Empowerment of family caregiver in front of stroke in hospital environment (original) (raw)

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.

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

Aging Clinical and Experimental Research, 2019

Dependence of stroke survivors regarding the ability to perform activities of daily living imposes a burden on family caregivers. The study evaluated the effect of the family-centered empowerment program on the ability of Iranian patients with stroke to perform activities of daily living, as well as on family caregiver burden. In this randomized controlled trial study, a total of 90 pairs of patients with stroke and their family caregivers was selected and randomly assigned to the intervention or control groups. Patients and their family caregivers participated in four family-centered empowerment program sessions over four consecutive days while the patient was hospitalized. The difference in the ability of patients with stroke in the intervention and control groups to perform activities of daily living was not significant 2 weeks after the intervention. However, the ability of patients with stroke in the intervention group to perform activities of daily living increased significantly 2 months after the intervention compared with the control group: 66 ± 35.95 and 51.31 ± 36.28, respectively (p = 0.047). Two weeks after the intervention, the family caregiver burden significantly decreased in the intervention group (29.55 ± 15.38) compared with the control group (38.77 ± 18.53 and p = 0.012). The burden in the intervention group also decreased 2 months after the intervention compared with the control group: 22.95 ± 15.68 and 36.11 ± 18.88, respectively (p < 0.001). Nurses can use the family-centered empowerment program to improve the quality of life of patients with stroke, and to reduce the burden of family caregivers.

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...

Experiences of Strokes’ Caregivers: A Qualitative Study

Jundishapur Journal of Chronic Disease Care, 2019

Background: Patients with stroke are dependent on their family to relieve their physical and emotional needs after discharge from the hospital. The family plays an important role in caring for them, which is a stressful task for the caregivers. Objectives: This study aimed at investigating the experiences of caregivers of patients with stroke. Methods: This is a qualitative study (descriptive phenomenology), in which the participants included seven caregivers of stroke patients. Data were collected through semi-structured interviews. Data analysis was performed based on Colaizzi. Results: The results in the study were summarized in three main categories: anxiety (tension and stress, concern about economic future), care consequences (fatigue, reduced family interactions), and neglected needs (psychological needs, educational needs). Conclusions: According to the purpose of the study and its implications, it is concluded that nurses and physicians should pay more attention to the needs and concerns of patients and their caregivers and try to resolve them with regard to the consequences of the disease.

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.

Roles and Problems of Stroke Caregivers: A Qualitative Study in Yogyakarta, Indonesia

F1000Research

Background: Caregivers play a central role in post-stroke patients care. However, the role of and problems managed by caregivers have not been widely studied, particularly in Indonesia. This study aims to explore the roles and problems of caregivers in post- stroke patients’ care. Method: This was a qualitative study. Caregivers of post-stroke patients from the homecare clinic of Dr Sardjito General Hospital were purposely selected during January 2017 to June 2018. Focus group discussions were conducted to explore the roles and problems of caregiving. Results: Themes related to caregivers’ roles were: connecting patients with medical personnel and other family members, maintaining patients’ health conditions by fulfilling basic needs and assisting rehabilitation, as well as maintaining patients’ psychological conditions by encouraging conversation, telling jokes, or recreation. On the other hand, themes related to caregivers’ problems were: lack of knowledge caused by education inad...

The Crisis of Stroke: Experiences of Patients and Their Family Caregivers

Topics in Stroke Rehabilitation, 2011

Purpose-Approximately 4.8 million stroke survivors are living in the community with some level of disability requiring the assistance of family caregivers. Stroke family caregivers are often unprepared for the demands required of them. The purpose of this grounded theory study was to explore the needs of stroke patients and their family caregivers as they transitioned through the stroke care continuum from acute care to inpatient rehabilitation to home. Methods-Thirty-eight participants, 19 recovering stroke patients (11 male, 8 female), 15 primary family caregivers (14 spouses, 1 mother), and 4 adult children were interviewed during their stay at a rehabilitation facility and within 6 months of discharge. Interview questions were loosely structured and focused on the stroke experience and how patients and caregivers were managing postdischarge. Data were analyzed using dimensional and comparative analysis. Results-Findings were organized in a conceptual framework illustrating the trajectory of the crisis of stroke. Stroke survivors and their caregivers faced enormous challenges as they moved through 3 phases of the trajectory: the stroke crisis, expectations for recovery, and the crisis of discharge. Findings from this study suggest that as caregivers move through the phases of the trajectory, they do not have a good understanding of the role to which they are committing, and they are often underprepared to take on even the basic tasks to meet the patients' needs on discharge. Conclusion-Stroke survivors and their caregivers do not have adequate time to deal with the shock and crisis of the stroke event, let alone the crisis of discharge and all of the new responsibilities with which they must deal. Keywords caregiving; discharge planning; qualitative research; stroke Each year, nearly 800,000 people experience a new or recurrent stroke event. 1 Approximately 4.8 million stroke survivors are living in the community with some level of disability, and 50% need assistance with activities of daily living (ADLs) or instrumental activities of daily living (IADLs). 2 As diagnosis and interventions for persons with stroke improve, the number of stroke survivors and, in turn, the number of familial caregivers will increase. Although stroke survivors often have significant functional limitations, the implementation of prospective payment systems for inpatient rehabilitation services in the United States has resulted in significant reductions in lengths of stay for stroke rehabilitation 3,4 by as much as 8 days. 5 These reductions are not new. In the 1980s, a study of more than 3,000 stroke patients showed that the length of acute care hospital stays reduced from 17.5 to 6.4 days. 6 Patients with stroke thus continue to be discharged home "quicker and sicker," resulting in increased stress on family caregivers who are typically

