护士-社工-大学生志愿者团队指导对长期卧床老年人主要照护者照护能力的影响研究

A study on care-giving competence of the primary caregivers influence on nurse-social worker- college student volunteer team guide for the long-term bedridden elderly

目的 探讨护士-社工-大学生志愿者团队指导对长期卧床老年人的主要照护者照护能力的影响.方法 便利选取2015年3-5月武汉市武昌区社会福利院长期卧床老年人60例及主要照护者—福利院养老护理员30名为研究对象.团队指导主要内容：发放指导手册、技能指导、心理支持、喘息照护等.2次/月,150 min/次,持续3个月.采用自身前后对照,以主要照护者的照护能力、长期卧床老年人日常生活自理能力为观察指标,进行干预前后观察指标的评定、对比.结果主要照护者干预前照护能力总分及相关照护知识、照护相关操作技术、照护行为及态度、决策及自我效能得分分别为（59.07±13.42）、（18.48±3.46）、（17.95±3.98）、（12.16±3.08）、（7.98±2.56）分;干预后得分分别为（66.64±14.16）、（20.32±3.58）、（20.48±2.74）、（14.29±3.03）、（9.65±2.07）分;干预后各维度得分均较干预前提高,差异有统计学意义（t=-2.87^-2.02,均P〈0.01）.60例长期卧床老年人洗澡、穿衣、床轮椅转移和进食日常生活自理能力干预前分别为8、13、21、18例,干预后分别为17、24、43、29例,干预后较干预前提高,差异有统计学意义（χ2=4.093~4.857,均P〈0.05）.结论护士-社工-大学生志愿者团队指导不仅提高了主要照护者的照护能力,而且提高了长期卧床老年人日常生活自理能力.

Objective To explore the effect of nurse-social worker-college student volunteer team guide on care-giving competence of the primary caregivers for the long-term bedridden elderly. Methods The research was conveniently focused on a total of 60 long-term bedridden elderly and 30 primary caregivers, pension caregiver in welfare home from March to May 2015. The nurse-social worker-college student volunteer team guide for the primary caregivers included distributing health manual, training skill, psychological support, respite care and so on. The intervention lasted for 3 months, twice a month, 150 minutes each time. This was a self comparison study. The care competence for the primary caregivers and self-care ability of daily activities for the long-term bedridden elderly were conducted before and after intervention. Results Before intervention, the total score of care-giving competence was 59.07 ± 13.42. After intervention, the total score was 66.64 ± 14.16. Before intervention, the scores of caring knowledge, operation technique, behavior and attitudes, decision-making and self-efficacy were as follows：18.48±3.46, 17.95±3.98, 12.16±3.08, 7.98±2.56. Whereas, after intervention, the scores were as follows：20.32±3.58, 20.48±2.74, 14.29±3.03, 9.65±2.07. Each dimension score after intervention was significantly higher than that before intervention （t=-2.87--2.02, P〈0.01）. For bathing, dressing, indoor transferring and eating in self-care ability of daily activities, the numbers of people in 60 long-term bedridden elderly were 8, 13, 21, 18 before intervention and 17, 24, 43, 29 after intervention. The self-care ability of daily activities of the primary caregivers such as bathing, dressing, indoor transferring and eating after intervention were significantly higher than that before intervention （χ2=4.093-4.857, P〈0.05）. Conclusions Nurse-social worker-college student volunteer team guide can enhance the care-giving competence of the primary caregivers as well as improve the self-care ability of daily activities for the long-term bedridden elderly.