Effects Of Nursing Intervention With Improved The Resources On Reducing Primary Family Caregivers' Burden In Caring Stroke Survivors

Objective This study was conducted to describe the level of the burden and the related factors among caregivers for stroke survivors and to test the effects of the comprehensive nursing intervention programme on reducing caregivers' burden.Methods This research was performed in two consecutive phases.In the first phase,180 stroke survivors and their primary family caregivers from 4 communities were interviewed by questionnaires to invenstigate the level and related factors of the burden.These questionnaires included Bakas caring outcoming scale(BCOS),self-rated burden(SRB),self-efficacy scale,social support scale,functional independent measure(FIM),cargiving knowledge and need of caregivers questionnaire.In the second phase,60 primary family caregivers were randomly selected from those who met the inclusion criterion in baseline and then divided into an intervention group of 30 and a control group of 30 respectively.There were no statistically significant difference in age,gender, education level,financial status,time of caregiving,the level of the burden, scores of caregiving knowledge,self-efficacy and social support between the two groups(P＞0.05).The subjects in the intervention group received a 3-month comprehensive nursing intervention programme while the control group patients received only routine care.Each participant in the intervention group received four collective education sessions,two caregivers' meetings,four to six home-visits,and three to four telephone-consultations.The effects of the intervention were evaluated by Bakas caring outcoming scale(BCOS),self self-efficacy scale,social support scale,functional independent measure(FIM) and careging knowledge at the end of the intervention and 3 months later.Results In the first phase,the mean score of SRB was 70.67 and the mean score of BCOS was 48.83±8.05.There were statistically significant differences between caregivers on or not on the job,and with or not with chronic disease,and with different education levels,income levels,time on caregiving everyday,tasks of caring everyday,time accompanying with the stroke patients,the motivations for caregiving,self efficacy and caring the stroke survivors with different functional independent levels.Multiple stepwise regression analysis demonstrate that functional independence level of stroke survivors,with or without chronic disease,tasks of caring everyday,inicomes,the numbers of co-caregivers and self efficacy entered regression equation(p＜0.05).In the second phase,①the caregiver's burden in the intervention group decreased.Analysis of variance of repeated measure and multivariate analysis of variance showed that the score of BCOS including total score,the score of the physical burden and social burden in the intervention group significantly increased compared with the control group (P＜0.05).②The resources of caregivers improved.Analysis of variance of repeated measure and multivariate analysis of variance showed the scores of caregiving knowledge and social support in the intervention group significantly increased compared with the control group(P＜0.05).③Analysis of variance of repeated measure and multivariate analysis of variance showed that functional independence level of stroke survivors in the intervention group did not significantly increased compared with the control group(P＞0.05).Conclusion The primary family caregivers for stroke survivors were experiencing a considerable burden.The nursing intervention to reduce caregivers' burden should emphasize increasing the stroke survivors' functional independence,giving the social support and improving the self-efficacy of caregivers.The comprehensive nursing intervention programme focusing on improving caregivers' resources significantly reduce the caregivers' burden through teaching the caregiving knowledge and skills,strengthening the social support and improving the level of stroke survivors' functional independence. The comprehensive nursing programme was effective in supporting the caregivers of stroke survivors and reduce their burden.