Effects of a Nursing Program Promoting Self-Care Capability for Family Caregivers of Older Adults with Stroke in Photharam District, Ratchaburi Province
Keywords:
older adults with stroke, self-care capability for family caregiver, nursing care of stroke patientsAbstract
This quasi-experimental research with a two-group pretest-posttest design aimed to examine the effects of a supportive-educative nursing system program on caregivers’ knowledge, caregiving ability for older adults with stroke, the patients’ ability in activities of daily living (ADL), and the occurrence of complications among older adults with stroke in Photharam District, Ratchaburi Province. The sample consisted of caregivers and older adults with stroke, divided into experimental and comparison groups of 24 participants each. The study was conducted over six weeks. The experimental group received a program based on Orem’s supportive-educative nursing system, which included: (1) guidance, (2) support, (3) teaching, and (4) creating a supportive learning environment for caregivers, along with a caregiver’s manual, home visits, and follow-up through telephone or LINE application. The comparison group received routine care from professional nurses at their respective primary care units. Data were collected using interviews and patient assessments. Research instruments included: a general information questionnaire, a caregiver ability assessment, a caregiver knowledge test, an ADL assessment, and a complication risk assessment for older adults with stroke. Data were analyzed using Chi-square test, Independent t-test, and Dependent t-test.
The results revealed that after the intervention, caregivers in the experimental group had significantly higher mean scores of knowledge and caregiving ability than those in the comparison group (p-value = .000). Older adults with stroke cared for by caregivers in the experimental group had significantly higher mean scores of ADL than those cared for by the comparison group (p-value = .005). However, there was no statistically significant difference in the occurrence of complications between the two groups (p-value = .054).
References
World Stroke Organization. The top 10 causes of death [Internet]. 2022 [cited 2025 Feb 10]. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
World Health Organization. Annual report 2019: Health for all [Internet]. 2019 [cited 2021 Feb 9]. Available from: https://apps.who.int/iris/bitstream/handle/10665/333249/9789290223214eng.pdf
Development Health System Group. Bureau of Non-Communicable Disease. Information of World Stroke Day [Internet]. 2016. [cited 2022 January 8]. Available from: http://www.thaincd.com/2016/news/announcement-detail.php?id=12303&gid=1-015-001
Pakdeewiwat P. Predictors of physical movement among patients after stroke during the first year. Royal Thai Army Nurses Journal. 2018;19:185-93. (in Thai)
Chunhabodi A, Suphanan T, Upray R, Thongsai S. Stress and needs of caregivers of stroke patients at home. Journal of Phrapokklao College of Nursing, Chanthaburi. 2013;24(1):1-9. (in Thai)
Pittayapong S. Situations, problems, and barriers of post-stroke care in the transitional period from hospital to home. Thai Red Cross Nursing Journal. 2018;11(2):26-39. (in Thai)
Wonginyoo A, Prasarnnet R, Wongcharee A. Stress and burden of caregivers of stroke patients in the community, Mueang District, Udon Thani Province. Journal of Health and Nursing Education. 2019;2(4):40-9. (in Thai)
Somsub N, Benjathammanont T, Thongtantham P, Praram S, Predee R, Tangsethian S, Srisaenpang S, Nonjui P. Costs of ischemic stroke patients with and without rt-PA treatment at Srinagarind Hospital. Northeastern Journal of Neuroscience. 2020;15(1):41-53. (in Thai)
Chanthong T. Post-stroke nursing care in a patient with coexisting diabetes and hypertension: A case study. Photharam Hospital; 2024. (in Thai)
Bunsil S, Panichkul K. Factors related to quality of life among stroke patients. Journal of Boromarajonani College of Nursing, Bangkok. 2016; 32(2): 68–80. (in Thai)
Ariyavichanon P. Stroke patient rehabilitation. Sanpasit Medical Journal. 2016; 37(1–3): 43–58. (in Thai)
Ottenbacher KJ, Hsu Y, Granger CV, Fiedler RC. The reliability of the Functional Independence Measure: A quantitative review. Arch Phys Med Rehabil. 1996; 78(2): 131–136.
