Paper
Wednesday, 19 July 2006
This presentation is part of : Providing Care Within an Appropriate Cultural Context
Mediators/Moderator of Quality of Life of Korean Family Caregivers with Older Stroke Patients
JuHee Lee, PhD, RN, School of Nursing, Univ. of Maryland, Baltimore, MD, USA and Sandra J. Picot, PhD, RN, FAAN, School of Nursing, University of Maryland, Baltimore, MD, USA.
Learning Objective #1: Discuss the antecedents of quality of life in a sample of family caregivers of Korean stroke patients.
Learning Objective #2: Articulate mediators and cultural moderator of the antecedents-quality of life relationships using the stress and coping model.
BACKGROUND: Most caregiver studies have focused on negative caregiver appraisals (i.e., burden, stress) within Caucasian women in the USA, limiting generalizability.  Using Lazarus’ stress and coping model, the study’s purpose was to examine proposed antecedents and mediators/moderator of QOL (quality of life) for Korean caregivers of older stroke patients. DESIGN: A cross-sectional design was used.  SAMPLE:  Using a convenience sampling method, a sample of caregivers (age 21+) (n = 145) of older stroke patients (60+) was recruited from three outpatient clinics of hospitals and two home health agencies in Seoul, Korea and a suburb.  VARIABLES: Antecedents were caregiver age, gender (0=male, 1=female), education, income, relationship to patient, obligation level (cultural characteristic), hours of caregiving/week, living arrangement; patient age, gender, stroke duration, and disability level. Mediators were perceived social support and caregiver appraisal. Moderator was caregiver obligation. Outcome variable was caregiver’s QOL. METHODS:  After informed consent, the questionnaires were self-administered.  Simultaneous and hierarchical multiple regressions were applied for data analyses using SPSS 13.0. FINDINGS:  The predictors explained 23% of QOL. Hours of caregiving/week (β = -.28, p< .01)  was a significant predictor indicating longer weekly hands-on care predicted lower QOL.  Additionally, gender predicted QOL significantly (β = -.20, p< .05) indicating that male caregivers had higher QOL than female caregivers.  Perceived social support mediated the antecedent variables-QOL relationship.  Obligation moderated the relationship between caregiver appraisal and QOL. In situations of high obligation, the effect of stress appraisal on QOL was buttressed in spouse caregivers. 

CONCLUSIONS: As hours of caregiving increase and women provide care, nurses need to refer them to community resources. Since perceived social support linked antecedents to increased QOL, recommending culturally consistent forms of social support can raise caregiver QOL. Spouses with low obligation should be targeted for stress-reduction. The study findings can be used to develop culturally specific interventions and social policies.

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