A Mixed Study On The Current Status Of The Resilience Of Family Caregivers Of Elderly Patients With COPD And Their Influencing Factors

ObjectiveThe mixed research method was used to investigate the current state of stress resistance of family caregivers of elderly COPD patients,to explore the influencing factors of resilience,and to provide evidence support for family caregivers to carry out targeted psychological intervention and implement health education,so as to further improve their quality of life.MethodsIn this study,family caregivers of elderly patients with COPD were selected as the research objects.The first part of the study used quantitative research method to investigate the status of resilience of family caregivers and their influencing factors.The second part deeply analyzed the family caregivers’the relevant factors affecting of the resilience from the perspective of care experience of family caregivers.Finally,a mixed research method combining quantitative research and qualitative research was used to comprehensively and deeply analyze the influencing factors of family caregivers’resilience.The detailed is as follows:(1)Quantitative study method:According to the inclusion and exclusion criteria,421 family caregivers from 3 tertiary class A hospitals in Gansu Province from November 2021 to January 2023 were selected by convenient sampling method.A cross-sectional survey of caregivers was conducted using the general information questionnaire(social demographic information of family caregivers,disease related information of patients and care-related conditions of family caregivers),Connor-Davidson Resilience Scale(CD-RISC),General Self-Efficacy Scale(GSES),Simplified Coping Style Questionnaire(SCSQ)and Social Support Rating Scale(SSRS).SPSS 26.0 was used to analyze the data.The main statistical analysis methods used were descriptive statistics,independent sample t test,chi-square test,Pearson correlation analysis and multiple linear regression analysis.(2)Qualitative study method:Phenomenological research method was used to select 11 family caregivers who met the inclusion and exclusion criteria from February2023 to March 2023 by purposive sampling.Data were collected by face-to-face,semi-structured and in-depth interviews.Colaizzi’s seven-step analysis method was used to analyze and summarize the interview data.(3)Through the integration of quantitative research and qualitative research results,the results explain and complement each other,and analyze the influencing factors of family caregivers’resilience from multiple perspectives and deep levels.Results(1)Results of quantitative study:(1)A total of 456 questionnaires were distributed and collected in this study.After eliminating invalid questionnaires,421 valid questionnaires remained,and the effective rate of questionnaire recovery was 92.3%.(2)The average score of resilience of family caregivers of elderly COPD patients was(65.96±18.02),with the highest score of 100 and the lowest score of 18.The resilience scale consisted of three dimensions,and the average scores of each dimension from high to low were tenacity(33.82±10.26),self-improvement(21.55±5.93),and optimism(10.58±3.28).(3)Univariate analysis showed that in terms of social demographic data of family caregivers,there were statistically significant differences in the total score and scores of each dimension of resilience of family caregivers with different education levels,residence,family monthly income,occupation and self-perceived health status(p<0.05).In terms of the patient’s disease-related condition,there were statistically significant differences in the total score and dimension scores of resilience of family caregivers with different activity of daily living(ADL)and medical expenses of patients(p<0.05).In terms of care-related conditions of family caregivers,there were statistically significant differences in the total score and scores of each dimension of resilience of family caregivers with different quality of family relationship and understanding of patients’disease knowledge(p<0.05).(4)Pearson correlation analysis showed that the resilience of family caregivers were positively correlated with self-efficacy,simple coping style and social support(p<0.01).(5)Multivariate analysis showed that the influencing factors of family caregivers’resilience were patients pay medical expenses at their own expense,ADL level of patients,family caregivers’self-efficacy,positive and negative coping styles.The above variables explained 61.8%of the variation of caregivers’resilience(R~2=0.618).(2)Results of qualitative study:Based on the analysis and refinement of the care experience of family caregivers of elderly COPD patients,a total of 2 related themes and 5 subthemes affecting resilience were condensed.Theme 1:Negative factors affecting family caregivers’resilience,including 3 subthemes:(1)Heavy economic burden;(2)Coping ability shortage;(3)Lack of support services.Theme 2:The positive factors affecting the resilience of family caregivers,including 2 subthemes:(1)Family relationship harmony;(2)Actively obtain care information.(3)Mixed research results:After further integration of quantitative and qualitative research results,it was concluded that patients’daily living ability,family economic burden,family caregivers’self-efficacy,coping ability,coping style and getting support were the influencing factors of their resilience.ConclusionThis study showed that the resilience of family caregivers of elderly patients with COPD is not good.The results based on the mixed research method showed that the resilience status of family caregivers was affected by patients’ability of daily living,family economic burden,self-efficacy,coping ability,coping style and getting support of family caregivers.Therefore,the mental health of family caregivers needs to be paid attention to and solved.In order to further improve their resilience level,it is recommended that the government provide financial assistance or disease cost subsidies to family caregivers in financial difficulties.Medical professionals should provide corresponding measures to improve patients’daily living ability and family caregivers’self-efficacy and coping ability,and encourage family caregivers to adopt positive coping styles.It is recommended that the government,medical institutions and communities provide long-term,comprehensive,comprehensive and standardized professional management and intervention from the perspective of care policy optimization,disease-related knowledge,and psychological and social support,so as to reduce the care burden of family caregivers and improve their quality of life.