| ObjectiveThis study adopts combined quantitative and qualitative research methods, In tangshan three first-class of three level hospital, the main caregivers and nursing personnel who nursed the neural medical hospital patients with cerebral apoplexy were researched. By discussing relevant knowledge, beliefs and behaviour (KAP) level and the influence factors of nursing staff and family main caregivers with the stroke rehabilitation, the effective rehabilitation education strategy was provided scientific basis.It make nursing staff, main caregivers and health professionals close coordination, promote physical, mental and social patients function recovery, improve the quality of life of the patients.MethodsFrom December 2009 to September 2010, using the method of convenient sampling, in three comprehensive three level of first-class hospital of tangshan worker's hospital, hebei joint university hospitaland kailuan hospital, the investigation objects were investigated by convenience sampling survey. Nursing staff 90,in patients with cerebral apoplexy and main caregivers every 200 accords with a condition.Quantitative research: adopt uniform survey scale to qualified main caregivers in patients within 3 days before discharge survey, which includes: basic situation, health, past medical history, rehabilitation ideas, knowledge, beliefs and behaviour questionnaire, the reliability and validity were inspected.The neural medical care personnel who meet the conditions were investigated by the investigation request forms, and assisted by head nurse. The questionnaires were distributed and recalled on the spot. The cognitive level, ability and activity of daily life, including psychological status were evaluated to meet the conditions of the stroke patients within 3 days before discharge. Of the cognitive level was evaluated by using simple cognitive level check list (mini-mental state examination,MMSE). were evaluated, The daily life activities( the ADL evaluation) used the functional independence measure scale (FIM). The psychological assessment was evaluated by using Hospital Anxiety Depression scale (HAD).Qualitative research: The study about nursing staff and main caregivers,in a single office, to face-to-face, semi-structured and in-depth interview method to collect data. First to interview object explain objectives, to get informed consent, after the whole the live recording was made. Every example case interview time is 35 ~ 60min sentence, then based on the content analysis, the conclusions were made.All material edited by building the database with EXCEL. They were statistical analysis by SPSS13.0. All data were descriptive analyzed for t-test, x2 test, analysis of variance, correlation analysis and multivariate linear regression analysis, P<0.05 was statistically significant.Results1.There were 207 cases who meet the requirements of stroke patients and main caregivers altogether in this investigation. The seven unqualified questionnaire were eliminated, the actual effective questionnaire were 200 cases, the validity was 96.62%. There were 94 nursing staff investigated, 4 unqualified questionnaire were eliminated, the actual effective questionnaire were 90, the validity was 95.74%.2.The mean knowledge score of caregivers was (33.55±8.99) points, accounting for 33.6 Percent of the full seore. The mean attitude score was (34.09±7.79)points, accounting for 57.0 percent of the full seore. The care behavior score was(26.38±6.29) points, accounting for 44.0 percent of the full seore.3.Pearson correlation analysis shows that caregivers between beliefs and behaviour (r=0.553, P<0.01); knowledge and behavior (r=0.499, P<0.01) there are positive correlation.4.By t-test and variance analysis showed that different gender, education, occupation, whether have family history, different residence and family caregivers in whether the medical care helps difference had statistical significance (P<0.05).5 There was a poor activity of daily living in the group wich has a low aregivers behavior score and know score. There has significant difference with the high-mark group(P<0.05).6 About total mark of aregivers behavior score and know score, the incidence of the patient anxious and athymia has significant difference between the high-mark group and the low(P<0.05).7.There was a high incidence of cognitive handicap in the group wich has a low aregivers behavior score and know score. There has significant difference with the high-mark group(P<0.01).8.The mean nursing care knowledge score was(54.52±8.19) points, accounting for 54.5 percent of the full score. The mean care belief score was(40.22±9.68)points, accounting for 67.0 percent of the full score. The mean care behavior score was(31.39±6.73) points, accounting for 52.2 percent of the full score.9.Pearson correlation analysis shows that there are positive correlation between the nursing knowledge and belief (r=0.343, P<0.01), beliefs and behaviour (r=0.766, P<0.01), knowledge and behavior (r=0.412, P<0.01).10. By t-test and variance analysis showed that there has statistical significance between different titles, whether have family history, whether the nursing staff do psychological nursing (P<0.05).Conclusions1.Main caregivers and nursing care knowledge score is still low. The belief score was at a relatively high level. The attending behavior score were also lower.2.There were positive correlation between the primary caregivers and nursing personnel's knowledge, beliefs and behaviour.3.The factors of influencing mainly caregivers KAP include the caregivers education, income, have relatives living, working, town have family history, profession, etc.4.The factors of influencing nursing staff KAP including stroke family history and titles.5.The nursing staff do not realize the importance of to learning stroke rehabilitation knowledge subjective. They have little chance to get continue education objectively. They have high demand to continue education and more chose to the study, but they have diversity enthusiasm low, working strain, night shift and much less chance to advanced study.6.There are many factors which affect the study chose of primary caregivers, which inclued cultural factors, stroke family history and propaganda influential of medical personnel. After analysis to main caregivers, they extract the knowledge by five types of orientation: active exploration; general initiative; passive receptive; hidebound type, negative indifference type. |
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