| ObjectiveThis study aimed to develop a nursing skills program and test its effects on people with dementia(PwD)and their caregivers.Methods1.Literature review: The domestic and foreign databases were searched to comprehensively understand and master the current research status of nursing skills for caregivers of PwD and analyze relevant interventions.2.Qualitative interview: 10 caregivers of PwD and 5 nurses were interviewed to make a supplement for nursing skills program.The results were analyzed by Colaizzi phenomenon analysis.3.Group discussion: The nursing skills program which include intervention form,time,contains,staff,etc were confirmed through the group discussion.4.Delphi expert consultation: The expert which from neurology,neurological rehabilitation,geriatric nursing or clinical medicine were selected to make importance judgment and propose amendment suggestions for nursing skills program.The mean,standard deviation,coefficient of variation and authoritative coefficient of expertconsultation were calculated according to the experts' scores on the importance,familiarity and judgment basis of each item.And evaluated the enthusiasm and authority of the experts.5.Preliminary test: Eight caregivers were randomly selected to test the nursing skills program.The program was modified according to the caregiver's reaction and opinions.6.Applied nursing ability program: This part was a quasi-experimental study design.Subjects were recruited from two departments of geriatrics in hospital of Zhengzhou.A total of 53 caregivers were included.The caregivers were randomly divided into intervention group(n=27)and control group(n=26).The control group received routine care,while the intervention group received routine care as well as the nursing skills program.Assessments were conducted at pre-intervention,post-intervention and one-month follow-up.The primary outcome was Dementia Caregivers' Nursing Ability Assessment Scale.The secondary outcomes were Quality of Life-Alzheimer's Disease scale(QoL-AD)and Zarit Burden Interview(ZBI).ResultsThe two rounds of Delphi response rate were 95% and 100%.The expert group authority coefficient was 0.897.In the first round of Delphi,the variation coefficient of 11 indicators were more than 0.25,the mean of 3 indicatosrs were less than 3.5.In the second round of Delphi,all indicators' variation coefficient was less than 0.25,and the mean were more than 3.5.After the first round of Delphi,3 indicators were deleted,13 indicators were modified,8 indicators were added.After the second round of Delphi,3 indicators were modified.As for nursing ability of caregivers,comparing with control group,caregivers who received The Nursing Skills Program showed significantly improvements at post-intervention and one-month follow-up(P<0.05).The main effects,time effects and interaction effects were statistically significant(P<0.05).There was significant difference(P<0.05)for post-intervention and one-month follow-up,compaired with pre-intervention.No significant difference was found between post-intervention andone-month follow-up(P>0.05).As for QoL of PwD,no significant difference(P>0.05)was found between control group and intervention group at post-intervention and one-month follow-up.The time effects and interaction effects were statistically significant(P<0.05).There were no significant difference of main effects(P>0.05).There was significant difference(P<0.05)of intervention groups for post-intervention and one-month follow-up,compaired with pre-intervention.No significant difference was found between post-intervention and one-month follow-up(P>0.05).As for caregiver burden,no significant difference(P>0.05)was found between control group and intervention group at post-intervention and significant difference(P<0.05)was found at one-month follow-up.The main effects,time effects and interaction effects were statistically significant(P<0.05).No significant difference of intervention groups was found when comparing the scores of each follow-up(P>0.05).ConclusionThe Nursing Skills Program for Caregivers of People with PwD based on Model of Caregiver Skill Building/Effectiveness which met the needs of caregivers has highly authoritative and good enthusiasm for this research.Experts believe that all indicators of the program were important and the opinions tend to be consistent.The Nursing Skills Program for Caregivers of People with PwD can improve the nursing ability,delay the decline of QoL and reduce burden of caregivers. |
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