Homayouni Abdolsamad, Vasli Parvaneh, Estebsari Fatemeh, Nasiri Maliheh
Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Nurs. 2022 Aug 16;21(1):229. doi: 10.1186/s12912-022-00961-8.
The chronic, progressive nature of multiple sclerosis (MS) demands long-term family-centered care for patients. In view of that, inadequate education and support provided for the family caregivers (FCGs) of MS patients increase their care burden (CB) and affect their lifestyle. This study aimed to investigate the impact of a healthy lifestyle empowerment program (HLEP) on CB and adherence to health-promoting behaviors (HPBs) in the FCGs of patients suffering from MS.
In this experimental study with parallel groups, conducted in Iran in 2020, a total of 60 FCGs of MS patients were recruited, and then randomized into intervention (n = 30) or control (n = 30) groups. The intervention program, the HLEP, was thus implemented virtually via WhatsApp in the intervention group upon coordinating with the MS Association in the city of Yasuj, Iran, and selecting the participants. The data were collected at three stages, including baseline, follow-up 1 (immediately after the HLEP), and follow-up 2 (three months after HLEP). The research tools were a 14-item demographic survey questionnaire, the 24-item Caregiver Burden Inventory, and the 52-item Health-Promoting Lifestyle Profile-II. Independent-samples t-test, repeated measures analysis of variance, and a linear mixed model were further used for statistical analyses, considering the significant level of 0.05.
The study results revealed a significant decrease in the CB scores from the baseline to the follow-up 2 (77.03 ± 15.76 to 42.33 ± 12.37), and a significant increase in the values of adherence to HPBs from the baseline to the follow-up 2 (123.53 ± 14.01 to 148.06 ± 15.04) were obtained in the intervention group (p < 0.001). The linear mixed model also showed that the significant absolute changes in the scores of CB and adherence to HPBs during the follow-ups in the intervention group, compared to those in the controls, were - 8.92 and 16.47 units, respectively (p < 0.001).
Health care managers, planners, and providers are highly recommended to start developing and implementing various HLEPs for reducing CB and improving adherence to HPBs among the FCGs of patients with MS.
多发性硬化症（MS）具有慢性、进行性的特点，需要为患者提供长期的家庭照护。鉴于此，为MS患者的家庭照护者（FCG）提供的教育和支持不足，会增加他们的照护负担（CB）并影响其生活方式。本研究旨在调查健康生活方式赋能计划（HLEP）对MS患者FCG的CB及健康促进行为（HPB）依从性的影响。
在2020年于伊朗进行的这项平行组实验研究中，共招募了60名MS患者的FCG，然后随机分为干预组（n = 30）和对照组（n = 30）。在与伊朗亚苏季市的MS协会协调并选定参与者后，干预组通过WhatsApp以虚拟方式实施了干预计划HLEP。数据在三个阶段收集，包括基线、随访1（HLEP结束后立即进行）和随访2（HLEP结束后三个月）。研究工具包括一份14项的人口统计学调查问卷、24项的照护者负担量表和52项的健康促进生活方式量表-II。考虑到显著水平为0.05，进一步使用独立样本t检验、重复测量方差分析和线性混合模型进行统计分析。
研究结果显示，干预组从基线到随访2，CB得分显著降低（从77.03±15.76降至42.33±12.37），HPB依从性值从基线到随访2显著增加（从123.53±14.01增至148.06±15.04）（p < 0.001）。线性混合模型还显示，与对照组相比，干预组随访期间CB得分和HPB依从性得分的显著绝对变化分别为-8.92和16.47单位（p < 0.001）。
强烈建议医疗保健管理者、规划者和提供者开始制定和实施各种HLEP，以减轻MS患者FCG的CB并提高其对HPB的依从性。
