A study to asses the effectivenesss of multifactorial interventon to improve the knowledge & practice regarding care of patients with stroke among caregivers in selected ward areas of pgims, rohtak

Volume: 11 | Issue: 01 | Year 2025 | Subscription
International Journal of Neurological Nursing
Received Date: 12/03/2024
Acceptance Date: 02/01/2025
Published On: 2025-02-15
First Page: 22
Last Page: 49

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By: RITUJAKHA ., HEMWATI ., and Surekha Dabla.

1Student, Department of Medical Surgical Nursing, College of Nursing,Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.

2Junior Lecturer, Department of Medical Surgical Nursing, College of Nursing,Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.

3Senior Professor & Head, Department of Neurological Nursing, College of Nursing,Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.

Abstract

The aim of this study was to assess whether involving patient caregivers in the care of stroke patients would influence their caregiving practices compared to caregivers who were not actively involved in the care process. The study was based on the nursing process model, which draws from Ludwin Von Bertalanffy’s General System Theory of Nursing. A quasi-experimental, pretest-posttest design was employed to evaluate the impact of caregiver participation in the care of stroke patients on their caregiving practices. A total of 60 caregivers were selected from a larger population using convenience sampling, based on specific inclusion criteria. Data were gathered through structured interviews and observational checklists. A pretest was conducted to evaluate the caregivers’ practices in meeting specific care needs, such as oral care, bed baths and back massages, tube feeding, and assistance with elimination. On the first day following the pretest, the investigator demonstrated techniques for providing care in these areas. Over the next two days, caregivers participated in the care activities alongside the investigator, receiving feedback and encouragement during the process. After one week, a posttest was conducted. In addition to data collection, caregivers were given the opportunity to ask questions and clarify any doubts for their benefit. The results showed a significant improvement in caregiving practices between the pretest and posttest. Notable improvements were observed in all four care areas: oral care (t=35.155, df=38, P=0.05), bed baths and back massages (t=45.78, df=38, P=0.05), tube feeding (t=58.99, df=38, P=0.05), and assistance with elimination (t=30.02, df=38, P=0.05). The overall mean practice score for the experimental group increased significantly from a pretest mean of 22.10 to a posttest mean of 57.80 (t=60.23, df=38, P=0.05). In contrast, no significant change was observed in the control group’s mean practice scores. The study concluded that involving caregivers in the direct care of stroke patients led to a substantial improvement in their caregiving practices. This active participation not only enhanced their skills but also contributed to greater patient safety and a reduction in the risk of complications.


Keywords: Caregiver involvement, Stroke patients, Caregiving practices, Nursing process model, Quasi-experimental design

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How to cite this article: RITUJAKHA ., HEMWATI ., and Surekha Dabla A study to asses the effectivenesss of multifactorial interventon to improve the knowledge & practice regarding care of patients with stroke among caregivers in selected ward areas of pgims, rohtak. International Journal of Neurological Nursing. 2025; 11(01): 22-49p.

How to cite this URL: RITUJAKHA ., HEMWATI ., and Surekha Dabla, A study to asses the effectivenesss of multifactorial interventon to improve the knowledge & practice regarding care of patients with stroke among caregivers in selected ward areas of pgims, rohtak. International Journal of Neurological Nursing. 2025; 11(01): 22-49p. Available from:https://journalspub.com/publication/ijnen/article=15230

Refrences:

