Realist Review: Understanding Effectiveness of Intervention Programs for Dementia Caregivers

PURPOSE: Caring for patients with dementia is a challenging issue entailing heavy responsibility. Many interventions for caregivers have been developed, but their effectiveness is not clear. This study aimed to examine how, why, and under what circumstances interventions for dementia caregivers affected their burden of caring. METHODS: Authors used a realist review approach to explore the evidence for how different interventions reduce the burden of dementia caregivers. We completed the literature review about the burden of dementia caregivers and extracted the theoretical concepts to explain context-mechanism-outcome configuration why an intervention may be effective in some situations and not others. Six databases were searched for experimental or quasi-experimental studies conducted from 2008 to 2017. Of 1,225 screened studies, 10 studies were eligible for inclusion. RESULTS: None of the studies included all the derived contexts while explaining in detail the mechanism of the intervention effectiveness. Among contexts, the variable of other family members requiring care was not included in all studies. Among the analyzed studies, no studies have applied repeated intervention. Most studies included only some variables of context and mechanism, and these variables did not directly explain the effectiveness of intervention. The effect of outcome variables was significant for each study, and the effects of research intervention and national services could not be separately described. CONCLUSION: Authors conclude that Korean culture's emphasis on relationships with others increases the burden of care. In context, Confucian norms and traditional femininity of Korea were reflected in the core. It is necessary to check the homogeneity of participants and the design of intervention to verify the effectiveness of the outcome variable of psychological burden.

Experiences of Spouses of Patients with Hematologic Malignancies: Finding a Way to Get Out of the Endless Tunnel

PURPOSE: This study was to explore experiences of spouses with hematologic malignancy patients. The main question was "What are experiences of spouses whose husband or wife was diagnosed with hematologic malignancy?". METHODS: Participants for this study were 12 spouses. Data were collected through individual in-depth unstructured interviews with participants from Feb, 2014 to June, 2015 and analyzed using Strauss and Corbin's grounded theory methodology RESULTS: A core category was 'Finding a way to get out of the endless tunnel'. The process is 1) Shock, 2) Confusion, 3) Struggle, 4) Living with the disease, 5) Maturation within the disease. The contextual conditions were 'Responsibility for patient', 'Fear of spouseless future'. The intervening conditions were 'Having support', 'Having closer marital relationship', Keeping patient's disease repressed. Finally, Participants reached 'Circling around the disease', 'Finding personal growth'. CONCLUSION: The results of this study could help understand the experiences of spouses of hematologic malignancy patients. The emerged process of their experiences gives a framework to develop strategies to help spouses to overcome disease.

Peer and Parental Influences on Adolescent Smoking / 간호학회지

PURPOSE: The purpose of this study was to determine the relationship between peer and parental factors and smoking behavior of adolescents in urban cities and to investigate whether there are gender differences. METHODS: A stratified and random cluster sampling design was used to obtain a cross-sectional sample of high school students in two urban cities. The sample consisted of 512 Korean adolescents (256 boys and 256 girls) aged 15 to 18 (mean age 16.7+/-.58). Self-reported questionnaire consisted of adolescent smoking behavior, peer smoking and alcohol use, parental smoking and alcohol use, father-mother-peer relationships and perceived social support from peers and parents. Multiple logistic regression analysis was used to examine the hypothesized model. RESULTS: The findings showed that peer and parental factors accounted for 30.3% of the variance in adolescent smoking and peer smoking was most strongly associated with adolescent smoking behavior (OR=10.18). In addition, peer smoking (OR=4.71), peer alcohol use (OR=4.21), and peer relationships (OR=1.03) were significantly associated with boys' smoking behavior. In girls, peer smoking (OR=26.50) and parent smoking (OR=5.48) were significantly associated with smoking behavior. CONCLUSIONS: Consistent with previous findings, peer smoking is a significant factor on adolescent smoking. Specifically, boys would be more influenced from peers than girls. Therefore, smoking prevention programs for adolescents might be focused on the social context such as, resisting to peer pressure and enhancing the self-efficacy to control.