| Objectives: To construct a comprehensive intervention program of caring touch based on the psychological capital intervention model and Swanson caring theory that meets the characteristics of the home dwelling disabled elderly,analyzing the effects on the subjective well-being,psychological capital and depression level of them,providing data for an empirical study on the expansion of the content of long-term care services at home.Methods:1.Intervention program construction: Based on theoretical research,policy research and literature research,the framework of the intervention program was formed by exploring the theoretical interconnections;semi-structured interviews were conducted with 15 elderly people with home dwelling disabilities using qualitative research.The home care needs of elderly people with disabilities were analyzed using the Colaizzi 7-step analysis method;the first draft of the intervention program was prepared after adapting the intervention program to the population.The intervention plan was finalized through two rounds of expert consultation.2.Intervention program application: A multi-stage sampling method was adopted to randomly select two institutions in the pre-experiment and three institutions in the formal experiment among the nine institutions currently providing home care services with long term care insurance in a county.A simple random sampling method was used to randomly select the elderly with disabilities who were entitled to home care with long term care insurance from the institutions according to the estimated sample size,and they were randomly divided into a control group(n=30),a hand touch group(n=30)and the comprehensive intervention group(n=30).The control group was provided with conventional long-term care insurance home care services.The hand touch group was given a hand touch program(Synder’s hand touch program combined with TCM acupressure techniques)for 12 weeks,three times a week for 10 min each time.The integrated intervention group was given the same frequency of 12 weeks of interventions based on the hand touch program combined with psychological capital intervention model and music therapy.Repeated measures ANOVA was used to compare the subjective well-being(Memorial University of Newfoundland scale of happiness,MUNSH),psychological capital level(Positive Psycap Questionnaire,PPQ),and depression status(Geriatric Depression Scale-15,GDS-15)of the elderly with disabilities in the three groups at week 0,week 6,and week 12 of the intervention.3.Qualitative study: Using purposive sampling method,a semi-structured in-depth interview was conducted around the interview outline to analyze the post-intervention experience of 15 elders with severe disability who were receiving long-term care insurance home care services in a county,Jiaxing City.Results:The interaction effects of group and measurement time for subjective well-being and depression scores and group main effects for psychological capital scores were significant(p<0.05)in the three groups of disabled elderly.Subjective well-being: Scores at 6 and 12 weeks of intervention in the combined intervention group were(31.13±5.97)and(32.13±5.29),respectively;significantly higher than in the control group [(24.57 ± 7.46)and(25.20 ± 6.58)] and the hand touch group [(26.67±6.76)and(27.90±7.00)](p< 0.001);the mean difference in scores at 12 weeks was greater in the comprehensive intervention group than in the hand touch group and the control group(P<0.05).Psychological capital: The highest score was(4.09±0.31)in the comprehensive intervention group at week 12 and the lowest was(3.78±0.32)in the control group,and there were statistical differences within the comprehensive intervention group and between the three groups(P<0.05).Depression: The lowest score in the comprehensive intervention group was(6.27±2.05)at week 6,which was significantly lower than the hand touch group(7.73±1.78)and the control group(9.27 ± 1.96)(p<0.05).The decrease in scores in the combined intervention group was higher in the first 6 weeks than in the last 6 weeks(P<0.05).After a comprehensive psychological capital-based caring touch intervention,three themes and 11 sub-themes were identified in the experience of the elderly with severe disabilities at home:(1)physical comfort(pain relief,physical strength,sleep improvement);(2)positive psychological experience(recognition of one’s abilities,sense of gain,optimism in coping with disability,adaptation and recovery in difficult situations,awakening of self-care awareness);(3)perception of social support(family companionship and assistance,care in formal care,satisfaction with national policies).Conclusions:1.The comprehensive psychological capital-based caring touch intervention helped to improve the subjective well-being and psychological capital of the elderly with severe disability at home and effectively alleviated depression,and had a significant effect on subjective well-being and depression at 6 weeks of the intervention.2.The comprehensive intervention program of caring touch based on psychological capital not only helps the disabled elderly to obtain positive psychological experience,but also increases physical comfort and realizes the humanistic care of mind and body.3.The intervention program of this study focuses on the practice of nursing humanistic care and the excavation of inner psychological power,which is a multi-dimensional and multi-sensory way to materialize the abstract concept of humanistic care into practicable nursing interventions,and has certain promotion and application value in the home care model. |
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