An Applied Intervention Study Of The Trans-Theoretical Model Of Change In Caregivers Of Stroke Hemiplegia Patients

objective :The effect of the trans-theoretical model of change on the care ability,care behavior and general self-efficacy of family caregivers of hemiplegic patients,as well as the readmission of patients with hemiplegia,was discussed,in order to provide a new reference for clinical medical staff to carry out the ability training of hemiplegic stroke caregivers.method :This study takes the trans-theoretical model of change as the guiding framework,integrates evidence-based evidence to construct an intervention program for stroke caregivers and observe clinical effects,which consists of three parts,which are as follows:1.Integrate the nursing and management evidence required by stroke hemiplegia patients: In order to provide stroke hemiplegia caregivers with more advanced and comprehensive care knowledge and skills,construct an intervention plan system for stroke hemiplegia caregivers,comprehensively and systematically search major databases and related literature,evaluate according to literature quality evaluation standards,and extract and sort out the nursing and management evidence required by stroke hemiplegic patients.2.Construct the intervention plan of stroke hemiplegia caregiver with the trans-theoretical model of change: take the trans-theoretical model of change as the guiding framework,take the aggregated evidence as the basis,and combine clinical experience to formulate the first draft of the stroke hemiplegia caregiver intervention plan based on the trans-theoretical model of change,further improve the intervention plan through expert group meetings and pre-experiments,and determine the final draft of the stroke hemiplegia caregiver intervention plan of the trans-theoretical model of change.3.Application of intervention plan and observation of clinical effect: family caregivers of stroke hemiplegia patients who met the criteria for inclusion in April ～ October 2022were selected,random sampling was used,and samples were screened by time group,and 41 cases were included in the control group and intervention group.the control group was given conventional treatment and care;The experimental group set up an intervention group to implement the nursing intervention of the trans-theoretical model of change on the basis of the control group.The effect of the intervention was evaluated by using the Stroke Caregiver Comprehensive Care Ability Questionnaire,the Caregiver’s Behavioral Stage,Stroke Caregiver Behavior Questionnaire,General Self-Efficacy Energy Scale,and the patient’s unplanned readmissions.Results:1.Summarize the best evidence-based medical evidence for the care and management of hemiplegic patients with stroke 28 itemsAfter screening and evaluation,13 articles were finally included,including 8 guidelines,3 systematic reviews,and 2 expert consensus,and the evidence was synthesized from four aspects: system management,rehabilitation nursing,complication prevention,and health education,and finally 28 best pieces of evidence were formed.2.A stroke hemiplegia caregiver intervention program constructed by the trans-theoretical model of changeBased on the best evidence,the first draft of the intervention plan for caregivers of stroke hemiplegia patients with the trans-theoretical model of change was formed,the research plan was modified with expert opinions,the study design was improved,and 6stroke hemiplegia caregivers who met the exclusion criteria were selected for pre-experiment,and after the pre-experiment,they communicated with the caregivers,listened to the real feelings of the caregivers in the intervention process,and adjusted the intervention plan with the intervention team members,and finally determined the final draft of the intervention plan for caregivers of stroke hemiplegia with the trans-theoretical model of change3.Completed the clinical effect observation of the intervention program In this study,a total of 82 stroke hemiplegia caregivers were included as the research subjects,and 5 samples were eventually lost,and the remaining 77 cases were completed,of which 40 cases were completed in the intervention group and 37 cases were completed in the control group.Before the intervention,the comprehensive care ability,behavioral stage,care behavior,and general self-efficacy of the two groups were not statistically significant(p>0.05),which were comparable.After one month of intervention,the behavioral stage of caregivers in the intervention group was not statistically significant compared with that of the control group(p>0.05),and the comprehensive care ability,caring behavior and general self-efficacy level of caregivers in the other intervention groups were significantly better than those in the control group,and the differences were significant(p<0.05).After 3 months of intervention,except for the readmission of patients cared for by caregivers in the intervention group compared with the control group(p>0.05),the comprehensive care ability,behavioral stage,nursing behavior and general self-efficacy level of caregivers in the other intervention groups were significantly better than those in the control group,and the differences were statistically significant(p<0.05).conclusion :1.The control group was given conventional nursing intervention,and the intervention group implemented nursing intervention based on the trans-theoretical model of change on the basis of the control group,and both intervention methods could improve the ability of stroke hemiplegic caregivers.2.The implementation of the intervention program based on the trans-theoretical model of change improved the caregiver’s care ability,which had a beneficial effect on the behavior stage of the caregiver,the caregiver’s behavior,and the general self-efficacy level of the caregiver.