KR20130049280A - Depression and its related factors among the family caregivers of the hospitalized stroke patients for rehabilitation therapy - Google Patents
Depression and its related factors among the family caregivers of the hospitalized stroke patients for rehabilitation therapy Download PDFInfo
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Abstract
The purpose of this study was to evaluate the depressive-related factors of the caregivers of stroke patients who were admitted to two general hospitals and four hospitals in Gwangju from October 26 to November 7, 2009. The survey was conducted with 175 family carers. Data collection was performed using a self-filled questionnaire.The survey contents were general characteristics of family caregivers, health-related characteristics of family caregivers, general characteristics related to patient care, general characteristics of patients, patients' daily living ability, The degree of burden and the caregiver's depression were examined, and t-test, analysis of variance, correlation analysis and stepwise multiple regression analysis were used to determine the caregiver's depression.
The research results are as follows.
1. The subjects were 68% of women and the mean age was 48.8 4.0 years. The average depression score of family caregivers was 18.58 / 1.25, and the degree of depression was mild 16.0%, moderate 28.6%, and severe 29.7%. Depression based on 10 points or more was 74.3%.
2. In the simple analysis, variables related to depression scores were age, marital status, relationship with patients, education, monthly income, subjective health status, frequency of visits by family and friends, intimacy with patients, and whether they were altered. The gender of patients was statistically significant in relation to depression score according to the characteristics of. As a result of analyzing the correlation between depressive scores and various variables of the patient caregivers, total burden of burden and daily living ability of the patients.
3. As a result of the stepwise multiple regression analysis, the relevant variables among the family caregivers' depression scores are less than 1 million won compared to the age and income level of family caregivers. Compared to more than one time, less than once a month or almost no, there was a burden score.
A prospective study aimed at finding out the variables that affect family caregivers' depression during nursing care in hospitals in the future, and prevents the onset of caregivers' mental illnesses and mitigates many factors affecting caregivers' depression. I think we need to come up with a way.
Description
The purpose of this study was to evaluate the depressive-related factors of the caregivers of stroke patients who were admitted to two general hospitals and four hospitals in Gwangju from October 26 to November 7, 2009. The survey was conducted with 175 family carers. Data collection was performed using a self-filled questionnaire.The survey contents were general characteristics of family caregivers, health-related characteristics of family caregivers, general characteristics related to patient care, general characteristics of patients, patients' daily living ability, The degree of burden and the caregiver's depression were examined, and t-test, analysis of variance, correlation analysis and stepwise multiple regression analysis were used to determine the caregiver's depression.
Stroke is a general term for diseases and accidents caused by cerebrovascular disorders, which cause sudden neurological deficits due to circulatory disorders in the cerebrovascular system, commonly referred to as stroke, and have a high mortality rate and damage caused by cerebrovascular dementia It is a serious disease with impaired cognitive function (Kim Byung-eun and Lee Hyang-yeon, 1990). About 25% of strokes die within one month of onset, and 75% of the survivors remain hemiplegic or permanently severe sequelae such as motor, cognitive, speech, and emotional disorders, depending on where the stroke occurs ( So-sun Kim, 1992). Many surviving stroke patients have permanent disabilities, and hemiplegic patients with stroke have difficulty living independently, such as eating, hygiene, and getting dressed and taken off, causing disabilities that require long-term care. It is necessary to continue the help of Lee (Lee Kang and Song Ae. 1996). The family caregivers who support and assist the living of these stroke patients are more burdened with life than the average person.
When someone in the family has a serious illness, the family member experiences organic symptoms such as insomnia, decreased appetite, weight loss, anxiety, decreased concentration, and depression (Kim, 1985). Caregivers with family members of severe illnesses, such as stroke, feel psychological threats or tensions due to stress and pressure (King & Gregor, 1985).
Family caregivers take care of long-term care for stroke patients and take care of their responsibilities as caregivers, taking into account rehabilitation and emotional changes after the onset of stroke. Caregivers also need to adapt to their physical and mental disorders. As the responsibility increases, the burden increases and the stress and depression increase. Prior studies have shown that most patients continue to recover physically for almost a year, but 28% of families with stroke suffer worsening in two years of care, and 12% are treated with anxiety, stress and depression. On the contrary, the function of the family, such as receiving, reported to deteriorate for several years (Park, Young-Ran, 2000).
