Application Of Phase Intervention Strategy On Family Caregivers In Patients With Stoma Based On “Timing It Right”framework

Object:Using the “Timing It Right” as a framework to understand the care experience and needs of caretakers of stoma patients in the care process,providing a basis for formulating intervention strategies,and explored the "4T" phase intervention strategy based on timing theory to caregiver care ability,caregiver’s needs,care burden,patient’s stoma adaptation level,and ostomy complications.Method:The study was conducted in two parts.The first part is qualitative research:Based on the timing theory,the caretakers of enterostomal patients in a top-three hospital in Zhenjiang were selected.Using semi-structured interviews,40 in-depth caregivers were interviewed to understand their care experience.In the second part of the intervention study,42 pairs of entero-ostomy patient caregivers and patients from a third class hospital in Zhenjiang City were selected as the control group,and 41 pairs of caregivers and patients from the second group of gutostomy patients were included in the intervention group.The caregiver is the object of intervention.The control group was given routine care,and the intervention group received the “4T” stage intervention strategy on the basis of routine care(Focusing on caregivers’ needs for care,the strategy developed around the caregivers’ four-stage care needs during the perioperative period,discharge preparation period,adjustment period and adaptation period).Taking the caregiving ability of the family carer,the caregiver’s needs,the care burden,the patient’s stoma adaptation level,and the incidence of colostomy complications as evaluation indicators,the effects were evaluated before intervention,at discharge,and 3 or 6 months after discharge.SPSS16.0 software was used for statistical analysis.Result:The first part of qualitative research results: According to the timing theory,through interviews with the caregiver of patients with intestinal stoma,establish and refine the care experience of the caregiver’s stage of care and corresponding period:(1)Perioperative period: Uncertainty of illness and post-traumatic stress disorder;(2)Preparation for discharge: challenge after subjective initiative adjustment;(3)Adjustment period: practice and re-cognition;(4)Adaptation period: post-traumatic growth.The second part of intervention research results:(1)The caregiving ability,care burden,and care needs of caregivers in the intervention group were better than the control group at the same time at different time points(P<0.05),and there was a significant interaction(P<0.05),but caregiver care needs There was no significant difference in the scores of some dimensions of the satisfied subscales compared with the control group(P>0.05).The upward trend of care ability and demand satisfaction in the intervention group was greater than that in the control group,and the downward trend in care burden was greater than in the control group.(2)The stoma adaptation level of the intervention group was better than that of the control group at the different time points(P<0.05),and there was a significant interaction(P<0.05);the increase of the stoma adaptation level in the intervention group was greater than Control group.Three months after discharge,the incidence of complications of stoma in the intervention group was lower than that in the control group,and the difference was significant(P<0.05).Conclusion:Qualitative research shows that caregivers have different intrinsic experiences and needs in different stages of care.Based on this,the “4T” phase intervention strategy is formulated to effectively meet caregiver’s needs and reduce their care by improving caregivers’ ability to care for them.Burden to improve the patient’s stoma adaptation level and reduce the incidence of colostomy complications.