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Factors Influencing Caregiver Reaction among Family Caregivers for Persons with Cancer

암환자 가족원의 건강정보이해력과 사회적 지지가 돌봄부담에 미치는 영향

  • Received : 2018.12.27
  • Accepted : 2019.03.20
  • Published : 2019.03.28

Abstract

The purpose of this study was to identify factors influencing family caregivers' reaction of persons with cancer. The study participants were 130 cancer patients and their family caregivers. Data on participant characteristics, caregiver reaction, perceived social support, and cancer related health literacy were collected from July 17 to November 7, 2018 using a structured questionnaire. Data were analyzed with the SPSS/WIN 23.0 program for descriptive statistics, using independent t-test, one-way analysis of variance, Pearson's correlation coefficient and enter multiple regression analysis. The determining factors affecting caregivers' reaction were in case of spouse of patient(${\beta}=.252$, p=.002), subjective health status(${\beta}=-.207$ p=.012), and health literacy (self-care, patient's needs and preference) (${\beta}=-.411$, p<.001; ${\beta}=.247$, p=.037 respectively), and their explanation power was about 37.9%. This finding underscores the need for developing and application of the individualized education program with health literacy improvement strategies for family caregivers of cancer patients.

본 연구는 암환자를 돌보는 가족원이 인식하는 암 관련 건강정보이해력과 사회적 지지가 돌봄부담에 미치는 영향을 파악하기 위한 서술적 상관관계 연구이다. 경상남도 J시 G대학교병원에 입원했거나 외래 방문한 암환자를 돌보는 가족원 130명을 대상으로 하여 2018년 7월 17일부터 11월 7일까지 구조화된 설문지를 사용하여 자료수집 후 SPSS/WIN 23.0으로 통계 분석하였다. 회귀분석 결과, 암환자를 돌보는 가족원이 환자의 배우자이면서(${\beta}=.252$, p=.002) 주관적 건강상태(${\beta}=-.207$ p=.012)와 자가간호 건강정보이해력이 낮을수록(${\beta}=-.411$, p<.001), 환자의 요구도와 선호도(${\beta}=.268$, p=.042) 및 의료인과의 적극적 관계에 대한 건강정보이해력(${\beta}=.247$, p=.037)이 높을수록 돌봄부담이 높은 것으로 파악되었으며, 37.9%의 설명력이 있는 것으로 나타났다(F=5.922, p<.001). 본 연구를 통해 암환자 가족의 돌봄부담에 주관적 건강상태와 건강정보이해력이 영향을 미침을 알 수 있었다. 따라서 암환자 가족원의 돌봄부담을 감소시키기 위해서 그들의 건강정보이해력을 향상 시킬 수 있는 개별화된 교육프로그램을 개발하여 적용하는 연구를 제언한다.

Keywords

Table 1. Difference in Perceived Health Status, Health Literacy, Social Support and Caregiver Reaction according to General Characteristics

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Table 2. Differences in Perceived Health Status, Health Literacy, Social Support and Caregiver Reaction according to Patient Characteristics

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Table 3. Differences in Perceived Health Status, Health Literacy, Social Support and Caregiver Reaction according to Patient Characteristics

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Table 4. Correlation among Health Status, Health Literacy, Social Support and Caregiver Reaction

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Table 5. Factors Affecting Caregiver Reaction of the Family Caregivers for Persons with Cancer

