Depression, Powerlessness, Social Support, and Socioeconomic Status in Middle Aged Community Residents / 정신간호학회지

PURPOSE: The main purpose of this study was to examine factors influencing depression in middle aged people in relation to powerlessness, social support, and sociodemographic variables. METHODS: The questionnaire survey was carried out with a convenience sample of 160 middle aged people in a community setting. The data analysis procedures included frequency, t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression using depression as the dependent variable. RESULTS: The prevalence of depression was 44.4%. There were significant differences in depression by number of members in the family, education, economic status, and subjective health status. Powerlessness was significantly different according to gender, economic status, and subjective health status. and social support according to economic status and subjective health status. Depression showed significant correlations with powerlessness and social support. Stepwise multiple regression revealed that factors significantly affecting variance included economic status, number of members in the family, powerlessness, and social support. These factors explained 43% of variance in depression. CONCLUSION: The results of this study suggest that to prevent the occurrence of depression, socio-environmental aspects including economic state should be considered when developing interventions for middle aged adults.

The Relationship of Powerlessness, Sense of Belonging and Nutritional Status in the Elderly / 재활간호학회지

PURPOSE: The aim of this study was to explore the relationship between powerlessness, sense of belonging and nutritional status of the elderly. METHOD: The study sample was 100 living at home and institutions. Data were collected by interview from Oct. to Dec. in 2003. The instruments were helplessness scale developed by Jung (1998), sense of belonging scale SOBI-A and nutritional initial screening. RESULT: The mean score of powerlessness was 2.71+/-.30, sense of belonging was 2.87+/-.19, and nutritional status was 4.42+/-.34. There was a statistically significant differences in powerlessness according to age (F=3.185, p=0.027), health status (F=6.945, P=0.002), religion (F=5.941, P=0.001), current spouse (t=-0.384, p=0.026), in sense of belonging according to age (F=4.40, P=0.006), length of education (F=10.64, P=<.0001) and in nutritional status according to age (F=3.34, P= 0.022), health status (F=2.86, P=0.027). There was a statistically significant correlation between powerlessness and nutritional status (r=0.219, p=0.029). CONCLUSION: Nurses are able to decrease powerlessness or increase sense of belonging and nutritional status of the elderly by developing the health promotion program, improving perceived health status and empowering social interaction of the elderly specifically living at institutions.

The Relationship among Powerlessness, Social Support and Life Satisfaction in the Elderly People

PURPOSE: The purpose of this study was to identify the correlation between the feeling of powerlessness, social support and life satisfaction in the elderly. METHODS: The subjects were 158 old people aged over 65 who were attending one of one college and three settlement houses for senior citizens located in B city. RESULTS: The relationship between the feeling of powerlessness and life satisfaction was in a moderate negative correlation with each other (r=-.433, p=.000). The relationship between social support and life satisfaction was in a moderate positive correlation with each other (r=.410, p=.000). It was found that the higher social support was, the higher life satisfaction was. There was remarkable difference in the form of family (F=2.69, p=.023), the form of residence (F=5.29, p=.002), whether to belong to a group (F=2.26, p=.025). CONCLUSION: For the reasons stated above, as the feeling of powerlessness is lower and social support is higher, life satisfaction is higher. The results clearly show that in order to improve life satisfaction of the elderly, we need to ease their feeling of powerlessness and enhance social support to them. Therefore, it is necessary to develop a nursing intervention program to reduce powerlessness and to improve social support for the elderly.

Construção e validação de um instrumento para avaliação do sentimento de impotência / Construction and validation of the instrument for assessment powerlessness

Sentimento de impotência é um conceito aceito como um foco clínico da prática de enfermagem. Os objetivos deste estudo foram: desenvolver e testar uma medida de sentimento de impotência para pacientes adultos; verificar se o sentimento de impotência é um construto distinto do de locus de controle e analisar a associação entre sentimento de impotência e locus de controle. Os itens foram desenvolvidos a partir das dimensões do modelo de impotência de White, Roberts (1993) e das características definidoras de impotência, segundo a North American Nursing Diagnosis Association. A validade de conteúdo foi afirmada para 23 itens pelo julgamento de seis juízes, segundo critérios estabelecidos por Pasquali (1998). Teste de inteligibilidade foi realizado com 25 pacientes e 21 itens foram retidos. O instrumento foi testado com 210 pacientes adultos de unidades médico-cirúrgicas para seleção de itens, confiabilidade e validade. Pela análise de itens, nove deles foram descartados. Os 12 itens remanescentes foram testados quanto à confiabilidade e à validade. Três subescalas geradas pela análise fatorial (Capacidade de Realizar Comportamentos, Capacidade de Tomar Decisões e Resposta Emocional ao Controle das Situações) não confirmaram o modelo de White, Roberts e demonstraram consistência interna entre 0,58 e 0,85. O alfa total foi 0,80. Estimativas iniciais de validade de critério e de construto foram obtidas com associações entre o instrumento desenvolvido e uma afirmação geral sobre a percepção de controle (p<0,000) e correlação daquele com escores de internalidade gerados a partir dos escores na Escala de Locus de Controle na Saúde (p=-0,33). Os itens da escala de Locus de Controle na Saúde foram bem discriminados dos itens de sentimento de impotência pela análise fatorial, sugerindo conceitos distintos. Com refinamento o instrumento de Medida do Sentimento de Impotência para pacientes adultos servirá de base para ) avaliar essa resposta psicossocial, definir e apreciar intervenções clínicas propostas para melhorar o conforto emocional de pacientes adultos