Development of the Family-Based Care Model for Stroke Survivors to Promote Healthy Family Dynamics: Participatory Action Research

Pacific Rim International Journal of Nursing Research

In many cultures around the world, including those in Thailand, family caregivers have different views on caring for stroke survivors. These views affect the caring process, which tends to be a heavy burden for caregivers. This study used participatory action research to develop the Family-Based Care Model for Stroke Survivors to Promote Healthy Family Dynamics. Stroke survivors and their family caregivers were recruited via purposive sampling from two primary care units in Nonthaburi, Thailand. Fourteen caregivers participated in four cycles of activities for 16 weeks and they were divided into two groups of seven. Data were collected using family group discussions, observations, home visits, telephone, LINE application, and field notes, as well as a family demographic questionnaire. Participants in each group created caregiving strategies to balance family life tailored for stroke survivors’ families. Individual and collective self-reflective cycles were used as a method that con...

Barriers and facilitators to caring for individuals with stroke in the community: the family's experience

Canadian Journal of Neuroscience Nursing, 2007

Purpose: This project explored caregivers' perceptions regarding the barriers and facilitators to undertaking the post-stroke caregiving role, particularly as related to the health care system, with the ultimate goal of identifying potential strategies that would assist families in successfully undertaking the role. Method: A qualitative study consisting of focus groups and individual interviews with caregivers of persons with stroke. Participants were asked about their needs in managing the care of their family member and the factors that facilitated and/or hindered the transition to the home and influenced them in maintaining their role. Results: Information from 14 caregiver participants identified the following as primary barriers to undertaking and maintaining the caregiving role: lack of collaboration with the health care team, the intensity of the caregiving role, the negative impact on the caregiver, and the lack of community support for the caregiving role. Caregivers identified the following factors as facilitative: coordination of care, progress of the patient towards normalcy, mastery of the caregiving role, supportive social environment, and accessible community resources. Discussion and conclusions: The results indicate there are facilitators that caregivers perceive as important both to undertaking and to sustaining the caregiving role. Consideration of these results in the design of interventions may lead to more effective interventions to support caregivers in undertaking and continuing in the caregiver role.

Key informants' perspectives on implementing caregiver programs in an organized system of stroke care

Disability and Rehabilitation, 2019

Purpose: Family caregivers provide essential support to individuals recovering after experiencing a stroke. Although clinical guidelines recommend the provision of caregiver education and support, these guidelines have not been implemented into standard clinical practice. The objective of this study was to gain insight from key informants-affiliates of a regional stroke system-to identify organization and system level barriers and facilitators associated with implementing stroke caregiver programs. Methods: Twelve key informants were interviewed. Informants discussed their experiences with and perceptions of caregiver programs. They also identified barriers and facilitators to implementing caregiver programs. Interview data were analyzed using inductive thematic analysis. Results: Three themes were generated: (1) lack of consensus on the need for caregiver education and support programs as part of the health care system; (2) a collaborative process is needed to engage stakeholders and identify champions (3) stakeholders need different types of evidence in support of implementation. Conclusions: This study provides initial insight into the potential barriers and facilitators needed to develop and implement stroke caregiver programs. Further exploration of these topics can inform caregiver program development and their implementation into stroke systems of care. ä IMPLICATIONS FOR REHABILITATION Rehabilitation research needs to demonstrate that caregivers are a unique group in need of support from the health care system. Rehabilitation research needs to contribute to the evidence that caregiver programs can improve patient, caregiver, and health system outcomes. Researchers can enhance caregiver program implementation through collaboration between researchers, stakeholders, and system change champions starting with program development.