Posttraumatic Growth and Related Factors of Child Protective Service Workers

OBJECTIVES: The aim of the study is to measure the level of vicarious trauma, posttraumatic growth (PTG), and other factors affecting PTG among child protective service workers. METHODS: We include posttraumatic stress, social support, stress coping, and demographic data as independent variables. Data was collected from 255 full-time social workers from 43 child protective agencies as acomplete enumeration and 204 included in the final analysis. RESULTS: The major findings of the study were as follows: The mean score of PTG was 44.09 (SD:21.73). Hierarchical multiple regression was adopted and "pursuing social support as a way of coping with stress" was the strongest predictive factor (beta=0.319, p<0.001) of PTG. CONCLUSION: We suggest that child protective workers are vulnerable to posttraumatic stress and mental health services are indicated. We also recommend various types of training for stress coping program, especially strengthening the social support system of the child protective service workers in South Korea.

The Socioeconomic Impact of Terminal Cancer on Patients' Families and Its Associated Factors

BACKGROUND: We conducted this study to investigate the financial burden of terminal cancer patient's family and to identify factors influencing their economic burden. METHODS: We approached 187 family members supporting their famly member with terminal cancer who was enrolled in four hospice and palliative care program. We constructed a questionnaire examining the impact of illness on their family. With multiple logistic analysis, we examined the patients' and family members' demographic and the patients' clinical factors associated with the burden caused by terminal cancer. RESULTS: The majority of families reported the loss of savings (54%), the need to make major life changes in order to care for the patient (50%), the loss of incomes (34%), the inability to function normally because of the stress of the illness (27%). Many families had to move to a less expensive home (18%), delay medical care for other family members (12%), or change educational plans for other family members (13%). Families that cared for patients who wanted to be cared for at institution (odds ratio: 2.72, 95% confidential interval: 1.19~6.19), patients with liver cancer (3.61, 1.53~8.57), and families who were poor caregivers (2.97, 1.24~7.10), or primary caregiver was a spouse (3.57, 1.47~8.68) were more likely to lose savings. Families that were in 'new couple' in family life cycle stages (3.91, 1.04~14.63), 'birth of the first child' (8.34, 2.74~25.32), and 'the adolescent family or the launching family' (10.56, 4.07~27.33), were more likely to lose savings than 'the empty family or the aging family'. CONCLUSION: Many families reported severe caregiving and economic burdens. Social and financial support need to be given to families with predictors of high economic burdens.

The Establishment of Hospice and Palliative Care System from the Cancer Patients and Families' Point of View

BACKGROUND: Many terminal cancer patients and families are affected with physical, emotional, and social problems. Many people claim that a type of medical services is needed to manage them such as hospice palliative care. There have not been many studies of cancer patients and families with respect to their opinions and attitudes on hospice palliative care for terminal cancer patients, although their views on it is important. METHODS: We surveyed 687 in-patients, out-patients and their families with cancer in 8 hospitals. The self-administered questionnaires included the following; 1) socio-demographic and clinical variables; 2) opinions on hospice palliative care; 3) attitudes on ethical issues associated with hospice palliative care; 4) factors associated with withholding futile care at the end-of-life. The data were analyzed with x2-test, Mantel-Haenszel x2-test, and multiple logistic regression. RESULTS: Almost 90% of the subjects agreed to the need of obtaining hospice palliative care with health care insurances and reaching a social consensus on the contents of its programs. Five hundred and seventy six (83.8%) subjects agreed to the need of using advanced directives. Two hundred and eighty five (72.2%) cancer patients and 200 (68.5%) families agreed to the need of withholding futile care at the end-of-life and of people accepting their cancer diagnosis with insight and living in the metropolis as they were more likely to do. In the multivariate analysis, the attitudes on withholding futile care at the end-of-life was significantly different only by insight of cancer diagnosis (OR; 1.09-3.15). CONCLUSION: This study showed that hospice palliative care should be established through social consensus on the issues related to ethics and insurances, and that cancer patients and families must have a right to choose such services with informed decision-making.