1. Global Burden of Disease Study 2019. Lancet. 2020; 396(10258):1204-1222.
2. Bakas T, et al. Stroke caregiver outcomes from the Telephone Assessment and Skill-Building Kit (TASK). Top Stroke Rehabil. 2015; 22(2):114-121.
3. Forster A, et al. A structured training programme for caregivers of inpatients after stroke (TRACS): a cluster randomised controlled trial and cost-effectiveness analysis. Lancet. 2013; 382(9910):2069-2076.
4. Bakas T, et al. Effects of a telephone‐based stroke caregiver intervention. J NeurosciNurs. 2015; 47(6):304-314.
5. Serrano S, et al. Multifaceted educational program to improve nurses’ and nursing assistants’ knowledge and practices about delirium: A cluster randomized trial. Int J Nurs Stud. 2017; 73:47-55.
6. Berenguer R, et al. Educational interventions to improve handover in health care: a systematic review. Med Educ. 2017; 51(4):345-359.
7. Chumbler NR, et al. Testing the effects of a standardized patient education program on health outcomes and utilization in acute care settings: Protocol for a pragmatic randomized control trial. BMC Health Serv Res. 2020; 20(1):1-9.
8. Kuriakose CK, et al. Effect of Oral Health Education on Caregivers Knowledge, Attitude, and Practice in Maintaining the Oral Health of Children with Disabilities. J Indian SocPedodPrev Dent. 2020; 38(1):34-39.
9. 2Tsai PF, et al. Effects of a Bed Bath and Massage Intervention on Institutionalized Elders’ Mood State and Sleep Quality. Res Aging. 2012; 34(2):181-201.
10. Mackereth PA, et al. A pilot randomised trial to measure the effects of a programme of home‐based back care intervention on carer wellbeing. Int J Older People Nurs. 2015; 10(4):287-296.
11. Radnitz CL, et al. Development and validation of the bowel care competency assessment tool for caregivers of patients with neurogenic bowel dysfunction. Spinal Cord. 2016; 54(11):1028-1035.
12. Chan EY, et al. Nursing Intervention for Managing Patients with Nasogastric Tube: A Review. J Nurs Care. 2017; 6(2):1-5.
13. Bakas T, et al. Telephone assessment and skill‐building kit for stroke caregivers: a randomized controlled clinical trial. Stroke. 2015; 46(12):3478-3487.
14. Silver FL, Norris JW. History of stroke. In: Encyclopedia of Life Sciences (eLS). John Wiley & Sons, Ltd; 2003.
15. Feigin VL, Norrving B, Mensah GA, editors. Atlas of Stroke. Wiley-Blackwell; 2020.
16. Caplan LR. Brain embolism. Informa Health Care; 2006.
17. Fisher M, Bogousslavsky J, editors. Current Review of Cerebrovascular Disease. People’s Medical Publishing House; 2010.
18. World Health Organization (WHO): Stroke, Cerebrovascular accident. Available online at: https://www.emro.who.int/health-topics/stroke-cerebrovascular-accident/index.html
19. Centers for Disease Control and Prevention (CDC): Stroke Facts. Available online at: https://www.cdc.gov/stroke/data-research/facts-stats/index.html
20. Li J, Kong X, Wang J, Zhu H, Zhong J, Cao Y, Wu B. Family functioning and patients’ depressive symptoms: comparison in perceived family function between patients who had an acute ischaemic stroke and their primary family caregivers – a cross-sectional study. BMJ Open. 2023 Nov 21;13(11):e068794. Doi: 10.1136/bmjopen-2022-068794. PMID: 37989357; PMCID: PMC10668298.
21. Mou H, Lam SKK, Chien WT. The effects of a family-focused dyadic psychoeducational intervention for stroke survivors and their family caregivers: A randomised controlled trial. Int J Nurs Stud. 2023 Jul;143:104504. Doi: 10.1016/j.ijnurstu.2023.104504. Epub 2023 Apr 17. PMID: 37149953.
22. Sahbaz T, Medin-Ceylan C. Stroke severity to determine musculoskeletal symptoms in family caregivers. Rev Lat Am Enfermagem. 2023 Oct 9;31:e4004. Doi: 10.1590/1518-8345.6725.4004. PMID: 37820216; PMCID: PMC10561800.
23. Lobo EH, Johnson T, Frølich A, Kensing F, Rasmussen LJ, Hosking SM, Page AT, Livingston PM, Islam SMS, Grundy J, Abdelrazek M. Utilization of social media communities for caregiver information support in stroke recovery: An analysis of content and interactions. PLoS One. 2022 Jan 26;17(1):e0262919. Doi: 10.1371/journal.pone.0262919. PMID: 35081150; PMCID: PMC8791510
24. Singh H, Nguyen T, Hahn-Goldberg S, Lewis-Fung S, Smith-Bayley S, Nelson MLA. A qualitative study exploring the experiences of individuals living with stroke and their caregivers with community-based poststroke services: A critical need for action. PLoS One. 2022 Oct 10;17(10):e0275673. Doi: 10.1371/journal.pone.0275673. PMID: 36215245; PMCID: PMC9550061.
25. Lin S. et al. The experience of stroke survivors and caregivers during hospital-to-home transitional care: A qualitative longitudinal study. Int J Nurs Stud. 2022 Jun;130:104213. Doi: 10.1016/j.ijnurstu.2022.104213. Epub 2022 Feb 26. PMID: 35378465.
