ArticlePDF Available

An Evaluation on the Effectiveness of Patient Care Education on Quality of Life of Stroke Caregivers: a Randomized Field Trial

Authors:

Abstract

Background & Objectives: Stroke is a debilitating and chronic disease. Caring of a patient with stroke can affect caregiver’s life dimensions, especially their quality of life. This study aimed to evaluate the effect of patient care education on caregivers’ quality of life of stroke patient. Materials & Methods: This randomized field trial was performed on 120stroke patients who were hospitalized in Vasei hospital in Sabzevar in 2014. Research units were randomly assigned to two groups: intervention group (n=60) and control group (n=60).Both groups completed SF-36 questionnaire before and one month after education. Data analyzed through chi-square, wilcoxon, paired t-test and independent t-test with STATAsoftware(V.12) with 5% significant level. Results: The results revealed that, one month after education, scores of quality of life was significantly higher in intervention group than control group. The most differences were in General Health (p=1.000), Role ofPhysical(p=1.000) and Role of Emotion (1.000). Conclusion: Teaching caring to caregivers of stroke patients leaded to enhancement of knowledge and skill in caring of patients and, finally, increased their quality of life. So,the importance of teaching care skills to caregivers by nurses must be paid more attention than before. Keywords: Family caregiver, Quality of life, Stroke.












E-mail: roakbarzadeh53@gmail.com


 

  

SF-36

 
>P>P>P
 





   
      
     
      
 









     



 
         
    
       -
.
 

     
      
    

        


    -


      
      


     
        
       



        



-

       -


       

   




 
    

      


      

    



 

  



    





-
      
     

   
     

      
    
    

         





      





SF-36
  " "

      
     

       

     
   




     
     



     
       
    
        


      
      
  




 
        



 
-
A  B 





         
      
    




    
SF-36    
    
      




     


          
    
      
        
      


     medsab.Rec.93.13 
 IRCT2014061918156N1 

stata-

        
   



       
   



 p= 

       
0p= 
       
   
 
P=


p<
p<  p<
p=

     

         


    -
>p



       
       
        



       


       
     
   
SF-12






      
      

        

  
   








±
±
P. value
P. value
F

±
±




±
±




±
±




±
±




±
±




±
±




±
±




±
±










±
±
P. value
T

±
±



±
±



±
±



±
±



±
±



±
±



±
±



±
±









     
        
    
         


    



       
         
      

      
 
       


      


-
  p  
        
p=
        
p    
   
 
         
  
 


SF-36 
""
p  

       
        
 p    
p 

       
        



       














  





  
 







>p
    
 
         

 


 
 
p=
   

        
p 
   
        

      


p

        
<p    

p 
       
       

    

 



      
-


       



    
    

   


References
1. Smeltzer SC, Bare BG, Hinkle JL, Cheever KH.Brunner and Suddarths textbook of Medical Surgical
Nursing.Philadelphia,Lippincott Williams and Wilkins,USA,2007.
2. Together to end stroke.2014.Available at: http://www.strokeassociation.org/strokeorg. Accessed may19.
2014.
3. Lopez-Bastida J, Moreno JO, Cerzo MW, Perestelo Perez L, Serrano-Aguilar. Socialand economic costs and


