| Abjective1.To investigate the current status of empowerment of primary caregivers of ICU transfer patients and the influencing factors,and to develop a family-centered empowering care intervention program for primary caregivers of ICU transfer patients based on the findings combined with literature review and recommendations of ICU medical staff.2.To explore the effects of the family-centered empowerment care intervention program based on empowerment theory and influencing factors on the empowerment ability,caregiving ability and family satisfaction of primary caregivers of ICU transfer patients,and to provide a reference basis for clinical health care professionals to improve the empowerment ability and caregiving ability of caregivers.Methods1.Investigative study phase.Using the convenience sampling method,Patients and primary caregivers who were hospitalized in ICUs in the east and west regions of the Affiliated Hospital of Yangzhou University from August 2020 to March 2021 and who met the nadir criteria were selected as the study population,and the researcher’s self-designed ICU transfer patient and primary caregiver-general information questionnaire was used,and the primary the questionnaire information collected was collated and entered into the data,and SPSS26.0 was used to analyze the statistical data after establishing the database.2.Pre-experiment.Patients and primary caregivers in the ICU transfer unit in the first week of March 2021 were selected to conduct a one-week pre-experiment of the constructed intervention program,and the intervention program was adjusted and finalized according to the pre-experiment.3.Intervention phase.216 patients who were transferred from the ICU of Yangzhou University Hospital from March to December 2021 were selected.The 104 patients were screened according to the inclusion and exclusion criteria and grouped semi-randomly according to the date of ICU admission.50 patients and primary caregivers transferred from ICU from March to June 2021 were used as the experimental group,and 54 patients and primary caregivers transferred from ICU from September to December 2021 were used as the control group.Delayed control group information collection due to the impact of the outbreak.The family-centered empowerment care intervention program was implemented in the experimental group based on the conventional hospital transfer intervention,and the empowerment ability,caregiving ability and family satisfaction of primary caregivers of patients in the experimental and control groups were compared before and after the intervention implementation.Descriptive statistics,chi-square test,two independent samples t-test and paired samples t-test were used for statistical analysis.Results1.270 questionnaires were distributed,7 invalid questionnaires were excluded,and 263 questionnaires were returned,with a valid return rate of 97.41%.263 ICU transfer patients’ primary caregiver empowerment scores ranged from 125 to 171,with a mean value of（148.35±9.09）,And the scores for each dimension were,personal resources score（17.32±3.00）,caregiver subjectivity score（15.26±2.11）,beliefs about caregiving score（16.63±2.31）,knowledge and skills about caregiving score（7.50± 1.24）,concerns about surroundings score（11.55±3.52）,relationship with the care recipient score（22.20± 1.72）,perceptions of caregiving role score（19.75±2.08）,kindness of care score（15.78±3.20）,and expectation of caregiving outcome score（22.43± 1.50）.The results of multiple linear regression analysis showed that primary caregiver gender,education level,Per capita monthly household income,availability of caregiving experience,caregiver health status,and conscious caregiving stress were the influencing factors of primary caregiver empowerment,explaining 56.7%of the total variation in primary caregiver empowerment in ICU transfer patients.2.stage of intervention program implementation.A total of 104 study cases were included in this study,with sample attrition of 7 cases and final completion of 97 cases,46 in the experimental group and 51 in the control group.The differences in general baseline information of ICU transfer patients and primary caregivers between the two groups before the intervention were not statistically significant（P>0.05）.①Empowerment ability of primary caregivers:the total score of empowerment ability of primary caregivers in the experimental group before the intervention（148.43±8.19）and the total score of the control group（147.69±18.33）,there was no statistically significant difference in the total score of empowerment ability of primary caregivers and the scores of each dimension between the two groups before the intervention（P>0.05）.After the intervention,the total score of empowerment ability of primary caregivers in the experimental group was（165.59±8.72）,and the total score of empowerment ability of primary caregivers in the control group was（150.86±7.42）,and the difference in the total score of empowerment ability of primary caregivers between the two groups was statistically significant（P<0.05）,and the scores of empowerment ability of primary caregivers in the experimental group were significantly better than those in the control group（P<0.05）.②Primary caregiver caregiving ability:The differences in the dimensions of primary caregiver caregiving ability and total scores between the two groups of patients before the intervention were not statistically significant（P>0.05）.The total score of primary caregiver caregiving ability in the experimental group was（33.96±6.42）before the intervention and（24.07±6.83）after the intervention,with statistically significant differences before and after the intervention（P<0.05）,while the total score of primary caregiving ability in the control group was（33.55±6.09）before the intervention and（30.18±4.81）after the intervention,with statistically significant differences before and after the intervention（P<0.05）.The difference between pre and post intervention was statistically significant（P<0.05）.However,The total score and dimensional score of caregiving ability of primary caregivers in the experimental group were lower than those in the control group after the intervention（P<0.05）.③Family satisfaction of ICU patients:there was no statistically significant difference in the total family satisfaction score of each dimension and total score of the two groups before the intervention（P>0.05）.After the intervention,the total score of family satisfaction,satisfaction with care and satisfaction with information in two dimensions scored significantly higher in the experimental group than in the control group,and the differences were statistically significant（P<0.05）.However,no difference was observed between the two groups in the dimension of satisfaction with decision making（P>0.05）.Conclusion1.The empowerment capacity of primary caregivers of patients transferred out of ICU was at a moderate to low level.Caregiver gender,education level,per capita monthly household income,availability of caregiving experience,health status,and conscious caregiving stress were the influencing factors of empowerment capacity.2.The family-centered empowering care intervention program for primary caregivers of ICU transfer patients can improve caregiver empowerment,caregiving capacity and family satisfaction,reduce caregiving stress,and have clinical significance for ICU transfer patients and caregivers. |
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