| Objective:A model of caregiver support intervention for first stroke patients based on the McMaster family functioning model theory was constructed to explore its intended effect on improving caregivers’ readiness for good home care outcome and comprehensive caregiving,as well as further improving patients’ quality of life and family functioning.Methods:1.The first draft of the caregiver support intervention model was formulated according to the McMaster family functioning model theory by combining literature analysis and the group’s preliminary survey of caregivers’ readiness for good home care for first stroke patients.Two rounds of expert consultation and pre-testing were conducted to further revise and refine the model,resulting in a family functioning-oriented caregiver support intervention model for first stroke patients.2.A convenience sample of 103 first stroke patients and their caregivers were selected from the neurology department of a tertiary care hospital in Shanxi Province to assess the effectiveness of the implementation of the caregiver support intervention model for a period of 3 months,and they were divided into control group(51 cases)and intervention group(52 cases)according to the time of entry into the section.The control group implemented usual care and the intervention group was given a caregiver support intervention model on top of this.The two groups were compared in terms of caregivers’ readiness for good home care outcome,comprehensive caregiving ability and the patients’ general functioning and patients’ quality of life scores.Results:1.A summary of the literature related to caregiver support intervention models for stroke patients in China and abroad in the last 5 years was conducted.13 papers were included,and the first draft of the intervention model was formulated according to the McMaster’s theory of family functioning with reference to existing models in China and abroad.Two rounds of expert consultation and pre-testing were conducted to further revise the model.The results of the expert consultation(including 13 experts)showed that the expert positivity coefficient was 100%,the authority coefficient was 0.927,the mean importance assignment for each entry was > 3.50,the coefficient of variation ranged from 0 to 0.17,and the Kendall coordination coefficient was 0.215 and 0.303 in that order,with P < 0.001 by 2-round chi-square test.In two rounds,76.92% and 30.77%of the experts in turn proposed targeted changes to the caregiver support intervention model items,which were discussed by the subject group and reasonably revised.The feedback and some of the issues raised during the implementation of the caregiver support intervention model in the pre-test were also refined to form the final caregiver support intervention model entries.2.A total of 103 first stroke patients and their caregivers were included.52patient-caregiver dyads in the intervention group,with a mean age of(67.02 ± 10.38)years for the patients and a mean age of(49.77±9.10)years for the caregivers and 51patient-caregiver dyads in the control group,with a mean age of(66.76±10.32)years for the patients and a mean age of(49.61±9.12)years for the caregivers.And a total of 7cases were lost during the implementation of the intervention,with a loss of follow-up rate of 6.36%.(1)A balanced test was conducted to compare the general information of patients and caregivers,the comprehensive caregiving ability of caregivers,patients’ general functioning and quality of life total scores and the scores of each dimension between the two groups before the intervention,and the differences were not statistically significant(P > 0.05)and were comparable.(2)Caregivers’ readiness for good home care outcome scores were higher in the intervention group than in the control group at discharge,with a statistically significant difference(P < 0.001).Caregivers had higher comprehensive caregiving ability total scores and scores on all dimensions at discharge,1 month and 3 months after discharge than the control group,and the difference was statistically significant(P < 0.001).Patients’ general functioning scores were lower than the control group at 1 month and 3months after discharge,and the difference was statistically significant(P < 0.001).The total scores of patients’ quality of life and the rest of the dimensions(except language,vision,and thinking)were higher for patients at 1 month and 3 months after discharge than for the control group,and the difference was statistically significant(P < 0.001).Conclusion:To sum up,the family function-oriented caregiver support intervention model for first stroke patients is scientifically sound and feasible,and is conducive to improving the readiness of caregivers to provide good home care and comprehensive caregiving ability,as well as enhancing patients’ family functioning level and effectively improving patients’ quality of life. |
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