Effectiveness of a Capacity Development Program for Caregivers of People with Mobility Disability

Abstract

Introduction People with mobility disability require care from knowledgeable and skilled caregivers in addition to their family members to effectively ensure their rehabilitation in terms of physical, psychological, environmental, and benefits/welfare. Although Thailand’s long-term care system mandates caregiver training by the Department of Health, Ministry of Health, this training currently does not adequately address the specific knowledge and skills necessary for caring for people with disabilities, leading to a significant gap in the long-term care system. Consequently, caregivers often lack confidence in properly managing care for those with mobility disability. 

Objectives This study aimed to investigate the effectiveness of a capacity development program for caregivers of people with mobility disability in a community in a northeastern province of Thailand. Specific objectives included: 1) To compare the knowledge of caregivers of people with mobility disability before and after participating in the program, and 2) To compare the skills of caregivers of people with mobility disability before and after participating in the program. 

Design This study employed a quasi-experimental design with a one-group pretest and posttest. The Kolb’s experiential learning theory was used to develop the study’s conceptual framework. The caregiver capacity-building program for people with mobility disability consisted of four phases with five activities: 1) Experience: drawing on previous experiences to facilitate learning and enhance the caregivers’ skills (Activity 1: Circle Up and Share Stories); 2) Reflection and Discussion: reviewing, reflecting on, and analyzing past experiences (Activity 2: Together, We Can Overcome Disability); 3) Concept: summarizing the lessons learned from reflection, sharing experiences, and group discussions, and developing new strategies to strengthen caregivers’ skills (Activity 3: Consolidate Ideas, Create New Solutions); and 4) Experimentation and Application: applying the new strategies and methods in practice to build caregivers’ knowledge and skills through experiential learning, leading to increased confidence and sustained empowerment (Activity 4: Knowing is Not Enough, Practice is Key and Activity 5: Empowering for Sustainability). 

Methods The participants consisted of 30 caregivers who completed a 70-hour elderly care training course by the Department of Health, Ministry of Health, and were working within the jurisdiction of a Community Medical Center. Through purposive sampling, the participants were selected based on the following inclusion criteria: 1) age at least 18 years old, 2) proficiency in Thai speaking, reading, and writing, and 3) willingness to participate in all activities throughout the study. The research tools included 1) the 8-week caregiver capacity-building program; 2) the Line’s official account, “Love and Care for Activities of Daily Living”; 3) the daily living activities promotion and rehabilitation manual; 4) the “Love and Care for Activities of Daily Living” video; 5) the knowledge assessment tool for caregivers of people with mobility disability, and 6) the skills assessment tool for caregivers of people with mobility disability. The content validity index of the program was .94. The reliability of the knowledge assessment tool revealed a Kuder-Richardson-20 (KR-20) of .82 while Cronbach’s alpha coefficient of the skills assessment tool was .91. Data were collected from January to March 2024. Data were then analyzed using descriptive statistics and the Paired t-test. 

Results The participants were all female, with a mean age of 55.67 years (SD = 5.82). Most of them were married (76.67%) and obtained primary education equal to high school/vocational certificate (36.67%). Most had experiences as caregivers and were trained for rehabilitation for people with mobility disability (83.33%). The research findings revealed that the participants had mean scores for knowledge after participating in the program (M = 18.73, SD = 1.72) higher than before the program (M = 12.73, SD = 3.04) with statistical significance (t = 16.716, p < .001). Also, after participating in the program, the participants had skills in caring for people with mobility disability (M = 55.03, SD = 4.85) higher than before the program (M = 36.60, SD = 7.53) with statistical significance (t = 10.087, p < .001). When considering skill dimensions, it was found that after participating in the program, the participants had skills in physical, psychological, environmental, and benefits/welfare higher than before participating in the program with statistical significance (t = 11.556, p <.001; t = 7.837, p <.001; t = 7.900, p <.001; t = 6.816 p <.001; t = 12.976, p <.001, respectively). The study results indicate the effectiveness of the caregiver capacity-building program in enhancing the caregivers’ knowledge and skills. However, this study has some limitations. The researcher assesses the caregivers’ skills, which may introduce unconscious bias. Additionally, the research design with a single group is a limitation. 

Recommendation Community health nurses and the healthcare team can apply the caregiver skill development program from this study to enhance the knowledge and skills of caregivers for people with mobility disability who are similar to the study participants. A future study should be designed as experimental research with a control group, and should include follow-up assessments of caregiver skills as well as the outcomes for those with disability.