| Objective:Based on the current situation that most stroke patients need long-term rehabilitation and care support due to their disabilities,but family caregivers have insufficient caring ability,the present study investigated the effects of training caregivers in the video teach-back method on the care ability and caregiver burden of family caregivers with stroke patients,as well as its effects on motor function,activities of daily living,and anxiety and depression in stroke patients.It provides a basis for the effectiveness and scientific validity of the video teach-back method applied to stroke family caregivers,and provides a new evidence-based method for the continuous rehabilitation care of stroke patients from hospital to their families.Methods:This study was a randomized controlled trial.A convenience sampling method was used in the present study.Stroke patients over 18 years of age who were diagnosed as first-ever stroke by cranial CT or MRI examination,and who were unable to take care of themselves completely and were conscious,were widely recruited from the Department of Rehabilitation Medicine in a grade-A hospital in Changchun,China,and then qualified family caregivers were selected according to the inclusion and exclusion criteria.A total of 50 participants were finally included and randomly divided into the intervention group and the control group.The caregivers in the control group were given routine health education,while the caregivers in the intervention group was trained by video teach-back method based on the control group for 3 weeks,with specific arrangements for 3 sessions per week and 9 sessions in total.The training content mainly included three aspects: stroke related knowledge,daily life care and rehabilitation training.The comprehensive caregiving ability assessment questionnaire and the Zarit Caregiver Burden Interview（ZBI）were used to evaluate the care ability and caregiving burden of family caregivers in both groups at baseline,post-intervention（3 weeks）,1 month post-discharge（7 weeks）,and 3 months post-discharge（15 weeks）,and the Motor function assessment scale（MAS）,Barthel index（BI）,the Self-Rating Anxiety Scale（SAS）and the Self-Rating depression scale（SDS）were used to evaluate motor function,activities of daily living,anxiety and depression of stroke patients in the two groups,respectively.SPSS 26.0 was used for statistical analysis.Independent sample t-test,chi-square test,Fisher’s exact test,and Mann-Whitney U test were used to compare the baseline data of participants in both groups.And repeated measures analysis of variance（repeated measures ANOVA）was used to compare the time effect,between-group effect,and time*group interaction effect of each outcome indicator between the two groups of participants at each time point.Independent sample t-test or Mann-Whitney U test was used for comparison between groups,and paired sample t-test or Wilcoxon signed rank sum test was used for intra-group comparison of intervention effects.Results:1.The baseline assessment: There were no statistical differences in the total care ability scores,the four sub-dimension scores,or the ZBI scores of the family caregivers in both groups at baseline（P > 0.05）.Also,there were no statistical differences in the MAS scores,BI index,SAS standard scores,or SDS standard scores of the two groups at baseline（P > 0.05）,which meant the data were comparable between the two groups.2.Analysis of the care ability of family caregivers: The results of the repeated measures ANOVA showed significant time effects,between-group effects and time*group interaction effects for the total care ability scores,the “knowledge of stroke” dimension scores,and the “Caregivers’ care skills” dimension scores.And compared to the data of baseline,the total care ability scores,the “knowledge of stroke” dimension,and the “caregivers’ care skills” dimension scores of the family caregivers in the intervention group were significantly higher at 3,7,and 15 weeks post-intervention（P < 0.05）.And the “self-management of stress and health”dimension scores of the family caregivers at 7weeks and 15 weeks after intervention in the intervention group were significantly higher compared to the data at baseline（P < 0.05）.Compared to the control group,the total care ability scores,the“knowledge of stroke” dimension,and the “Caregivers’ care skills” dimension scores of the family caregivers in the intervention group were significantly higher at 3,7,and 15 weeks after intervention（P < 0.05）.And the “Coping strategies” dimension scores of the family caregivers in the intervention group were significantly higher at15 weeks post-intervention compared to the data from the control group（P < 0.05）.While there were no statistical difference in the “self-management of stress and health” and “coping strategies” dimension scores of the family caregivers in the intervention group at remaining time points（P> 0.05）.3.Analysis of the caregivers’ burden: Compared to baseline,the ZBI scores of the caregivers in the intervention group were significantly lower at 3,7,and 15 weeks post-intervention（P< 0.05）.Compared to the control group,there was no statistical difference in the ZBI scores of caregivers in the intervention group at 3 weeks post-intervention（P > 0.05）.However,the ZBI scores of caregivers in the intervention group at 7weeks and 15 weeks after the intervention were significantly lower compared to the data in the control group（P < 0.05）.4.Analysis for motor function and activities of daily living: The results of the repeated measures ANOVA showed that there were significant time effects and time*group interaction effects for MAS scores and BI index,but the between-group effects were not significant.Compared with baseline,the MAS scores and BI index of stroke patients in the intervention group were significantly increased at 3,7 and15 weeks after the intervention（P < 0.05）.Compared with the control group,there was no statistically significant difference in the MAS scores and BI index of patients in the intervention group at 3 weeks post-intervention（P > 0.05）.However,at 7 and15 weeks after the intervention,the MAS scores of patients in the intervention group were significantly increased compared with the data in the control group（P < 0.05）,while the BI index of patients in the intervention group were also significantly increased（P < 0.05）at 15 weeks after the intervention compared with the data in the control group.5.Analysis of anxiety and depression in stroke patients: The results of the repeated measures ANOVA showed significant time effects and time*group interaction effects for SAS and SDS scores,and there were significant between-group effects for SAS scores.Compared to baseline,the SAS and SDS scores of patients in the intervention group were significantly lower at 3,7,and 15 weeks post-intervention（P < 0.05）.Compared with the control group,the SAS and SDS scores of patients in the intervention group were significantly lower at 7 and 15weeks（P < 0.05）.However,there were no significant differences in the SAS and SDS scores between the two groups at 3 weeks（P > 0.05）.Conclusions:1.Compared with the routine health education group,training caregivers through the video teach-back method can significantly improve the care ability of family caregivers of stroke patients,especially in terms of the knowledge and skill dimensions,and it does not increasing the caregivers’ burden.2.Training caregivers through the video teach-back method significantly improved motor function and activities of daily living in stroke patients,especially at7 and 15 weeks after the intervention.3.Training caregivers through the video teach-back method significantly improved anxiety and depression in stroke patients.4.The video teach-back method is effective and safe for in-hospital training of stroke family caregivers,and it is a suitable model for the current hospital-family continuous rehabilitation for stroke patients. |
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