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References

  1. Korean Statistical Information Service. (2016). Cancer statistics. Statistics Korea. http://kosis.kr/statisticsList/statisticsList_01List.jsp?vwcd=MT_ZTITLE&parentId=D#SubContont
  2. National Cancer Information Center. (2017). 5 year relative survival rate. https://www.cancer.go.kr/lay1/S1T648C650/contents.do
  3. K. E. Lee & Y. G. Son. (2016). Research Trends of Quality of Life after Gastrectomy among Gastric Cancer Patients in Korea. Asian Oncology Nursing, 16(2), 55-66. DOI: 10.5388/aon.2016.16.2.59
  4. Q. P. Li, Y. W. Mak & A. Y. Loke. (2013). Spouses' experience of caregiving for cancer patients: a literature review. International Nursing Review, 60(2), 178-187. DOI: 10.1111/inr.12000
  5. Y. S. Choi, J. H. Bae, N. H. Kim & Y. S. Tae. (2016). Factors Influencing Burden among Family Caregivers of Elderly Cancer Patients. Asian Oncology Nursing, 16(1), 20-29. DOI: 10.5388/aon.2016.16.1.20
  6. E. Y. Yang & Y. A. Kim. (2015). Burden and Quality of Life in Terminal Cancer Patient's Family Caregivers in the area of Jellanam-do. Journal of the Korea Academia-Industrial, 16(6), 3954-3962. DOI: 10.5762/KAIS.2015.16.6.3954
  7. Y. S. Lee. (2009). A study of effect on quality of life of cancer patient's caregiver: focusing on the mediating effect of feeling of burden and growth. Korean Journal of Social Welfare, 61(2), 325-348. https://doi.org/10.20970/kasw.2009.61.2.013
  8. Y. M. Kim, C. S. Carver, K. M. Shaffer, T. Gansler & R. S. Cannady. (2015). Cancer caregiving predicts physical impairments: roles of earlier caregiving stress and being a spousal caregiver. Cancer, 121(2), 302-310. DOI: 10.1002/cncr.29040
  9. D. Y. Yang, H. L. Kim, E. S. Kang, D. E. Kim, E. Y. Bae & J. H. Kim. (2017). Pattern and determinants of catastrophic health expenditure in the households with cancer patients. The Korean Journal of Health Economics and Policy, 23(1), 53-70.
  10. M. J. Hong, Y. S. Tae & M. Y. Noh. (2012). Relationships between Stress, Ways of Coping and Burnout of Family Caregivers of Cancer Patients. Asian Oncology Nursing, 12(1), 92-99. DOI: 10.5388/aon.2012.12.1.92
  11. H. Ishikawa, T. Takeuchi & E. Yano. (2008). Measuring functional, communicative, and critical health literacy among diabetic patients. Diabetes Care, 31(5), 874-879. DOI: 10.2377/dc07-1932
  12. Office of Disease Prevention and Health Promotion. (2018). Healthy People 2020 Consortium. https://www.healthypeople.gov/
  13. E. Yeun et al. (2018). Measuring cancer caregiver health literacy: Validation of the Health Literacy of Caregivers Scale-Cancer (HLCS-C) in an Australian population. Health & Social Care in the Community, 26(3), 330-344. DOI: 10.1111/hsc.12524
  14. T. T. A. Ranhman. (2014). Health literacy: prevalence among elderly care givers and its impact on the frequency of elderly hospitalization and elderly health related quality of life. Advances in Aging Research, 3(5), 380-387. DOI: 10.4236/aar.2014.35048
  15. E. Y. Yeun, T. Knight, L. A. Ricciardelli & S. Burney. (2018). Health literacy of caregivers of adult care recipients: A systematic scoping review. Health & Social Care in the Community, 26(2), 191-206. DOI: 10.1111/hsc.12368
  16. Y. Tang. (2008). Social support of elderly caregivers. International Journa of Business and Management, 3(8), 81-84. DOI: 10.5539/ijbm.v3n8p81
  17. E. Noohi, H. Peyrovi, Z. I. Goghary & M. Kazemi. (2016). Perception of social support among family caregivers of vegetative patients: A qulitative study. Consciousness and Cognition, 41, 150-158. DOI: 10.1016/j.concog.2016.02.015
  18. K. L. Siedlecki, T. A. Salthouse, S. Oishi & S. Jeswani. (2014). The relationship between social support and subjective well-being across age. Social indicators research, 117(2), 561-576. DOI: 10.1007/s11205-013-0361-4
