| Objective To investigate caring behavior and caregiver burden of caregivers of patients with pressure ulcer, and analyze their influencing factors. To explore the effects on caring behavior and caregiver burden of an intervention program that is designed based on the Transaction Model of Stress and Coping and guidelines of Best Practice.Methods This research was performed in two consecutive phases.In the first phase,a total of 146 caregivers of patients with pressure ulcer were recruited by convenience sampling method.They were investigated with Pressure Ulcer Caring Behaviors Questionnaire,Caregiver Burden Inventory(CBI),Caregivers' Knowledge about Pressure Ulcer Questionnaire,and General Self-Efficacy Scale(GSES).In the second phase,a quasi-experimental study was designed.46 caregivers of patients with pressure ulcer were recruited by convenience sampling method and randomly assigned to intervention group(n=23) or control group(n=23).There were no statistically significant differences in demographic data and information about pressure ulcer and caring between two groups(P> 0.05).The caregivers in the control group received routine out-patient education care.The caregivers in the intervention group received a 3-month intervention program in addition to the routine education care, which included two individual guidances, one home-visit,and six to seven telephone-consultations. The effects of the intervention were evaluated by Pressure Ulcer Caring Behaviors Questionnaire, CBI,Caregivers' Knowledge about Pressure Ulcer Questionnaire,GSES,the Score of transposition sheet and wound-cleaning sheet,the healing rate and recurrence rate of pressure ulcer at 1 week,1 month and 3 months later.Results In the first phase, the results were as follows.①For each dimension of Caregivers'Knowledge about Pressure Ulcer Questionnaire, the mean score of knowledge about pressure ulcer was 16.89±4.23, caregivers' perceived susceptibility to pressure ulcer was 10.27±2.38, perceived severity of patient's pressure ulcer was 19.38±3.49. The mean score of GSES was 2.47±0.68.②The mean score of Pressure Ulcer Caring Behaviors Questionnaire was 39.98±6.33.For each dimension of it, position care exhibited the lowest score, followed by wound care, nutritional support and skin care.③The mean score of CBI was 35.51±14.15. For each dimension of it,time dependence burden exhibited the highest score, followed by physical burden developmental burden,social burden and emotional burden.④Multiple stepwise regression analysis demonstrated that caregivers'perceived severity of patient's pressure ulcer,self-efficacy,perceived susceptibility to pressure ulcer,and other three factors accounted for 37.5% of the variance in caring behaviors; caring time per day,caregivers' perceptions of susceptibility to pressure ulcer,and other two factors accounted for 23.6% of the variance in caregiver burden.In the second phase,①both the mean score of transposition sheet and wound-cleaning sheet in the intervention group significantly increased compared with the control group 1 week after intervention(P<0.001, P< 0.01).②Analysis of variance of repeated measure and multivariate analysis of variance showed that the mean score of knowledge about pressure ulcer in the intervention group significantly increased compared with the control group (P<0.01).③)Analysis of variance of repeated measure showed that the mean score of caregivers' perceptions of susceptibility to pressure ulcer had a trend of changing with time (P <0.001),but the trend was not different in different group(P>0.05). Multivariate analysis of variance showed the score of caregivers' perceptions of susceptibility to pressure ulcer in the intervention group significantly increased compared with the control group after 1 month((P< 0.05). There was no statistically significant difference between two groups after 3 month(P> 0.05).④Analysis of variance of repeated measure and multivariate analysis of variance showed that the mean score of caregivers' perceived severity of patient's pressure ulcer in the intervention group significantly increased compared with the control group (P< 0.05).⑤Analysis of variance of repeated measure showed that the mean score of GSES had no significant difference between two groups (P>0.05).⑥Analysis of variance of repeated measure and multivariate analysis of variance showed that the mean score of Caring Behaviors Questionnaire in the intervention group significantly increased compared with the control group (P<0.001).⑦Analysis of variance of repeated measure showed that the mean score of CBI had a trend of changing with time (P<0.01),but the trend was not different in different group(P >0.05).⑧There were no statistically significant differences both in the healing rate and the recurrence rate of pressure ulcer between two groups(P>0.05).Conclusion The caring behavior of caregivers of patients with pressure ulcer was not enough and they had moderate caregiver burden.The intervention program designed using the Transaction Model of Stress and Coping as the theoretical foundation and following guidelines of Best Practice was effective for improving caregivers'caring behaviors through increasing caregivers' knowledge about pressure ulcer, perceived susceptibility to pressure ulcer and perceived severity of patient's pressure ulcer.Its effects on caregiver burden,the healing rate and recurrence rate of pressure ulcer need to confirm in the future study.
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