Current Situation And Intervention Of Benefit Finding Of Caregivers Of Young And Middle-aged Of First-episode Stroke Patients

BackgroundStroke has become the "number one killer" threatening human health,and Young and middle-aged people are at the peak of their life and career.Once a stroke is diagnosed,it will bring severe economic pressure and care burden to the families and society.At the same time,long-term care will be very detrimental to the physical and mental health development of caregivers.In the past,most studies only focused on the negative effects of caregivers,However,this can not be compared with the caregiver’s experience in the care process.Therefore,we can try to explore the level of benefit and influencing factors of first-episode young and middle-aged stroke caregivers in the process of care from the perspective of positive psychology,and develop targeted interventions according to their results to explore the intervention of benefit finding.ObjectiveTo understand the current situation and influencing factors of the benefit finding of the first-episode young and middle-aged stroke caregivers;To explore the intervention effect of mindfulness decompression combined with health education on the first-episode young and middle-aged stroke caregivers.Method1.In the first part,This study adopts current situation survey.convenience sampling was adopted to select the first-episode young and middle-aged stroke patients and caregivers of 266 were investigated in a third class hospital in Zhengzhou were investigated.by The General Information Questionnaire,Zarit Burden Interview,Generalized anxiety disorder,Perceived Benefits of Caregiving Scale Sand ocial Assessment Aupport Scale,were used as the research tool.2.In the second part,Totally 80 first-episode young and middle-aged stroke caregivers from a tertiary hospital in Zhengzhou city,it were rs were divided into 40 cases in the intervention group and 40 cases in the control group.The control group was given routine nursing,and the trial group was given 8 weeks of MBSR on the basis of routine nursing.The effects before and after intervention were evaluated by The Perceived Benefits of Caregiving Scale,WHOQOL-BREF（36）and Self-Rating Anxiety Scale.Data were collected after 1 month,2 months and 3 months of intervention to evaluate the effect of intervention.3.SPSS 26.0 software was used for data analysis;The counting data are described by frequency and composition ratio;Measurement data are expressed in（` X ± S）,M（P25,P75）;T-test,one-way ANOVA,χ~2 Test,Wilcoxon test,Pearson and Spearman correlation analysis,multiple stepwise regression analysis,path model using AMOS23.0software.The generalized path estimation model and repeated measurement analysis 0were used to evaluate the effect of intervention.Result1.The total score of the first-episode young and middle-aged stroke caregivers’ benefit finding was（98.61±9.30）.The total score of caregivers’ benefit finding was positively correlated with the total score of social support（r=0.490,P<0.01）,negatively correlated with the burden of care（r=-0.639,P<0.01）,and negatively correlated with anxiety（r=-0.679,P<0.01）.Multiple linear regression analysis showed that the age of caregivers,satisfaction with care roles,patients’ self-care ability,care burden,social support and anxiety level were the influencing factors of the sense of benefit of first-episode young and middle-aged stroke caregivers（all P< 0.05）,which could explain58.7% of the overall variation.2.The results of path analysis show that social support plays an intermediary role not only between the burden of care and benefit finding,but also between anxiety and benefit finding.The mediating effect of social support accounted for 34.6% and 48% of the total effect respectively.3.Before the intervention,the general information of patients and caregivers,the score of caregivers’ of benefit finding,the score of disease uncertainty,the score of quality of life and the score of anxiety in the two groups were compared.The difference was not statistically significant（P>0.05）.One month,two months and three months after the intervention,except three months after the intervention,there was no significant difference in the scores of family growth and self sublimation in the benefit finding between the two groups（P>0.05）.the total scores of benefit finding and other dimensions,quality of life and each dimension in the intervention group were higher than those in the control group（P<0.05）;One month after the intervention,there was no significant difference in the score of indeterminate dimension of disease uncertainty between the two groups（P>0.05）.The total score of disease uncertainty and other dimensions,anxiety in the intervention group were lower than those in the control group（P<0.05）.The total scores of benefit finding and each dimension,the total scores of disease uncertainty and each dimension,the total scores of quality of life and each dimension,and the total scores of anxiety at different time points had significant differences in inter group effect,time effect and interaction effect（P<0.05）.Conclusion1.The caregiver’s benefit finding of the first-episode young and middle-aged stroke patients is at the medium level.The caregiver’s age,satisfaction with the care role,the patient’s self-care ability,care burden,social support and anxiety level are the main influencing factors;Social support is not only the intermediary effect of care burden and anxiety,but also the intermediary effect of anxiety and benefit finding.2.Mindfulness decompression therapy combined with health education can significantly reduce the disease uncertainty and anxiety level of first-episode young and middle-aged stroke caregivers,improve their quality of life,and improve their sense of benefit.