Grant Joan S, Elliott Timothy R, Weaver Michael, Bartolucci Alfred A, Giger Joyce Newman
University of Alabama School of Nursing, University of Alabama at Birmingham, 35294-0113, USA. grantj@admin..son.uab.edu
Stroke. 2002 Aug;33(8):2060-5. doi: 10.1161/01.str.0000020711.38824.e3.
Social problem-solving therapy shows promise as an intervention to improve the well-being of family caregivers. There is some evidence that training in problem solving may be effectively delivered by telephone. The purpose of this study was to quantify the impact of social problem-solving telephone partnerships on primary family caregiver outcomes after stroke survivors are discharged home from a rehabilitation facility.
Using a randomized 3-group repeated-measures experimental design, 74 stroke survivors with an admitting diagnosis of ischemic stroke and their primary family caregivers were entered into the study. The intervention consisted of an initial 3-hour home visit between a trained nurse and the family caregiver within 1 week after discharge to begin problem-solving skill training. This initial session was followed by weekly (the first month) and biweekly (the second and third month) telephone contacts.
Compared with the sham intervention and control groups, family caregivers who participated in the social problem-solving telephone partnership intervention group had better problem-solving skills; greater caregiver preparedness; less depression; and significant improvement in measures of vitality, social functioning, mental health, and role limitations related to emotional problems. There were no significant differences among the groups in caregiver burden. Satisfaction with healthcare services decreased over time in the control group while remaining comparable in the intervention and sham intervention groups.
These results indicate that problem-solving training may be useful for family caregivers of stroke survivors after discharge from rehabilitative facilities.
社会问题解决疗法作为一种改善家庭照顾者幸福感的干预措施显示出前景。有证据表明，问题解决训练可以通过电话有效开展。本研究的目的是量化社会问题解决电话合作关系对中风幸存者从康复机构出院回家后家庭主要照顾者结局的影响。
采用随机三组重复测量实验设计，74名入院诊断为缺血性中风的中风幸存者及其家庭主要照顾者纳入研究。干预措施包括出院后1周内由一名经过培训的护士与家庭照顾者进行一次为期3小时的家访，以开始问题解决技能培训。在首次家访之后，每周（第1个月）和每两周（第2个月和第3个月）进行电话联系。
与假干预组和对照组相比，参与社会问题解决电话合作关系干预组的家庭照顾者具有更好的问题解决技能；照顾者准备更充分；抑郁程度更低；在活力、社会功能、心理健康以及与情感问题相关的角色限制等指标上有显著改善。各组在照顾者负担方面无显著差异。对照组对医疗服务的满意度随时间下降，而干预组和假干预组的满意度保持相当。
这些结果表明，问题解决训练可能对中风幸存者从康复机构出院后的家庭照顾者有用。
