Impacts of an Empowerment Programme on Family Caregivers’ Ability to Assist Stroke Patients to Perform Joint Exercise
Keywords:
empowerment, joint exercises, family, strokeAbstract
Objective: To study possible impacts that an empowerment programme could have on family caregivers’ ability to enable stroke patients to do joint exercise
Design: Quasi-experimental research, with one-group repeated measurements
Methodology: The sample consisted of 21 participants from families with hemorrhagic and ischemic stroke patients. The participants were supporting the patients at their homes as family caregivers. In this study, the participants received a six-week empowerment programme developed based on Gibson’s (1995) empowerment framework. The programme emphasised: 1) discovery and analysis of realities, as well as problems and obstacles related to joint exercise; 2) critical reflection and thorough review of joint exercise practice, to reach mutual problem-solving agreements; 3) decisions on proper exercise activities and plans for exercise methods suitable for individual stroke patients and their families; and 4) maintaining of effective exercise methods, through home-visit and phone-mediated follow-ups, for the purposes of assurance, encouragement, and assessment. The datagathering instruments consisted of 1) a questionnaire on general information of each family; and 2) an assessment form focusing on family caregivers’ performance in helping stroke patients with their joint exercise. The data were analysed using descriptive statistics and the Wilcoxon Matched Pairs Signed-Ranks test.
Results: After the programme intervention, the participants displayed a significant increase in their mean score on supporting stroke patients’ performance of joint exercise (p < 0.01).
Recommendations: The empowerment program can be used as a guideline to promote family-based joint exercise practice for stroke patients, and as a means of increasing the family caregivers’ knowledge, ability, and confidence in providing the patients with continuous care.
References
Prasat Neurological Institute. Clinical practice guidelines for stroke rehabilitation. 1st Edition. Bangkok: Tana Press; 2016. (in Thai)
World Stroke Organization. World Stroke Organization Annual Reprot 2019. [Internet]. [Cited 2020 Aug 1].Available from: https://www.world-stroke.org/assets/downloads/WSO_2019_ Annual _Report_online.pdf
Ministry of Public Health. Strategy and Planning Division. Public Health Statistics A.D.2019. Nonthaburi: Strategy and Planning Division, Ministry of Public Health; 2020. (in Thai)
Ministry of Public Health. Strategy and Planning Division. Case report summary 2018. Nonthaburi: Strategy and Planning Division, Ministry of Public Health; 2019. (in Thai)
Ministry of Public Health. Strategy and Planning Division. Regional Health Profile 2012-2017. Nonthaburi: Chinauksorn Printing; 2018. (in Thai)
Saicamthon P, Areechokechai D, Tipsriraj S. Standardized morbidity rate of cerebrovascular disease, regional health 1, 2014 [Internet]. 2014 [Cited 2019 oct 8]. Available from: http://odpc1.ddc.moph.go.th/epidpc10/download. php?fle=21_1.pdf&loc= major&type=load (in Thai)
Division of Non Communicable Diseases. Number and rate of patients in 2016-2017 (Hypertension, Diabetes Mellitus, Coronary Artery Disease, Stroke, COPD). [Internet]. 2019 [Cited 2020 Mar 13]. Available from: https://bit.ly/2Wx6prj. (in Thai)
Seesawang J, Rungnoei N. Nursing care for stroke patients: strategies towards patient-centered care. J Nurs Sci 2016;34(3):10-8. (in Thai)
Kunyodying T, Pothiban L, Khampolsiri T. Dependency of the elderly with stroke, caregiver burden, social support, and quality of life among older caregivers. Nursing Journal 2015;42:12-31. (in Thai)
Matozinho CVO, Teixeira-Salmela LF, Samora GAR, Sant’Anna R, Faria CDCM, Scianni A. Incidence and potential predictors of early onset of upper-limb contractures after stroke. Disabil Rehabil 2019 Jul 22;1-7. doi: 10.1080/09638288.2019.1637949.
