With the demanding level of care needed for people with dementia, more Korean families are institutionalizing their relatives with dementia. This presents particular concerns for the Korean culture that values family responsibility for elder care. The purpose of this study was to describe Korean family members' perceptions of stress and satisfaction with care, the caregiving role, the family-staff relations. A purposive sample of 94 family members in 10 long-term care dementia care facilities in Korea participated in the study. Family Perceptions of Care Tool and Family Perceptions of Caregiving Role developed by Maas and Buckwalter (1990) were used to investigate Korean family caregivers' perceptions of care. Findings from the study can be summarized as follows: a) family caregivers showed the lowest satisfaction level for staff management effectiveness, especially for facility's resources available for care, and (b) family caregivers showed the highest stress from staff members' control on caregiving, feeling the same responsibilities after placement, and guilt over their placement. The results contribute to the understanding of Korean family caregivers' perceptions of caregiving and the care relationship after institutionalizing their elderly persons with dementia.
Aged ; Caregivers ; Dementia* ; Guilt ; Humans ; Korea ; Long-Term Care

PURPOSE: The purpose of this study was to explore the experiences of bereavement for main family members who had made and followed DNR decision for their family members. METHOD: This qualitative study was based on a grounded theory, and used in-depth interview techniques with the bereaved 10 main family members who had been treated and died under DNR order. RESULTS: The causal condition of the family member was 'Releasing', and the main consequent phenomenon were 'Blaming self and ruminating'. The contextual condition was 'The memory of the deceased'. The action/reaction strategy was 'Purifying'. The intervening condition was 'Supporting system', and the consequence was 'Acceptance'. The experience after bereavement of the family member on DNR decision were rational processes that purified themselves and healed the guilt feeling about the decision from reflective assessment and response about DNR decision. Based on this results, the substantive theory 'Reflective self healing' was derived. CONCLUSION: The main family members in following DNR decision are more likely to have unhealthy emotional condition than others in normal bereavement process. But they overcame the grief of bereavement through reflective self healing process.
Bereavement ; Grief ; Guilt ; Humans ; Memory ; Qualitative Research ; Resuscitation Orders

This study aimed to ascertain whether medical students would enter a closed area where there was a raging epidemic of an infectious disease with a high fatality rate, and includes reasons for the students entering or refusing to enter. Participants included 50 second-year medical students. They were assigned to read a novel entitled 28, written by Youjeong Jeong, and discuss it in groups. Using their book reports, their decisions of whether or not to enter Hwayang, the city from the novel, and the reasons for their decisions were analyzed; we furthermore investigated the factors affecting their decisions. Among the 50 respondents, 18 students (36%) answered that they would enter, and the remaining 32 students (64%) answered that they would not enter the zone. The reasons given for entering were responsibility (44%), sense of ethics (33%), social duty (17%), and sense of guilt (6%). The reasons the students provided for not entering were inefficiency (44%), worry regarding family (28%), needlessness of sacrifice (19%), and safety not ensured (9%). Students who had four or fewer family members were more likely to enter Hwayang than were students who had five or more family members (odds ratio, 1.85). Students who had completed over 100 hours of volunteer work were more likely to enter Hwayang than were students who had volunteered less than 100 hours (odds ratio, 2.04). Owing to their "responsibility" as a doctor, 36% of medical students answered that they would enter an exclusion zone in an infected district with a high fatality rate. However, 64% answered they would not enter because of "inefficiency." For the medical students it is still a question 'To enter or not to enter?'
Communicable Diseases ; Surveys and Questionnaires ; Ethics ; Guilt ; Humans ; Mortality* ; Odds Ratio ; Rage ; Students, Medical* ; Volunteers ; Writing

