| Objective To evaluate the status of care preparedness,anxiety and depression of the primary caregivers of patients with initial stroke.To analyze the related factors to preparedness and its relationship with anxiety and depression.To explore the effects of nursing intervention based on the theory of focused solving model on the care preparedness and negative emotions of the primary caregivers with stroke.Methods The first stage: From June to October 2018,230 family caregivers of stroke patients were selected by convenient sampling methods in cerebral department of a third-grade class-A hospital in Yangzhou.The survey tools include general information questionnaire of patients and caregivers,Caregiver Preparedness Scale,Self-rating Anxiety Scale and Self-rating Depression Scale.Spss19.0 was used to analyze and process the data to reflect the situation of care preparedness and its related factors,to explain the status of anxiety and depression.The second stage: According to inclusion and exclusion criteria,totally 88 family caregivers of stroke patients were enrolled in cerebral department of a third-grade class-A hospital in Yangzhou from November 2018 to August 2019.From November 2018 to March 2019,44 caregivers were recruited in control group.From April to August 2019,44 caregivers were recruited in intervention group.The control group applied the traditional problem-solving mode on the basis of routine nursing,and the intervention group introduced the focus solution to routine care.Before and after the intervention,the caregiver preparedness,anxiety and depression of the caregivers were evaluated.Results 1.Preparedness,anxiety and depression in caregivers of stroke patients.In this study,a total of 230 questionnaires were distributed and 220 valid questionnaires were returned.The average total score of caregiver preparedness was(18.28 ± 6.08)points.The highest score for physical need was(2.52 ± 0.79),the items with poor scores were(2.16 ± 0.82)for providing a mutually satisfactory care,and(2.01 ± 0.81)for dealing with emergencies.The SAS score of the main caregivers of stroke patients was(39.09 ± 8.20)points,and the SDS score was(40.23 ± 7.88).Both SAS and SDS scores were higher than the domestic norm,and compared with domestic norm the difference was statistically significant(P<0.05).2.The influencing factors of caregiver preparedness in stroke patients. Multiple linear regression showed that the six variables including patient's disease pay mode,caregiver's age,gender,education level,current health condition and whether there are other co-caregivers,entered the regression equation,which could predict 79.5% of the total score variation.There was a negative correlation between caregiver preparedness and anxiety level(r=-0.574,P<0.05).There was a negative correlation between caregiver preparedness and depression level(r=-0.641,P<0.05).3.Intervention effects of solution focused model on preparedness,anxiety and depression of caregivers in stoke patients.Before the intervention,there was no significant difference in general information,caregiver preparedness scores,SAS and SDS scores,the changes of anxiety and depression levels between two groups(P>0.05).During the intervention,3 cases in control group were lost to follow-up while 2 cases in intervention group.The final study subjects included 83 subjects,including 41 cases in the control group and 42 cases in the intervention group.After the intervention,the indicators of the two groups of caregivers were evaluated again:(1)Caregiver preparedness: the total score of caregiver preparedness in two groups after intervention were increased,statistically significant difference(P<0.05),and the total score of caregiver preparedness in intervention group was significantly higher than the control group(P< 0.05).(2)Anxiety: the SAS score in the two groups after intervention were decreased,statistically significant difference(P<0.05),and the score of SAS in intervention group was significantly lower than the control group(P<0.05).After the intervention,the changes of anxiety level between the two groups of caregivers were compared,the proportion of the caregivers with mild and moderate anxiety in intervention group was significantly reduced,and 73.81% caregivers' anxiety score was below 50 points,which was statistically significant compared with the control group(P<0.05).(3)Depression: the SDS score in the two groups after intervention were decreased,statistically significant difference(P<0.05),and the score of SDS in intervention group was significantly lower than the control group(P<0.05).After the intervention,the changes of depression level between the two groups of caregivers were compared,64.29% caregivers' depression score was below 53 points,and the proportion of the caregivers with mild and moderate depression in intervention group was significantly reduced,which was statistically significant compared with the control group(P<0.05).(4)The difference of changes in caregiver preparedness,anxiety and depression score between two groups before and after intervention: results showed that,the difference of caregiver preparedness in intervention group was(6.16 ± 1.78),more significant than the control group(2.98 ± 1.17),with statistical significance(P<0.05).The difference of anxiety score was(10.05 ± 3.56)in the intervention group while(5.83 ± 2.94)in the control group,with statistical significance(P<0.05).The depression score of intervention group decreased(8.19 ± 4.13)points while(3.80 ± 3.00)in the control group after intervention,the difference was statistically significant(P<0.05).Conclusion 1.The preparedness of the main caregivers of stroke patients is at a moderate level,which needs to be improved.The preparedness for dealing with emergencies and providing a mutually satisfactory care is poor.Patient's disease pay mode,caregiver's age,gender,education level,current health condition and whether there are other co-caregivers are the main influencing factors related to caregiver preparedness.2.The main caregivers of stroke patients have different levels of anxiety and depression.Caregiver preparedness is negatively correlated with anxiety and depression.3.Compared with the traditional problem-solving model,focused solving model can effectively improve the care preparedness of the main caregivers of stroke patients and alleviate anxiety and depression. |
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