  19. I, J. Lee & M. Y. Kim. (2012). The moderating effects of social support on the relationship between care burden and marital adjustment in cancer patients' spouse. Korean Journal of Social Welfare studies, 43(3), 125-150. https://doi.org/10.16999/kasws.2012.43.3.125
  20. C. C. Hendrix et al. (2016). Effects of enhanced caregiver training program on cancer caregiver's self-efficacy, preparedness, and psychological well-being. Supportive Care in Cancer, 24(1), 327-336. DOI: 10.1007/s00520-015-2797-3
  21. Z. K. Nejad, A. M. Adhdam, H. Hassankhani & Z. Sanaat. (2016). The effects of patient-caregiver education and follow-up program on the breast cancer caregiver strain index. Iranian Red Crescent Medical Journal, 18(3), e21627. DOI: 10.5812/ircmj.21627
  22. F. Faul, E. Erdfelder, A. Buchner & A. G. Lang. (2009). Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149-1160. DOI: 10.3578/brm.41.4.1149
  23. Korea Labor Institute. (2008). https://www.kli.re.kr/kli/index.do
  24. C. Walts, O. L. Strickland & E. Lenz. (2010). Measurement in nursing and health research. New York : Springer Publishing Company.
  25. G. D. Zimet, N. W. Dahlem, S. G. Zimet & G. K. Farley. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52(1), 30-41. DOI: 10.1207/s15327752jpa5201_2
  26. Y. S. Lee. (2009). A Study of Effect on Quality of life of Cancer patient's Caregiver: Focusing on the Mediating effect of Feeling of burden and Growth. Doctoral dissertation, Ewha Women University, Seoul.
  27. B. A. Given, C. W. Given & S. Kozachik. (2010). Family support in advanced cancer. CA: a Cancer Journal for Clinicians, 51(4), 213-231. DOI: 10.3322/canjclin.51.4.213
  28. Y. S. Rhee, I. Y. Han, I. J. Lee & E. J. Nam. (2009). Cross Cultural Validation of the Caregiver Reaction Assessment (CRA) for Cancer Patient's Caregiver. Korean Journal of Health Promotion and Diseases Prevention, 29(3), 189-198.
  29. J. Y. Tan, A. Molassiotis, M. Lloyd-Williams & J. Yorke. (2018). Burden, emotional distress and quality of life among informal caregivers of lung cancer patients: An exploratory study. European Journal of Cancer Care, 27(1), e12691. DOI : 10.1111/ecc.12691
  30. J. Y. Lee, H. K. Chang. (2018). Factors influencing family caregivers' self-management of acute stroke survivors. Korean Journal of Adult Nursing, 30(6), 669-380. DOI: 10.7475/kjan.2018.30.6.669
  31. J. K. Monin, B. Levy, M. Doyle, R. Schulz & T. Kershaw. (2017). The impact of both spousal caregivers' and care recipients' health on relationship satisfaction in the caregiver health effects study. Journal of Health Psychology, 1359105317699682. DOI : 10.1177/1359105317699682
  32. I. Abdollahpour, S. Nedjat, M. Noroozian, Y. Salimi & Majdzadeh, R. (2014). Caregiver burden: the strongest predictor of self-rated health in caregivers of patients with dementia. Journal of Geriatric Psychiatry and Neurology, 27(3), 172-180. DOI : 10.1177/0891988714524627
  33. Y. KIM & R. Schulz. (2008). Family caregivers' strains: comparative analysis of cancer caregiving with dementia, diabetes, and frail elderly caregiving. Journal of Aging and Health, 20(5), 483-503. DOI : 10.1177/0898264308317533
  34. Asian Oncology Nursing. (2018). Oncology Nursing: Treatment and Care 3rd education. Seoul: Fornurse
  35. K. Milbury, H. Badr, F. Fossella, K. M. Pisters & C. L. Carmack. (2013). Longitudinal associations between caregiver burden and patient and spouse distress in couples coping with lung cancer. Supportive Care in Cancer, 21(9), 2371-2379. DOI : 10.1007/s00520-013-1795-6S.
