Journal List > J Korean Acad Psychiatr Ment Health Nurs > v.21(3) > 1057943

Kim, Park, Lee, and Lee: Resilience of Families with Elderly Patients with Dementia



The purpose of this study was to pave the way for developing nursing intervention strategies to enhance family resilience by identifying unique patterns of resilience in families of elderly patients with dementia.


The Q-methodology was used to define types and describe characteristics of family resilience. After in-depth interviews with 12 family members of patients with dementia and study of related literature, final 50 Q-samples were selected by collecting the opinions of experts. The selected 50 Q-statements were sorted by 30 family members (P-samples). The PC-QUNAL program was used to analyze Q-sort data.


Four distinctive Q-factors for family resilience were identified: I. Seeking positive meaning, II. Developing reasonable cooperation with family members, III. Accepting reality passively, IV. Depending on external resources.


Families caring for elderly patients with dementia show unique patterns of family resilience, which result from multi-factors, such as their own belief systems or culture, organizational patterns, and communication processes, in dealing with crisis. The results of this study can be useful in confirming the types of resilience of families of patients with dementia and their characteristics, and the underlying data can be used as to develop tailored nursing strategies for strengthening family capacities to master adversity.

Figures and Tables

Table 1
Eigen Value, Explained Variance, and Cumulated Variance of Q Factors
Table 2
Factor Weights by Q Factors and Characteristics of the Subjects

P sample who shows the highest factor weight among P samples of each Q factor.

DL=daughter-in-law; ES=elementary school; MS=middle school; HS=high school; GS=graduate school; NH=nursing home; HHC=home health care; DC=daycare center; CWC=community welfare center.

Table 3
Array of Z-score of Four Q Factors and Q Items


1. Antonovosky A. Stress, coping, and health in families. 1998. Thousand Oaks, CA: Sage.
2. Bae KW, Choi MH. Resilience in children with chronic illness and in their family. J Korean Acad Child Health Nurs. 2006. 12:223–232.
3. Covinsky KE, Newcomer R, Fox P, Wood J, Sands L, Dane K, et al. Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. J Gen Intern Med. 2003. 18:1006–1014.
4. Donaldson C, Tarrier N, Burns A. The impact of the symptoms of dementia on caregivers. Br J Psychiatry. 1997. 170:62–68.
5. Dunkin JJ, Anderson-Hanley C. Dementia caregiver burden: A review of the literature and guidelines for assessment and intervention. Neurology. 1998. 51:1 Suppl 1. S53–S67.
6. Fitzpatrick KE, Vacha-Haase T. Marital satisfaction and resilience in caregivers of spouses with dementia. Clin Gerontol. 2010. 33:165–180.
7. Gaugler JE, Kane RL, Newcomer R. Resilience and transitions from dementia caregiving. J Gerontol B Psychol Sci Soc Sci. 2007. 62:P38–P44.
8. Harmell AL, Chattillion EA, Roepke SK, Mausbach BT. A review of the psychobiology of dementia caregiving: A focus on resilience factors. Curr Psychiatry Rep. 2011. 13:219–224.
9. Hawley DR. Clinical implications of family resilience. Am J Fam Ther. 2000. 28:101–116.
10. Janevic MR, Connell CM. Racial, ethnic, and cultural differences in the dementia caregiving experience: Recent findings. Gerontologist. 2001. 41:334–347.
11. Kim HK. Q-methodology: Philosophy of science, theory, analysis, and applications. 2008. Seoul: Communication Books.
12. Kim SD, Kim YH. The effect of family resilience on the life satisfaction of the family caregivers of the elderly with the dementia. J Welf Aged. 2009. 45:7–31.
13. Kim SM, Lee YJ, Yoo SJ, Park MJ. Hassles in caring dementia patients at home: From family caregivers' perspectives. J Korean Acad Psychiatr Ment Health Nurs. 2007. 16:357–367.
14. Lee HH. Resilience of adolescents according to the problem-drinking in parents. 2003. Seoul: Yonsei University;Unpublished master's thesis.
15. Lee IS, Park YS, Song MS, Lee EO, Kim HS, Park YH, et al. A study on the development of the Korean family resilience scale. J Korean Acad Nurs. 2002. 32:560–569.
16. Lee SJ, Park HR, Kim NC. Life satisfaction and burden for primary caregivers of patients with dementia in day care centers and in their homes. J Korean Gerontol Nurs. 2005. 7:37–46.
17. Lee SY, Park HR, Choi SE, Lee SJ. Depression and depression relating variables for caregivers of patients with dementia in home. J Korean Acad Psychiatr Ment Health Nurs. 2005. 14:250–259.
18. Levine C. The loneliness of the long-term caregiver. Caring. 1999. 18:54–57.
19. McCubbin HI, Thompson AI, McCubbin MA. Family assessment: Resiliency, coping, and adaptation-inventories for research and practice. 1996. Wisconsin: University of Wisconsin Publisher.
20. Nichols M, Schwartz R. Family therapy: Concepts and methods. 2000. 5th ed. Needham Heights: Allyn & Bacon.
21. Ross L, Holliman D, Dixon DR. Resilience in family caregivers. J Gerontol Soc Work. 2003. 40(3):81–96.
22. Tusaie K, Dyer J. Resilience: A historical review of the construct. Holist Nurs Pract. 2004. 18:3–10.
23. Walsh F. Strengthening family resilience. 1998. New York: Guilford Press.
24. Walsh F. A family resilience framework: Innovative practice applications. Fam Relat. 2002. 51:130–137.
25. Yoo YS. The study on factors affecting adaption of the family with the elderly dementia. J Welf Aged. 2007. 38:31–50.
Similar articles