Study On The Effects Of Transitional Care Intervention For The Family Caregivers Of Stroke

Objectives(1)To develop a questionnaire for assessing the stroke caregivers’ comprehensive care-giving ability;(2)To explore the effectiveness of transitional care intervention on the stress of stroke family caregivers.MethodsThe development of the questionnaire was based on the framework of "model for caregiver skill-building" developed by Farran. The items of the questionnaire were shaped through semi-constructure interview, literature study and then through experts consultation, revision, the initial questionnaire was developed.216stroke caregivers were investigated to test the reliability and validity of the questionnaire.Employ random controlled trail methods.96stroke caregivers whose relatives were treated in Tianjin First Center Hospital were selected and allocated into two groups randomly. During the hospitalization, both groups were given conventional care. Three days before discharge, caregivers and patients in the experimental group began to receive transitional care intervention, including health education, methods of rehabilitation and care-giving skills training, guidance for caregivers self-extracting, and periodic follow-up after discharge. The caregivers and patients in the control group only received routine discharge guidance. Caregivers’stress, comprehensive care-giving ability, anxiety, depression were assessed at baseline,6and12weeks after the intervention. The patients’ability of daily living (ADL) was also assessed at baseline and12weeks after the intervention. Independent t-test, Chi-square test, repeated measure ANOVA were used to analyze the data.Results1、Reliability and validity of questionnaire(1)Validity:the content validity index(CVI) for overall questionnaire was0.97, the items’CVI were between0.8～1.0. The correlation analysis indicated that the structure of the questionnaire was excellent. Through exploratory factor analysis, seven factors were extracted which can explain the cumulative rate of62.891%. From professional perspective, seven factors can emerge into four that were consistent with the theory construction.(2)Reliability:the Cronbach’s a coefficient of overall questionnaire was0.938, while four dimensions were0.770～0.886; The Split-half coefficient of over questionnaire was0.856, while four dimensions were0.819-0.880. Except for knowledge, the other three dimensions’retest reliability were0.894～0.929.2、Intervention results(1)The stress of caregivers in experimental group at6and12weeks post-intervention were lower than pre-intervention(P<0.01); The stress of caregivers in control group didn’t decline until12weeks after intervention (P<0.01). At6and12weeks post-intervention, the experimental group caregivers showed lower stress than control group(P<0.01).(2)The caregivers’comprehensive care-giving ability in both groups appeared a rising trend after intervention(P<0.01), but at6and12weeks post-intervention, the experimental group caregivers showed higher care-giving ability than control group(P <0.01).(3)At6weeks post-intervention, the experimental group caregivers’anxiety was lower than control group(P<0.05), and at12weeks post-intervention, both anxiety and depression of caregivers in experimental group were lower than control group(P <0.01).(4)The patients in both groups improved in ADL(P<0.01), but the experimental group patients’ADL were higher than control group at12weeks post-intervention(P <0.01).Conclusions1、The questionnaire for assessing the comprehensive care-giving ability of stroke caregivers has been preliminary developed, and it has good reliability and validity.2、Transitonal care intervention exerts positive effects on relieving stress, maintaining physical and psychological well being of stroke caregivers, and also promotes patients rehabilitation.