health-related quality of life in stroke survivors in the Canary Islands, Spain. BMC Health Serv Res. 2012;
12: 315.
4. Khatiban M, Kheirollahi A, Oshvandi KH, Alhani F, KH Oshvandi, Feradmal J. The effect of family-based
educationon knowledge and self-esteem of caregiver of patients with stroke:a randomized controlled trial. J
Mazand Univ Med Sci. 2014;23(110):237-43.
5. Gil-Guillen V, Carratala-Munuera C, Ortega JCA, Orozco-Beltran D, Ribera JM, Expósito AP, et al.
Protective factors in patients aged over 65 with stroke treated by physiotherapy, showing cognitive
impairment, in the Valencia Community. Protection Study in Older People (EPACV). BMC Neurol.
2012;12(1):118.
6. Vincent C, Desrosiers J, Landreville P, Demers L; BRAD group. Burden of caregivers of people with stroke:
evolution and predictors. Cerebrovasc Dis. 2009;27(5):456-64.
7. Dalvandi A, Ekman S-L, Khankeh HR, Maddah SSB, Lutzen K, Heikkilä K. Lack of continuity of
rehabilitation care for stroke survivors: Iranian family caregivers' experience. Middle East Journal of Age &
Ageing. 2011;7(5): 27-35.
8. Reinhard SC, Given B, Petlick NH, Bemis A. Supporting family caregivers in providing care. Patient safety
and quality: an evidence-based handbook for nurses Rockville (MD): Agency for Healthcare Research and
Quality (US). 2008.
9. Opara JA, Jaracz K. Quality of life of poststroke patients and their caregivers. J Med Life. 2010;3(3):216-
20.
10. Baumann M, Couffignal S, Le Bihan E, Chau N. Life satisfaction two-years after stroke onset: the effects of
gender, sex occupational status, memory function and quality of life among stroke patients (Newsqol) and
their family caregivers (Whoqol-bref) in Luxembourg. BMC Neurol. 2012;12(1):105.
11. Hayashi Y, Hai HH, Tai NA. Assessment of the Needs of Caregivers of Stroke Patients at State-Owned
Acute-Care Hospitals in Southern Vietnam, 2011. Prev Chronic Dis. 2013;10:1-9.
12. Koohestani HR, Baghcheghi N. Burn out in caregivers of patients with stroke and its related factors. Hakim.
2012;14(4):242-8. [persian]
13. khanjani MS, hatamizadeh N, hoseini MA, rahgozar MM. Effectiveness of care education to family
caregivers of cerebral palsy pediatrics on their quality of life. Rehab J. 2009;10(3):38-42. [Persian]
14. Masoodi R, Alhani F, Moghadassi J, Ghorbani M. The effect of family-centered empowerment model on
skill, attitude, and knowledge of multiple sclerosis caregivers. J Birjand Univ Med Sci. 2010;17(2):87-97.
[Persian]
15. Montazeri A ,Goshtasebi A, Vahdaninia M, Gandek B. The Short Form Health Survey (SF-36): translation
and validation study of the Iranian version. Qual Life Res. 2005;14(3):875-82.
16. Tagharrobi Z, Sharifi KH, Sooky Z. Psychometric evaluation of the short forms of barthel index in the
elderly residing in nursing homes. FEYZ. 2012;2(1):26-38. [Persian]
17. Northouse LL, Mood DW, Schafenacker A, Montie JE, Sandler HM, Forman JD, et al. Randomized clinical
trial of a family intervention for prostate cancer patients and their spouses. Cancer. 2007;110(12):2809-18.
18. Belgacem B, Auclair C, Fedor M-C, Brugnon D, Blanquet M, Tournilhac O, et al. A caregiver educational
program improves quality of life and burden for cancer patients and their caregivers: a randomised clinical
trial. Eur J Oncol Nurs. 2013;17(6):870-6.
19. Molazem Z, Falahati T, Jahanbin I, Jafari P, Ghadakpour S. The effect of psycho-educational interventions
on the quality of life of the family caregivers of the patients with spinal cordinjury: a randomized controlled
trial. Int J Community Based Nurs Midwifery. 2014;2(1):31-9.
20. Jalili N, Rassafiani M, Dalvand H, Haghgoo HA, Farzi M. The effectiveness of handling training on stress
and quality of life among mothers of children with cerebral palsy aged 4-12 years old. Journal of Research in
Rehabilitation Sciences. 2013;9(1):48-58.[Persian]
21. Rodgers H, Atkinson C, Bond S, Suddes M, Dobson R, Curless R. Randomized controlled trial of a
comprehensive stroke education program for patients and caregivers. Stroke. 1999;30(12):2585-91.
Journal of Sabzevar University of Medical Sciences, Volume 22, Number 6, January & February 2016