Powerlessness is a concept accepted as clinical focus of nursing practice. The aims of this study were: to develop and test a measure of powerlessness in adult patients; to verify whether powerlessness is a construct distinct from locus of control and to analyse the association between powerlessness and locus of control. Items were developed from the powerless dimensions of the White, Roberts (1993) model and from the defining characteristics of powerlessness according to the North American Nursing Diagnosis Association (2002, 2003). Content validity was supported for 23 itens through the rating of six experts following criteria established by Pasquali (1998). Intelligibility test was performed in 25 patients and 21 items were retained. The instrument was tested with 210 adult patients of medical-surgical wards for item selection, reliability and validity. Through item analysis nine items were discarded. The remaining 12 items were tested for reliability and validity. Three subscales generated by factor analysis (Ability to Perform Behaviors, Ability to Make Decisions and Emotional Responses to Personal Control) did not confirm the White, Roberts model, and demonstrated internal consistency ranging from .58 to .85. Total scale alpha was .80. Initial estimates of criterion-related and construct validity were documented with associations between the developed measure and a general statement on personal control perception (p<.000), and correlation with internality scores generated from scores on Health Locus of Control Scale (p=-.33).Items of Health Locus of Control were well discriminated from the powerlessness items through factor analysis, suggesting they are distinct concepts. With refinement the Measure of Powerlessness for Adult Patients will provide a basis for assessing this psychosocial response, definition and evaluating clinical interventions designed to enhance the emotional comfort of adult patients

Influence of Self-Esteem and Family-Support on Powerlessness of Hospitalized Elderly Patients with Chronic Disease / 성인간호학회지

PURPOSE: The purpose of this study was to identify an influence of self-esteem and family- support on powerlessness of hospitalized elderly patients with chronic disease. METHOD: The subjects were 151 hospitalized elderly patients, age over 60, with chronic disease and admitted for at least 1 week. The data were collected by individual interview using a tructured questionnaire during the period from July 10th to August l0th, 2003 from three general hospitals in Busan. The data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation, hierarchical multiple regression. RESULT: The level of self-esteem, family support, and powerlessness was 38.00, 38.26, and 38.38, respectively. There was a significant positive correlation between self-esteem and family support and a negative correlation between self-esteem and powerlessness and between family support and powerlessness. Self-esteem and family support were each significant predictor of powerlessness. CONCLUSION: This study showed the hospitalized elderly patients need greater family-support and higher self-esteem to relieve the level of powerlessness. I suggest to study for replication in a larger sample size and considering the lengths of hospitalization for generalization of this study and to develop individual intervention programs for increasing family support and self esteem and testify their effects on the relief of powerlessness of the elderly.

A resposta psicossocial de impotência em pacientes no pós-operatório de cirurgia cardíaca / La respuesta psico-social de impotencia en pacientes en el postoperatorio de cirurgía cardíaca / The psychosocial response of powerlessness on postoperative cardiac surgery patients

OBJETIVOS: descrever a impotência no pós-operatório de cirurgia cardíaca quanto a freqüência, intensidade, características definidoras e comparar a impotência em pacientes em pós-operatório de cirurgias de válvula (VAL) e de coronária (RM). MÉTODO: a presença de impotência foi definida pela análise de entrevistas de 75 pacientes em pós-operatório de cirurgia cardíaca (60 por cento em pós-operatório de RM e 40 por cento de VAL). RESULTADOS: 44 (58,7 por cento) pacientes apresentaram impotência. Não houve diferenças quanto a freqüência (p=0,84) e intensidade (p=0,73) de impotência entre os pós-operados de VAL e os de RM. As características definidoras mais freqüentes nos pacientes com impotência foram: "expressões verbais relativas à falta de controle ou de influências sobre uma situação" (77,3 por cento), "dúvida para planejar o futuro e estabelecer objetivos" (75,0 por cento), "expressão de dúvida acerca do desempenho de papéis" (63,6 por cento) e "expressões de insatisfação e frustração pela inabilidade no desempenho de tarefas e/ou atividades pessoais" (56,8 por cento).

