. The findings of the study provided fundamental information for developing programs to support the given family caregivers for successful role adaptation.
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PURPOSE This study's purpose is to classify and analyze caregivers' recognition of the elderly suicidal intents. METHODS This study uses applied Q-methodology to measure human subjectivity in depth. Concretely, 35 statements are composed in depth interviews and literature investigation. Then, Q-cards and distributive chart of Q-sampling were given to 25 caregivers randomly-selected, who were asked to arrange them on a 7-score based. After coding Q-factor analysis is carried out with the PC-QUANL program. RESULTS Four types of indicators of the elderly suicidal intents were identified by the caregivers. These are Knowledge-based recognition, Behavioral measure based recognition, Negative comprehension and Sympathy. CONCLUSION In this study, four types of recognition were yielded among the caregivers and the characteristics of each type were analyzed. These findings may be useful in assessing suicidal potential and nursing interventions.
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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.
PURPOSE This study aimed to develop the first standardized education & training program for education of senile long-term care managers to improve the quality of senile long-term care service. METHODS The study developed programs through literature review, specialists' conference and interview with the linear approach from February, 2007 to May, 2007. RESULTS Senile long-term care managers should have qualification of 51 items in knowledge, 35 items in technology and 17 items in attitude. Total 8 subjects were education & training subjects of senile long-term care managers and the study proposed targets of each subject and education & training level divided into top, middle and bottom. Total education & training hours were composed of 70 hours in theory, 50 hours in practical technique and 40 hours in social welfare practice in agencies. CONCLUSION The study will contributed development of the first education & training programs for education of senile long-term care managers. Therefore, the study proposes that the study will be applied to a systematical education & training course through program verification after applying real programs to senile long-term care managers and that it is necessary to develop the standardized education & training program for higher senile long-term care managers.
PURPOSE The objective of this study was to define the predictors of health related quality of life(HRQoL) of women caregivers of the demented elderly patients. METHODS The subjects of this study were 140 pairs of patients with dementia and their caregivers. The characteristics of dementia patients and caregivers, Barthel index and SF-36 were measured in this study. T-test, ANOVA, Pearson correlation coefficient, and stepwise multiple regression were used for data analysis. RESULTS The health related quality of life(HRQoL) score of women caregivers was 288.35+/-66.10 for norm based scoring. HRQoL of women caregivers was correlated with patients' ADL, severity of dementia, caregivers' age, burden, and family support. The major factors that affected the physical components of women caregivers of patients with dementia was the age of the caregiver, burden, and ADL which explained 36.0% of HRQoL. The main predictors of women caregivers' emotional state was the caregiver's burden. CONCLUSION Patients' support systems must be implemented to improve the physical HRQoL of caregivers. A caregivers' burden relief program needs to be prepared to increase their emotional HRQoL and further studies and efforts will be needed to evaluate those effects.
PURPOSE This study was designed to systematically explore and elicit information about terminally ill cancer patients' and primary family caregivers' subjectivity of death. METHOD Using Q-methodology, 21 terminally ill cancer patients and 19 primary family caregivers sorted 40 statements during personal interviews. RESULTS The results of this study show that terminally ill cancer patients have four factors ('Attachment to life', 'Hope for heaven', 'Resignation to reality', 'Avoidance of pain') of response and primary caregivers have four factors('Dependence on religion', 'Faithfulness to reality', 'Obedience to fate', 'Agony of reality'). Comparing the subjectivities of death of terminally ill cancer patients and primary family caregivers, 'Hope for heaven' and 'Dependence on religion' reveal the similarities of their outlook. On the other hand, 'Attachment to life', 'Resignation to reality', 'Avoidance of pain', 'Faithfulness to reality', 'Obedience to fate', 'Agony of reality' reveals different aspects of their outlook. The group of terminally ill cancer patients and their families divided into four types. Type A was 'Attachment to life and Agony of reality', type B was 'Attachment to life and Obedience to fate', type C was 'Hope for heaven and Dependence on religion' and type D was 'Resignation to reality and Faithfulness to reality'. The positive group was C or 'Hope for heaven and Dependence on religion'. CONCLUSION There are significant differences found in the subjective structure of death among terminally ill cancer patients and primary family caregivers. Therefore, it is necessary to develop an individualized nursing intervention for terminally ill cancer patients and family caregivers.
PURPOSE The research aims to understand the lived experience of the caregivers of chronic renal failure(CRF) patients and its essential meaning. The results of the study can be used as basic materials for developing comprehensive intervention methods of care givers of CRF patients. METHOD: The research used van Manen's hermeneutic and phenomenological research methods in order to describe the lived experience and to understand its meaning. It concentrates on the understanding the essence of experience and consists of existential survey, hermeneutic and phenomenological reflection and hermeneutic writings. Participants in this research were five women care givers of CRF patients who had hemolysis at C university hospital in a metropolitan city, the period of data collection was from July 27 to Sep. 4, 2004 and major data of results in the following 5 essential themes. 'sole responsibility for the patient enduring everything', 'creating their own field', 'heavy and painful life without hope of their private life', 'wishing not to be inherited and consoling each other'. CONCLUSION: The above findings point out that the experience of care givers of CRF patient affected and changed all parts of an individual life and his or her family life. Therefore, it suggests that total family nursing care must be considered in order to provide the holistic caring for CRF patients and their care givers.
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.
PURPOSE The purpose of this study is to identify the effects of telephonic counseling on burnout, depression, life satisfaction, and perceived physical health among family caregivers of older adults with dementia. METHOD Subjects were randomly assigned into telephonic counseling group (n=21) and the comparison group (n=32). A weekly telephone counseling was conducted by research assistants for 12 weeks. T-test were used to answer the research questions. RESULT 1) There were no significant differences between the two groups on the level of burnout, depression, life satisfaction, and perceived physical health after telephone counseling. 2) Spouse caregivers under the telephone counseling tended to report higher perceived physical health than comparison group at the post-test (t=-1.88, p=.08). Spouse caregivers under the telephone counseling tended to report higher emotional exhaustion and lower feeling of self achievement. 3) Daughter-in-law caregivers under telephone counseling showed increased feeling of self achievement, improved physical health condition, and decreased depression. CONCLUSION This study showed potential effects of the problem-solving telephone counseling to improve perceived physical health and to reduce the level of burnout and depression. The findings suggest the necessity of screening most vulnerable subgroups of caregivers to increase the effectiveness of nursing intervention such as telephone counseling.
The purpose of this research was to examine the effect of support group intervention on the various adaptations of primary family caregivers caring for Cerebro-Vascular Accident patients. The nonequivalent control group pretest- posttest design within the framework of Lazarus & Folkman's stress-adaptation model was used for this experimental study. The subjects were 86 primary family caregivers caring for Cerebro-Vascular Accident patients at K hospital in Taegu, D herbal hospital in Kyung Ju, H hospital in Pohang from March, 1998 to July, 1998. Among 86 subjects, 43 were placed in an experimental group and 43 in a control group. The experimental group was treated by researcher who administered informational and emotional support group intervention once a week over a five weeks period. The data were collected through interviews. Collected data was analized by means of a chi-square test, t-test, ANCOVA, and Pearson correlation coefficient. The results of this research were as follows: 1. Physical, emotional, and social adaptation scores in the experimental group were revealed to be significantly higher than those of the control group. 2. There was significant positive correlation among physical health, subjective burden, depression and objective burden. Accordingly, it is concluded that informational and emotional support group intervention was a useful nursing intervention on the various adaptations of primary family caregivers caring for Cerebro-Vascular Accident patients.
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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