Compared to the caregiver of the home patient, the caregiver of a patient who is hospitalized is exposed to various health and life threats, such as sudden changes in the environment in which the patient must live in the hospital, economic problems such as discontinuing hospital expenses and economic activities, and limited social activities. It is believed that the health status of the hospital caregiver is more likely to worsen.
According to previous studies, caregivers and emotional support of caregivers are very important factors for the recovery and rehabilitation of stroke patients who experience feelings such as anxiety, depression, anger, and shame due to impaired psychological function (Cho Sung-Hee, 1990). In this process, when treating stroke patients in hospitals, it would be useful to care about the health of the caregiver as well as the patient's health.
Depression is generally conceptualized as mood and depression, and is a useful indicator of psychological well-being and mental health. According to the Psychiatric Dictionary (1999), depression refers to feelings of sadness, despair, and depression. Depression is a syndrome that consists of symptoms that occur in various mental or physical disorders, or that may be incidental to those disorders. As a result, accidents are slowed, physical activity is reduced, guilt and despair are lost, and eating and sleeping disorders are common. Therefore, depression is one of the various emotions that humans have, and depression can be regarded as having a continuous characteristic ranging from the normal category experienced to the abnormal category requiring the help of psychotherapy. In addition, it can be understood as a concept that encompasses not only emotional aspects such as helplessness, frustration, loss, etc., but also physical symptoms such as loss of appetite, insomnia, fatigue, and weight loss (Kim, Kyung-Shin, Kim, Kyung-Ran 2002). Depression is also described as an emotional disorder in cognitive terms (Beck, 1979). Studies on the caregivers of stroke patients have shown that the burden and depression of caregivers at home is much higher, Few studies have been conducted with family carers of hospitalized patients.
Identify the level of depression experienced by family caregivers of stroke patients admitted to the hospital and identify the relationship between various factors experienced by caregivers and depression
The questionnaire consisted of the general characteristics of the family carer (gender, age, relationship with the patient, marital status, religion, education, occupation, and monthly income), the health status and health-related behaviors of the family carer (subjective health status, smoking). Status, drinking status, exercise, body type), characteristics related to the patient's care (number of visits by other family members, hospitalization fee, patient's prognosis, degree of intimacy with the patient, whether caregiving, nursing education, nursing period), It was composed of the tools to measure general characteristics of patients (gender, marital status, education, occupation, medical security), daily living ability of patients, burden and depression of caregivers.
The patient's ability to perform daily life was measured by using a tool consisting of a three-point scale with 10 items developed by Yang Young-hee (1992) modified by the Barthel index (1965). Two points were awarded for help and three points for full help. The higher the total score, the greater the dependence on everyday life. The reliability at the time of development was Cronbach's alpha = .95, and in this study, Cronbach's alpha = .918.
The burden of caregivers was developed by Zarit, Reever (1980), Montgomery, Gonyea (1985), and Novak & Guest (1989), translated, corrected and supplemented by Seo Mi-hye and Ogasil (1993). A total of 20 questions in 5 areas were used, divided into 4 items in physical area, 4 in social area, and 7 in emotional area. The responses to each question consisted of the Likert 5-point scale, which is not at all 1 to 5, and the higher the score, the greater the burden. The reliability in this study was Cronbach's alpha = .926.
The depression of caregivers of stroke patients was based on the Beck Depression Inventory (BDI) developed by Beck (1961) and by Lee Young-ho and Song Jong-yong (1991). The White Depression Scale is one of the most widely used assessment methods for depression evaluation and reported to have an excellent and similar effect on screening depression (Nielsen, Williams, 1980). The questionnaire was composed of 21 questions, and the responses to the questions were measured in four stages and were selected from none (0 points) to very severe (3 points). Depression scores range from a minimum of 0 to a maximum of 63, with higher scores indicating higher depression. The scores of 0-9 were not depressed, 10-15 were mild depressed, 16-23 were severe depressed, and 24-63 were severe depressed (Lee Young-ho and Song Jong-yong, 1991). The reliability of the tool in this study was Cronbach's alpha = .917.