An Evaluation on the Effectiveness of Patient Care
Education on Quality of Life of Stroke Caregivers: a
Randomized Field Trial
Mahtab Gholizade.,
M.Sc. Student of Nursing School, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar,
Iran
Rahim Akrami.,
M. Sc. Of Epidemiology, Lecturer of Department of Community Medicine,School of Medicine,Sabzevar University of
Medical Sciences, Sabzevar, Iran
Moosaalreza Tadayonfar.,
Lecturer and M.Sc. in nursing, School of Nursing and Midwifery, Sabzevar University of Medical Science, sabzevar, Iran
* Roya Akbarzadeh.,
Lecturer and MSc in Nursing, Department of Anesthesiology, Paramedicine School, Sabzevar University of Medical
Sciences, Sabzevar, Iran
Received:11/04/2015, Revised:20/05/2015, Accepted:22/06/2015
Abstract
Background & Objectives: Stroke is a debilitating and chronic
disease. Caring of a patient with stroke can affect caregiver’s life
dimensions, especially their quality of life. This study aimed to
evaluate the effect of patient care education on caregivers’
quality of life of stroke patient.
Materials & Methods: This randomized field trial was performed
on 120stroke patients who were hospitalized in Vasei hospital in
Sabzevar in 2014. Research units were randomly assigned to
two groups: intervention group (n=60) and control group
(n=60).Both groups completed SF-36 questionnaire before and
one month after education. Data analyzed through chi-square,
wilcoxon, paired t-test and independent t-test with
STATAsoftware(V.12) with 5% significant level.
Results: The results revealed that, one month after education,
scores of quality of life was significantly higher in intervention
group than control group. The most differences were in General
Health (p=1.000), Role ofPhysical(p=1.000) and Role of Emotion
(1.000).
Conclusion: Teaching caring to caregivers of stroke patients
leaded to enhancement of knowledge and skill in caring of
patients and, finally, increased their quality of life. So,the
importance of teaching care skills to caregivers by nurses must
be paid more attention than before.
Keywords: Family caregiver, Quality of life, Stroke.
Corresponding Author:
RoyaAkbarzadeh,
Paramedicine School, Sabzevar
University of Medical Sciences,
Sabzevar, Iran
E-mail:
roakbarzadeh53@gmail.com
... Considering social values, one of the important sources of care for these patients is their family. 15 A caregiver is the one who carries out most of the cares and support of the stroke patient after returning home. 16 Caring for a person suffering from a chronic illness creates a lot of stress for the caregiver and patient's family. ...
... 21 Gholizadeh et al. demonstrated that empowering stroke patients' caregivers, through providing required training programs, led to improved quality of life. 15 Additionally, Khatibian et al. and Kheirollahi et al. indicated that training caregivers of patients with stroke based on the family-centered empowerment model led to increased knowledge and self-esteem, and as a result, their role and assistance in effective care improved. 22, 23 Previous studies revealed that the quality of life of these caregivers decreased after discharge, and this indicated that caregivers needed help and support for adapting to lifestyle changes. ...
... "Assessment of the effectiveness of patient care training on the QoL of caregivers of stroke patients" was the study title conducted by Gholizadeh et al. In the intervention and control groups, there was a significant difference in how education affected general health, proving that education has a positive impact on patients' general health [23]. ...
Article
Full-text available
The present study aims to determine the effect of two educational methods of pamphlets and videos on the quality of life (QoL) of patients with chronic obstructive pulmonary disease (COPD). This study is quasi-experimental. Patients with COPD who are admitted to and treated at the internal department of Shohada Qaen Hospital make up the population of this study. Giving an informative pamphlet was used as the training intervention's first group while showing an instructional video (CD) was used as its second group. The patients were given educational pamphlets or educational CDs throughout their hospital stay, and they were instructed to implement the educational materials at home. With the use of the SF-36 tool, the QoL of both groups of patients was assessed at the time of discharge and served as a baseline for comparison one month later. A total of 80 COPD patients participated in this study. Among 80 participants, 40 of them were in the educational pamphlet group and 40 of them were in the educational videos group. According to the SF-36 questionnaire, the mean score of QoL before and after the intervention in the educational videos group was 37.84 (SD=11.35) and 59.97 (SD=11.31), respectively, which indicated a significant difference after the intervention (P≤0.001). The mean score of QoL before and after the intervention in the educational pamphlet group was 31.93 (SD=13.50) and 45.63 (SD=14.27), respectively, which indicated a significant difference after the intervention (P<0.001). Overall, based on the obtained results, self-care education through video content and pamphlet improves the level of QoL in patients with COPD. Therefore, medical staff, especially nurses, can improve QoL in patients with COPD by using video and pamphlet self-care educational methods.
... Quality of life as an indicator of quality of care and part of the treatment plan for chronic patients should be considered by health care providers because the quality of life of caregivers of these patients can also be directly related to the quality of life of patients [16]. Therefore, measuring the quality of life of caregivers seems necessary. ...
Article
Full-text available
