The Cognitive Behavioural Intervention On Main Caregivers Of Patients With Aortic Dissection During Their Caregiving Experience

ObjectivesTo evaluate the impacts of cognitive behavioral intervention based on the stress assessment coping theory on caregiving burden,quality of life and social support Via investigating the current situation and main influential factors for main caregivers of patients with Aortic Dissection(AD)during their caregiving experiences,and to provide the reference basis for promoting the application of this mode in clinical nursing and improving the patients rehabilitation and reduce the family or social burden.Methods(1)A total of 170 main caregivers of the patients with Aortic Dissection were extracted from the Cardiothoracic surgery department of a third-grade class-A hospital in Hengyang City by convenient samples from May 2016 to June 2017.The basic data of patients with Aortic Dissection and their main caregivers were collected using the questionnaires."The Zarit Burden Interview","the Positive Aspects of Caregiving" and "the Social Support Rating Scale" were used to evaluate levels of caregiving burden,quality of life and social support.(2)The proper participants(n=10)were chosen as interviewees for qualitative research during the investigation's going on.The status of those main caregivers' problems and mood experience and its influential factors in depth were approached.(3)A total of 97 main caregivers of the patients whose scores of caregiving burden ?21 with Aortic Dissection,who were from a third-grade class-A hospital,were selected and randomly divided into the control group(n=49)and the intervention group(n=48)according to the chronological order of admission.All caregivers were treated with routine health education.Meanwhile,the caregivers in the intervention group were added the treatment with cognitive behavior model intervention based on the stress assessment coping theory.The intervention effects were evaluated before and after the intervention including caregiving burden,quality of life and social support.(4)Software package for statistical analysis 17.0(SPSS17.0)was used to analyze the data.The measurement data were expressed by mean ± standard deviation(X ±S);the counting data were expressed by number(n)or rate(%).The statistical methods involved the Chi square(?2)test,two independent samples t test or approximate t test,paired t test.P<0.05 was expressed as statistically significant.Results(1)A total of 162 valid questionnaires were collected in this study.Among 162 main caregivers of the patients with Aortic Dissection,the total scores of caregiving burden were(34.26±17.26),59.88%(97)of the patients had moderate to severe caregiving burden.The scores of personal burden were(22.25±7.54),and the scores of responsibility burden were(8.97±4.72).The scores of the dimension of body health were(46.37±7.54)and the scores of the dimension of mental health were(46.05±7.86)for quality of life of main caregivers.(2)The total scores of social support were(37.55±6.51);and the scores of its dimensions of objective support,subjective support,and utilization of social support were respectively(8.42±4.76),(21.61 ±3.23),and(7.52±3.69).(3)There were four topics in qualitative studies including the psychological burden and heavy pressure of caregiving,the lack of knowledge about diseases,the exhaustion and decline of health status,and the heavy financial burden.(4)There was no significant difference for the general demographic data of main caregivers of the patients with Aortic Dissection or the patients with aortic dissection between 2 groups before the intervention(P>0.05).(5)After the intervention,two groups burden of caregivers to take care of the total score and each dimension score were statistically significant(P < 0.05);Intervention group care burden of caregivers scored significantly lower than control group in total scores and all dimensions burden,the difference was statistically significant(P < 0.05).(6)After the intervention,two groups of caregivers of body health score were decreased,but the decline was not significant,there was no statistically significant difference(P > 0.05),score after the intervention of mental health were statistically significant(P <0.05).Caregivers of scores of mental health intervention group was obviously higher than the other,the difference was statistically significant(P < 0.05).(7)After the intervention,two groups of the total score of social support of caregivers were statistically significant(P < 0.05);Caregivers of social support intervention group was obviously higher than the control group,the difference was statistically significant(P < 0.05).Conclusions(1)The caregiving burden of main caregivers of patients with Aortic Dissection was at the medium and tending to severe level.(2)Cognitive behavior intervention could reduce the care burden of main caregivers of the patients with aortic dissection,personal burden,and responsibility burden.(3)Cognitive behavior intervention could improve the quality of life of main caregivers of the patients with aortic dissection and effectively enhance their social support.