Abstract
Chronic illness requiring attention and management during a long period of time puts great burden onto
patients, their family and society.
For patients with chronic illnesses, providing social support is the most important, and the fundamental
support comes from their spouses. Amount and quality of support from spouses seems to differentiated
according to the sex of patients. Female patients tend to believe that their spouses are not very supportive.
Therefore, the researchers assessed the burden of husbands of female arthritis patients to discover the
factors that result in greater burden. Also, they developed a theoretical model of husbands' care for
their wives through a qualitative research into husbands' experience.
Method 1: The study material was 650 female arthritis patients registered in an arthritis clinic. The
questionnaire about the disease experience of female arthritis patients and the burden of husbands were
sent. Returned questionnaires numbered 210(32.3%) and 27 were excluded because of inadequate answers.
The remaining 183 questionnaires were analyzed. The mean age of the patients was 51 years and the mean
age of spouses was 55 years. The mean marital period was 28 years. The average duration since diagnosis
was 9.1 years. Education level was varied from primary school to graduate school, and average
income/month was 1,517,300 won.
Method 2: Initial questionnaire studies on the burden of husbands were performed. Among 183
responding husbands, 23 consented to participate for a qualitative research. Data was obtained by direct and
telephone interviews. The mean age of participants was 58 years, and the educational level and
socioeconomic status also varied.
Result:
1. Husbands' burden: The average burden was 57.68 with a range of 6-96.
2. Burden and general characteristics: The husband's burden correlated with the age of the patients, numbers
in the family, therapy methods, patient's level of discomfort, patient's disease severity, patient's level of
dependence and the husband's understanding of the level of severity. 3. Linear correlation analysis on
burden: The husbands' burden is explained in 22.5% by husband's recognition of level of severity and
husbands' age.
4. There were four patterns of the burden on husbands: both objectve burden and subjective burden were
high(pattern I), both of objectve burden and subjective burden were low(pattern II), objective burden was
high but subjective burden was low(pattern III), objective burden was low but subjective burden was
high(pattern IV). The pattern was correlated with the family income, educational level of the patients and
their husbands, therapy methods, patient's level of discomfort, patient's disease severity, patient's level of
dependence and husband's understanding of level of severity.
5. The core category of the caring experience of the husbands with arthritis patients was "companionship". The
causal factor was the patients' experience due to symptoms : physical disfigurement, pain, immobility,
limitation of house chores, and limitation of social activities. Contextural factors are husbands' identification
of housework and husbands' concern about the disease. The mediating factors are economic problems, fear of
aging, feeling of limitation and family support. The strategy for interaction is mind control and how to solve
emotional stress. The "companionship" resulted from caring activities, participation of household activities,
helping patients' to coping with emotional experience.
6. Companionship is established through the process of entering intervention, and caring state of mind. Entering
intervention is the phase of participation of therapy and involvement of houseworks. The caring phase
consists of decision on therapy, providing therapy, providing direct care, and taking over the household role
of wife. Through caring phase, the changing phase set a stage in which husbands consolidate the relationship
with their wives, and are reminded of the meaning of marriage. As a result, in changing phase, husbands'
companionship is enhanced.
In conclusion, nursing care of chronic illnesses should include a family member especially the
spouse. All information on disease shoud be provided to patients and whole family member. Strong
support should also be provided to overcome difficulties in taking over role of other sex. Then the quality of
life of patients and families will be much improved.