Background Patients with stroke need complete care due to physical and mental problems and prevention of exacerbation of symptoms. The quality of life of caregivers of these patients is affected by full-time care. The aim of this study was to investigate the psychometric properties of the Persian version of the adult carers quality of life questionnaire (AC-QoL) on stroke caregivers.Methods In this cross-sectional study, the original scale was translated as forward-backward method. Face and content validity were performed qualitatively. In construct validity, 358 caregivers with a mean age of 36.32 ± 8.42 years were included in the study. Exploratory factor analysis was performed by maximum likelihood method and Promax rotation. Internal consistency was assessed with Cronbach’s alpha and McDonald omega coefficients.ResultsIn exploratory factor analysis, 7 factors were extracted of caring choice, sense of value, personal growth, support of caring, ability to care, money matter and carer satisfaction extracted, which together explained 41.04% of the total variance. The alpha coefficient of all items was 0.899. Cronbach alpha and McDonald omega coefficients for all dimensions of the questionnaire were above 0.7.Conclusions The Persian version of the AC-QoL is valid for caregivers of patients with stroke and can be used in future studies.
... Some studies have also shown that educating patients with stroke allows them to pay more attention to their disorders and to be more responsive to the control and management of the illness (Eghlidi et al., 2016;Gholizadeh et al., 2015). Eames et al. (2013) examined the effects of an educational package, including psychological and physical training on the QoL in patients with stroke and their family members. ...
... The results showed that the dimensions of quality of life of caregivers were significantly higher in the intervention group 1 month after the training compared with the control group. 19 which was completely consistent with the results of our study. In addition, the results of this study showed that patient care education improves the dimensions of general, physical, and mental health in caregivers of patients. ...
Article
Full-text available
Background Care for stroke patients at home is a very complicated and tough activity. Objective The study was conducted to examine the effect of patient care education on burden of care and quality of life of caregivers of stroke patients. Materials and methods The study was an educational trial conducted on 100 caregivers of the stroke patients in Al-Zahra educational hospital, Isfahan, Iran. The intervention group received some training to empower caregivers in family-oriented care in form of an educational counseling program. Data were collected and analyzed using the questionnaires, including demographic, quality of life Short Form-36, and Zarit burden of care questionnaires. Results The mean ages of caregivers were 48.52 years in the intervention and 45.14 years in the control groups. The results indicated significant differences in mean of quality of life and burden of care in the caregivers of the intervention group after intervention (P<0.01), which was insignificant in the control group. The average burden on the caregivers of both groups was significantly associated with health status, economic status, marital status, the number of children, care hours, care days, and familial relationship of the caregivers with the patients (P<0.01) before intervention. In addition, quality of life of both groups was significantly related to their health status (P<0.01) before intervention. Conclusion Patient care education reduced the burden of care and improved quality of life of the caregivers of stroke patients. Thus, to reduce the complications of caring for stroke patients, family education should be the priority of nursing and discharging procedures.
Article
Background Thickened water has been widely used in patients with dysphagia who receive oral feeding, but there is little evidence for tube‐feeding patients. Objective To explore the effects of thickened water swallow training in tube‐feeding and dysphagia patients in the acute and early subacute phases of stroke. Methods A quasi‐experimental study. Hospitalised patients with acute and early subacute stroke who received tube feeding due to dysphagia were recruited from March to December 2021. Patients assigned to the intervention group ( n = 23) received thickened water swallow training three times daily until the feeding tube was removed or they were discharged, and patients in the control group ( n = 23) received usual care. The main outcomes were duration of tube feeding and rates of weaning at discharge. Results Patients in the intervention group had a shorter tube‐feeding duration ( p = .046) and a higher rate of weaning at discharge ( p = .017) than those in the control group. Significant interaction effects between time and group were detected regarding quality of life except for the swallowing burden dimension. Conclusions Thickened water swallow training is feasible and effective for stroke patients with tube feeding and can shorten the duration of tube feeding and improve the rates of weaning and quality of life. Healthcare providers in nonrehabilitation units should actively conduct swallowing function intervention training to maximise the potential for acute and early subacute phase rehabilitation.
Article
Full-text available
