| Objective1. To develop the Dementia Caring Knowledge Scale to find out the current status of dementia caring knowledge of formal dementia caregiver in elderly homes of Fujian province in order to provide the theory basis for further interventions. 2. To study on quality of life, social support, knowledge, attitude, and practice of senile dementia caregivers in elder homes of Fujian province and analyze the influencing factors by survey and qualitative interview. 3. To evaluate the effect on empowerment intervention towards the dementia caregivers in elder homes of Fuzhou city.Methods1. Dementia Caring Knowledge Scale was developed based on the theory of Maslow’s hierarchy of needs by literature review and Delphi experts consulting. The reliability and validity of the scale were assessed by the internal consistency reliability, retest reliability, face validity, content validity,discriminant validity and construct validity. 2. A stratified convenience sample of 298 dementia caregivers from 41 elderly homes of 9 cities in Fujian province was investigated by SF-12 Quality of Life Questionnaire, Social Support Rating Scale, Dementia Caring Knowledge Scale, Positive Aspects of Caregiving Scale and Simplified Coping Style Questionnaire. The status and their influencing factors were statistical analyzed by descriptive survey, independent sample t-test, nonparametric test, multiple linear stepwise regressions. Fifteen nursing aids and three managers from 4 public and private elderly homes were semi-structured depth interviewed and the phenomenological analysis method was used to describe the knowledge, attitude and practice of the dementia caregivers in elder homes of Fuzhou city. 3. A number of 55 dementia caregivers from one public and one private elder home were randomly assigned into the control group and the intervention group. Thecontrol group of 31 caregivers accepted routine training and the dementia caring handbook for self-learning. And the intervention group of 24 caregivers accepted empowerment interventions for 8 times according to the 5 steps of empowerment as recognizing problems, expressing feelings, setting up goals, making plans and evaluating results. The quality of life, social support, knowledge, attitude, and practice of both groups were analyzed and compared using Wilcoxon signed rank test through the baseline survey and the questionnaire survey after interventions.Results1. The Dementia Caring Knowledge Scale consisted of 22 items and 5 dimensions of physical dimension, security dimension, love and belonging dimension, self-esteem dimension and self-realization dimension. The Cronbach ’s alpha coefficient was 0.626, the result of retest reliability showed significant correlation(p < 0.01). The content validity indexes were between 0.86 ~ 1, and the average content validity index was 0.95. The scale could distinguish the scores between nurses in hospitals and the dementia caregivers in elder homes, which indicating a good discriminant validity. Confirmatory factor analysis showed that the NFI and CFI failed to reach the ideal statistical standards, but chi square/df < 3, RMSEA < 0.1 which could interpret as a good fitting model. 2. The general level of quality of life of the samples was high, of which normal spiritual fraction reached 69.8%, normal body fraction reached 97.3%. More than half of the proportion of social support reached high levels, the general social support score was even higher than the national norm. The overall accuracy of Dementia Caring Knowledge Scale was 59.09%. The Positive Aspects of Caregiving stated high level. The positive coping scores were relatively high, and negative coping scores were low. The Caregiver’s age, social supports were the influencing factors of quality of life. Gender, training participating, relationship with the caring objects, life outlook, marital status, Buddhism embrace, cultural degree, self-evaluation of work, the body fraction of quality of life and positive aspect of cargiving were the influencing factors of social support. Negative coping, culture degree and positive aspects of caregiving were the influencing factors of dementia caring knowledge. Negative coping, relationship with the caring objects, age, work shift and the social support were the influencing factors of the positive aspect of caregiving. Utilization degree of support, caringknowledge, self-approval and training participation were the influencing factors of coping styles.And we drew the conclusions that dementia caregivers in elderly homes wished to be trained, they had positive belief for caring, and their copying capacities varied according to semi-structured depth interviewed and the phenomenological analysis. 3. Both empowerment intervention and routine training plus dementia caring handbook self-learning could improve the social support, dementia caring knowledge and coping style of caregivers in elder homes. And the scores of body fraction of quality of life, social support, dementia caring knowledge and positive coping among intervention group were higher than the control group. The intervention objects had good compliance towards participating empowerment interventions and they had good reviews towards the contents and effects of the interventions.Conclusions1. The Dementia Caring Knowledge Scale has reasonable structure and acceptable reliability and validity which can reflect the theme of the study. 2. The general levels of quality of life, social support, and positive aspect of cargiving and coping style of the samples are high while the dementia caring knowledge is relatively low. There’re positive aspects of caregiving, such as accomplishments and good relationships with their caring objects producing by caring, the copying capacities of the dementia caregivers varied, and it’s necessary to further strengthen training of dementia caregivers. 3. Empowerment intervention provides opportunities for the caregivers to talking and expressing their feelings, it’s beneficial to explore their working experiences, it empowers the caregivers to find out the problems and to solve them positively, and it emphasizes to interact with the participants that are beneficial to adjust the empowerment program. Empowerment interventions could promote the quality of life, social support, caring knowledge and coping abilities of the caregivers. |
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