Research On The Status And Influencing Factors Of Primary Caregivers’ Empowerment Of Laryngectomy Patients

ObjectiveThe objective of this study is to investigate the present situation among main caregivers of laryngectomy patients,and analysis the influence factors of main caregivers’ empowerment.It will provide scientific references to develop an empowerment program for primary caregivers of laryngectomy patients,which will ultimately improve empowerment ability of caregivers.Methods1.Quantitative researchFrom Sep 2020 to Sep 2021,a total of 192 laryngectomy patients and their primary caregivers in the department of otorhinolaryngology-head and neck surgery in two grade-A hospitals in Qingdao were selected by convenience sampling method..The patients were investigated by general information questionnaire and daily living ability assessment.The primary caregivers were investigated using general information Questionnaire,Primary Caregiver Empowerment Scale(MCEM),Simple Coping Style Scale(SCSQ),and Caregiver Burden Scale(ZBI).Excel software was used for preliminary collation of data,and the software SPSS26.0 was used for statistical analysis.Descriptive statistical analysis,independent sample t-test,one-way ANOVA,Pearson correlation analysis and multiple linear stepwise regression analysis were adopted for data analyses.2.Qualitative researchFrom Oct 2021 to Jan 2022,we recruited 11 primary caregivers of laryngectomy patients in the department of otorhinolaryngology head and neck surgery in two grade A hospitals in Qingdao by purpose sampling method.Based on the interview outline,semi-structured interviews were conducted with 11 primary caregivers of laryngectomy patients to further understand the influence of related factors on caregivers’ empowerment.The interview data were sorted out and analyzed by Colaizzi 7-step analysis method.Results1.Quantitative research results(1)The present situation of caregivers’ empowerment of patients with laryngectomyThis study showed that the average score of empowerment ability of primary caregivers was(150.54±12.19),and the total score of all items in the scale was(2.95±0.24).Items of each dimension are ranked from highest to lowest,The following scores were(3.46±0.50)for relationship with caregivers,(3.28±0.54)for good care,(3.16±0.50)for expectation of care results,(2.94±0.50)for belief in care,(2.86±0.61)for knowledge and skills of care,and(2.83±0.51)for surrounding concerns,caregivers’ subjectivity(2.74±0.46),caregivers’ understanding of the role of care(2.73±0.44)and personal resources(2.57±0.38).(2)The results of univariate analysis showed that the age of patients,psychological status,daily living ability,gender of caregivers,education level,health status,and number of caregivers sharing had a statistically significant impact on the empowerment score of caregivers(P<0.05).(3)Pearson correlation analysis showed that: Caregiver positive coping style was positively correlated with caregiver empowerment(r=0.305,P<0.01),patients’ daily living ability was positively correlated with caregiver empowerment(r=0.387,P<0.001),caregiver burden was negatively correlated with caregiver empowerment(r=0.473,P<0.01).(4)The results of the multivariate regression analysis showed that the influential factors of caregivers’ empowerment were caregiver burden(β=-0.390,P<0.001),patient’s ability to live daily(β=-7.036,P=0.043),caregiver health status(β=-2.377,P=0.043),caregiver positive coping score(β=0.763,P=0.001),caregiver education level(β=1.871,P=0.004)and patient’s age(β=-2.444,P=0.021).2.Qualitative research resultsAfter sorting out and analyzing the interview data,the following five themes are extracted:(1)verbal communication difficulties with laryngectomy patients;(2)lack of knowledge about post-laryngectomy care;(3)primary caregivers of laryngectomy did not establish a concept of health empowerment care;(4)primary caregivers of laryngectomy face physical and mental stress;(5)there are insufficient social support resources for primary caregivers of laryngectomy.Conclusion1.The empowerment ability of the primary caregivers of laryngectomy patients is at a medium and low level,and the empowerment ability needs to be improved.2.The factors influencing the empowerment of primary caregivers of patients with laryngectomy include patient’s age,patient’s ability to live daily,caregiver’s health status,caregiver’s education level,caregiver’s active coping and caregiver’s burden.3.The empowerment of caregivers of patients with laryngectomy was influenced by their physical and mental status,nursing philosophy,communication,social resources,disease knowledge and other factors.Medical staff should intervene according to the factors that affect caregivers’ empowerment ability,so as to improve caregivers’ empowerment ability.