Introduction: Complications of nephrotic syndrome reduce quality of life in parents. Self-care education is associated with the possibility of reducing mortality and improving disease outcome. The aim of this study was to determine the effect of self-care education on quality of life of parents of children with nephrotic syndrome. Methods: In this randomized clinical trial study, 60 parents of children with nephrotic syndrome, aged 7-18 years, were randomly divided into two equal groups of experimental and control. Data collection tools were demographic information form and World Health Organization Quality of Life Questionnaire. The experimental group received 2 sessions of 60 minutes of self-care training based on Orem theory. The control group did not receive any training. The results of the intervention were analyzed after 4 weeks by SPSS 23 software. Results: The mean scores of quality of life in the experimental and control groups before the intervention were 74/3 ± 36/51 and52/4 ± 46/51 , respectively (P>0.05) No significant difference was observed between the two groups. One month after the intervention, it was 26/3 ± 90/99 in the experimental group and 27/9 ± 20/51 in the control group, which Significant difference was observed between the two groups (P<0.05). Conclusions: Self care education based on Orem's theory is effective in increasing the quality of life of parents of children with nephrotic syndrome which can be used as a complementary and effective method to improve that in parents of this group of patients.
Article
Full-text available
Abstract Background & Aims: Stroke can lead to post-stroke depression, which has severe negative effects on the quality of life of the patients. Post-stroke depression and quality of life may have interactions with each other. The aim of this study was to determine the effect of home care education to caregivers on depression and quality of life in stroke patients in Imam Khomeini educational and treatment center, Urmia, 2019-2020. Materials & Methods: The present study is a clinical trial in which a pre-test and post-test design with a control and test group was used. The sample size was 66 eligible patients who were randomly divided into two equal groups of intervention and control. The demographic information form of patients and their caregivers was completed by reviewing the records and interviews, and all the subjectsunderwent a pre-test to assess depression and quality of life using the Beck Depression Inventory (Second Edition) and the stroke-specific quality of life questionnaire. The intervention included conducting home care training for caregivers in four 60-minute sessions, once a week by the researcher at the patients' home by face-to-face method, with discussions and questions. Post-test was performed one month after the intervention in the intervention and control groups to assess depression and quality of life using previous questionnaires. Results: The findings showed that before the intervention, the two groups did not have a statistically significant difference (p = 0.981), but after the intervention, the two groups had a statistically significant difference in depression scores. In the intervention group, depression score decreased from 39.45 before the intervention to 22.52 after the intervention (p <0.001), while in the control group, this trend was almost unchanged and constant. The results also showed that before the intervention the two groups did not have a statistically significant difference in the quality of life score (p = 0.471) but the two groups had a statistically significant difference after the intervention in quality of life scores. The quality of life score in the intervention group increased from 118.58 before the intervention to the 183.97 after the intervention (p <0.001), while this trend remained almost unchanged in the control group. Conclusion: Based on the findings of the present study, home care training for caregivers is effective in reducing depression and improving the quality of life in stroke patients. Keywords: Education, Home Care, Caregivers, Depression, Quality Of Life, Stroke
Article
Full-text available
Abstract Background & Aims: Stroke can lead to post-stroke depression, which has severe negative effects on the quality of life of the patients. Post-stroke depression and quality of life may have interactions with each other. The aim of this study was to determine the effect of home care education to caregivers on depression and quality of life in stroke patients in Imam Khomeini educational and treatment center, Urmia, 2019-2020. Materials & Methods: The present study is a clinical trial in which a pre-test and post-test design with a control and test group was used. The sample size was 66 eligible patients who were randomly divided into two equal groups of intervention and control. The demographic information form of patients and their caregivers was completed by reviewing the records and interviews, and all the subjectsunderwent a pre-test to assess depression and quality of life using the Beck Depression Inventory (Second Edition) and the stroke-specific quality of life questionnaire. The intervention included conducting home care training for caregivers in four 60-minute sessions, once a week by the researcher at the patients' home by face-to-face method, with discussions and questions. Post-test was performed one month after the intervention in the intervention and control groups to assess depression and quality of life using previous questionnaires. Results: The findings showed that before the intervention, the two groups did not have a statistically significant difference (p = 0.981), but after the intervention, the two groups had a statistically significant difference in depression scores. In the intervention group, depression score decreased from 39.45 before the intervention to 22.52 after the intervention (p <0.001), while in the control group, this trend was almost unchanged and constant. The results also showed that before the intervention the two groups did not have a statistically significant difference in the quality of life score (p = 0.471) but the two groups had a statistically significant difference after the intervention in quality of life scores. The quality of life score in the intervention group increased from 118.58 before the intervention to the 183.97 after the intervention (p <0.001), while this trend remained almost unchanged in the control group. Conclusion: Based on the findings of the present study, home care training for caregivers is effective in reducing depression and improving the quality of life in stroke patients. Keywords: Education, Home Care, Caregivers, Depression, Quality Of Life, Stroke Address: Urmia University of Medical Sciences, School of Nursing and Midwifery, Urmia, Iran Tel: +989144476149 Email: naderaghakhani2000@gmail.com 1
