The Study On The Mechanism Of The Effects Of Physical And Mental Health,Caring Ability And Social Support Of Stroke Caregivers On The Self-care Ability Of Strokes

Objective:To understand the current situation of physical and mental health,caring ability and social support of the main caregivers of stroke,and to analyze the mechanism of the influence of physical and mental health,caring ability and social support on the self-care ability of the main caregivers of stroke.It provides a reference basis for improving the physical and mental health and caring ability of caregivers and promoting the recovery of patients' self-care ability by means of supportive intervention in the future.Methods:Using cluster sampling method,260 stroke patients and main caregivers from March 2017 to September 2018 in the rehabilitation department of the first affiliated Hospital of Nanchang University were selected from May 2018 to November 2018.Through on-the-spot investigation,telephone follow-up,WeChat follow-up and out-patient follow-up,a questionnaire survey was used to understand the physical and mental health,care ability,social support status and self-care ability of the main caregivers of cerebral apoplexy.260 questionnaires were sent out in this study,242 valid questionnaires were recovered.By means of multivariate regression analysis and path analysis,the influence mechanism of caregiver's physical and mental health,caring ability and social support on patients' self-care ability was studied.Results:(1)In the assessment of physical and mental health status of stroke caregiver,the score of vitality dimension was the lowest(51.26 ±17.15),the scores of physiologic function,physical pain,general health status,social function,mental health and vitality of the main caregivers of stroke patients were significantly lower than those of the national norm(P < 0.05).In the evaluation of care ability,the average score was(78.71 ±16.97),the mean score was 56.22%,the score was lower,and the disease knowledge related score was the lowest(50.92%),Self-stress and health management accounted for the highest percentage(63.20%).In the evaluation of social support,the score of family support dimension was the highest(20.40 ±3.62),and the score of friend support dimension was the lowest(16.82 ±4.52).(2)The correlation coefficient between physical and mental health,care ability,social support and self-care ability of caregiver was 0.302(P < 0.05),and the correlation coefficient between physical and mental health and self-care ability of caregiver was 0.302(P < 0.05).The correlation coefficient between care ability and self-care ability was 0.388(P < 0.05),and the correlation coefficient between social support and self-care ability was 0.121(P > 0.05).The correlation coefficient between physical and mental health and care ability was 0.368(P < 0.05),the correlation coefficient between social support and care ability was 0.483(P < 0.05),and the correlation coefficient between social support and physical and mental health was 0.374(P < 0.05).(3)In the study of influencing factors of patients' self-care ability,left hemiplegia(Beta = 0.386),right hemiplegia(Beta = 0.243),caregiver care ability(Beta = 0.267),course of stroke(Beta = 0.129),The duration of daily care(Beta=-0.271),the educational level of caregivers(Beta=-0.148),whether the caregivers are complicated with chronic diseases(Beta=-0.144),and the physical and mental health of caregivers(Beta= 0.177).Children(Beta = 0.339)and brothers and sisters(Beta = 0.218)entered the regression equation.Regression analysis could explain that the coefficient of variation of the total score of self-care ability recovery was 55.5%.In the study on the influencing factors of the care ability of the main caregivers,whether the caregivers assisted the patients in rehabilitation exercise(Beta =-0.338),the social support of the caregivers(Beta = 0.223),and the self-care ability of the patients(Beta = 0.258).The educational level of the caregiver(Beta = 0.216),the physical and mental health of the caregiver(Beta = 0.155),and whether the caregiver lived with the patient(Beta =-0.126)entered the regression equation(P < 0.216).Regression analysis could explain that the coefficient of variation of the total score of care ability of caregivers was 57.0%.(4)In the path analysis of the effects of physical health,care ability and social support of stroke caregivers on the self-care ability of stroke,the standardized path coefficient of the influence of care ability on patients' self-care ability was 0.36,The standardized path coefficient of the influence of body health on self-care ability is 0.12,the standardized path coefficient of body health effect on care ability is 0.14,and the standardized path coefficient of social support on care ability is 0.46.The influence of physical health on self-care ability was 0.05(0.14 × 0.36).The influence of social support on self-care ability was 0.17(0.46 × 0.36).The caregiver's care ability played an intermediary role between the caregiver's physical health and the patient's self-care ability,the ratio of indirect effect to total effect was 28.32%.Conclusions:(1)The physical and mental health of the main caregivers of cerebral apoplexy is low,and the disease of the patients has a great influence on the caregivers.The comprehensive care ability of stroke caregivers is at a low level,especially in mastering the knowledge of stroke disease.Stroke caregivers believe that family support is stronger in social support,but less support from friends and other social stakeholders.Medical staff and other social stakeholders should pay attention to the physical and mental health and care ability of the main caregivers of stroke.(2)There was a weak positive correlation between the main caregiver's care ability,physical and mental health and the patient's self-care ability,while the main caregiver's social support had no correlation with the patient's self-care ability.There was a moderate positive correlation between the social support of the main caregiver and the care ability of the main caregiver,and a weak positive correlation between the physical and mental health and the care ability.There was a weak positive correlation between the main caregivers' social support and their physical and mental health.(3)The patient's hemiplegic side(left,right),the course of stroke,the caring ability of the caregiver,the duration of daily care,the educational level of the caregiver,whether the caregiver is complicated with chronic disease,physical and mental health,and the relationship with the patient(children,Brothers and sisters)are the influencing factors of the recovery of patients' self-care ability.Among the influencing factors of caregiver's care ability,whether the caregiver assists the patient in rehabilitation exercise,the caregiver's social support,the patient's self-care ability,the caregiver's educational level,the caregiver's physical and mental health,Whether the caregiver lives with the patient is the influencing factor of the caregiver's care ability.(4)The caregiver's body health,care ability have a direct positive effect on the patient's self-care ability,body health,social support have a direct positive effect on the care ability.Social support has an indirect positive effect on self-care ability.Care ability plays a full intermediary role between social support and patient's self-care ability,and partly plays an intermediary role between body health and patient's self-care ability.