The effect of family-centered empowerment program on the family caregiver burden and the activities of daily living of Iranian patients with stroke: a randomized controlled trial study (original) (raw)
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The Effect of a Family-centered Empowerment Model on the Quality of Life of Patients With Stroke
Journal of Client-Centered Nursing Care, 2020
Background: Stroke upsets the quality of life of the patients and their families. The participation of the family in caring for these patients is inevitable. Empowerment programs enhance patients’ motivation and knowledge and improve their quality of life and self-care. This research aimed to determine the effect of a program based on the family-centered empowerment model on the quality of life of patients with stroke. Methods: This clinical trial study was performed on 100 patients with stroke in Shahid Beheshti Hospital in Kashan City, Iran. The subjects were first recruited purposefully and then were randomly divided into two groups. The experimental group received a family-centered empowerment training in 8 sessions, while the control group received no intervention. The patients in the two groups completed the stroke-specific quality of life scale before the intervention, immediately after the intervention, and one and two months after the last training session. The obtained data were analyzed using the Chi-square test, repeated measures ANOVA, and t-test in SPSS V. 19. Results: Comparison of the experimental and control groups showed that the total score of quality of life significantly changed immediately after the intervention, and one and two months later (P<0.05). Repeated measures ANOVA results reported a significant interaction between time and group in the total quality of life score and some of its dimensions (energy, family role, social role, language, mobility, self-care, upper extremity function, and work/productivity) (P≤0.05). Conclusion: This model of empowerment can improve the quality of life of patients with stroke. This model is recommended to use in the educational program of these patients.
Family-Centered Empowerment Model Effect on Stroke Patients and their Care Givers
Egyptian Journal of Health Care, 2022
Background: Most stroke survivors will be cared for by family caregivers with limited training. Families actively involved in care feel more prepared for the new responsibilities of caring for the stroke survivor. Empowerment and self-efficacy are critical, yet they are frequently overlooked. This study aims to evaluate the effect of family centered empowerment model on stroke patients and their care givers. Methods: In this work, a quasi-experimental design was adopted. This research was carried out in the Nasr City Insurance Hospital's ICU. The study comprised fifty stroke patients and fifty of their caregivers from the previous context. Tools: Pre-test data were collected using two socio-demographic data sources for patients and caregiver, as well as three questionnaire instruments for self-efficacy and burden level. The researched subject was given an empowerment intervention, after which post-test data was obtained. Results: The findings reveal that there was a substantial change in self-efficacy categories before and after empowerment among the patients and caregivers tested. Pre-empowerment, all caregivers had a severe burden level, but after empowerment, two-thirds of them have a low to moderate burden level. Conclusions: According to the findings of this study, caregivers' self-efficacy, self-esteem, perceived threat, and finally burden levels can be increased, facilitating the path to healthy ageing and being healthy during this period, by using a family-based empowerment model on a regular and consistent basis. Recommendation: The study advised that empowerment programs be designed to equip people and their caregivers to participate in activities, particularly in the early stages.
International Journal of Nursing Sciences
The family caregiver's role is an important influence factor of patient's adaptation behaviour and quality of life after stroke. The purpose of this research was to identify the effect of caregiver empowerment program based on the adaptation model (CEP-BAM) on functional capacity and quality of life of patients after stroke. Methods: This research was a quasi-experimental research with a pre-and post-test control group design. The total participants who completed the research were 80 patients and their families, 40 participants in the intervention group and 40 participants in the control group. We conducted home visits to perform the intervention. The measurement of functional capacity and quality of life performed four times (pre-test and three times post-test). Data analysis was performed using the repeated measurement ANOVA or general linear model repeated measure (GLM-RM). Results: This research proves a significant difference in functional capacity and quality of life between the two groups and between pre-test and sixth months after intervention (P < 0.05). The quality of life of the intervention group in the sixth month after intervention was better than that of the control group (33.40 ± 3.65 vs 30.60 ± 2.78) with a significant difference (P < 0.05). Conclusion: It is concluded that CEP-BAM effectively increased patients' functional capacity and quality of life after a stroke in the sixth month after intervention.
Caregiver empowerment program based on the adaptation model increase stroke family caregiver outcome
Frontiers of Nursing
Objective Post-stroke disability and psychosocial disorders cause burdens for the families of stroke patients, including physical and financial burdens. The physical and psychological health of family caregivers determines the quality of care they provide to patients. The purpose of this study was to identify the effectiveness of the Caregiver Empowerment Program Based on the Adaptation Model (CEP-BAM) in increasing the family caregiver's coping ability against various problems and reducing their burden while caring for the stroke patient. Methods This research was a quasi-experimental study with pre- and post-test control group design. The intervention group received CEP-BAM, while the control group received a conventional intervention in the form of a discharge planning program for family caregivers in the hospital. The samples were caregivers who care for and facilitate the recovery of stroke patients during their convalescence at home. We selected the samples from the popula...
Empowerment of family caregiver in front of stroke in hospital environment
Revista Brasileira de Enfermagem
Objectives: to understand how the empowerment of family caregivers of people with stroke occurs in the hospital environment. Methods: a qualitative research, participatory action research, articulated with Paulo Freire’s Research Itinerary, developed in April 2018 with family caregivers, in a Stroke Unit. Results: three predominant codes were coded: the need for empowerment and autonomy to experience the care situation; the challenges experienced in becoming a caregiver; and family support. Participants presented a lack of information inherent to the care process, with distancing from empowerment to perform the function in dehospitalization. Dialogue revealed empowerment as a possibility for critical awareness and skill development. Conclusions: it highlights the importance of directing health promotion for caregivers, inserting them in the care process, recognizing their needs and intensifying practices that promote empowerment for care, bypassing curative actions.
