背景:中风会对幸存者及其家庭护理人员造成各种身体和心理社会障碍(即,中风二元)。二重心理教育似乎是提供中风知识和自我护理或护理技能以改善中风二重健康结果的一种有前途的方法。因此,我们设计并测试了以家庭为重点的心理教育干预措施,以改善卒中二重组的健康结局.
目的:研究以家庭为重点的双源心理教育干预对中风幸存者和家庭照顾者的功能和心理社会结果的影响。
方法:单盲,采用重复措施设计的平行组随机对照试验。
方法:济南两家综合医院和一家康复机构,中国。
方法:卒中幸存者和家庭照顾者(N=162个二元组)。
方法:将二元组随机分配到心理教育组和对照组,仅常规护理(每组N=81二元组)。干预措施包括出院前三次结构化的面对面教育课程(每次一小时)和出院后每周四次的电话咨询电话。研究结果包括幸存者功能和照顾者负担(主要结果),和其他次要结果(即,护理能力,二元应对,抑郁和焦虑症状,家庭功能,和二元关系,以及幸存者医疗保健利用和护理相关伤害)。在基线(T0)和立即(T1)和干预后3个月(T2)收集数据。使用广义估计方程模型估计干预效果。
结果:在T1(β=-6.01,p=0.026)和T2(β=-6.73,p=0.039)时,与对照组相比,心理教育组的参与者的照顾者负担明显减少。但对幸存者功能的影响不显著,除了T1时的情绪域(β=7.22,p=0.015)。此外,干预对护理能力的改善显著(β=0.98,p=0.013;β=1.58,p<0.001),幸存者抑郁症状(β=-1.56,p=0.007;β=-2.06,p=0.005),T1和T2时的二元关系(β=0.26,p=0.012;β=0.27,p=0.022),以及T2时的幸存者应对(β=6.73,p=0.008)。
结论:我们的研究增加了以家庭为中心的双程心理教育对常规中风康复和家庭护理的益处。未来的研究可以评估其对具有不同社会人口统计学和卒中相关特征的卒中幸存者家庭的长期影响。
背景:中国临床试验注册中心(ChiCTR2100042684)。招聘:2021年3月至6月。
BACKGROUND: Stroke can cause a variety of physical and psychosocial disturbances for both survivors and their family caregivers (i.e., stroke dyads). Dyadic psychoeducation appears to be a promising approach for providing knowledge of stroke and self-care or caregiving skills to improve stroke dyads\' health outcomes. Therefore, a family-focused psychoeducation intervention was designed and tested to improve the health outcomes of stroke dyads.
OBJECTIVE: To examine the effects of a family-focused dyadic psychoeducational intervention on the functional and psychosocial outcomes of stroke survivors and family caregivers.
METHODS: A single-blinded, parallel-group randomised controlled trial with repeated-measures design.
METHODS: Two general hospitals and one rehabilitation facility in Jinan, China.
METHODS: Stroke survivors and family caregivers (N = 162 dyads).
METHODS: The dyads were randomly allocated to either psychoeducation or control group with usual care only (N = 81 dyads per group). The intervention included three structured face-to-face education sessions (one hour per session) in hospital pre-discharge and four weekly telephone counselling calls post-discharge. Study outcomes included survivor functioning and caregiver burden (primary outcomes), and other secondary outcomes (i.e., caregiving competence, dyads\' coping, depressive and anxiety symptoms, family functioning, and dyadic relationship, as well as survivor healthcare utilisation and caregiving-related injury). Data were collected at baseline (T0) and immediately (T1) and 3 months post-intervention (T2). The intervention effects were estimated using generalised estimating equation models.
RESULTS: Participants in the psychoeducation group revealed significantly greater reductions on caregiver burden than the control group at T1 (β = -6.01, p = 0.026) and T2 (β = -6.73, p = 0.039), but non-significant effects on survivor functioning, except in emotion domain at T1 (β = 7.22, p = 0.015). In addition, the intervention demonstrated significantly greater improvements on caregiving competence (β = 0.98, p = 0.013; β = 1.58, p < 0.001), survivors\' depressive symptoms (β = -1.56, p = 0.007; β = -2.06, p = 0.005), and dyadic relationship (β = 0.26, p = 0.012; β = 0.27, p = 0.022) at T1 and T2, as well as on survivor coping at T2 (β = 6.73, p = 0.008).
CONCLUSIONS: Our study added values on the benefits of family-focused dyadic psychoeducation to routine stroke rehabilitation and family care. Future research can evaluate its long-term effects for families of stroke survivors with diverse socio-demographic and stroke-related characteristics.
BACKGROUND: Chinese Clinical Trial Registry (ChiCTR2100042684). Recruitment: March to June 2021.