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사회가 복잡해짐에 따라 각종 사고 등으로 인하여 뇌?척수손상환자를 포함한 만성질환자가 날로 증가하는 추세에 있다. 뇌?척수손상환자는 인지나 활동의 장애가 있으므로 환자를 돌보는 가족 누군가가 필요하다. 따라서 뇌?척수손상 환자와 같은 만성질환자를 돌보는 가족은 많은 문제를 경험하며 그 대표적인 현상이 부담감이다. 부담감의 축적은 질적인 삶을 저해하므로 간호사는 부담감을 줄여주는 간호전략을 개발하여 가족의 안녕한 삶을 도와줘야 한다. 건강에 유용한 개념인 사회적 지지가 부담감을 감소시키는 유용한 방법으로 권장된다. 부담감과 같은 주관적이고 심리저긴 문제해결은 사회적지지 중에서도 특히 전문가가 촉진하거나 동료들 중심의 모임을 통한 그룹지지가 효과적이다.
The number of chronically disabled people has increased with the increase in traffic and other accidents in today´s complicated social life. Patients who are chronically disabled are dependent on family primary caregivers over a long term. Thus, the family carries substantial burden and a decrease in well-being related to caring for a patient who is disabled. But this problem is generally not noticed in our society because it is taken for granted that family members will care for chronically ill patients. A major part of the nurse´s role should be helping these caregivers develop nursing interventions which would minimize their burden.
Social support is widely posited as a valuable resource for individual well-being. An important and useful method to reduce the burden of the caregiver is social support, especially group social support. Thus social support groups are being used with increasing frequency to help caregivers cope with the burden of caregiving.
This study design was a pre-post test pre-experimental design for the purpose of testing the effect of a caregiver social support group on the burden and quality of life of family primary caregivers of patients with brain and spinal cord injuries.
The caregiver social support group as the experimental treatment was carried out with five subgroups over a five week period. Each subgroup consisted of 8-10 primary caregiver members which met as a social support group, weekly, for one and half hour
over the five week period. Caregiver social support was initiated by the researcher and led by a peer member.
The theoretical framework for this study was derived from the family stress theory by McCubbin and McCubbin(1987) and the main effect model of social support theory.
The sample consisted of 44 family members who were identified as the family primary caregivers for the patients with brain and spinal cord injuries. The period of data collection was from June 1, 1992 to August 28, 1992.
Data of pretest and posttest were collected through an interview using a structured questionnaire. The instruments used in this study were Burden Scale, Quality of life Scale, NSSQ, Moiale Scale, Symptom Checklist-48 Family APGAR, and the Family Perception Scale about patients.
The collected data were analyzed using paired t-test, multiple regression, Kruskal-Wallis one way ANOVA, and process and content analysis.
The results are as follows
1. Hypothesis 1 ; "There will be a difference in burden between the time before and after participation in a caregiver social support group" was supported (t=5.76, P<.001).
2. Hypothesis 2 ; "There will be a difference in quality of life between the time before and after participation in a caregiver social support group" was supported (t= -4.83, P<.001).
3. The predictive variables for burden were the scores for the scores for the SCL-48, and the family APGAR, and for quality of life were the family APGAR, the primary caregiver´s degree of difficulty in caring, and the primary caregiver´s educational level.
4. There was no difference for burden or quality of life for the demographic characteristics of the primary caregivers or of the patients with brain and spinal cord injuries.
5. The relationship between burden and quality of life was found to be a moderately negative correlation that was statistically significant(r=-.44, P<.01).
In conclusion, it was found that the caregiver social support group was an effective nursing intervention for reducing primary caregiver burden and for the improvement of quality for the primary caregiver.
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