Wiwatwanich S, Chitapankul S, Kespitchyawan J. A study of readiness and needs of patients discharged from general and regional hospitals under the Ministry of Public Health: A one-day survey. Bangkok: Thai Geriatric Research and Development Institute Foundation; 2012. (in Thai)
Suksathien R. Access to inpatient acute stroke rehabilitation services at Maharaj Nakhon Ratchasima Hospital: Related factors and outcomes. Journal of Rehabilitation Medicine. 2014;24(2):37-43. (in Thai)
Orem DE, Taylor SG, Renpenning KM. Nursing: Concepts of practice. 5th ed. Boston: Mosby; 1995.
Suebsoddee A, Iamsawatikul W, Nuisorn M. Effects of a caregiver capability development program on stroke patients’ muscle rehabilitation in Phanom Dong Rak District, Surin Province. Nursing Journal. 2019;68(3):11–20. (in Thai)
Chaiwongnakphan C, Jinawin S, Yosthavi W. Effects of a support and education nursing program on stress and caregiver capability for patients with neurological problems. Southern College Network Journal of Nursing and Public Health. 2017;4(3):203–217. (in Thai)
Prateepwattanaphan V, Piyanut, Buaphet A. Effects of a supportive-educative nursing program on caregivers’ ability and stroke Muslim patients’ ADL performance. Ramathibodi Nursing Journal. 2021;27(3):343–359. (in Thai)
Sarawarangkul R, Chintapanayakun T, Lertprapai K. Effects of a nursing support and education program via LINE application on caregiver ability and stroke patients’ daily living at home. Royal Thai Police Nursing Journal. 2023;15(1):87–100. (in Thai)
Institute of Geriatric Medicine. Thai Mental State Examination: MMSE-Thai 2002. Nonthaburi: Ministry of Public Health; 1999.
Traiyawong D, Lakamphan S, Rawiwarakul T. Effects of a supportive-educative nursing program on caregivers’ ability to care for stroke patients at home [Master’s thesis in Community Nurse Practitioner]. Mahidol University; 2019. (in Thai)
Glass GV, Hopkins KD. Statistical methods in education and psychology. 3rd ed. Boston: Allyn & Bacon; 1996.
Cohen J. The t test for means. In: Statistical power analysis for the behavioral sciences. New York: Academic Press; 1988. p. 20–44.
Bureau of Geriatric Health, Department of Health, Ministry of Public Health. Standard guideline for elderly health promotion services in community and sub-district hospitals. Bangkok: Ministry of Public Health; 2018.
The National Pressure Ulcer Advisory Panel (NPUAP). NPUAP pressure injury stages. 2016.
Hongssoi S, Khunsongkiet W, Masingboon K. Effects of a continuous caregiver empowerment program on caregiver ability, activity performance, and complications in stroke patients. Journal of Community Development and Quality of Life. 2013;1(1):77–89. (in Thai)
Yubonpring J. Effects of swallowing rehabilitation on swallowing ability and aspiration in head and neck cancer patients after surgery [Master’s thesis in Nursing Science]. Mahidol University; 2009. (in Thai)
Senasana S, Komchakkaphan P, Isaramalai S. Development of a caregiver skill training program for home-based stroke patients. Journal of Preventive Medicine Association Thailand. 2017;7(2):212–22. (in Thai)
Sukkaset T, Iamsawasdikul W, Nuysorn M. Effects of a caregiver competence development program on caring for stroke patients in Thap Khlo District, Phichit Province. TJN Journal of Nursing. 2018;67(3):19–27. (in Thai)
Prateepwatthanapan V, Piyanuch, Buaphet A. Effects of a supportive and educational nursing program on caregivers’ competence and activities of daily living of Muslim stroke patients. Ramathibodi Nursing Journal. 2021;27(3):343–359. (in Thai)
Sarawarangkul R, Chintapanyakul T, Lertprapai K. Effects of a supportive and educational nursing program for caregivers via LINE application on caregivers’ competence and patients’ activities of daily living at home. Police Nursing Journal. 2023;15(1):87–100. (in Thai)
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Thai Public Health Nurses Association
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ตีพิมพ์และแผนภูมิรูปภาพถือเป็นลิขสิทธิ์ของวารสารพยาบาลสาธารณสุข (Thai Public Health Nurses Association)