BMC Health Services Research, 2021
Background Stroke can impose a heavy burden on caregivers. Caring for stroke patients at home is more challenging than in hospitals with facilities. The purpose of this study was to evaluate the effect of a supportive home care program on caregiver burden with stroke patients. Methods This was an experimental study. One hundred sixteen caregivers of stroke patients were recruited using convenience sampling from two university-affiliated hospitals in Tehran from June 2019 to February 2020. They were randomly allocated into two groups (supportive home care program and routine hospital education program) using a randomized block design. The supportive home care program included eight educational sessions delivered in the hospital before discharge, and with home visits after hospital discharge. Caregiver burden was measured using Caregiver Burden Inventory. The data were analyzed using independent samples t-test and Analysis of Covariance. Results Caregiver burden in the routine educati...
Investigating the needs of family caregivers of older stroke patients: a longitudinal study in Iran
BMC Geriatrics, 2020
Background The high burden of care associated with older stroke patients is a factor that threatens the health of family caregivers. Identifying the needs of family caregivers in this group of patients can help provide effective solutions. The present study aimed to determine the needs of family caregivers of older stroke patients. Methods The sample size of this longitudinal study included 200 family caregivers of older stroke patients from two hospitals in Iran. Data collection included demographics, responses to family caregivers’ needs questionnaires, and the Barthel Index which was taken in four stages including admission time, pre-discharge, two weeks and 12 weeks post-discharge. Results The results showed that all participants at all stages of the study identified “respect for the patient when providing education, treatment, or rehabilitation” as one of their needs. There was a statistically significant relationship between the older adult survivor’s age and the number of fam...
BMJ Open, 2022
ObjectivesTo evaluate the effectiveness of a tailored multidimensional intervention in reducing the care burden of family caregivers of stroke survivors. This intervention considered caregivers’ perceived needs and incorporated three evidence-based dimensions (psychoeducation, skill-building and peer support).DesignA prospective randomised control trial.SettingA community-based study conducted in Egypt.ParticipantsA total of 110 caregivers aged ≥18 years who cared for a survivor within 6 months of stroke, with modified Rankin Scale scores of 3–5, and without other physical disabilities or terminal illnesses were recruited between December 2019 and May 2020. Participants were assigned to the intervention group (IG; n=55) and control group (CG; n=55) through open-label, parallel 1:1 randomisation.InterventionThe IG was provided with tailored multidimensional interventions for 6 months until November 2020, including three home visits, six home-based telephone calls and one peer-support...
BMJ, 2020
Introduction Caring for stroke survivors creates high levels of care burden among family caregivers. Previous initiatives at alleviating the care burden have been unsuccessful. The proposed study aims to evaluate the effect of a tailored multidimensional intervention on the care burden among family caregivers of stroke survivors. Based on the perceived needs of family caregivers, this intervention takes into account scientific recommendations to combine three different approaches: skill-building, psychoeducation and peer support. Methods and analysis Using a prospective, randomised, open-label, parallel-group design, 110 family caregivers will be enrolled from Dakahlia Governorate, Egypt between December 2019 and May 2020, and randomly assigned to either the intervention group or the control group. The tailored multidimensional intervention will be administered for 6 months, including three home visits, six home-based telephone calls and one peer support session. The primary outcome is the care burden as measured using the Zarit Burden Interview. Secondary outcomes include changes in the family caregivers' perceived needs (Family Needs Questionnaire-Revised), coping strategies (Brief-Coping Orientation to Problems Experienced) and quality of life (WHO Quality of Life-BREF). Outcomes evaluation will be conducted at baseline (T0), month 3 (T1) and month 6 (T2). Independent t-test will be performed to compare the mean values of study variables between the two groups at both T1 and T2. After adjusting for confounding variables, analysis of covariance will be used to assess the effect of the intervention. In addition, repeated measures analysis of variance will be conducted to assess changes in effect over time. Ethics and dissemination This study was approved by the Research Ethics Committee of the Faculty of Nursing, Mansoura University, Mansoura, Egypt (P.0195). The results will be published in a scientific peer-reviewed journal, and findings will be disseminated at the local and international levels. Trial registration number NCT04211662.
Patient Education and Counseling, 2006
Objective: The objective of this study was to evaluate the strengths and weaknesses of a group support program and a home visiting program for family caregivers of stroke patients. It also examined the best fit between intervention variant and family caregiver and patient characteristics. van den Heuvel's previous effect study showed positive effects of the same intervention program, but unlike our present study differences between the two support variants could not be measured. Methods: Of 257 family caregivers who were included and randomly assigned to an intervention variant or a control group, 127 family caregivers completed the intervention in either the group program or the home visiting program. Results: Evaluation data showed that both intervention variants had been helpful and feasible, but home visit participants missed peer contact and follow-up contacts were missed in both intervention programs. In comparison to the home visiting program, the group program participants showed more benefit especially with respect to informational and emotional components. Caregivers' preference for type of intervention revealed that both types of intervention had its supporters. Those that preferred the group program could be clearly characterised: they were burdened, lived with a more psychologically handicapped relative, were using active coping strategies more frequently or lived in a region which is considered to be more sociable. Conclusion: The present study adds extensively to van den Heuvel's effect study with respect to discriminative aspects of group and home intervention programs and their respective benefits for specific family caregiver groups. Practice implications: In order to suitably match an intervention type with specific caregiver characteristics the intervention provider should utilize caregiver self-selection or undertake professional screening of caregiver burden. Telephone contacts should be offered in addition to the interventions. #