Stroke which is a typical chronic disease accompanied by disabilities in daily living, requires long-term observation and care and makes it difficult to predict a process of treatment and prognoses. Especially, caregivers of stroke patients in rehabil... Stroke which is a typical chronic disease accompanied by disabilities in daily living, requires long-term observation and care and makes it difficult to predict a process of treatment and prognoses. Especially, caregivers of stroke patients in rehabilitation hospitals may confront a diversity of medical barriers during the long period of recovery. In this situation, the role of good navigation is needed to give practical help to caregivers who form the primary support system for Stroke patients so that they can not only see the burden of care reduced but also play a role as an informal caregiver. It is therefore necessary to provide a nursing intervention based on a navigation program as a general guide that provides and connects various types of education, information, care skills, and service provision in pursuit of successful return to a community from entrance into a rehabilitation hospitals. The purpose of this study was to develop a navigation program based on the Professional Navigaion Framework of Fillion et al. (2009) for caregivers of stroke patients in rehabilitation hospitals and determine the effectiveness of the factors for continuity and empowerment in many ways. This is a quasi-experimental study with non-equivalent control group non-synchronized design. It was conducted in a total of 44 caregivers (22 in the control group and 22 in the experimental group) of patients diagnosed with Stroke for the first time in a single rehabilitation centers in B Metropolitan City from June 28 to August 31, 2016. The experimental tool was based on the Professional Navigation Framework of Fillion et al. (2009) according to literature review with the advice of a professor in the relevant field. With the program, the effectiveness of the factors for continuity (information, management, and relationships) and those for empowerment (encouragement, positive coping, and support) was determined in terms of the burden of care, anxiety, depression, self-efficacy, caregiving mastery, the quality of life, and patients' activities of daily living. Intervention was provided for each concept, 90 minutes per session, for eight sessions in total; the experimental group was divided into two sub-groups, who were then provided with a navigation program in the lecture hall of the hospital through all the sessions. The instruments in this study included the care burden inventory developed by Seo and Oh (1993), the hospital anxiety and depression scale, which is Oh and others' (1999) Korean translation of the Hospital Anxiety and Depression (HAD) scale developed by Zigmond et al. (1983), the caregiving mastery scale adapted by Lee (2013), the self-efficacy scale developed by Sherer et al. (1982), the quality of life scale developed by Choi (2009), and the Modified Barthel Index (MBI) adapted by Vancly and Cooper (1989). The data were analyzed using an SPSS 21.0 program to determine the real number, percentage, and the mean and standard deviation and perform χ²-test, Fisher`s exact test, t-test and Shapiro wilk. The results are as follows: 1. The navigation program in this study is as follows: In this study, I have built the navigation program for primary caregivers of stroke patients in rehabilitation hospitals on the basis of the Professional Navigation Framework developed by Fillion et al. (2009) and through literature review, advices of specialized professors, and qualitative interview with the subjects. The program provides intervention for each construct with the aim of reinforcing the factors for nursing continuity (information, management, and relations) and those for empowerment promotion (encouragement, positive coping, and support) and determining their effects among primary caregivers of stroke patients and is composed of three stages introduction, education, and activity in a total of 8 sessions (2 sessions a week and 90 minutes per session). 2. Findings from this study supported the following hypotesis 1) Hypothesis 1: "After the intervention, the decrease in the level of burden in the experimental group will be greater than the one in the conrol group." This hypothesis was tested by t-test and was supported after the intervention was administered, the decrease in the level of burden was significantly greater in the experimental group than the control group." Thus the hypothesis 1 was supported(t=-9.99, ρ<.001). 2) Hypothesis 2: "After the intervention the decrease in the level of anxiety in the experimental group will be greater than the one in the control group."Thus the hypothesis 2 was supported(t=-7.88, ρ<.001). 3) Hypothesis 3: "After the intervention the decrease in the level of depression in the experimental group will be greater than the one in the control group." Thus the hypothesis 3 was supported(t=-10.24, ρ<.001). 4) Hypothesis 4: "After the intervention the decrease in the level of self-efficacy in the experimental group will be greater than the one in the control group." Thus the hypothesis 4 was supported(t=8.66, ρ<.001). 5) Hypothesis 5: "After the intervention the decrease in the level of Caregiving Mastery in the experimental group will be greater than the one in the control group." Thus the hypothesis 5 was supported(t=8.82, ρ<.001). 6) Hypothesis 6: "After the intervention the decrease in the level of quality of life in the experimental group will be greater than the one in the control group." Thus the hypothesis 6 was supported(t=4.50, ρ<.001). 7) Hypothesis 7: "After the intervention the decrease in the level of activities of daily living in the experimental group patients will be greater than the one in the control group patients." Thus the hypothesis 7 was supported(t=2.89, ρ=.006). In conclusion, the navigation program in this study was effective in reducing the burden of care, anxiety, and depression for caregivers of stroke patients in a rehabilitation hospitals, in improving their self-efficacy, caregiving mastery, quality of life, and patients' activities of daily living. It is therefore necessary to use this navigation program new nursing intervention strategy for caregivers of stroke patients in clinical practice. Key words: Rehabilitation Hospitals, Caregivers, Stroke Patients, Navigation Program ，韩语论文网站，韩语论文题目 |
