Research On The Quality Of Life And Care Experience Of The Family Caregiver Of Diabetic Foot

Objectives :(1) To transform the Carer Qol instrument into simplified Chinese following the steps of culture adjustment, and test the reliability and validity of the Chinese version Carer Qol in family caregivers of diabetic foot.(2) To survey the quality of life and care experience of family caregivers, explore the correlative factors, and discuss the relationship between care experience and quality of life.(3) To clarify the scientific connotation of the caregivers' positive experience, so to provide a theoretical framework for future research.Methods: This study used a mixed methods approach to collect the data: the first part is quantitative research with questionnaire survey, and the second part is qualitative research. The questionnaire for quantitative survey includes the characters of caregivers, care recipients and care situations, the Care-Related Quality of Life instrument(Carer Qol), Zarit Caregiver Burden Interview(ZBI), Positive Aspect of Caregiving(PAC) and EQ-5D. The questionnaire was distributed to 120 family caregivers of hospitalized patients with diabetic foot in Tianjin. The data was analyzed by using SPSS 19.0 and AMOS 20.0. The qualitative research was conducted by using semi-structured interview. 10 family caregivers were interviewed individually. The interview outline was designed on the basis of Conceptual Framework of the Positive Aspects of Caregiving(CFPAC) and literature review. The qualitative data was analyzed using Colaizzi and framework analysis methods.Results: 1. Quantitative com Ponent(1) Reliability and validity of the Carer Qol instrument: the ICCs of Carer Qol-7D ranged between 0.668 and 0.821; the ICC of Carer Qol-VAS was 0.861. The factor analysis results showed that, Carer Qol-7D includes two factors, they were positive experience(positive dimensions) and negative experience(negative dimensions). The positive dimensions of Carer Qol-7D were positively correlated with caregivers' positive experience, and the negative dimensions were positively correlated with the care burden. The dimensions of mental health problem and physical health problem were negatively correlated with EQ-5D. The Carer Qol instrument was able to discriminate caregivers' quality of life between different levels of the care-recipients'self-care ability.(2) Family caregivers' quality of life was reduced, and their physical and mental health was not good. The average scores of Carer Qol-VAS and Carer Qol-7D were 6.52 ± 2.43 and 72.17 ± 17.23, respectively. The scores of EQ-5D-VAS and EQ-5D index(based on the Chinese population preferences) were 80.82 ± 14.41 and 0.919 ± 0.101, respectively. The average scores of ZBI and PAC were 32.09 ± 14.33 and 34.17 ± 8.01. The family caregivers' quality of life, positive experience and care burden were affected by some factors.(3) Family caregivers' experience, care related quality of life and general quality of life affect their health related quality of life directly or indirectly. 2. Quantitative component: Family caregivers' positive experience include 4 parts, they were the quality of caregiver and care-receiver daily relationship, the caregiver's feeling of accomplishment, the meaning of the caregiver's role in daily life and caregivers' benefits. Family caregivers' positive experience was influenced by their self-efficacy, the enrichment events and the context factors. The positive experience reinforced the caregiver's well-being ultimately.Conclusions: 1. The Chinese version Carer Qol instrument met the need of psychometrics, and it could be applied in the group of family caregivers of diabetic foot. The reliability and validity of Carer Qol instrument was well except support dimension in Carer Qol-7D. Compared with the health-related quality of life instrument, Carer Qol had obvious advantages in evaluating family caregivers' quality of life for the higher sensitivity. 2. Family caregivers' quality of life was associated with care burden and positive experience. The above three were influenced by different factors from care-recipients, care situations and caregivers themselves. 3. The CFPAC can be used to explain the positive experience of family caregivers, and it provides theoretical basis for future research.