Article
Full-text available
The effect of family-centered empowerment model on skill, attitude , and knowledge of multiple sclerosis caregivers R. Masoodi1, F. Alhani2, J. Moghadassi3, M. Ghorbani4 Background and Aim: Caring for patients with multiple sclerosis brings about a lot of tension for the caregivers and the family. Implementation of an empowerment program leads to self-control and preventive behaviors. This study aimed at determining the effects of a family-centered empowerment model on knowledge, attitude and skill of care givers of multiple sclerotic patients. Materials and Methods: This clinical-trial study was done on 70 care givers of multiple sclerotic patients who were divided into case and control groups. Family-centered empowerment model was applied for three months and then the questionnaires regarding skill, attitude, and knowledge of the participants were collected. The obtained data was analyzed by means of SPSS software (version 11.5) and dedicational statistical tests at the significant level of P<0.05. Results: Independent T-test revealed that there was no significant difference in the mean knowledge, attitude, and skill scores in the case and control groups before intervention (P>0.05); whereas the difference was significant three months after intervention (P=0.001). Besides, mean knowledge, attitude and skill scores of the caregivers in the case group significantly increased three months after intervention (P=0.001), but there was no significant difference in the mentioned factors in the care-givers of control group after three months (P>0.05). Conclusion: Empowerment of caregivers for patients with multiple sclerosis promotes their knowledge, attitude and skills leading to more efficient care for these patients. Planning and implementing more effective programs for those caring for chronic diseases is recommended. Key Words: Family-centered empowerment model, Knowledge, Attitude, Skill, Caregivers, Multiple Sclerosis Journal of Birjand University of Medical Sciences. 2010; 17(2):87-97
Article
Full-text available
Background and Objective: Stroke is a common disabling disorder that requires the involvement of family caregivers to successfully encourage the patient’s rehabilitation. This is especially true in Iran, where the family members commonly have the main responsibility of care of disabled persons. The aim of this study was to explore the Iranian family caregivers’ experience of providing rehabilitation care at home. Method: A grounded theory approach and the main tenets of constant comparative method were used. Twelve participants were interviewed using semi-structured in-depth interviews. Findings: The core concept was identified as “lack of continuity of rehabilitation care”. Seven main cat-egories were identified. Three of them were related to the problems family caregivers faced, including inadequate knowledge and skills, inappropriate accessibility to rehabilitative services, and inadequate social insurance. Four categories were about the strategies that family caregivers used to deal with the major con-cerns; modifying home environment, managing coexisting medical conditions, improving nurses’ roles and, relying on family unity. Conclusion: Family caregivers need continuity of rehabilitative care besides their family engagement, to enable access to care. They also need support from adequate social insurance and increased access to
Article
Full-text available
Background: Family caregivers usually report the reduction of their life quality due to one of the family member’s spinal cord injury. Thus, the present study aimed to investigate the effectiveness of psycho-educational interventions on the life quality of the family caregivers of the patients with spinal cord injury. Methods: The present randomized controlled trial was conducted on 72 family caregivers who had the primary responsibility of taking care of the patients with spinal cord injury. The participants were randomly divided into intervention (n=36) and control groups (n=36). The intervention group was involved in 90-minute educational sessions held once a week for four weeks. Both groups completed SF-36 questionnaire before and 2 and 6 weeks after the intervention. Then, the data were analyzed through independent t-test, Chi-square, and repeated measures ANOVA. Results: All the caregivers had low quality of life and the lowest mean score was related to mental health in both groups. After the intervention, various dimensions of life quality had improved in the intervention group’s caregivers compared to the control group (P<0.05). Conclusion: The study results revealed the positive effect of psycho-educational interventions on the life quality of the caregivers of the patients with spinal cord injury. According to the results, the authorities have to pay special attention to the problems of this group and educational interventions have to be continuously followed. Trial Registration Number: IRCT2013070811388N2
Article
Full-text available