  36. S. J. Kang, T. W. Lee, G. S. Kim & J. H. Lee. (2012). The levels of health literacy and related factors among middle-aged adults in Seoul, Korea. Korean Journal of Health Education and Promotion, 29(3), 75-89.
  37. C. H. Grcia, S. E. Espinoza, M. Lichtenstein & H. P. Hazuda. (2013). Health literacy associations between Hispanic elderly patients and their caregivers. Journal of health communication, 18(sup1), 256-272. DOI :10.1080/10810730.2013.829135
  38. E. Y. Yuen, T. Knight, S. Dodson, L. Ricciardelli, S. Burney & P. M. Livingston. (2014). Development of the Health Literacy of Caregivers Scale-Cancer (HLCS-C): item generation and content validity testing. BMC Family Practice, 15(1), 202. DOI : 10.1186/s12875-014-0202-9
  39. E. Y. Choi et al. (2017). The Relationship between Health Literacy and Mental Health of Older Adults: Focusing on the Moderating Effect of Social Support. Korean Journal of Gerontological Social, 72(3), 251-282.
  40. D. Demirtepe-Saygili & O. Bozo. (2011). Perceived social support as a moderator of the relationship between caregiver well-being indicators and psychological symptoms. Journal of Health Psychology, 16(7), 1091-1100. DOI : 10.1177/1359105311399486
  41. M. P. Jensen, A. E. Smith, C. H. Bombardier, K. M. Yorkston, J. Miro & I. R. Molton. (2014). Social support, depression, and physical disability: age and diagnostic group effects. Disability and Health Journal, 7(2), 164-172. DOI : 10.1016/j.dhjo.2013.11.001
  42. K. H. Kim & Y. S. Shin. (2017). The Effect of Caregiver Reaction on Psychological Well-being among Family Caregivers of Cancer Patients. Korean Journal of Adult Nursing, 29(6), 647-656. https://doi.org/10.7475/kjan.2017.29.6.647
  43. J. H. Kim. (2018). Meta analysis of the correlation between health literacy and health related variables. Korean Journal of Health Education and Promotion, 35(1), 101-113. https://doi.org/10.14367/kjhep.2018.35.1.101
  44. H. Shim, Y. J. Kim & M. J. Park. (2016). Differences on satisfaction of healthcare applications by smartphone users's characteristics. Journal of the Korea Academia-Industrial, 17(7), 410-419.
  45. S. H. Kim. (2010). Older adults' self-reported difficulty in understanding and utilizing health information. Journal of the Korean Gerontological Society, 30(4), 1281-1292.
  46. M. K. Hyde et al. (2018). Predictors of long-term distress in female partners of men diagnosed with prostate cancer. Psycho-oncology, 27(3), 946-954. DOI : 10/1002/pon34617 https://doi.org/10.1002/pon.4617
  47. W. Duggleby, H. Doell. D. Cooper, R. Thomas & S. Ghosh. (2014). The quality of life of male spouses of women with breast cancer: Hope. self-efficacy, and perceptions of guilt. Cancer Nursing, 37, E28-E35. DOI : 10.1097/NCC.0b13e318027ca807
  48. I. J. Lee. (2018). Predictors on the Health-Related Quality of Life in Families with Cancer Survivor: Focusing on the Comparison with Families of Cancer Patient Receiving Treatment. Journal of the Korea Convergence Society, 9(11), 443-454. DOI : 10.15207/JKCS.2018.9.211.443
  49. J. Ploeg et al. (2017). Managing multiple chronic conditions in the community: a Canadian qualitative study of the experiences of older adults, family caregivers and healthcare providers. BMC Geriatrics, 17(1), 40. DOI : 10.1186/s12877-017-0431-6
  50. B. Xie, Z. Su, Y. Liu, M. Wang & M. Zhang. (2015). Health information wanted and obtained from doctors/nurses: a comparison of Chinese cancer patients and family caregivers. Suppotive Care in Cancer, 23(10), 2873-2880. DOI : 10.1007/s00520-015-2651-7
  51. J. N. Dionne-Odom et al.' (2017). The self-care practices of family caregivers of persons with poor prognosis cancer: differences by varying levels of caregiver well-being and preparedness. Supportive Care in Cancer, 25(8), 2437-2444. DOI : 10.1007/s00520-017-3650-7