PURPOSE: The purpose of this study was to describe the essential structure of the lived experience of working mothers' parenting burden in Korea. METHODS: Eight working mothers with young children were interviewed. The Colaizzi analysis of phenomenological research was applied. RESULTS: Seven theme clusters were extracted: a life with constant conflict, sense of guilt, feeling anxious because of lack of information about education for their children, social stigma as a deficient mother, family relationship becoming distant, a life being exhausted, day to day struggle. CONCLUSION: These results provide an opportunity to have a better understanding of the experiences of working mothers related to parenting their young children. It would also serve as a medium for the formulation of appropriate nursing intervention relevant to burdens of parenthood.
Child ; Family Relations ; Guilt ; Humans ; Korea ; Mothers ; Parenting ; Parents ; Social Stigma

PURPOSE: Although Hemophilia is a relatively rare hereditary disease, and is treatable with blood products, the parenting stress and guilt of hemophilic patients and their mothers are always high. This study was done to assess the extent of parenting stress, guilt, parenting attitude and parenting satisfaction of mothers with a hemophilic child. METHOD: The participants in this study were 119 mothers with a hemophilic child who were registered members of the Korea Hemophilia Foundation, and 287 mothers with a healthy child. In order to measure the dimensions related to parenting stress, guilt, parenting attitude and parenting satisfaction, the Questionnaire on Parenting Stress Index, Maternal Guilt Scale, Parenting Attitude Scale & Parenting Satisfaction Scale were administered. We analysed the differences between mothers with a hemophilic child and a healthy child in the questionnaire scores using the SPSS program. RESULT: Parenting stress and guilt of mothers with a hemophilic child were higher than with a healthy child. Parenting attitude and parenting satisfaction of mothers with a hemophilic child were lower than with a healthy child. CONCLUSION: The results may help medical professionals understand mothers with a hemophilic child and give basic assistance to develop a nursing intervention by exploring possible ways to alleviate such parenting stress and guilt.
Child ; Genetic Diseases, Inborn ; Guilt ; Hemophilia A ; Humans ; Korea ; Mothers ; Parenting ; Parents ; Surveys and Questionnaires

PURPOSE: This study was conducted to identify the caring experience of the mothers of childhood burn patients. METHODS: Data were collected from 28 mothers of childhood burn patients, through semi-structured in-depth interviews. Data were categorized and coded by using content analysis. RESULTS: 27 categories and 102 statements were drawn from 4 domains. The analyzed domains were psychological sufferings, confronted harsh reality, coping method, and future concerns. Psychological sufferings were categorized heartache, sense of guilt, confusion, regret, depression, sorriness, getting hurt, frustration and upset feeling. Confronted harsh nature were categorized economic difficulty, physical burn-out, lack of caring other children and family troubles. Coping method were categorized positive thinking, having hope, ventilating feelings, accepting the situations, demanding help from family members, changing patterns of the burned child rearing, collecting information for burn treatment, refusing accept the condition of burned child, avoiding personal and social relationship, and reliance on religion. Concerns were categorized concerns of growth and adaptation of the burned child, anxiety for scar, concerns of adapting school life and vague future concerns. CONCLUSION: The nursing interventions for early assessing psychological problems and providing social supports for caring both burn patients and other siblings should be provided to the mothers of childhood burn patients.
Adaptation, Psychological ; Anxiety ; Burns ; Child ; Child Rearing ; Cicatrix ; Depression ; Frustration ; Guilt ; Humans ; Mothers ; Siblings ; Thinking

OBJECTIVES: We performed a systematic review to assess and aggregate the available evidence on the frequency, expected effects, obstacles, and facilitators of disclosure of patient safety incidents (DPSI). METHODS: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for this systematic review and searched PubMed, Scopus, and the Cochrane Library for English articles published between 1990 and 2014. Two authors independently conducted the title screening and abstract review. Ninety-nine articles were selected for full-text reviews. One author extracted the data and another verified them. RESULTS: There was considerable variation in the reported frequency of DPSI among medical professionals. The main expected effects of DPSI were decreased intention of the general public to file medical lawsuits and punish medical professionals, increased credibility of medical professionals, increased intention of patients to revisit and recommend physicians or hospitals, higher ratings of quality of care, and alleviation of feelings of guilt among medical professionals. The obstacles to DPSI were fear of medical lawsuits and punishment, fear of a damaged professional reputation among colleagues and patients, diminished patient trust, the complexity of the situation, and the absence of a patient safety culture. However, the factors facilitating DPSI included the creation of a safe environment for reporting patient safety incidents, as well as guidelines and education for DPSI. CONCLUSIONS: The reported frequency of the experience of the general public with DPSI was somewhat lower than the reported frequency of DPSI among medical professionals. Although we identified various expected effects of DPSI, more empirical evidence from real cases is required.
Disclosure* ; Education ; Guilt ; Humans ; Intention ; Mass Screening ; Medical Errors ; Patient Safety* ; Punishment

