PURPOSE
This study was to test a theoretical model examining the relationships among social support, illness demands, marital adjustment, family coping and family functioning in couples more than three years after breast cancer diagnosis.
METHODS
A causal modeling methodology was used to test the specified relationships in the recursive theoretical model. A total of 60 couples with breast cancer were recruited from January to April 2005. Five standardized questionnaires were used to measure the theoretical concepts: social support (ISSB), illness demands (DOII), marital adjustment (DAS), family coping (F-COPES), and family functioning (FACESII).
RESULTS
Path analysis results from the wives and the husbands revealed different patterns. Three hypotheses were supported in the wife model as predicted: social support and family coping, family coping and family functioning, and social support and marital adjustment (trend). Five hypotheses were supported in the husband model as predicted: social support and illness demands, also social support and marital adjustment, illness demands and marital adjustment, marital adjustment and family coping, and family coping and family functioning.
CONCLUSION
This study provides valuable information for developing various interventions with social support for improving family functioning of breast cancer couples in the middle adaption stage (more than three years after diagnosis).

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.

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.

The purpose of this study was : 1) to develop and test a theoretical model examining relationships among social support( and social network size ), illness demands, marital adjustment, family coping, and an outcome measure of family functioning in response to a mother's breast cancer in the early postdiagnostic phase ; 2) to investigate the sources of functional social support : and 3) to assess characteristics of social support networks for Korean families with breast cancer. This study used a cross-sectional, correlational design with a causal modeling methodology to test the specified relationships in the recursive theoretical model. the convenience sample of this study consisted of 82 married Korean couples with recently diagnosed breast cancer in the child-rearing mother. Six standardized questionnaires were used to measure the theoretical concepts : social support (ISSB), social network(ASSIS), illness demands(DOII), marital adjustment(DAS), family coping(F-COPES), and family functioning(FACESII). The theoretical model was tested on the aggregated couples' data( family data ) and on mothers and fathers data. Path analysis results from the mothers and the fathers revealed different patterns. A core set of predictive variables were identified with three data sets showing consistent effects on family functioning level-marital adjustment and family coping, marital adjustment and family functioning, and family coping and family functioning. Namely, the level of family functioning was directly and positively affected by family coping behavior and the level of marital adjustment ; the level of marital adjustment had a direct positive effect on family coping behavior. In two reduced models from couples' and mothers' data, three sets of predicted relationships were supported, social support and marital adjustment, and s and marital adjustment. The level of social support received had a direct positive effect on both the level of marital adjustment and family coping behavior, and the experienced illness demands had a direct negative effect on the level of marital adjustment. Few significant gender differences were found in terms of 1) actual and perceived network sizes, need for support, and satisfaction with the support received for each type of functional social support, 20 total network size encompassing all types of functional social support, as well as, 3) the amount of functional social support received. These findings may prove useful for health care professionals working with Korean families with breast cancer or other chronic illness.

The purpose of this study was to provide basic informations for developing family-focused nursing interventions for families with chronic illness. the results of this study were as follows. In family caregiver systems, spouses of chronically ill patients showed higher anxiety scores9t=4.71, P=.000) and higher scores of the perceived importance of family functioning(t=3.67, P=.000) than those of children of chronically ill patients. But spouses showed lower scores of the satisfaction of family functioning (t=2.92, P=.005) than those of children of chronically ill patients. For spouses of chronically ill patients, the correlation between the satisfaction of family functioning and anxiety turned out to be significant9r=-.518, P=.001). However for children the correlation between them was not statistically significant. Findings of this study suggest that families with chronic illness need family-focused nursing interventions to relieve their anxiety and to improve family functioning. In conclusion, the investigation about family functioning and anxiety provides useful information for family-focused nursing care, especially for spouses of chronically ill patients. This information will contribute to developing the support systems for family caregivers and the education programs that helps chronically ill patients.