PURPOSE: There has been very little study on the associations between patient's symptoms themselves and family caregiver (FC)'s depression in the palliative phase. This cross-sectional study was to investigate the relationship between symptom features of terminally ill cancer patients and their FC's depression. METHODS: We performed a multicenter survey using the MD Anderson symptom inventory and the Hospital Anxiety and Depression Scale. A total of 293 patient-FC pairs were recruited from seven tertiary medical centers. A multivariate regression analysis was applied for identifying the relevant factors associated with FC depression and for estimating adjusted depression score of FCs. RESULTS: Among various psychosocial factors, low FC quality of life, low social support, spouse, and more caregiving time were significantly associated with FCs' depression. According to the presence of FCs' depression, there were significant differences in some symptom characteristics of patients. Even after adjusting for the relevant confounders, depression scores were lower in FCs caring for patients who had negative symptoms (loss of appetite, P=0.005; drowsiness, P=0.024; and dry mouth, P=0.043) than in FCs caring for patients who had not. FCs caring for patients with severe appetite loss had lower depression scores than those with not severe one (P=0.039). CONCLUSION: Our result suggests that patient's symptom characteristics might be helpful when evaluating a FC's depression.
Anxiety ; Appetite ; Caregivers* ; Cross-Sectional Studies ; Depression* ; Humans ; Mouth ; Psychology ; Quality of Life ; Sleep Stages ; Spouses ; Symptom Assessment ; Terminal Care ; Terminally Ill*

PURPOSE: This study was conducted to assess predictor variables of husbands in multicultural families and examine the relationship among variables after setting up a hypothetical model including influencing factors, so as to provide a framework necessary for developing nursing interventions of domestic violence. METHODS: The participants were 260 husbands in multicultural families in four cities in Korea. Data were analyzed using SPSS 22.0 and AMOS 20.0. RESULTS: Self-control, social support, family of origin violence experience and stress on cultural adaptation directly affected to dysfunctional communication, and the explanatory power of the variables was 64.7%. Family of origin violence experience in domestic stress on cultural adaptation, and dysfunctional communication were directly related to domestic violence in multicultural families, and the explanatory power of the variables was 64.6%. We found out that all variables in the model had mediation effects to domestic violence through dysfunctional communication. In other words, self-control and social support had complete mediation effects, and family of origin violence experience in domestic violence and stress on cultural adaptation had partial mediation effects. CONCLUSIONS: The variables explained in this study should be considered as predictive factors of domestic violence in multicultural families, and used to provide preventive nursing intervention. Our resutls can be taken into account for developing and implementing programs on alleviating dysfunctional communication in multicultural families in Korea.
Acculturation ; Communication ; Cross-Sectional Studies ; *Cultural Diversity ; Domestic Violence/ethnology/*statistics & numerical data ; Emigrants and Immigrants/psychology/statistics & numerical data ; Female ; Humans ; Male ; Models, Psychological ; Republic of Korea/epidemiology ; Self-Control/psychology ; Social Support ; Spouses/ethnology/psychology/statistics & numerical data ; Stress, Psychological/ethnology/etiology

PURPOSE: The purpose of this study was to develop an Enneagram program (EP) and examine the effects on codependency, anger and interpersonal relationship in wives of alcoholics. METHODS: A nonequivalent control group pre-posttest design was used. Participants were 26 wives of alcoholics (experimental group: 12, control group: 14). From March 17 to August 18, 2014, six two-hour sessions of EP were provided to the experimental group over six weeks. Data were collected using the Codependency Recovery Potential Survey (CRPS), Korean State-Trait Anger Expression Inventory (STAXI-K) and Relationship Change Scale (RCS). and analyzed using PASW 18.0 with Fisher's exact test, t-test, and Mann-Whitney U test. RESULTS: The experimental group showed lower scores for codependency (Z=-2.17, p=.030) and anger (Z=-2.43, p=.015) than the control group. However, there was no significant difference in interpersonal relationship score between two groups. CONCLUSION: The EP for wives of alcoholics was effective in improving codependency and anger. A randomized clinical trial is needed to confirm the value of this EP.
Alcoholics* ; Anger* ; Codependency (Psychology)* ; Humans ; Spouses*

PURPOSE: This study was done to examine the relation of uncertainty, uncertainty appraisal, and self-management in patients undergoing hemodialysis, and to identify factors influencing self-management. METHODS: A convenience sample of 92 patients receiving hemodialysis was selected. Data were collected using a structured questionnaire and medical records. The collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlations and multiple regression analysis with the SPSS/WIN 20.0 program. RESULTS: The participants showed a moderate level of uncertainty with the highest score being for ambiguity among the four uncertainty subdomains. Scores for uncertainty danger or opportunity appraisals were under the mid points. The participants were found to perform a high level of self-management such as diet control, management of arteriovenous fistula, exercise, medication, physical management, measurements of body weight and blood pressure, and social activity. The self-management of participants undergoing hemodialysis showed a significant relationship with uncertainty and uncertainty appraisal. The significant factors influencing self-management were uncertainty, uncertainty opportunity appraisal, hemodialysis duration, and having a spouse. These variables explained 32.8% of the variance in self-management. CONCLUSION: The results suggest that intervention programs to reduce the level of uncertainty and to increase the level of uncertainty opportunity appraisal among patients would improve the self-management of hemodialysis patients.
Adult ; Aged ; Female ; Humans ; Kidney Failure, Chronic/*psychology ; Male ; Middle Aged ; Quality of Life ; Regression Analysis ; Renal Dialysis ; *Self Care ; Spouses ; Surveys and Questionnaires ; *Uncertainty