OBJECTIVES: This study aimed to identify the characteristics of depression in early dementia and mild cognitive impairment patients. METHODS: We included 412 community-dwelling elderly. They were assessed with Mini-Mental Status Examination in the Korean version of the CERAD Assessment Packet (MMSE-KC), Clinical Dementia Rating Scale (CDR), Korean version of Geriatric Depression Scale (GDS) and Korean version of Hamilton Depression Rating Scale (HDRS). All patients were divided three groups, nondemented group (ND), mild cognitive impairment group (MCI), and early dementia group (ED). We compared depressive symptoms between three groups using each items of HDRS. RESULTS: Prevalence of depression (GDS> or =16) was 24.6% in ND, 33.3% in MCI and 41% in ED. Several items of HDRS, depressed mood, feeling of guilt, loss of work & interests, psychomotor retardation, psychomotor agitation, psychic anxiety, somatic anxiety, and gastrointestinal symptoms, were significantly associated with cognitive decline in all subjects. However, no item of HDRS was significantly associated with cognitive decline in depressive patients. CONCLUSION: This study suggests that the prevalence of depression may increase as cognitive function declines. There was no difference in depressive symptoms between three groups.
Aged ; Alzheimer Disease* ; Anxiety ; Dementia ; Depression* ; Guilt ; Humans ; Mild Cognitive Impairment* ; Prevalence* ; Psychomotor Agitation

The clinical features of elderly depression are similar to those of younger's, but there are some differences in frequency. First, compared with younger adults, elderly depressive patients are more likely to show melancholic feature. They complain more physical symptoms rather than depressive mood, so they are occasionally regarded as having "atypical depression". Second, geriatric depression frequently has psychotic feature, especially delusion of guilt or nihilism. Finally sometimes they may have decline of cognitive functions, i.e. pseudodementia, so it is important and hard to distinghush it from dementia. In the case that have longer duration of episode, severe depression, non-melancholic symptoms, or delusion, illness is prone to be chronic and develop dementia. Bipolar disorder in elderly is also similar to that in adults in overall clinical manifestation, but has some differences in the following ponits;fewer hyperactivity, fewer thought problem, and less association with life-event. Also, manic delirium is frequent in elderly. The prognosis of elderly mania is various.
Adult ; Aged* ; Bipolar Disorder ; Delirium ; Delusions ; Dementia ; Depression ; Factitious Disorders ; Guilt ; Humans ; Mood Disorders* ; Prognosis*

The clinical features of elderly depression are similar to those of younger's, but there are some differences in frequency. First, compared with younger adults, elderly depressive patients are more likely to show melancholic feature. They complain more physical symptoms rather than depressive mood, so they are occasionally regarded as having "atypical depression". Second, geriatric depression frequently has psychotic feature, especially delusion of guilt or nihilism. Finally sometimes they may have decline of cognitive functions, i.e. pseudodementia, so it is important and hard to distinghush it from dementia. In the case that have longer duration of episode, severe depression, non-melancholic symptoms, or delusion, illness is prone to be chronic and develop dementia. Bipolar disorder in elderly is also similar to that in adults in overall clinical manifestation, but has some differences in the following ponits;fewer hyperactivity, fewer thought problem, and less association with life-event. Also, manic delirium is frequent in elderly. The prognosis of elderly mania is various.
Adult ; Aged* ; Bipolar Disorder ; Delirium ; Delusions ; Dementia ; Depression ; Factitious Disorders ; Guilt ; Humans ; Mood Disorders* ; Prognosis*