As a result of the caregiver's depression, the caregiver's age was significantly related to the degree of depression. Depression score increased with age, and depression score was the highest in the group over 60 years old. Multiple regression analysis also showed that depression scores increased with age. There was also a difference in the degree of depression in education, and the higher the educational level, the lower the score of depression. The higher the level of education, the more realistic the reactions are and the more appropriate the emotions are, the more adaptable the situation is (Synder and Wilson, 1977). Myers et al. (1975) also found that the higher the level of education, the better ways to cope with depression, ask for help from experts, and know more about yourself. Insisted that they act to protect themselves.
In this study, the monthly income was statistically significant in the depression score, and as the monthly income increased, the depression score decreased. The depression score was the highest when the monthly income was less than 1 million won than the monthly income of over 3 million won, which may be due to the heavy burden of hospital expenses and the burden of the home economy. The health status perceived by the caregiver was 49.7%, and the respondents showed statistically significant depression. The regression analysis showed that the caregiver was associated with the depressive score. This was similar to the results of Jeong Ok-bun (2004) and Yang Soo-hyang (2003), and caring for others in a state in which they do not feel healthy acts as a stress and burden (Clipp, Geroge, 1990). Many are expected to have difficulty in caring for patients.
The depression score (30.67) was the highest and statistically significant when there were few family visits among patients related to nursing care. Multiple regression analysis showed that the number of visits by the family was less than once or a month, compared to three or more times a week. It was significantly higher when there was almost no. This is consistent with the findings of Yang Mi-Kyung (2006), and it seems that the number of visits appropriate for the patient and the caregiver is emotional support, which has a positive effect on the caregiver's depression, indicating that they are not alienated from other family members. Intimacy with the patients affected the depression scores. The depression score was highest when the relationship with the patients was normal.
Burden total score was also related to depression score, and the regression analysis showed significant results. The higher the burden, the higher the depression score. This is in line with the results of Lee Kwan-hee (1985) and Park Sung-ha (2002), who studied the relationship between the burden and depression of family members with brain injury.The reason why the burden greatly affects the depression score is that the greater the burden, the more patients are required by their parents. As the role and dependence increase, the role increases and the work to be done increases the stress and the depression score increases.
The research results are as follows.
A prospective study aimed at finding out the variables that affect family caregivers' depression during nursing care in hospitals in the future, and prevents the onset of caregivers' mental illness and alleviates a number of factors affecting caregivers' depression. I think we need to come up with a way.
1) General Characteristics of Family Caregivers
Of the 175 family carers who had strokes, 32% were male and 68% were female. The age of the family carers was 50.59 years old, 27.4%, 60 years or older, and 26.9%. The average age (standard deviation) of family carers was 48.8. (14.0) years old. The relationship with patients was 52.0% of spouses and 33.1% of children, and 78.3% were married. The degree of education of guardians was 41.1% for high school graduates and 29.1% for college graduates and 70.9% of job guardians. The monthly income was 36.6% for less than one million won and 34.3% for one million won or nine million won.
2) Family Caregivers' Health-Related Characteristics
The subjective health status of stroke family caregivers was usually 49.7%, and caregivers feeling good was 49.7%. Smoking status was 73.7% non-smoking, alcohol consumption was 37.1%, current and past drinking was 32.0% and 30.9%, respectively. Respondents who did not exercise were 73.7% and their body type was normal. Was 52.6%.
3) characteristics related to the care of the patient
The number of visits by family and friends during the nursing of patients was 30.9%, 1 ~ 2 times a week and 1-3 times a month, and 35.4% of the guardians said that the hospitalization fee was solved by the property they had or the money they had saved. 23.4% of the respondents said that they could solve this problem with their help. The expected prognosis at the time of discharge from the patient was slightly improved, but 69.1% of the respondents said they would have sequelae, 23.4% said they would get worse, 69.7% said they had good intimacy with the patient, 24%. In the case of caring, 67.4% of the employees were shifted, and the duration of caring was 33.1% for 3 months to less than 1 year, 25.1% for less than 1 year to 2 years. Appeared. The burden of the caregivers was emotional burden (average 21.22 .02, economic burden 7.43.08, physical burden 10.36, 88, social burden 15.33 .49, dependent burden 13.4.34) The combined burden score was 67.15 5.4 points.
