The Hope-based Psychological Nterventions On Main Caregivers Of Convalescent Patients With Spinal Cord Injury During Their Caregiving Experiences

Objectives To evaluate the impacts of psychological interventions based on the hope theory on lowering the caregiving burden and improving positive experience Via exploring the current situation and main influential factors for main caregivers of convalescent patients with Spinal Cord Injury during their caregiving experiences,and to provide the reference basis for promoting the application of this mode in clinical nursing.Methods(1)A total of 193 caregivers of patients with spinal cord injury were extracted from the rehabilitation department of four third-grade class-A hospitals in Changsha City and Hengyang City by convenient samples from 2015.06 to 2016.12.The basic data of patients with Spinal Cord Injury and their main caregivers were collected using the questionnaires.The Zarit Burden Interview and the Positive Aspects of Caregiving were used to evaluate levels of caregiving burden and positive experience,and the relationship between them was analyzed.(2)The proper participants(n=12)were chosen as interviewees for qualitative research during the investigation's going on.The status of those main caregivers' positive experience and its influential factors in depth were found out.(3)A total of 70 main caregivers of patients with Spinal Cord Injury,who were from a third-grade class-A hospital,were selected and evenly and randomly divided into the control group(n=35)and the intervention group(n=35)according to the chronological order of admission.All caregivers were treated with routine health education including rehabilitation theory training,caregiving skills training,common problems in the caregiving process,simple coping mode,and etc.Meanwhile,the caregivers in the intervention group were treated with psychological intervention based on the hope theory.The intervention effects were evaluated before the intervention,after the first month and the third month of the intervention,respectively.(4)Software package for statistical analysis 17.0(SPSS17.0)was used to analyze the data.The statistical methods involved the paired t test,X2 test,and multivariate Logistic regression analysis.P < 0.05 was expressed as statistically significant.Results(1)The scores of caregiving burden and positive experience of main caregivers of 193 patients with Spinal Cord Injury were(41.544±7.186)and(29.41±3.18),respectively.There was negative correlation between them.The patients' injuried level,injuried degree,self-care ability,family monthly income,cooperative caregivers,and the total caregiving time could explain 61.8% of the total variance and those were independently influential factors for their caregiving burden.(2)The positive caregiving experience in qualitative research could be concluded 4 themes as following:(1)exploring obvious periodic changes in psychology and adaptation to caregiving situations;(2)keeping a balance point and releasing caregiver burden;(3)helping each other and realizing the genuine caregiving value;(4)keeping rehabilitation exercise and beginning to make plans for the future.(3)Compared the demographic characteristics,scores of caregiving burden and the levels of positive feeling between the main caregivers in the intervention group and the control group before intervention,the differences were not statistically significant(P>0.05).(4)After 1month's intervention,the mean score of total caregiving burden(35.88±6.85)and role burden(21.50±2.96)of caregivers in the intervention group were significantly lower than those in the control group[(39.60±6.65),(23.24±3.17)]((P<0.05);there were no statistically significant differences compared the score of personal mean burden of caregivers between in the intervention(6.53±1.72)and in the control group(7.45±3.00)(P>0.05).After 3 months' intervention,the scores of total mean caregiving burden,role burden,personal burden [(35.14±4.82),(20.71±2.47),(6.05±1.48)]in the intervention group were obviously lower than those in the control group [(39.45±6.58),(22.97±3.12),(7.60±2.96)](P<0.05).(5)After 1 month and 3 month intervention,the scores of the positive feeling,self affirmation and life expectation in the intervention group were obviously higher than those in the control group,respectively(P<0.05).Meanwhile,after intervention,their scores in the intervention group were significantly higher than those before intervention(P<0.05);their scores after 3 months' intervention were obviously higher than those after 1 month's intervention.Conclusions(1)The caregiving burden of main caregivers of patients with Spinal Cord Injury was at the moderate level,while the positive experience was at the medium and low level.(2)To evaluate caregiving burden of main caregivers of patients with Spinal Cord Injury mainly based on the influential factors including impacted level of patients,impacted degree,self-care ability,family monthly income,cooperative caregivers,and the total caregiving time.(3)The psychological intervention based on the hope theory could effectively improve the positive experience and lowering caregiving burden of main caregivers of Spinal Cord Injury patients.