照顾者教练计划在直肠癌患者主要照顾者中的应用效果

Application effects of caregiver coaching program in primary caregivers of patients with colorectal neoplasms

目的观察照顾者教练计划在直肠癌患者主要照顾者中的应用效果。方法采用便利抽样法,选取2018年1月-2019年1月于首都医科大学附属北京友谊医院住院治疗的直肠癌患者的114名主要照顾者为研究对象,采用抽签法随机分为常规干预组(60名)和教练计划组(54名)。常规干预组于出院前给予常规的出院指导,教练计划组在常规干预基础上实行照顾者教练计划,即通过培训后,以具有照顾经验的照顾者作为照顾者教练去辅导照顾者,为其提供专业的照护知识和技能及心理支持。两组均持续干预12周。采用中文版家属照顾能力量表(FCTI)和照顾负担问卷(CBI)于出院时和干预12周后评估并比较两组照顾者的照顾能力和照顾负担。结果干预12周后,教练计划组适应照顾者角色能力、应变并为患者提供帮助能力、调整自我和患者情绪能力、协调其他照护资源的能力及调整自我生活与照顾活动冲突的能力5个维度评分均较出院时降低,且均低于常规干预组,差异有统计学意义(P<0.01)。干预12周后,常规干预组时间依赖性、发展受限性、身体性、社交性、情感性5个维度的评分与出院时比较,差异均无统计学意义(P>0.05),而教练计划组5个维度得分均较出院时降低,且均低于常规干预组,差异均有统计学意义(P<0.01)。结论照顾者教练计划可以提高直肠癌患者主要照顾者的照顾能力,降低照顾负担,是一种具有较好应用前景的干预方法。

Objective To observe the application effect of caregiver coaching program in primary caregivers of patients with colorectal neoplasms.Methods A total of 114 primary caregivers of patients with colorectal neoplasms who were hospitalized and treated in Beijing Friendship Hospital,Capital Medical University from January 2018 to January 2019 were selected as the research objects by the convenient sampling method.The routine intervention group was given routine discharge guidance before discharge.The coaching program group implemented the caregiver coaching program on the basis of routine intervention,that was,after training,the caregivers with nursing experience acted as caregiver coaches to mentor the caregivers and provided professional care knowledge and skills as well as psychological support.Interventions in two groups both lasted for 12 weeks.The Chinese version of Family Caregiver Task Inventory(FCTI)and Caregiver Burden Inventory(CBI)were used to assess and compare the care capacity and care burden of caregivers between two groups at discharge and after 12 weeks of intervention.Results After 12 weeks of intervention,the five-dimensional scores of adapting to the caregiver's role ability,adapting and providing assistance for patients ability,adjusting self and patient's emotional ability,coordinating other care resources and adjusting the conflicts between self-life and care activities ability in the coaching program group were all lower than those at discharge and the routine intervention group,and the differences were statistically significant(P<0.01).After 12 weeks of intervention,there was no statistically significant difference in scores of the five dimensions of time dependence,developmental limitation,body,sociability and emotionality in the routine intervention group compared with those at discharge(P>0.05).However,scores of these five dimensions of the coaching program group were lower than those at discharge and they were all lower than those of the routine intervention group.The differences were statistically significant(P<0.01).Conclusions The caregiver coaching program can improve the care ability of primary caregivers of patients with colorectal neoplasms and reduce their care burden.It is an intervention method with better application prospects.