26. Manzekele Bin Kitoko G, Vivalya BMN, Vagheni MM, Matonda Ma Nzuzi T, MampunzaLusambulu S, Lelo GM, Mpembi MN, Mampunza Ma Miezi S. Psychological Burden in Stroke Survivors and Caregivers Dyads at the Rehabilitation Center of Kinshasa (Democratic Republic of Congo): A Cross-Sectional Study. J Stroke Cerebrovasc Dis. 2022 Jun;31(6):106447. Doi: 10.1016/j.jstrokecerebrovasdis.2022.106447. Epub 2022 Mar 31. PMID: 35367847.
27. Liu Y, Guo H. Empowerment in Chinese primary caregivers of post-stroke patients with dispractice: A cross-sectional study. Medicine (Baltimore). 2021 Feb 5;100(5):e23774. Doi: 10.1097/MD.0000000000023774. PMID: 33592833; PMCID: PMC7870185
28. Tyagi S, Luo N, Tan CS, Tan KB, Tan BY, Menon E, Venketasubramanian N, Loh WC, Fan SH, Yang KLT, Chan ASL, Farwin A, Lukman ZB, Koh GC. Support system diversity among family caregivers of stroke survivors: a qualitative study exploring Asian perspectives. BMC Geriatr. 2021 Oct 25;21(1):594. Doi: 10.1186/s12877-021-02557-4. PMID: 34696724; PMCID: PMC8543837.
29. Wang J, Liu J, Li L, Man J, Yue S, Liu Z. Effect of education and muscle relaxation program on anxiety, depression and care burden in caregivers of acute stroke survivors: A randomized, controlled study. Medicine (Baltimore). 2021 Jan 29;100(4):e24154. Doi: 10.1097/MD.0000000000024154. PMID: 33530205; PMCID: PMC7850736.
30. Silva JKD, Boery RNSO. Effectiveness of a support intervention for family caregivers and stroke survivors. Rev Lat Am Enfermagem. 2021 Sep 3;29:e3482. Doi: 10.1590/1518-8345.4991.3482. PMID: 34495192; PMCID: PMC8432573.
31. Chen L, Xiao LD, Chamberlain D, Newman P. Enablers and barriers in hospital-to-home transitional care for stroke survivors and caregivers: A systematic review. J ClinNurs. 2021 Oct;30(19-20):2786-2807. Doi: 10.1111/jocn.15807. Epub 2021 Apr 19. PMID: 33872424.
32. Jones F, Gombert- K, Honey S, Cloud G, Harris R, Macdonald A, McKevitt C, Robert G, Clarke D. Addressing inactivity after stroke: The Collaborative Rehabilitation in Acute Stroke (CREATE) study. Int J Stroke. 2021 Aug;16(6):669-682. Doi: 10.1177/1747493020969367. Epub 2020 Nov 2. PMID: 33138735; PMCID: PMC8366168.
33. Ahmad Ainuddin H, Romli MH, Hamid TA, Sf Salim M, Mackenzie L. An Exploratory Qualitative Study With Older Malaysian Stroke Survivors, Caregivers, and Healthcare Practitioners About Falls and Rehabilitation for Falls After Stroke. Front Public Health. 2021 Apr 27;9:611814. Doi: 10.3389/fpubh.2021.611814. PMID: 33987161; PMCID: PMC8110702.
34. Chong WFW, Ng LH, Ho RM, Koh GCH, Hoenig H, Matchar DB, Yap P, Venketasubramanian N, Tan KB, Ning C, Menon E, Chang HM, De Silva DA, Lee KE, Tan BY, Young SHY, Ng YS, Tu TM, Ang YH, Yeo TT, Merchant RA, Kong KH, Singh R, Ng YL, Cheong A. Stroke Rehabilitation Use and Caregiver Psychosocial Health Profiles in Singapore: A Latent Profile Transition Analysis. J Am Med Dir Assoc. 2021 Nov;22(11):2350-2357.e2. doi: 10.1016/j.jamda.2021.02.036. Epub 2021 Apr 2. PMID: 33812841.
35. Labberton AS, Augestad LA, Thommessen B, Barra M. The association of stroke severity with health-related quality of life in survivors of acute cerebrovascular disease and their informal caregivers during the first year post stroke: a survey study. Qual Life Res. 2020 Oct;29(10):2679-2693. Doi: 10.1007/s11136-020-02516-3. Epub 2020 May . PMID: 32388786; PMCID: PMC7561590.
36. Farahani MA, Bahloli S, JamshidiOrak R, Ghaffari F. Investigating the needs of family caregivers of older stroke patients: a longitudinal study in Iran. BMC Geriatr. 2020 Aug 28;20(1):313. Doi: 10.1186/s12877-020-01670-0. PMID: 32859159; PMCID: PMC7456020
37. Vluggen TPMM, van Haastregt JCM, Verbunt JA, van Heugten CM, Schols JMGA. Feasibility of an integrated multidisciplinary geriatric rehabilitation programme for older stroke patients: a process evaluation. BMC Neurol. 2020 May 29;20(1):219. Doi: 10.1186/s12883-020-01791-4. PMID: 32471443; PMCID: PMC7260779.
38. Kokorelias KM, Lu FKT, Santos JR, Xu Y, Leung R, Cameron JI. “Caregiving is a full-time job” impacting stroke caregivers’ health and well-being: A qualitative meta-synthesis. Health Soc Care Community. 2020 Mar;28(2):325-340. Doi: 10.1111/hsc.12895. Epub 2019 Nov 26. PMID: 31769128.
39. Ugur HG, Erci B. The Effect of Home Care for Stroke Patients and Education of Caregivers on the Caregiver Burden and Quality of Life. ActaClin Croat. 2019 Jun;58(2):321-332. Doi: 10.20471/acc.2019.58.02.16. PMID: 31819329; PMCID: PMC6884374.
40. Shinde,M.(2019) “ Effect of demonstration regarding feeding of hemiplegia patient among care givers” ; Nursing Image, no.1, 6 April

