| Objectives:To understand the anxiety, depression and self-efficacy levels of caregivers of inpatients in Neurosurgery Department;to analyze factors related to caregivers'anxiety, depression and self-efficacy; to analyze the internal correlations of caregivers'anxiety, depression and self-efficacy; to evaluate the nursing interventions'effects on alleviating caregivers'anxiety and depression and improving self-efficacy levels; to provide theoretical basis of the nursing interventions to improve the quality of care and improve caregivers'quality of life.Method:From January to June in 2009,caregivers of patients who got head injury, stroke, and intracranial tumors and stayed more than 14 days were included to fill the questionnaires at the Sino-Japanese Friendship Hospital of Jilin University, at the Neurosurgery department. Data was collected by literature queries and questionnaires. Steffen'Caregiver'Self-efficacy Scale (CSES) (2002) and Inpatients with Anxiety and Depression Questionnaire (HADS) were chosen through the pre-survey and re-revision. Two dimensions of 10 projects of CSES were used for self-relaxation and self-balancing and two dimensions of 14 projects of HADS were used to test the anxiety and depression. The questionnaires were distributed and collected by two nurses from the department. The intervention group was composed of all nurses who have been trained. And the comprehensive psychological care intervention was given to the caregivers by the intervention group. Data was compared with that of control group (caregivers from January to March) SPSS13.0 for Windows was used for data entry and analysis. Content:The questionnaire of this study included Inpatients Anxiety and Depression Questionnaire (The Hospital Anxiety and Depression Scale, HADS) and Caregivers Self-efficacy Scale (Caregivers Self-Efficacy Scale, CSES). The demographic information included gender and disease of patients, gender, age, profession and educational qualifications of caregivers and relationship between patients and caregivers. Descriptive analysis and one way-ANOVA were used to compare caregivers'anxiety, depression and self-efficacy level and its related factors. Paired T test was used to evaluate the nursing intervention's effect to alleviate caregiver anxiety and depressive symptoms; Spearman correlation was used to analyze the correlation of caregiver anxiety, depression and self-efficacy.Results:1. Factors related to anxiety of caregivers were the academic qualifications of caregivers and the relationship between caregivers and patients.Caregiver anxiety levels were different in different academic qualifications of caregivers (F = 5.505, P <0.05). Anxiety of caregivers with primary school education was the highest (14.0667±0.85338), significantly higher than the delimitation value of anxiety (11).There were also different anxiety levels in spouse, children and other relatives(F = 3.521, P <0.05). Spouse had the highest degree of anxiety (13.5161±0.7246), significantly higher than the anxiety of delimitation value (11), followed by parents, brothers and sisters (11.500±2.90115), and anxiety of the children were the lowest (9.9091±1.03595).In addition, there was no anxiety difference in gender of patients and caregivers of patients with different diseases. Also there was no anxiety level difference in different gender and profession of caregivers2. There was no depression difference of caregiver in group comparison.In this study, there was no depression difference according to patients'gender, the risk of disease and the relationship between caregivers and patients, caregivers' gender, occupation and education. Therefore, depression of caregivers was not affected by different gender, illness and other factors of patients, relations, occupation nor educational attainment of caregivers.3. Nursing intervention was significantly effective to alleviate anxiety and depression of caregivers.The total dimension of anxiety was 10.5062±3.81813 in experimental group while that of control group was 11.7910±4.68254. The first 5 items of anxiety was different after the intervention, which meant that anxiety levels of caregivers dropped significantly. Depression score of the experimental group was 11.7284±3.09844 while that of the control group was 13.0896±3.21328. Scores of D6, D8, D10 and D14 dropped significantly after interventions.4. Self-efficacy of caregiver was increasing significantly after the nursing intervention.Self-efficacy score of caregiver in experimental group was 59.4074±10.01596 while that of the control group was 57.9552±18.04408.Self-efficacy scores of self-relaxation dimension of each item were significantly increased after intervention (P<.0001). There was no significant score difference of Q10 in self-balancing dimension (T =- 1.42, P = 0.1578), scores of the rest items were all different.5.Correlations of self-efficacy and anxiety and depression of caregiversSelf-efficacy and anxiety level of caregivers were significantly negatively correlated (P <0.01). Self-efficacy was negatively correlated with the total scores of anxiety and depression (P <0.05). However, there was no correlation between self- efficacy and the depression level of caregivers.Conclusion:Factors related to anxiety of caregivers were the relationship with patients and academic qualifications. There was no anxiety difference of caregivers in gender of patients, different diseases of patients, gender and occupations of caregivers. Depression of caregivers was not different in the group comparison. Nursing intervention was significantly effective to alleviate anxiety and depression of caregivers and to increase the self-efficacy level of caregivers. Self-efficacy of caregivers was negatively correlated with anxiety level. In addition, self-efficacy of caregivers was negatively correlated with the total score of anxiety and depression. However, self-efficacy of caregivers was not correlated with the depression level of caregivers.
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