Involving caregivers in activating patients with stroke in nursing homes
Summary
Involving caregivers in activating patients with stroke in nursing homes
Introduction: Many patients with stroke depend on help from caregivers with activities of daily living (ADL). Therefore, caregivers must be trained during inpatient rehabilitation. Also, patients with stroke in rehabilitation settings are found to be alone and inactive for more than 60% of the day. Studies have shown that involving partners in caregiving activities and training resulted in less depression, improved quality of life and better functional status.
Aim: To investigate the impact of involving caregivers in training of patients, using a caregiver training program (CTP), on therapeutic activity of patients with stroke, during clinical rehabilitation in nursing homes. Second aim was to investigate the impact of this CTP on caregiver burden.
Method: Quasi-experimental study using a pretest-posttest design, with two independent samples was conducted. Demographic and health care data were collected from patients and caregivers (instruments respectively Barthel Index (BI) and Caregiver Strain Index (CSI)). Patients’ activities were observed using Behavioural Mapping (BM: including therapeutic and non-therapeutic activities) before and after implementation of the CTP.
Results: Patients in the posttest group spent 38.5 minutes a day more on therapeutic activities, than those in the pretest. Patients in the posttest spent significantly less time on non-therapeutic activities as eating and ‘dressing and hygiene’ and spent significantly more time at their patient room. However, they also spent more time on autonomous exercising. Positive effect was found on caregiver burden.
Conclusion: Involving caregivers in inpatient rehabilitation seems promising in activating patients with stroke, enhancing daily amount of therapeutic activities and decreasing caregiver burden.
Recommendations: Future research should investigate barriers and motivators of caregivers and patients with stroke and based on this, interventions should be tailored to the specific needs of patients and caregivers. It is important to involve nurses in supporting and facilitating caregivers in exercising with patients.