| Objective :On the basis of cross-sectional study,this study constructed a care skills intervention program for family caregivers of AMI patients by Delphi expert consultation method,and conducted an empirical study on the intervention program to explore the effect of the program on the care ability,care burden and quality of life of family caregivers.It provides a reference for the intervention of care skills of family caregivers of AMI patients,and provides a reference for patients to further provide scientific,reasonable and personalized home care.Methods :Part 1 : Cross-sectional studyConvenience sampling method was used to select family caregivers of AMI patients who visited the Department of Cardiology of a third-grade class-A hospital in Nanchang City,Jiangxi Province from January 2022 to March 2022.The subjects anonymously filled in the Chinese version of Family Caregiver ’s Care Ability Test(Family Caregiver Task Inventory,FCTI),Zarit Caregiver Burden Interview(Zarit Burden Interview,ZBI),Caregiver Preparation Scale(Caregiver Preparedness Scale,CPS)and other data.Part 2 : Construction of care skills intervention program for family caregivers of AMI patientsOn the basis of cross-sectional study results and literature research,combined with the theory of empowerment,the first draft of the intervention plan was formed.Through two rounds of Delphi expert consultation,the intervention plan for the care skills of family caregivers of AMI patients was improved,and the test draft of the intervention plan was formed.Three AMI patients and their family caregivers were pre-tested,and finally a formal intervention plan was formed.Part 3 : Empirical study on the intervention program of care skills of family caregivers of AMI patientsUsing the convenience sampling method,AMI patients and their family caregivers who were treated in the Department of Cardiology of a tertiary hospital in Nanchang City,Jiangxi Province from March 2022 to December 2022 were selected as the research objects.According to the ward,they were divided into experimental group and control group.The first ward of cardiology was the control group,and the third ward was the experimental group,with 43 cases in each group,a total of 86 subjects.The family caregivers in the control group were given routine nursing,and the family caregivers in the experimental group were given nursing skill intervention program on this basis.The intervention lasted for 3 weeks,including 4 themes.Two interventions were conducted during hospitalization,including theoretical knowledge guidance and skill knowledge guidance.Each intervention lasted for30-45 minutes.After discharge,online intervention was used to learn about emotional management and interpersonal communication.Before and after the intervention,the Chinese version of the Family Caregiver Capacity Inventory(FCTI),the Zarit Caregiver Burden Inventory(ZBI),and the Chinese version of the Short Form-12 Health Survey(SF-12 Health Survey,SF-12)were distributed to family caregivers for evaluation.After 3 months of intervention,through outpatient follow-up or telephone follow-up,the number of smoking,readmission of cardiovascular adverse events and body mass index information of the two groups were obtained,and the statistical differences between the two groups were compared.Results :Part 1 : A total of 217 questionnaires were collected in the cross-sectional study,of which 214 were valid.The results showed that the care ability of family caregivers of AMI patients needed to be improved,the burden of care was heavy,and the care readiness was insufficient.The results of univariate analysis showed that the patient ’s gender,history of chronic diseases,age,marital status,working status,family per capita monthly income,and chronic disease status of family caregivers may be the influencing factors of care ability.Part 2 : Delphi expert consultation A total of 12 experts participated,and the recovery rates of the two rounds of questionnaires were 80% and 100%,respectively.The expert authority coefficient was 0.85,and the expert opinion coordination coefficient was 0.36 and 0.32(P<0.05).The concentration degree of expert opinion was high,and the coefficient of variation of item importance score was less than0.25,which was retained.The final care skills intervention program for family caregivers of AMI patients has a total of 4 themes,which are theoretical knowledge guidance,skill knowledge guidance,emotional management and interpersonal communication guidance.Part 3 :(1)Comparison of general data : There was no significant difference in general data between the two groups(P>0.05).(2)Comparison between groups before intervention : Before intervention,there was no significant difference in the total score of care ability and the scores of each dimension,care burden and each dimension between the two groups(P>0.05).There was no significant difference in the quality of life scores between the two groups(P>0.05).(3)Comparison within the group before and after intervention : There was no significant difference in the scores of care ability and each dimension,the total score of care burden and the quality of life of patients before and after intervention in the control group(P>0.05).The dimensions of personal burden and responsibility burden in the care burden were statistically significant(P<0.05).Compared with before intervention,the assessment of family and social care ability of family caregivers in the experimental group after intervention.(4)Comparison between groups after intervention: Compared with the control group,after the intervention of family caregivers in the experimental group,except for the assessment of family and community resources in the care ability,the rest were statistically significant(P<0.05),and the number of smoking and readmission rate of patients were statistically significant(P<0.05),and there was no significant difference in the physical condition of patients(P>0.05).Conclusion :1.In this study,a cross-sectional study method was used to construct a care skills intervention program for family caregivers of AMI patients through Delphi expert consultation method based on the empowerment theory.The construction method and process were scientific and rigorous,and the empirical research of the program was carried out in a combination of online and offline models.The application effect was good.Through the intervention of four themes,the care ability of family caregivers can be significantly improved,the burden of care can be reduced,and the quality of life of patients ’ home rehabilitation can be improved,and the number of daily smoking of patients can be effectively controlled,and the readmission rate of cardiovascular events can be reduced.The care skills intervention program for family caregivers of AMI patients provides new ideas for improving the quality of life of patients during home rehabilitation,and provides a reference for the design of home rehabilitation nursing programs for AMI patients and their family caregivers,which can be further promoted and applied in clinical patients. |
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