Development of a home-based family caregiver cancer education program

INTRODUCTION: This article describes a home-based educational program developed specifically for family caregivers of cancer patients who receive hospice and home care. The overall aim of this educational program is to specifically address family caregivers' needs for acquisition of necessary knowledge and skills to meet the physical and psychosocial demands associated with caring for a patient with advanced cancer. PROGRAM DEVELOPMENT: Originally, components of this program were offered in a small group discussion format within hospital and community settings. The educational program was transformed to accommodate the unique needs and constraints of homebound family caregivers who have very limited time and/or opportunities for support and education outside of the home. The program is comprised of educational modules that provide hospice and home care professionals with written and audiovisual materials designed to facilitate brief, structured, educational encounters with family caregivers in the home setting. DISCUSSION: Two hundred thirty-seven educational module kits were distributed to professionals affiliated with twenty-four home care and hospice agencies in the Greater Philadelphia area. Results of a telephone survey designed to elicit evaluation data from professional staff members who had used the educational modules are presented. Limitations, plans for future program evaluation, cost implications, and implementation recommendations related to this educational program are described.     

Development and evaluation of a Mexican immigrant family support program.

A report to Congress in the fall of 1998 warned that immigrant children are in a state of emergency regarding access to health care. This article presents the three phases involved in developing, implementing, and evaluating a Mexican American Problem Solving (MAPS) program designed to promote the mental health of families. Methods were Phase 1 focus groups to identify concerns and desired approaches for intervention; Phase 2 instrument assessment and prevalence assessment of mental health; and Phase 3 intervention testing. In Phases 1 and 2, 67% of mothers and 59% of children had mental health scores that required referral for evaluation. Participating mothers and children reported positive views of the intervention and showed significant improvements in mental health scores.     

Parenting preemies: a unique program for family support and education after NICU discharge

Research supports the importance of family-centered care in the neonatal intensive care unit (NICU). The significance of continuity in family-centered care beyond the NICU has recently gained attention. Parenting Preemies is a unique and easily replicated postdischarge program designed to ease the transition from hospital to home for NICU graduates and their families. The comprehensive program provides an effective means to demonstrate ongoing, family-centered, and cost-effective outreach after discharge. The specific target population includes premature, low birth-weight, and special needs infants, and their parents. A multidisciplinary team utilizes evidenced-based principles to facilitate an education and support group, in conjunction with home visits, as the foundation for promotion of optimal outcomes for preemies and their parents. Participant satisfaction is consistently positive.     

Evaluation of family stroke education

To increase families' involvement in rehabilitation, a series of informational sessions called the Family Stroke Education Class was implemented at a 305 bed medical center serving disabled veterans and their families. Questionnaires completed by family and patients at the meetings showed that anxiety level decreased significantly. More than 90% of participants felt more comfortable about approaching team members with questions in the future, and 77% felt more informed as a result of taking the class. Knowledge scores improved significantly and sustained over a 3 month time period. The educational format was a practical way of including the needs and soliciting participation of the family as well as a means for providing basic information on stroke rehabilitation.     

脑卒中三级预防健康教育方案的设计与应用

目的评价脑卒中三级预防健康教育方案对患者健康知识及遵医行为的影响。方法成立脑卒中三级预防健康教育工作小组,设计健康教育方案及专科护士培训方案,对脑卒中高危患者实施一级预防健康教育,对脑卒中发病患者实施二级预防健康教育,对脑卒中后遗症患者实施三级预防健康教育。结果实施脑卒中三级预防健康教育后,提高了脑卒中高危患者及患者对脑卒中相关知识知晓率(P0.01),同时改善了患者的行为依从性(P0.01)。结论脑卒中三级预防健康教育能提高患者疾病相关知识掌握程度,增强行为依从性,达到了患者主动采取正确的行为方式,预防脑卒中的发病、致残、复发的目的。     

初次脑卒中康复过程中家庭和社会支持的作用

对于脑卒中患者,普遍认为家庭和社会支持可以从患者生理和心理健康方面影响患者的护理和康复状况。随着医学模式的转变,人们越来越重视家庭和社会因素对人类健康的影响;注重个性、情绪等因素对身心疾病的发生、发展和转归的作用。脑卒中患者的康复直接影响患者自我形象、自我信心和各种社会因素的应激能力。而良好的家庭社会因素,可促进患者转归和康复。     

A family caregiver-oriented discharge planning program for older stroke patients and their family caregivers

Aims. To test the effectiveness of a discharge planning program for dyads of older stroke survivors and their family caregivers in Taiwan. Background. Family caregivers of stroke survivors often feel inadequately prepared to deal with the physical, cognitive and emotional needs of the stroke survivors. However, little information could be found on discharge planning programs for caregivers of stroke survivors in Asian families. Design. A randomised experimental design was used to explore the effects of a discharge planning program for 158 dyads of older stroke patients and their family caregivers. Methods. The control group (n = 86 dyads) received only routine hospital discharge planning services and the experimental group (n = 72 dyads) received routine hospital discharge planning services plus the caregiver‐oriented discharge planning program. Outcome variables were measured at baseline, before discharge and one month after hospital discharge. Variables were measured by the Nurse Evaluation of Caregiver Preparation Scale, Preparedness for Caregiving Scale, Caregiver Discharge Needs Satisfaction Scale and Perception of Balance between Competing Needs Scale. Results. Caregivers in the experimental group had significantly better nurse evaluation and self‐evaluation of preparation after the program than before, and greater satisfaction of discharge needs one month after discharge than before discharge. Caregivers in the experimental group had significantly better nurse evaluations and self‐evaluations of preparation and better satisfaction of discharge needs after the program compared with the control group. However, no significant difference was found between caregiver groups in perceived balance of competing needs. Conclusions. This discharge planning program benefited family caregivers of older stroke patients during the transition from hospitalisation to one month after discharge. Relevance to clinical practice. This caregiver‐oriented discharge planning program, with its emphasis on individualised health education and home visits following discharge may improve caregivers’ preparation and the satisfaction of their needs during the discharge transition.     