OBJECTIVETo verify the clinical efficacy of acupuncture and moxibustion on depressive states of stroke patients' spouses.

METHODSForty-four subjects who were stroke patients' spouses and according with inclusive criteria with mild or moderate depressive states were randomly divided into an acupuncture-moxibustion group and a blank control group, 22 cases in each group. In the acupuncture-moxibustion group, acupuncture was applied at Baihui (GV 20), Shenting (GV 24), Sishencong (EX-HN 1), Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3), and suspended moxibustion was used at Shenque (CV 8), Guanyuan (CV 4) and Zhongwan (CV 12). The treatment was given twice a week for continuous 8 weeks. In the blank control group, neither acupuncture nor moxibustion treatment was given, and the patients were only treated with health and psychological guidance. Before treatment and after 8-week treatment, scores of self-rating depression scale (SDS) and numbers of insomnia severity grade were observed.

RESULTSIn the two groups, the scores of SDS were both reduced than those before treatment (both P<0.05), and the decrease in the acupuncture-moxibustion group was more obvious (P<0.05). After treatment, the number of insomnia severity grade in the acupuncture-moxibustion group was improved than that before treatment (P<0.001), and the improvement was evidently superior to that in the blank control group (P<0.05). The numbers of insomnia severity grade of the blank control group before and after treatment had no statistic significance (P>0.05).

CONCLUSIONThe acupuncture and moxibustion intervention plan has clinical treatment significance on the improvement of mild and moderate depressive states for the stroke patients' primary caregivers who are the patients' spouses.

Aged ; Depression ; therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Spouses ; psychology ; Stroke ; psychology

This study investigated gender differences in symptom profiles of major depressive disorder (MDD) in the Korean general population. Data were pooled from the series of nationwide Korean Epidemiologic Catchment Area surveys conducted in 2001, 2006 and 2011, respectively. Of the 18,807 participants, 507 (397 women and 110 men) were diagnosed with MDD within the prior 12 months. In agreement with previous studies, women with MDD appeared to be more vulnerable to experiencing atypical depressive episodes defined as depression with two or more symptoms of fatigue, increased appetite and hypersomnia (P < 0.001). In terms of individual symptoms, female gender was significantly related with higher prevalence of fatigue (P = 0.008), hypersomnia (P = 0.001), noticeable psychomotor retardation (P = 0.029) and suicidal attempts (P = 0.016) with adjustment for birth cohort effect, partner status, and employment status. In the same analysis, men with MDD appeared more vulnerable to decreased libido than women (P = 0.009). This is the first report to demonstrate gender differences in symptomatology of MDD in the general Korean population, and the results are comparable to previous investigations from western societies. Assumingly, the intercultural similarity in female preponderance to atypical depression might reflect the common biological construct underlying the gender difference in mechanism of MDD. In clinical settings, gender differences of MDD should be carefully considered, because these features could be related with treatment response and drug side effects.
Adult ; Aged ; Aged, 80 and over ; Depression/*diagnosis/*epidemiology/psychology ; Depressive Disorder, Major/*diagnosis/*epidemiology/psychology ; Employment/psychology/statistics & numerical data ; Fatigue/*epidemiology/psychology ; Female ; Health Surveys ; Humans ; Male ; Middle Aged ; Prevalence ; Reproducibility of Results ; Republic of Korea/epidemiology ; Risk Assessment ; Sensitivity and Specificity ; Sex Distribution ; Sex Factors ; Spouses/psychology/statistics & numerical data ; Symptom Assessment/*statistics & numerical data ; Young Adult

PURPOSE: In this study the effects of forgiveness therapy on the resilience, self-esteem, and spirituality of wives of men suffering from alcohol abuse was examined. METHODS: The study design was a quasi-experimental design. Forgiveness therapy was conducted once a week for 12 weeks. Data were obtained from March 2012 to December 2013. Participants were chosen from women in two Alcohol Counseling Centers. Of the 29 participants, 16 were assigned to the experimental group and 13 to the control group. Data were analyzed using descriptive statistics, t-test, chi2-test, and repeated measure ANOVA. RESULTS: There were statistically significantly differences for resilience, self-esteem, and spirituality between the experimental and control groups. Forgiveness therapy improved the resilience, self-esteem, and spirituality in the experimental group compared to the control group (p<.05). In follow-up tests, the experimental group had a statistically significantly increase only in self-esteem. CONCLUSION: This study results show that forgiveness therapy is effective in improving resilience, self-esteem, and spirituality in wives of men suffering from alcohol abuse. Therefore, forgiveness therapy can be considered a useful nursing intervention to promote improvements in emotional stability and provide pain relief for these wives.
Adult ; Alcoholism/diagnosis ; Female ; *Forgiveness ; Humans ; Male ; Middle Aged ; *Program Evaluation ; Questionnaires ; *Resilience, Psychological ; *Self Concept ; *Spirituality ; Spouses/*psychology

