Result of Enhancing caregiver skills empowerment for intermediate stroke patients in Acupuncture Department at Debaratana Nakhon Ratchasima Hospital

Abstract

The objective of this action research was to study the results of skill development of caregivers of intermediate stroke patients who received acupuncture treatment. The mixed-method research was used to select 30 purposive samples of intermediate stroke patients and 30 caregivers. The first phase was a quantitative cross-sectional study. Data were collected by interviews and retrospective chart review method. The results were analyzed and presented using the numbers, percentages, means, and standard deviations. The factors associated the rehabilitation of intermediate stroke patients was identified using the Chi square test. The results showed that factors associated with increase Barthel Index for Activities of Daily Living (ADLs Barthel Index) were patients who received acupuncture treatment within 7 and 14 days after illness and patients who did not have a nasogastric tube. In the second phase, caregivers were trained using empowerment teaching and group discussions with a patient care manual. Comparison of caregiver’s skill scores before and after development using Wilcoxon Signed Ranks Test found that the scores increased significantly. Average score before skill training: 53 points, Average score after skill training: 55.50 points (Z=-2.235, p<0.05). Comparison of the difference between the Barthel Index for Activities of Daily Living (ADLs Barthel Index) of the patients when the study began, 1month, 2months and 3months using One way repeated measures ANOVA found the Barthel Index for Activities of Daily Living (ADLs Barthel Index) of the patients increased significantly (F=82.99, p<0.05). Focus group discussions revealed that caregivers were afraid and anxious about caring for patients with nasogastric tubes. Therefore, a nursing practice guideline on safe swallowing training was developed to enable patients to swallow independently without nasogastric tubes, which affects the patient’s level of daily routine. Recommendations for future studies include studying the results of using the developed nursing practice guideline and applying empowerment teaching to patients with other chronic diseases.