Using clinical data in program design: a family support program for families with preterm infants

HMOs can use clinical data culled from computerized medical records and provider and patient interviews to examine the impact of premature infant births on the family. The results can help guide health plans in developing a clinical intervention program to address the physical and emotional consequences of low birthweight babies. The Harvard Pilgrim Health Care experience describes the data collection process administrators are taking to design such a clinical intervention.     

Effect of a home leisure education program after stroke: a randomized controlled trial

Desrosiers J, Noreau L, Rochette A, Carbonneau H, Fontaine L, Viscogliosi C, Bravo G. Effect of a home leisure education program after stroke: a randomized controlled trial.

Objective

To evaluate the effect of a leisure education program on participation in and satisfaction with leisure activities (leisure-related outcomes), and well-being, depressive symptoms, and quality of life (primary outcomes) after stroke.

Design

Randomized controlled trial.

Setting

Home and community.

Participants

Sixty-two people with stroke.

Intervention

Experimental participants (n=33) received the leisure education program at home once a week for 8 to 12 weeks. Control participants (n=29) were visited at home at a similar frequency. Participants were evaluated before and after the program by a blinded assessor.

Main Outcome Measures

Change from preintervention to postintervention in: minutes of leisure activity per day, number of leisure activities, the Leisure Satisfaction Scale, the Individualized Leisure Profile, the General Well-Being Schedule (GWBS), the Center for Epidemiological Studies Depression Scale, and the Stroke-Adapted Sickness Impact Profile (SA-SIP30).

Results

There was a statistically significant difference in change scores between the groups for satisfaction with leisure with a mean difference of 11.9 points (95% confidence interval [CI], 4.2−19.5) and participation in active leisure with a mean difference of 14.0 minutes (95% CI, 3.2−24.9). There was also a statistically significant difference between groups for improvement in depressive symptoms with a mean difference of −7.2 (95% CI, −12.5 to −1.9). Differences between groups were not statistically significant on the SA-SIP30 (0.2; 95% CI, −1.3 to 1.8) and GWBS (2.2; 95% CI, −5.6 to 10.0).

Conclusions

The results indicate the effectiveness of the leisure education program for improving participation in leisure activities, improving satisfaction with leisure and reducing depression in people with stroke.     

Health support program for family members with hospitalized child

In 2001, we began conducting Health Support Programs on the pediatric ward of Miyazaki Medical College Hospital. The program is designed to help family members who accompany and care for their children who are ill and hospitalized to practice some physical movements for their own benefit. An interview survey was undertaken to clarify the effects and the purpose of the program by evaluating subjective data from program participants, as well as by evaluating changes in participants' blood pressure rates. Findings indicate that the program's effects include "reduction of stress and/or lack of exercise," "refreshing effect," "comfort and/or exhilaration," "relaxation," and "alleviation of physical symptoms." We also have noted that mothers become more aware of their own health issues and that the program offers an opportunity to reexamine their health conditions. Furtherrnore, we have learned that for parents and children who participate together, the program offers a fun environment, and that, on occasion, mothers are the ones who are cared for in the program.     

Rural case management for stroke: the development of a community-based screening and education program

This article describes the evolution of a Community-Based Stroke Risk Screening and Education Program at a 400-bed regional medical center located in southeastern Alabama. The author outlines the implementation of a case management-oriented program developed to target the specific high-risk populations residing in this rural area. Retrospective chart reviews were used to identify a large discrepancy between patient-recognized onset of stroke symptoms and the actual time it took for the patient to present to the Emergency Department (ED). A performance improvement goal was initiated to increase community awareness of stroke warning signs, stroke risk, and prevention. Summaries of the research process, design, and outcome data overwhelmingly indicated a positive correlation between stroke education and ED presentation time.     

Development of a healthy bladder education program for older adults

The Healthy Bladder Program was developed as part of an academic and health care partnership and was designed specifically for older adults residing in independent and assisted living. Program content was based on best practices that can be used by nursing staff to provide information about promoting and maintaining bladder health. One hundred eighty older adults, recruited from long-term care retirement communities, attended the 1-hour program. Findings showed that the program was successful in providing bladder health information that older adults could use immediately; suggestions are given for best practice applications.     

以家庭照护者需求为导向的出院准备计划在脑卒中患者中的应用研究

目的:探讨以家庭照护者需求为导向的出院准备计划在脑卒中患者中的应用效果。方法:92例脑卒中患者随机分为观察组和对照组各46例,观察组家庭照护者给予以家庭照护者需求为导向的出院准备计划,对照组则对家庭照护者不进行特殊干预。比较2组家庭照护者出院准备度、患者出院期间照护情况以及患者生活质量。结果:2组出院后1周、1个月和2个月家庭照护者出院准备度与出院当日比较,均明显提高(P0.05),且观察组各时间点明显高于对照组(P0.05)。出院后,观察组在患者照护结果各条目评分上明显优于对照组(P0.05)。观察组出院后1周、1个月和2个月患者生活质量与出院当日及对照组比较均明显提高(P0.05),对照组出院后各时间点比较差异无统计学意义。结论:以家庭照护者需求为导向的出院准备计划的实施能够提高家庭照护者的准备度,改善出院后患者照护结果,提升患者的生活质量,值得推广应用。