Care for stroke patients has improved steadily in southern Vietnam. Medical treatments such as thrombolytic therapy have been implemented at several hospitals, and stroke-care units composed of a team of various health professionals have been created. However, little attention has been focused on providing support to caregivers of stroke patients. This study aimed to characterize the caregivers of stroke patients who were treated in state-owned acute-care hospitals and to learn about their needs when patients are discharged. Such information can be used to enhance the caregiver's support system. We used questionnaires to conduct a descriptive study in 2011 at a state-owned acute-care hospital in southern Vietnam. We recruited study participants from among caregivers of stroke patients who had been informed of their hospital discharge date. We assessed 8 caregiver characteristics, and caregiver participants selected their needs from the survey's list of 15 possible needs. We analyzed the data by using the independent sample t test and logistic regression. Of the 93 caregivers who consented to participate, 86 (92.5%) completed the survey and indicated their concerns at discharge. The most frequently cited need was information on how to prevent stroke recurrence (72, 83.7%), followed by which drugs are most effective in preventing a relapse (62, 72.1%), how long recovery would take (61, 70.9%), and availability of hospitals in the patient's hometown (60, 69.8%). A little over half of caregivers indicated financial concerns. A caregiver's need for information on diet for a stroke survivor increased with the caregiver's education level. This study revealed several needs among caregivers of stroke survivors in southern Vietnam that are similar to those found by studies of caregivers of stroke survivors in high-income countries. Our findings suggest that comprehensive stroke care that includes caregiver education about healthful diets and prevention of stroke recurrence is needed at state-owned acute-care hospitals in southern Vietnam.
Article
Full-text available
Introduction: It is common for parents with cerebral palsy children to expose further stress and affect all aspects of their quality of life. This study was carried out in order to determine the effectiveness of handling training program on the stress and quality of life of mothers with children with cerebral palsy. Materials and Methods: This control trial study was performed with two groups of experimental (n = 29) and control (n = 25) were selected by randomized convenience sampling method. Data collection tools included demographic questionnaire, SF-36 quality of life, the Resource and Stress Questionnaires. All data collected before and after three months of intervention. Statistical analysis was carried out by SPSS, version 16. Results: The mother’s mean age in control and intervention groups were 32.8 (SD = 4.9) and 35.3 (SD = 4.4) years respectively. Also, children’s mean age in control and intervention groups were 6.2 (SD = 2.1) and 7 (SD = 2.8) years. There was a significant difference in quality of life after intervention between two groups (P < 0.05). However, difference was not significant in two dimensions of physical functioning and Emotional health (P > 0.05). Also, there was a statistically significant difference between all dimensions of stress measures in two groups (P < 0.05). Conclusion: According to these findings, handling training program reduced stress and enhanced the quality of life of mothers with children with cerebral palsy in this study. Keywords: Quality of life, Stress, Cerebral palsy, Handling training, Caregivers
Article
Full-text available
Background Family function may have an influence on the mental health deterioration of the caregivers of dependent family members and it could have a varying importance on the care of dependents. Little attention has been paid to the preparation of minor stroke survivors for the recovery trajectory or the spouse for the caregiving role. Therefore, this study protocol intends to analyze the influence of family function on the protection of patients with stroke sequels needing physiotherapy in the family environment. Methods/Design This is an analytical observational design, prospective cohort study and using a qualitative methodology by means of data collected in the “interviews of life”. The study will be carried out by the Rehabilitation Service at Hospital of Elda in the Valencia Community. All patients that have been diagnosed with stroke and need physiotherapy treatment, having a dependency grade assigned and consent to participate in the study, will undergo a monitoring of one year in order to assess the predictive factors depending on the dependence of the people affected. Discussion Our research aims to analyze the perception of caregivers, their difficulties to work, and the influence of family function. Moreover, it aims to register the perception of the patients with stroke sequel over the care received and whether they feel protected in their family environment.
Article
Full-text available
Background Life satisfaction (LS) of cerebrovascular disease survivors and their family caregivers may relate to socioeconomic factors, impaired functions, health-related quality of life (QoL), but their respective influences remain unclear. This study assessed, two years post-stroke onset, the effects of these factors on patients’ LS and family caregivers’ LS in Luxembourg. Methods All stroke patients admitted to all hospitals in Luxembourg were identified by the ‘Inspection Général de la Sécurité Sociale’ using the only national system database for care expenditure reimbursement. Their diagnosis was confirmed by medical investigator. The sample included ninety four patients living at home having given consent (mean age 65.5 years) and sixty two main caregivers (mean age 59.3 years). Questionnaires were completed during face-to-face interviews. LS was assessed via European single question (range 