The effects of a telenursing health promotion program on health-promoting behaviors of the family caregivers of stroke patients
Keywords:
family caregiver, health-promoting behavior, telenursingAbstract
This quasi-experimental research aimed to study the effects of a health promotion program for family caregivers of stroke patients through a telenursing approach. The sample consisted of 60 family caregivers of stroke patients, selected using simple random sampling with computer program to randomly select 30 caregivers per group based on inclusion criteria. The experimental group received a telenursing health promotion program for family caregivers, which was designed based on Pender’s Health Promotion Model. The program included telephone and Line video calls to assess physical and psychosocial health, behavior-specific emotional and cognitive counseling, and deliver individualized health promotion education for caregivers. The intervention consisted of three sessions. The control group received standard care. Data were collected using a health-promoting behavior assessment questionnaire before participating in the program, and at 3 and 6 months after participating in the program. Data were analyzed using chi-square test, Fisher’s exact test, two-way repeated measures ANOVA, and Bonferroni test.
The results showed that 1) The experimental group had a significantly higher mean score for health-promoting behaviors at 3 months and 6 months after participating in the program compared to before participating in the program (p < .05, p < .05, respectively). 2)The experimental group had a significantly higher mean score for health-promoting behaviors than the comparison group at 3 months and 6 months after participating in the program (p < .05, p < .05, respectively).
In conclusion, caregivers who participated in the health promotion program for family caregivers of stroke patients showed improved health-promoting behaviors, which may contribute to better health and provide effective patient care. The program could be adapted for caregivers of patients with other chronic diseases, and further experimental research should be conducted to evaluate its effectiveness.
References
Secretariat Office for the National Non-Communicable Disease Plan, Non-Communicable Disease Division, Department of Disease Control, Ministry of Public Health. National plan for the prevention and control of non-communicable diseases (2023-2027) Thailand [Internet]. 2025 [cited 2025 Feb 2]. Available from: https://ddc.moph.go.th/uploads/publish/1625920241004031950.pdf (in Thai)
Strategy and planning division. Public health statistics A.D. 2021 [Internet]. 2024 [cited 2024 Nov 27]. Available from: https://spd.moph.go.th/wpcontent/uploads/2022/11/Hstatistic64.pdf (in Thai)
Srichote W, Pitchayakoon N. Effectiveness of home-based continuing care programs on burden among caregivers of stroke patients: a systematic review and meta-analysis. Nurs J CMU 2024;51(4):146-65. (in Thai)
McCarthy MJ, Lyons KS, Schellinger J, Stapleton K, Bakas T. Interpersonal relationship challenges among stroke survivors and family caregivers. Soc Work Health Care 2020;59(2):91-107. doi:10.1080/00981389.2020.1714827.
Kokorelias KM, Lu FKT, Santos JR, Xu Y, Leung R, Cameron JI. “Caregiving is a full-time job” impacting stroke caregivers' health and well-being: a qualitative meta-synthesis. Health Soc Care Community 2020;28(2):325-40. doi:10.1111/hsc.12895.
Wang L, Liu J, Wu L, Zhang J, Fang H. Caregiving experiences of stroke caregivers: a systematic review and meta-synthesis of qualitative studies. Medicine (Baltimore) 2023;102(13):e33392. doi:10.1097/MD.0000000000033392.
Kennedy A, Date D. Health psychology and stress management [Internet]. 2022 [cited 2025 Feb 2]. Available from: https://www.researchgate.net/publication/358606469_Health_Psychology_Stress_Management.
Kavga A, Govina O, Galanis P, Kalemikerakis I, Vlachou E, Fotos N, et al. Determinants of health promotion behaviors among family caregivers of stroke survivors. Diseases 2021;9(1):1-15. doi:10.3390/diseases9010010.
Bakas T, McCarthy MJ, Miller EL. Systematic review of the evidence for stroke family caregiver and dyad interventions. Stroke 2022;53(8):2093-102. doi:10.1161/STROKEAHA.121.034090.
Homayouni A, Vasli P, Estebsari F, Nasiri M. Reducing care burden and improving adherence to health-promoting behaviors among family caregivers of patients with multiple sclerosis through a healthy lifestyle empowerment program. BMC Nurs 2022;21(1):1-12. doi:10.1186/s12912-022-00961-8.
Lök N, Bademli K. Pilot testing of the “first you should get stronger” program among caregivers of older adults with dementia. Arch Gerontol Geriatr 2017;68:84-9. doi:10.1016/j.archger.2016.09.006.
Farran CJ, Paun O, Cothran F, Etkin CD, Rajan KB, Eisenstein A, et al. Impact of an individualized physical activity intervention on improving mental health outcomes in family caregivers of persons with dementia: a randomized controlled trial. AIMS Med Sci 2016;3(1):15-31. doi:10.3934/medsci.2016.1.15.
Rerkluenrit J. Effect of learning-awareness-telephone-home visiting (LATH) program on health-promoting behavior among family caregivers of patients with heart failure. J Nurs Health Care 2017;35(4):61-71. (in Thai).
Yuan M, Srirat C, Wangsrikhun S. Caregiver burdens and perceived self-efficacy of family caregivers of stroke survivors during the COVID-19 pandemic in Chengdu, the people’s republic of China. Nurs J CMU 2023;50(4):1-13.
Voraraksa J, Ongiem A, Molek R, Vichitvejpaisal P. Telemedicine and telenursing: revolutionizing remote healthcare delivery. J Med Health Sci 2024;31(1):128-39. (in Thai)
Pender NJ, Murdaugh CL, Parsons MA. Health promotion in nursing practice. 5th ed. New Jersey: Pearson Education; 2006.
Faul F. G*Power version 3.1.9.2 [Internet]. 2020 [cited 2020 Jun 9]. Available from: https://www.psychologie.hhu.de/arbeitsgruppen/allgemeine-psychologie-undarbeitspsychologie/gpower.
Chow SC, Shao J, Wang H, Lokhnygina Y. Sample size calculations in clinical research. 3rd ed. New York: Chapman and Hall/CRC; 2017.
Liu Y, Hughes MC, Baumbach A, Derain L. An online intervention to improve the health and well-being of informal caregivers of individuals with Alzheimer's disease: a pilot study. PEC Innov 2023;3:100229. doi:10.1016/j.pecinn.2023.100229.
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