PURPOSE: The purpose of this study was to identify whether the couple perceived breast cancer as a traumatic event, to evaluate the association among posttraumatic growth, dyadic adjustment, and quality of life and to explore the predictors affecting quality of life of the couple. METHODS: A cross-sectional comparative survey design was utilized. Participants were 57 couples recruited from a national cancer center in Korea. Data were analyzed using paired t-test, McNemar test and independent t-test. On the basis of variables found to be significantly associated with quality of life, multiple regression was used to examine the simultaneous influence of multiple predictors. RESULTS: Breast cancers survivors and spouses perceived breast cancer as a traumatic event (43.9% and 24.6%, respectively). The global quality of life was explained by perception as trauma (beta= -19.79) and posttraumatic growth (beta=0.46) in survivors, and perception as trauma (beta= -18.81) and dyadic adjustment (beta=0.53) in spouses. CONCLUSION: Results suggest that future research should use qualitative methods to evaluate why contemplating reasons for cancer contributed to posttraumatic growth, examine other potential predictors of quality of life such as dyadic adjustment and intimacy, and identify links between posttraumatic growth and other psychological outcomes such as distress and well-being, using prospective analyses.
Adaptation, Psychological ; Adult ; Breast Neoplasms/pathology/*psychology ; Cross-Sectional Studies ; Female ; Humans ; Interpersonal Relations ; Male ; Marriage ; Middle Aged ; *Quality of Life ; Questionnaires ; Spouses/*psychology ; Survivors

PURPOSE: The purpose of this study was to identify the factors affecting the unmet healthcare needs of married immigrant women. METHODS: This study was a secondary data analysis using data from the 2009 National Survey of Multicultural Families. Data collected from 58,735 married immigrant women who had spouses were analyzed using descriptive statistics, Chi-square test, and logistic regression. RESULTS: Overall, 9.9% of married immigrant women have unmet healthcare needs. The significant predictors related to unmet healthcare needs were young age, high level of education, employed, country of origin, long period of residence, low income, uninsured, urban area, low level of subjective health status, and illness experience over past two weeks. In particular, four variables (long period of residence, low income, subjective health status, and illness experience over past two weeks) significantly predicted unmet healthcare needs for women from all countries of origin. CONCLUSION: The results of the study indicate that common predictors related to unmet healthcare needs of married immigrant women are a long period of residence, low income, subjective health status, and illness experience over past two weeks. Therefore intervention strategies to decrease unmet healthcare needs should focus on these significant predictors.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Emigrants and Immigrants/*psychology/*statistics & numerical data ; Female ; *Health Services Needs and Demand ; Health Status ; Humans ; Logistic Models ; Middle Aged ; Odds Ratio ; Questionnaires ; Socioeconomic Factors ; Spouses/psychology/*statistics & numerical data ; Women/*psychology ; Young Adult

PURPOSE: This study was done to examine actor and partner effect of dementia knowledge, self-efficacy and depression on dementia preventive behavior in elderly couples. METHODS: Participants were 115 couples aged 60 years or over who met eligibility criteria. All measures were self-administered. Data were analyzed using SPSS 18.0 and AMOS 18.0 program. RESULTS: Dementia knowledge in elderly couples showed actor and partner effect on dementia preventive behavior. Self-efficacy in the wife did not have direct effects on dementia preventive behavior, but showed indirect effects through dementia knowledge. Self-efficacy in the husband showed direct effects on dementia preventive behavior and indirect effects through dementia knowledge. Wife's depression had direct actor effect on dementia preventive behavior and indirect effect through self-efficacy and dementia knowledge. Husband's depression did not have direct actor effect on dementia preventive behavior, but indirect effect through self-efficacy and dementia knowledge. Effect size of wives' dementia knowledge, self-efficacy and depression on dementia preventive behavior was larger than that of husbands'. Dementia preventive behavior, dementia knowledge and depression had a mutual effect. CONCLUSION: Results indicate that to promote dementia preventive activity in elderly couples, programs should be conducted for both of the couple, but focused differently for wife and husband.
Aged ; Aged, 80 and over ; Dementia/*prevention & control ; *Depression ; Female ; Humans ; Knowledge ; Male ; Middle Aged ; Questionnaires ; *Self Efficacy ; Spouses/*psychology