| Objective:To construct health education intervention program based on the empowerment theory,and explore its application effect on improving the caring ability and care readiness of primary caregivers of temporary enterostomy patients,reducing the burden of care and the occurrence of ostomy-related complications.Methods:1.Construction of intervention program(1)Literature research:Search from the domestic and foreign databases from the establishment of the database to October 2021,analyzed the literature related to education intervention program,obtained the main contents of intervention program.(2)Qualitative research:Phenomenological analysis was used for this qualitative research,a semi-structured in-depth interview was conducted among the primary caregivers with temporary colostomy to explore their care needs,in a Grade3A hospital in Henan Province from December 2021 to January 2022.Based on the enabling theory,combined with the results of literature review and qualitative studies,developing the first draft of an empowerment education intervention program.(3)Experts consultation:Conducted expert consultation with 15 experts in related fields,and modified the first draft of the intervention program of enabling education for primary caregivers of temporary enterostomy patients according to their opinions.(4)Pre-test:10 primary caregivers of temporary enterostomy patients were selected for pre-test,revise the intervention program based on the problems reported by the primary caregiver,and the draft of readiness for empowerment education intervention plan for the primary caregiver of temporary enterostomy patients was formed.2.Application of intervention programAccording to the inclusion and exclusion criteria,from April 2022 to September 2022,this study selected 92 primary caregivers were selected from the gastrointestinal surgery department of a Grade 3A hospital in Henan Province from April 2022 to September 2022 as the research objects.46 primary caregivers in the control group received routine nursing,and 46 primary caregivers in the intervention group received empowerment education intervention on the basis of routine nursing.The care ability,care readiness,care burden,stoma and surrounding skin complications of primary caregivers were used as evaluation indexes.The scores of care ability,care readiness,and care burden of primary caregivers were evaluated before intervention,two weeks and one month after intervention,and the incidence of patients’stoma and surrounding skin complications were counted two weeks and one month after intervention.Application of IBM SPSS SPSS26.0 software was carried out on the collected data of statistical description,independent sample t-test,χ2-test,Fisher’s accurate inspection or the Mann-Whitney U rank and inspection,repeated measurement variance for statistical analysis.The test level was 0.05.Results:1.Outcome of the program development intervention(1)The results of literature review:The literature related to the empowerment education w as systematically searched,screened one by one,and finally included 9 relevant literatures.Upon a nalyzing the aforementioned literature,summarizing the intervention program timing,format,content,evaluation criteria,and evaluation period.(2)The results of qualitive research:12 primary caregivers reached data saturation,and interview recordings were transcribed.Four themes were extracted:care difficulties,care burden,social support and post-traumatic growth.(3)Intervention program of empowerment-based education for primary caregiver of temporary enterostomy:The intervention contents included stoma nursing education,postoperative physiological and psychological adjustment,disease knowledge and skills guidance,prevention,identification and treatment of stoma and surrounding skin complications,selection and acquisition of stoma products,discharge coordination,return visit.The intervention themes were mutual understanding and planning.Bedside demonstration replacement process;practice skill operations together;early warning education of ostomy and surrounding skin complications;daily life guidance and access to ostomy related resources;social support for secure care;I can handle the ostomy care.2.The results of application of the intervention program:During the intervention,there were 4 cases lost to follow-up in the intervention group and 5 cases lost to follow-up in the control group.In total,there were 83 cases,with 42 cases in the intervention group and 41 cases in the control group,finally completed the whole intervention process.(1)There were no significant differences in the general information,care ability,care readiness and care burden of the two groups of primary caregivers before intervention(P>0.05).(2)Care ability:Two weeks after intervention and one month after intervention,the total scores of primary caregivers in the intervention group were lower than those in the control group,and the difference was statistically significant(P<0.05),repeated measures analysis of variance showed that the time effect,intergroup effect and interaction effect of total score of caregiving ability,adaptation to caregiving role,coping and providing assistance,evaluation of family and community resources,adjustment of individual and caregiving need dimension scores of the two groups of primary caregivers were statistically significant(P<0.05).The time effect and interaction effect of the dimension score of personal emotion processing were statistically significant(P<0.05).(3)Care readiness:Two weeks after intervention and one month after intervention,the total score of care readiness of main caregivers in the intervention group was higher than that in the control group,and the difference was statistically significant(P<0.05),repeated measures analysis of variance showed that the time effects,intergroup effects and interaction effects of total score of caregiving readiness,physiological needs,development of relevant services,coping with caregiving stress,satisfaction of care,access to medical information,and overall readiness of the two groups of main caregivers were statistically significant(P<0.05).The time and interaction effects of emotional needs and emergency response were statistically significant(P<0.05).(4)Care burden:Two weeks and one month after intervention,the total score of care burden of main caregivers in the intervention group was lower than that in the control group,and the difference was statistically significant repeated measures analysis of variance showed that there was statistical significance in the time effect,intergroup effect and interaction effect of the two groups of main caregivers’responsibility burden dimension scores(P<0.05).(5)Ostomy and surrounding skin complications:Two weeks after intervention,there was no significant difference in the incidence of ostomy and surrounding skin complications between two groups(P>0.05).Only one month after the intervention,the incidence of ostomy and peripheral skin complications in the intervention group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:The health education intervention program based on the theory of empowerment theroy can improve the care ability and readiness of primary caregiver,relieve the care burden of primary caregiver,and reduce the incidence of ostomy and surrounding skin complications. |
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