Thueakthong W, Kumthornthip W, Khongsri N. A Comparison of immediate effect of neurophysiologic versus orthopedic stretching in reducing post-stroke upper limb spasticity (ENOS-PULS): a Preliminary Study. J Thai Rehabil Med 2015;25(1):22-9. (in Thai)
Peung sa-ium V, Chaiyasung P, Phongsupasa W, Joomjana S. The development of caregiver’s empowerment program of bed bound elderly in the community. Nursing Public Health and Education Journal 2017;18(3):83-95. (in Thai)
Trithavin U. The effects of caregivers empowerment program on performance of bedridden elderly care in Bangban Distrinct, Phra Nakhon Si Ayutthaya Province. Journal of Preventive Medicine Association of Thailand 2018;8(2):268-80. (in Thai)
Rhestifujiayani E, Huriani E, Muharriza. Comparison of muscle strength in stroke patients between the given and not given range of motion exercise. Nurse Media Journal of Nursing 2015;5(2):88-100. doi: 10.14710/nmjn.v5i2.1053483
Hosseini ZS, Peyrovi H, Gohari M. The effect of early passive range of motion exercise on motor function of people with stroke: a randomized controlled trial. J Caring Sci 2019 Mar 1; 8(1):39-44. doi: 10. 15171/jcs.2019.006.
Junsree V. The effects of a family management enhancing program on the caregivers’ skill, and early mobility, and complications of stroke patients [Dissertation]. Bangkok: Thammasat University; 2017. (in Thai)
Deyhoul N, Vasli P, Rohani C, Shakeri N, Hosseini M. The effect of family-centered empowerment program on the family caregiver burden and the activities of daily living of Iranian patients with stroke: a randomized controlled trial study. Aging Clin Exp Res 2020 Jul;32(7):1343-52. doi: 10.1007/s40520- 019-01321-4.
Sukket T, Iemsawasdikul W, Nuysri M. The effects of an ability development program for caregivers of cerebrovascular patients at Thapklo District, Phichit Province. Thai Journal of Nursing 2018;67(3):19-27. (in Thai)
Pitthayapong S. Situations, problems, and barriers of post-stoke care in the transitional period from hospital to home. Thai Red Cross Nursing Journal 2018; 11(2):26-39. (in Thai)
Boonsin S, Panidchakul K. Factors related to need of caregivers in stroke patients. Journal of Boromarajonani College of Nursing 2016;32(2):67-80. (in Thai)
Nantadee O, Thongkhum S, Siyuthana W. Problems and needs of caregivers in stroke patients at Thoen District, Lumpong Province. Journal of Health Sciences Scholarship 2017; 4(1):29-41. (in Thai)
Gibson CH. The process of empowerment in mothers of chronically ill children. J Adv Nurs 1995;21(6): 1201-10. doi:10.1046/j.1365-2648.1995.2106 1201.x
Punasiri S, Rodphan J, Triraphee S, Chunthamun W.Effect of the empowerment program on care ability of caregivers of stroke patients. Journal of Nursing Division 2009;36(3):47-57. (in Thai)
Intarasombat P. Health assessment in the elderly. Rama Nurs J 1996;2(3):44-57. (in Thai)
Sirindhorn National Medical Rehabilitation Institute. Rehabilitation after hemiplegia from stroke. Nonthaburi: Sirindhorn National Medical Rehabilitation Institute;2007. (in Thai)
Srijai P. Effect of the empowerment program on muscle exercise practicing for physical disability person among the village health volunteers. [Dissertation]. Chiang Mai: Chiang Mai University; 2019. (in Thai)
Chafjiri RT, Navabi N, Shamsalinia A, Ghaffari F. The relationship between the spiritual attitude of the family caregivers of older patients with stroke and their burden. Clin Interv Aging 2017 Mar 1;12:453-8. doi: 10.2147/CIA.S121285.
