Investigating the Effect of Home-Based Training for Family Caregivers on the Incidence of Bedsore in Patients with Stroke in Ali Ebne Abitaleb Hospital, Zahedan, Iran: A Clinical Trial Study

Abstract

Background: Bedsore is a common problem in patients with stroke, causing an increased number of hospitalizations, increased healthcare costs, and mortality of these patients. Typically, due to their numerous problems, these patients are not able to take care of themselves and thus their care providers play an important role in providing care at their home. Objectives: The present study was conducted with the aim of investigating home-based training on the incidence of bedsore in patients with stroke, during year 2017. Methods: In the present clinical trial study, 70 family caregivers of stroke patients that had referred to Ali Ebne Abitaleb Hospital, Zahedan, Iran, were chosen through available sampling and then randomly assigned to control and intervention groups. In the intervention group, explanations were provided for the family caregivers about stroke, its resulting problems, bedsore, methods for preventing and caring for bedsore at home. The explanations were provided at the place of residence of the patient at the time of discharge as well as two and three weeks after discharge at home, and on the patient's bedside. In the control group, on the other hand, routine trainings of the ward were given. After 12 weeks, both groups were evaluated in terms of incidence of bedsore, based on scoring presented by the National Pressure Ulcer Advisory Panel (NPUAP). Data analysis was performed by chi-square and t-test, using SPSS 21. Results: The number of individuals in each group was 35. Frequency of incidence of bedsore after the intervention in the intervention and control groups was 25.7 and 48.6%, respectively. The statistical results indicated that there was a significant difference between the two groups in terms of frequency of bedsore (P = 0.046). Conclusions: Home-based training is a practical and inexpensive method for participation of family members in providing care for patients with stroke and reducing incidence of bedsore in these patients.

Transitional care to caregivers of dependent older people: an integrative literature review

“…For caregivers to have proper answers, written material about the transmitted information must be arranged for, because it favors learning and allows caregivers to review the addressed contents (8) . A study associated having information with having motivation to provide care (31) .…”

“…Emotional support was probably the intervention that was most cited in the literature as being a priority for caregivers, given that its absence can hinder adaptation to the new role and contribute to an increased overload, reduced well-being, and worse health in this population. These problems can lead to a decrease in the quality of care provided to dependent older people (24)(25)(30)(31)(32)(33)(34) .…”

“…Other authors warned that the difficulties are mostly resting and sleeping, because of the efforts involved in caregiving, and managing time to take care of themselves, keep interpersonal relationships, have spare time to enjoy leisure activities, and have social life (30) . This finding is doubly worrying, because of the negative influence on both caregivers' health and the quality of care they provide (8,(30)(31)(32) .…”

Hospital‐acquired pressure ulcer incident rates among hospitals that implement an education program for staff, patients, and family caregivers inclusive of an after discharge follow‐up program in Saudi Arabia

“…The study concluded that home-based training of family members is cost effective and is practical in reducing PU incidence. 22 Many parts of the Saudi multi-faceted program were seen representationally throughout the PUPPs that were reviewed. These included the importance of early identification of high PU risk patients, 22 the use of Braden Scale, 14 the inclusion of a Wound Care Nurse, 19 discharge instructions, 23 as well as the importance of Patient/Family Centered Care.…”

“…22 Many parts of the Saudi multi-faceted program were seen representationally throughout the PUPPs that were reviewed. These included the importance of early identification of high PU risk patients, 22 the use of Braden Scale, 14 the inclusion of a Wound Care Nurse, 19 discharge instructions, 23 as well as the importance of Patient/Family Centered Care. 19 All this, in addition to the education provided and interventions (repositioning, assessment, nutrition, skin care) implemented.…”