4) general characteristics of stroke patients
The mean age (standard deviation) of 175 stroke patients admitted to the hospital was 58.8 (12.3) years, and 58.3% were male and 41.7% female, 86.3% married, 35.4% married, and 26.3% middle school. 70.9% of the patients were occupational and 28% were unemployed. The types of medical insurance were 50.3% for medical insurance patients and 32% for medical care patients. Daily living performance was 24.5 (5.1) points on average (standard deviation).
5) Depression of Family Caregivers
The mean (standard deviation) depression score of the caregivers of stroke patients was 18.58 / 1.25, and the degree of depression was 25.7% normal, mild depression 16.0%, moderate depression 28.6%, severe depression 29.7%, and depressed 74.3. It was%.
2. Relationship between Characteristics of Family Caregivers and Depression
1) Relationship between general characteristics of family caregivers and depression
As a result of comparing depressive scores according to general characteristics of caregivers, they were statistically significant in age, marital status, relationship with patients, education, and monthly income. Depression scores were 15.40 / 0.13 when the age was under 40-49 years, 20.69 / 1.26 when the age was under 50-59, and 23.21 / 2.13 when the age was over 60. There was a statistically significant difference in depression scores by age.
In marital status, the depression score was 19.58 / 1.43 when married, and the depression score was 14.97 / .87 when unmarried. The depression score was highest when the caregiver was the parent of the patient. The average depression score was 25.45 / 1.67 The mean depression score was 21.45 / 1.70 when the guardian was the spouse of the patient. The average depression score was 28.27 / 3.15 for elementary school graduates, 22.07 / 1.12 for middle school graduates, 18.04 / 1.02 for high school graduates, and 14.43 / .26 for college graduates. The depression score was 23.16 / 2.01 when the monthly income was less than 1 million won, and 18.23 / .90 when the price was 100-199 million, 14.07 / .38 when the price was 200-299 million, and 11.95 / .54 when the price was over 3 million won. The higher the score, the lower the score.
2) Relationship with Depression Score According to Health Care Characteristics of Family Caregivers
Depression scores according to the health status and health-related characteristics of family caregivers were statistically significant only in the subjective health condition felt by the caregivers. Depression score was 20.34 / 0.62 for 15.08 / 1.92 points for those who felt good for their health and 20.34 / 0.62 for feeling normal. Depression score was 21.70 / .70 for bad feelings. The smoking status, drinking status, exercise status, and body type perceived by the person were not statistically significant, but the depressed score was 19.47 / 1.38 when the guardian exercised, and 16.07 / 0.58 score when not exercising. The score was higher. The depressive score was 20.18 / 3.06 when the guardian's body was thin, and the depressive score was higher when the guardian's body was thin.
3) Relationship between patient care and depression
Depression scores related to patient care were statistically significant in family, friends visits, patient intimacy, and alternation, but there was no statistically significant relationship between hospitalization cost solution, patient prognosis, caring period and nursing education. Depression score was 14.64 / .11 when visiting family and friends visited statistically significant more than 14.64 / .11, depression score was 15.59 1.50 when 1-2 times a week, 18.04 .91 when 1-3 times a month, 1 per month Depression scores increased as visits decreased to 23.54 / 1.31 for less than one hour and 30.67 / .87 for few visits. The depression score was 23.57 / 1.11, which was the highest when the patient's intimacy was normal. The depression score was 16.80 / 0.67, which was the lowest when the patient was intimate. The depression score was 20.27 / 1.03 when changing care and the depression score was 15.07 / 0.97 when not shifting. The highest score for depression was 22.71 / 2.61, and the highest score for depression was 19.78 / 1.56 for patients with prognosis. At 23.77 / 1.51, and below 1 year-2 years, the depression score was 20.50 / 1.90 and the depression score was less than 3 months-1 year, which was 16.00 / 0.86.
