基于时机理论以家庭为中心的护理模式对急性脑出血患者照顾者照顾能力的影响

目的评价基于时机理论(timing it right,TIR)的以家庭为中心的护理模式(patient and family-centered care,PFCC)对急性脑出血患者照顾者的照顾能力、照顾负担影响。方法将2018年3月至8月本院收治的脑出血患者33例及其照顾者33名设为对照组,给予常规康复健康教育指导;2018年9月至2019年2月本院收治的脑出血患者33例及其照顾者33名设为试验组,实施基于TIR的以家庭为中心的护理模式。在干预前及干预后3个月、6个月分别评估两组患者照顾者的照顾能力、照顾负担并了解干预期间患者不良事件发生情况。结果实施不同时间点两组患者照顾能力、照顾负担的时间效应、组间效应、交互效应差异,均有统计学意义(均P<0.001)。试验组干预后3个月、干预后6个月的照顾能力总分、照顾负担总分低于同期对照组,差异均有统计学意义(均P<0.05)。结论基于时机理论的以家庭为中心的护理模式,能提高急性脑出血患者照顾者照顾能力并降低其照顾负担。

Ability and burden of family carers to care the patients in recovery from acute cerebral haemorrhage:a study in the influence of"timing it right"rehabilitation

Objective To study the influence of"Timing It Right"on ability,burden and quality of the life of family member carers who look after the patients at home for rehabilitation and in recovery from acute cerebral haemorrhage.Methods Thirty-three patients who had acute cerebral haemorrhage together with the family carers and hospitalized from September 2018 to February 2019 were set as study group(n=33),and the other thirty-three same patients who were hospitalized from March to October 2018 were set as control group(n=33).The patients in the control group were given routine family carer-based rehabilitation,while the patients in the observation group were given family carer based TIR rehabilitation.The two groups were compared by the scores of family caregivers task inventory(FCTI)and Zarit caregiver burden interview(ZBI)before and after the rehabilitation.Results There were significant differences in the effect of time,intergroup efficacy and score of interaction efficacy in each dimension,total score of FITC scale and ZBI score between the two groups(P<0.001).The scores of each dimension,total score of FITC scale and ZBI score in the observation group were significantly lower than what in the control group at the same period of time(P<0.05),either in-hospital or at 3 months of interventional therapy at home.Conclusions The family carer based TIR could formulate intervention method in phases for the relatives of patients who are receiving rehabilitational treatment after acute cerebral haemorrhage.It may significantly improve the ability of family carer and quality of the life and reduce the burden in family care,so it should be clinically promoted and applied.