AIMS: to describe powerlessness on postoperative cardiac surgery patients according to frequency, intensity, defining characteristics and to compare powerlessness between valvular surgery patients (VAL) and coronary artery bypass surgery patients (CAB). METHODS: powerlessness was defined through the analyses of interviews of 75 patients (60 percent VAL and 40 percent CAB). RESULTS: 58.7 percent patients presented powerlessness. There were not differences according to powerlessness frequency (p=0.84) and intensity (p=0.73) between VAL and CAB patients. The defining characteristics most frequent on powerless patients were: "verbal expressions of having no control or influence over situation" (77.3 percent), "doubts regarding planning future and stating objectives" (75 percent), "expressions of doubt regarding role performance" (63.6 percent), and "expressions of dissatisfaction and frustration over inability to perform previous tasks and /or activities" (56.8 percent).

OBJETIVOS: describir la impotencia en el postoperatorio de cirurgía cardíaca cuánto a la frecuencia, intensidad, caracteristicas definidoras y comparar la impotencia en pacientes en postoperatorio de cirurgía de válvula (VAL) y de coronaria (RM). METODOS: La impotencia fue definida por el analises de entrevista de 75 pacientes (60 por ciento RM y 40 por cientoVAL). RESULTADOS: 58,7 por ciento presentaron impotencia. No hulo diferencias cúanto a la frecuencia (p=0,84) e intensidad (p=0,73) de impotencia entre los postoperados de VAL y los de RM. Las caracteristicas definidoras más frecuentes en los pacientes com impotencia fueron: "expresiones verbales relacionadas com la falta de control o de influencias acerca de una situación" (77,3 por ciento), "dudas para planear el futuro y establecer objetivos"(75,0 por ciento) "expresión de duda acerca del desempenõ de roles" (63,6 por ciento) y "expresiones de insatisfacción y frustración por la inabilidad en el desempeño de tareas y/o actividades personales"(56,8 por ciento).

Uncertainty, Social Suppot & Powerlessness in Mothers of Handicapped Children / 아동간호학회지

The purposes of this study were to measure the degree of perceived uncertainty, social support & powerlessness, to examine the relationship between the perceived uncertainty, social support & powerlessness and then to find the predictors of powerlessness in mother's of handicapped children. The subjects of this study consist of 102 mothers of handicapped children, registered at rehabilitation & handicapped children school. Data was collected from September 1998 to March 1999. The tools used in this study were Mishel's the Parents' Perception of Uncertainty Scale (28 item, 4 likert scale), Miller's Powerlessness measurement Scale(28 item, 4 likert scale) & Cohen's Interpersonal Support Evaluation List(40 items, 4 liken scale). Data was analyzed by t-test, ANOVA, Duncan comparison, Pearson Correlation coefficient & Stepwise multiple regression Results of this study are summarized as follows : 1. Mothers perceived their uncertainty to be slightly high(Mn 2.50). The degree of perceived uncertainty by the four components were followed as lack of clarity(2.69), unpredictability(2.56), ambiguity(2.56) & lack of information(2.46). The degree of perceived uncertainty of the mothers of handicapped children revealed to be influenced significantly by age of children, admission experience, disability types of children. 2. The degree of mothers' powerlessness was measured to be slightly high(Mn 2.14). The degree of perceived powerlessness of the mothers with handcapped children revealed to be influenced significantly by age of children, duration of illness admission experience, & marital status of the mothers. 3. Mothers perceived their social support to be slightly high(Mn 2.71). The degree of perceived social support revealed to be influenced significantly by sex of children, married state of mothers. 4. Mothers' uncertainty was related positively to the mothers' powerlessness(r=.33, p=.0008). And also mothers' powerlessness was related inversely to social support(r=-.50, p=.0001). But, mothers' uncertainty was not related to social support significantly. 5. To analyze the variables which affect powerlessness, stepwise regression was implemented. As a result, about 61% of the powerlessness were explained by social support, marital status of the mothers and perceived uncertainty. Based upon these results, it is recommended that the nurses, who are caring handicapped children and their families, provide various support programs for them to overcome their difficulties. Also programs which decrease the uncertainty & powerlessness used social support multidimensionally & individually are recommended to be developed.

