Community Team Support Intervention On Coping Style And Subjective Well-being For Family Caregivers Of End-of-life Patients

Objective To develop a community team support intervention including home care education on knowledge and skills and emotional support for family caregivers of end-of-life patients. To evaluate the effect of the community team support intervention on self-efficacy, coping style and subjective well-being. To describe the family caregivers’experiences after the community team support intervention.Methods Family caregivers meeting to the criterion were recruited and divided into intervention and control group by cluster randomization. There were no statistic differences in age, gender, Bathel index of patients, age, gender, education level of caregivers, their relations to patients and caregiving conditions (p>0.05). Caregivers of intervention group were given community team support intervention including knowledge and skills education and emotional support via home visits and telephone consultations for three months in addition to routine care, while the control group only received routine care. Quantitative measures of simplified coping style, general self-efficacy, and general well-being and semi-structured interviews were adopted to evaluate the effect of the intervention.Results①The baseline survey showed that general self-efficacy score of caregivers was lower than that of norm group. The scores of general self-efficacy, positive and negative coping style and general well-being were of moderate level while dimensions of concern for health, energy and life satisfaction were of lower level.②The score of general self-efficacy was significantly higher in the intervention group than that in the control group at 3rd month after intervention(p<0.001).③The scores of positive coping and negative coping and the total score of simplified coping style were significantly higher in the intervention group than those in the control group at 3rd month after intervention(p<0.01, p<0.05, p<0.001).④The decline on concern for health dimension and increase on life satisfaction dimension of subjective well-being were significant in the intervention group(p<0.01, p<0.05). There was no significant difference of general well-being between groups at 3rd month after intervention.⑤Narrative experiences addressed by caregivers after intervention were concluded into 4 themes: Enhancing coping resources; obtaining emotional support; self-realization during caregiving; and helping patients pursuing the essence of life.Conclusion The community team support intervention focusing on knowledge and skills education and emotional support help to improve self-efficacy, promote positive coping of family caregivers. It also indicated the possibility of better life satisfaction and subjective well-being.