| ObjectiveTo understand the level of family resilience with CP child,explore the correlation of family resilience with family functioning, coping styles and resilience, identify factors and mechanism which influences the family resilience; To describe the process of family adaptation with CP child, Preliminary development of family resilience intervention model of Cerebral Palsyto provide reference for clinical psychological intervention, promoting clinical nurse to assist family with CP fully using family resilience to get through complex and lengthy medical rehabilitation process and reach positive family adaptation.Methods1. With sampling by ward, we selected 205 inpatient cases from 3 wardsamong the research object from cerebral palsy rehabilitation department in someone 3A hospital from December in 2014 to February in 2015, to survey with the Family Resilience Assessment Scale, Resilience Questionnaire of Children with Special Need, FAD-GF and SCSQ2. Taking phenomenology method of qualitative research from June in 2015 to January in 2016, with purpose sampling method, we selected 12 caregivers and 8 medical staff according to inclusion criteria and interview with semi-structured outline. On the basis of literature review and mixed research, preliminarily building family resilience intervention model.Results1.The average score of family resilience with CP child was (183.19±25.97),the sub-scale of family belief and family strength was respectively (64.45±9.50), (118.74±17.69). The average item score was higher than 3,above average level.2. The score of family functioning was from 12 to 39,the average total score was (27.07±4.71),the average item score was (2.25±0.35), below average level.3. The resilience’s each dimension score of caregiver was from 2.78 to 3.98, except acceptance dimension, all above average level.4.Compared with domestic relatedresearch,positively coping dimension was statistically significant difference (t=7.391,P<0.01), while negatively coping dimension not.5.Using the family resilience scores as dependent variable, general demography and disease related data as independent variable to do t-test and ANOVA, it showed that statistically significant difference (P<0.05) in the patient’s age, treatment time, the severity of brain damage, the degree of education of the caregivers, work situation and the medical expense payment. Scores of family resilience with caregiver’s resilience, positively coping, coping styles are moderately positive correlation, with problem solving, emotional support, optimistic and strong are lowly positive correlation, and with family functioning is moderately negative correlation(P<0.01); The family resilience scores as dependent variable, the above results which showed significant difference as independent variable to do multiple liner regressions. It showed that three major influencing factors for family resilience, accounting for 49.2%.The highest is family functioning (b=-0.464), next are positively coping (b=0.358), and work situation (b=0.142).6. Family with cerebral palsy have experienced the process of family adaptation from the shock when was diagnosed,chronic persistent period of pressure and difficulties, development of family resilience to meet future. Family beliefs, family organizational patterns, communication and problem-solving played significant role on family resilience.7. The family resilience intervention model included 5 steps. Firstly, preparation phase:to establish a good relationship between nurses and patients; Secondly, to evaluate main factors which influenced family resilience from quantitative research; Thirdly, to implement family resilience intervention project according to qualitative research; Fourthly, to preliminarily evaluate intervention effect and adjust the intervention measures; Lastly, to summarize the successful experience in the process of intervention for further draw up detailed intervention plan.Conclusion1. Most family with cerebral palsy are resilient, family resilience was influenced by general demography and disease related data, including the patient’s age, treatment time, the severity of brain damage, the degree of education of the caregivers, work situation and the medical expense payment.2. The major factors of family resilience of family with CP children are family functioning, positive copingand work situation, family functioning, positive coping can predict family resilience well.Family functioning is mediating variable of family resilience.3. Family adaptation of family with CP child needed a long process, Preliminary development of the intervention model of family resilience providereferences for clinical nurses to do assessment and intervention for family with CP child. |
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