4) Relationship between depression level according to general characteristics of patients
The depression score according to the general characteristics of the patients was statistically significant. The mean score of caregivers was 21.15 / 1.23 when the patients were male, and 16.38 / 0.97 when female. The marital status, education level, job status, and medical insurance were not statistically significant, but the depression score was highest at 21.60 / 3.71 when the patient was unmarried, and the depressed score of the caregiver was 19.89 / 1.24 The degree of depression was high.
5) Correlation between depression scores and other variables
As a result of analyzing the correlation between depressive score and various variables, the burden score (r = 0.528), daily living performance (r = 0.161), and age of the caregiver (r = 0.317) were statistically significant. There was a relationship. In other words, as the burden score, daily living ability, and caregiver age increased, depression scores increased significantly.
3. Characteristics related to depressive scores of caregivers (multiple regression analysis results)
The depressive score of the guardian was the dependent variable. The multivariate regression analysis was carried out using the general and health-related characteristics of the guardian, the performance score of the patient's daily living ability, and the burden score of each burden as independent variables. In addition, multiple regression analysis using stepwise selection was performed using the variables that were statistically significant in the simple analysis.
The variables affecting the caregiver's depression score were age, income level, health status of the caregiver, the number of family visits, and the relationship and burden with the patients. The explanatory power of these variables was 42.6%. Depression scores increased with age. The depression scores were higher for those who earned less than 1 million won than for those who earned more than 3 million won. The number of visits by family was significantly higher than less than once a month or almost no visits compared to three or more times a week. Depression scores increased statistically with higher burden scores.
Claims (1)
The questionnaire consisted of the general characteristics of the family carer (gender, age, relationship with the patient, marital status, religion, education, occupation, and monthly income), the health status and health-related behaviors of the family carer (subjective health status, smoking). Status, drinking status, exercise, body type), characteristics related to the patient's care (number of visits by other family members, hospitalization fee, patient's prognosis, degree of intimacy with the patient, whether caregiving, nursing education, nursing period), It was composed of the tools to measure general characteristics of patients (gender, marital status, education, occupation, medical security), daily living ability of patients, burden and depression of caregivers.
The patient's ability to perform daily life was measured by using a tool consisting of a three-point scale with 10 items developed by Yang Young-hee (1992) modified by the Barthel index (1965). Two points were awarded for help and three points for full help.
The burden of caregivers was developed by Zarit, Reever (1980), Montgomery, Gonyea (1985), and Novak & Guest (1989), translated, corrected and supplemented by Seo Mi-hye and Ogasil (1993). A total of 20 questions in 5 areas were used, divided into 4 items in physical area, 4 in social area, and 7 in emotional area. The responses to each question consisted of the Likert 5-point scale, which was given from 1 point to 5 points, which is not so, and the higher the score, the greater the burden.
The depression of caregivers of stroke patients was based on the Beck Depression Inventory (BDI) developed by Beck (1961) and by Lee Young-ho and Song Jong-yong (1991). The White Depression Scale is one of the most widely used assessment methods for depression evaluation and reported to have an excellent and similar effect on screening depression (Nielsen, Williams, 1980). The questionnaire was composed of 21 questions, and the responses to the questions were measured in four stages and were selected from none (0 points) to very severe (3 points). Depression scores range from a minimum of 0 to a maximum of 63, with higher scores indicating higher depression. The scores of 0-9 were not depressed, 10-15 were mild depressed, 16-23 were severe depressed, and 24-63 were severe depressed (Lee Young-ho and Song Jong-yong, 1991).
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
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| KR20190046904A (en) * | 2016-09-28 | 2019-05-07 | 고에키 자이단 호징 고베 이료 산교 도시 스이신 기코 | A dementia prevention care burden determination device, a dementia care burden degree determination method, a dementia care burden degree determination program, a dementia treatment effectiveness determination device, a dementia prevention treatment effectiveness determination method, and a dementia prevention treatment effectiveness determination program |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
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| KR20190046904A (en) * | 2016-09-28 | 2019-05-07 | 고에키 자이단 호징 고베 이료 산교 도시 스이신 기코 | A dementia prevention care burden determination device, a dementia care burden degree determination method, a dementia care burden degree determination program, a dementia treatment effectiveness determination device, a dementia prevention treatment effectiveness determination method, and a dementia prevention treatment effectiveness determination program |
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