| Objectives1.To construct the benefit-finding intervention program for stroke caregivers in the community.2.To evaluate the effectiveness of the benefit-finding intervention program in heightening caregivers’ benefit finding,reducing the burden of caregivers and improving the quality of life of caregivers and patients.To provide valuable intervention references for community stroke caregivers and survivors.MethodsThis study consists of two parts.The first part focused on the construction process of the benefit finding intervention program for stroke caregivers.Through the comprehensive combination of literature analysis,qualitative research as well as the previous investigation of influencing factors,the intervention program was initially constructed.The final version of the intervention program was determined through carrying through consultation between the expert Delphi and 10 experts and a pilot test with 5 stroke attendants.The second part discussed the practical application of the intervention program.By convenience sampling,a total of 76 caregivers conforming to the inclusion criteria under the jurisdiction of two community health service centers in Zhengzhou were selected.Stroke caregivers were randomly divided into two groups:the control group and the intervention group by draw lots,with 38 caregivers in each group respectively.The control group received the nine-week routine health education,while the intervention group received the nine-week benefit finding intervention program as a contrast.There were several evaluation tools to be utilized including Stroke-specific Quality of Life Scale(SS-QOL),Adult Carer Quality of Life Questionnaire(AC-QoL),Perceived Benefits of Caregiving Scale as well as Zarit Caregiver Burden Interview(ZBI).Approaches of repeated measures analysis of variances(repeated measure ANOVA),generalized estimating equation(GEE),descriptive statistics,t-test,and the rank-sum test were adopted for data analysis.Besides,the two-side test was also employed,and the test level was α=0.05.ResultsBased on the introduction of the first part,the first and important thing was to perform relevant systematic literature search for benefit finding with time range from January 2000 to May 2018.The specific aspects needed to be payed attention to for further literature analysis including:title,research type,author,year of publication,research purposes,sample source,sample size,main outcome indicators,intervention methods,research results,and conclusions.By combining both literature analysis and qualitative research results,the intervention program was initially constructed.Afterwards,the initial intervention program was successfully revised according to the consultations between the expert Delphi and other experts and also the preliminary test.The effective recovery rate of two rounds of expert consultation was 100%,and the expert’s authority coefficient was 0.92,indicating that the benefit-finding intervention program could be eventually developed.In this study,a total of 76 community stroke caregivers were selected,of which 8 caregivers were lost for follow-up and the missed follow-up rate was 10.5%.Therefore,34 caregivers were included in the intervention group,with mean age(68.56 ± 5.90)years,and 34 caregivers in the control group,with mean age(67.00 ±4.42)years.The benefit finding of caregivers:The repeated measure ANOVA was adopted to explore the difference in the benefit finding between two groups.We found that there presented a significant difference in the total score of the benefit finding between two groups(F=17.661,P<0.001).The intra-group comparison results between two groups revealed that there were differences in the total score of the benefit finding at each time point(F=211.998,P<0.001).The total score of the benefit finding had an interaction between two groups on time and groups(F=118.035,P<0.001).The results reflected that there was a significant difference in the total score of the benefit finding between two groups after post-intervention and one-month post-intervention(P<0.001).During the three-month follow-up,no significant difference was discovered in the total score of the benefit finding between two groups(P>0.05).The burden of caregivers:The repeated measure ANOVA was employed to explore the difference in caregivers’ burden between two groups.There has a significant difference in the total score of the ZBI between two groups(F=31.727,P<0.001).The intra-group comparison results between two groups reflected the differences in the total score of the ZBI at each time point(F=462.348,P<0.001).The total score of the ZBI had an interaction between two groups on time and groups(F=18.479,P<0.001).The independent sample t-test results showed that there was a significant difference in the total score of the ZBI between two groups during each follow-up(P<0.001).The quality of life of caregivers:The GEE was employed to explore the difference in the quality of life of caregivers between two groups.A significant difference could be found in the total score of the AC-QoL between two groups(Waldχ2=75.452,P<0.001).The intra-group comparison outcomes between two groups showed that there were differences in the total score of the AC-QoL at each time point(Wald χ2=441.786,P<0.001).The total score of the AC-QoL had an interaction between two groups on time and groups(Wald χ2=160.427,P<0.001).The results revealed that there was a significant difference in the total score of the AC-QoL between two groups during each follow-up(P<0.05).The quality of life of patients:The GEE was adopted to explore the difference in the quality of life of patients between two groups.No significant difference could be discovered in the total score of the SS-QOL between two groups(Wald χ2=75.452,P>0.05).The intra-group comparison outcomes between two groups showed that there were differences in the total score of the SS-QOL during each follow-up(Waldχ2=441.786,P<0.001).The total score of the SS-QOL had an interaction between two groups on time and groups(Wald χ2=160.427,P<0.001).The results reflected that there was a significant difference in the total score of the AC-QoL between two groups during post-intervention and one month follow-up(P<0.05).During the three-month follow-up,no significant difference was found in the total score of the SS-QOL between two groups(P>0.05).ConclusionsBased on the analysis results above,it can be concluded that the intervention program was scientific,comprehensive and easy to accept,which can efficiently improve benefit finding and reduce the burden of caregivers,and also can enhance the quality of life of caregivers and patients.The benefit-finding intervention program can effectively promote the recovery of stroke survivors and promote the development of caregivers’ mental health,which can provide valuable references for community medical staff on psychological health education. |