41. Bunketorp-Käll L, Lundgren-Nilsson Å, Nilsson M, Blomstrand C. Multimodal rehabilitation in the late phase after stroke enhances the life situation of informal caregivers. Top Stroke Rehabil. 2018 Apr;25(3):161-167. Doi: 10.1080/10749357.2017.1413761. Epub 2017 Dec 13. PMID: 29237339.
42. Torregosa MB, Sada R, Perez I. Dealing with stroke: Perspectives from stroke survivors and stroke caregivers from an underserved Hispanic community. Nurs Health Sci. 2018 Sep;20(3):361-369. Doi: 10.1111/nhs.12414. Epub 2018 Mar 7. PMID: 29512845.
43. Krishnan S, Pappadis MR, Weller SC, Stearnes M, Kumar A, Ottenbacher KJ, Reistetter TA. Needs of Stroke Survivors as Perceived by Their Caregivers: A Scoping Review. Am J Phys Med Rehabil. 2017 Jul;96(7):487-505. Doi: 10.1097/PHM.0000000000000717. PMID: 28628537; PMCID: PMC5493392.
44. Krieger T, Feron F, Dorant E. Developing a complex intervention programme for informal caregivers of stroke survivors: The Caregivers’ Guide. Scand J Caring Sci. 2017 Mar;31(1):146-156. Doi: 10.1111/scs.12344. Epub 2016 Jul 21. PMID: 27440738.
45. Jhaveri MM, Benjamin-Garner R, Rianon N, Sherer M, Francisco G, Vahidy F, Kobayashi K, Gaber M, Shoemake P, Vu K, Trevino A, Grotta J, Savitz S. Telemedicine-guided education on secondary stroke and fall prevention following inpatient rehabilitation for Texas patients with stroke and their caregivers: a feasibility pilot study. BMJ Open. 2017 Sep 3;7(9):e017340. Doi: 10.1136/bmjopen-2017-017340. PMID: 28871024; PMCID: PMC558905
46. Laitinen P. Participation of informal caregivers in the hospital care of elderly patients and their evaluations of the care given: pilot study in three different hospitals. J Adv Nurs. 1992 Oct;17(10):1233-7. doi: 10.1111/j.1365-2648.1992.tb01840.x. PMID: 1430626.
47. Silver HJ, Wellman NS. Family caregiver training is needed to improve outcomes for older adults using home care technologies. J Am Diet Assoc. 2002 Jun;102(6):831-6. doi: 10.1016/s0002-8223(02)90185-9. PMID: 12067050.
48. Kokorelias KM, Lu FKT, Santos JR, Xu Y, Leung R, Cameron JI. “Caregiving is a full-time job” impacting stroke caregivers’ health and well-being: A qualitative meta-synthesis. Health Soc Care Community. 2020 Mar;28(2):325-340. Doi: 10.1111/hsc.12895. Epub 2019 Nov 26. PMID: 31769128.