1–10), survivors’ QoL via Newsqol (11 dimensions), and caregivers’ QoL via Whoqol-bref (4 domains) (range 0–100). Data were analysed using multiple regression models. Results Two years after stroke onset, 44.7% of patients suffered from impaired sensory function, 35.1% from impaired motor function, and 31.9% from impaired memory function. Mean patient’ LS was 7.1/10 (SD 1.9). It was higher in women (+12.4) and lower among unemployed socioeconomically active patients (−13.1, vs. retired people). Adjusted for sex, occupation, impaired motor and memory functions, LS positively correlated with scores of Newsqol feelings, sleep, emotion, cognition and pain dimensions (slopes 0.20 to 0.31), but did not correlate with those of caregivers’ Whoqol-bref domains. Family caregiver’ LS was 7.2 (SD 1.7). It was lower in those with patients suffering from impaired memory function (−12.8) as well as from feelings and emotion issues (slopes 0.22). It was associated with all caregivers’ Whoqol-bref domains (physical health, psychological health, environment, and social relationships) (slopes 0.53 to 0.68). Conclusions Two-year post-cerebrovascular disease patient’ LS was associated with gender, occupation, and impaired memory function. It correlated with feelings, sleep, emotion, cognition, and pain issues. Family caregivers of patients with impaired memory function had lower LS. Family caregiver’ LS correlated with dimensions of patients’ feelings (less independent, yourself, life changed, depressed, useless, less control because of stroke) and emotion (get more emotional, fear of another stroke or to become dependent on others), and with their own QoL. LS, Newsqol, and Whoqol appeared to be appropriate tools. Our findings may be useful for policy makers in relation to family and medical-social issues of stroke home-based rehabilitation.
Article
Full-text available
Cost-of-illness analysis is the main method of providing an overall vision of the economic impact of a disease. Such studies have been used to set priorities for healthcare policies and inform resource allocation. The aim of this study was to determine the economic burden and health-related quality of life (HRQOL) in the first, second and third years after surviving a stroke in the Canary Islands, Spain. Cross-sectional, retrospective study of 448 patients with stroke based on ICD 9 discharge codes, who received outpatient care at five hospitals. The study was approved by the Research Ethics Committee of Nuestra Señora de la Candelaria University Hospital. Data on demographic characteristics, health resource utilization, informal care, labor productivity losses and HRQOL were collected from the hospital admissions databases and questionnaires completed by stroke patients or their caregivers. Labor productivity losses were calculated from physical units and converted into monetary units with a human capital-based method. HRQOL was measured with the EuroQol EQ-5D questionnaire. Healthcare costs, productivity losses and informal care costs were analyzed with log-normal, probit and ordered probit multivariate models. The average cost for each stroke survivor was €17 618 in the first, €14 453 in the second and €12 924 in the third year after the stroke; the reference year for unit prices was 2004. The largest expenditures in the first year were informal care and hospitalizations; in the second and third years the main costs were for informal care, productivity losses and medication. Mean EQ-5D index scores for stroke survivors were 0.50 for the first, 0.47 for the second and 0.46 for the third year, and mean EQ-5D visual analog scale scores were 56, 52 and 55, respectively. The main strengths of this study lie in our bottom-up-approach to costing, and in the evaluation of stroke survivors from a broad perspective (societal costs) in the first, second and third years after surviving the stroke. This type of analysis is rare in the Spanish context. We conclude that stroke incurs considerable societal costs among survivors to three years and there is substantial deterioration in HRQOL.
Article
Purpose of the research: The French setting, including laws and guidelines, advocates greater involvement of informal caregivers in the care of cancer patients to protect the caregivers from depression, distress, and a decrease in their quality of life. This study aimed to assess the efficacy of a caregiver educational programme by measuring two outcomes: patients' and caregivers' quality of life and caregivers' burden. Methods and sample: A multicentre randomised controlled trial was performed in six oncology wards in French hospitals. Eligible patients had a cancer, a main caregiver, allowed their caregivers' involvement, and received an inclusion agreement by a doctor/psychologist dyad. The experimental group participated in an educational programme performed by nurses to improve their skills in meal support, nursing care, welfare care, or symptom management. The SF36 and the Zarit burden scales were used to measure quality of life and caregivers' burden at the beginning and at the end of the study. Key results: 67 patients were randomised and 33 were included in the experimental group. Evolution scores, which measured the difference between baseline and final scores, showed an improvement in patients' and caregivers' quality of life and an alleviated burden for experimental group caregivers. Conclusions: An educational programme for caregivers encourages the involvement of patients, informal caregivers and health-care providers in a triangular relationship which enhances the quality of life of patients and caregivers alike and decreases caregivers' burden. Care organisation should therefore be rethought as a triangular relationship between patients, caregivers and health-care providers, with nurses as the mainstay.