A Study of Tool Development for Powerlessness of Elderly and the Degree of Elderly's Powerlessness / 간호학회지

The purpose of this study was to develop a tool to assess the powerlessness and to measure the powerlessness of elderly. From the result of pre-test, twenty seven items were finally selected to survey the elderly's powerlessness. The questionnaires on the elderly's powerlessness were drafted so that such tool may be evaluated in accordance with the four point Likert Scale. The number of subjects is 1,150 with ages of 60 years or more and who live in a large city, a small and middle-sized city and a rural area. The subjects of the test and retest were 85 elderlies. Collected data were analyzed by utilizing SAS program with Cronbach's alpa and Pearson's correlation, factor analysis method and known group techniques, descriptive statics, t-test and ANOVA. The results from this study were summarized below: 1. When the factor analysis method was applied for validity, the tool for powerlessness of elderly was separated into 5 factors: loss of self-confidence to deal with physical, emotional, social aspects of life; expulsion by others from meaningful human relate; perception that life is meaningless and time passes quickly; falling behind young people; being rejected by other people, having no influence on others. An application of the known group technique showed a significant difference with the result of the degree of elderly's powerlessness tools developed by the two groups, with illness and without. 2. In testing reliability, it was found that coefficient of test-retest was .9435(P<.0001) when the test-retest method was used as a test of stability, and that the alpha coefficient of internal consistency was .9141 over all items within the tool of elderly's powerlessness. 3. In powerlessness of elderly, total mean is 2.8493. And in factor of powerlessness, the highest factor is falling behind young people (M=3.1713), the lowest factor is loss of self- confidence to deal with physical, emotional, social aspects of life(M=2.6080). 4. The results from the test for the degree of powerlessness, according to the subject's demographic variables, showed that there were significant differences between age, sex, marital status, educational level, religion, possession of house, job, monthly pocket money, health status, illness and a place of residence.

The Relationship among Family Support, Powerlessness and Depression in the elderly patient / 성인간호학회지

This study was a descriptive correlationstudy. It tried to test the relationships between family support, powerlessness and depression in the elderly patient to develop basic data for nursing intervention. The subjects of this study were 61 patients, over the age of 60, who were admitted in one university hospital in Daegue. The data were analyzed by percentage, ANOVA and Pearson correlation coefficient. The results were as follows: 1. The mean score for family support was 3.52 (maximum score ; 4). The mean score for powerlessness was 2.51 (maximum score ; 4). The mean score for depression was 2.35(maximum score ; 4). 2. In general characteristics, educational level and number of children were significantly related to the level of depression 3. The correlations between family support and powerlessness, or family support and depression were negative. The correlation between power-lessness and depression was positive. This study revealed that powerlessness and depression were correlated with family support. Consequently, the implication for nursing is that there is a need to develop an intervention program for the patient's family in order to improve family support.

A Study on the Powerlessness, Self-Esteem, and Family Support of Elderly Home Residents / 성인간호학회지

This study was designed and undertaken to find out the degree of powerlessness, self-esteem and family support of elderly home residents and to determine the relationship between powerlessness, self-esteem and family support. The data were collected from October 1st to 20th, 1998. The subjects in this study were 271 elderly home residents over the age 60 living in Taejon city. The study tool for measuring powerlessness was developed by S.E.Chung(1998), the other for measuring self-esteem, was a self-esteem scale developed by Rosenberg, and the tool for measuring family support was developed by Choi(1983), Cobb(1976) and Kang(1984). Data were analysed for percentage, mean, t-test, ANOVA and Peason-correlation coefficients using the SPSS program. The results of this study were as follows ; 1. The degree of powerlessness, self-esteem and family support was scored avove the median. 2. The relationship between powerlessness and self-esteem revealed a no significant inverse correlation, but powerlessness and family support, showed a significant inverse correlation, and self-esteem and family support, registered a very statistically significant correlation. 3. The general characteristics showing the differences of the elderly' powerlessness were sex, one' s health of state compared to other elderly' and living expense load. These yielded statistically very significant results. 4. The general characteristics showing the differences of the elderly' self-esteem were sex, state of ownership of a house, age, religion, one's health of state compared to other elderly'. Among these, sex and state of ownership of a house revealed statistically very significant differences, also age, religion and one's health of state produced statistically significant differences. 5. The general characteristics showing the differences of the elderly' family support were sex, state of ownership of a house, having some diagnosed diseases or not and one's health of state compared to other elderly' health. These also showed statistically significant differences. In conclusion, the factors influencing the elderly' powerlessness, self-esteem and family support generally were age, sex, their economic independence and health of state(which included especially having a diagnosed disease). Also, the family support was needed to reduce their powerlessness and to have their self-esteem highly.