1
|
Zhang W, Gao Y, Ye M, Zhou L. Post-stroke family resilience is correlated with family functioning among stroke survivors: The mediating role of patient's coping and self-efficacy. Nurs Open 2024; 11:e2230. [PMID: 38940513 PMCID: PMC11212063 DOI: 10.1002/nop2.2230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/28/2024] [Accepted: 06/17/2024] [Indexed: 06/29/2024] Open
Abstract
AIM Family resilience and healthy family functioning are crucial for stroke survivors' rehabilitation. This study aimed to determine the mediating effects of self-efficacy and confrontation coping on the relationship between family resilience and functioning among patients with first-episode stroke. DESIGN A cross-sectional design was applied. METHODS 288 patients with first-episode stroke were recruited from 7 hospitals in Shangqiu and Shanghai, China, from July 2020 to October 2020. A shortened Chinese version of the Family Resilience Assessment Scale, family adaptation, partnership, growth, affection and resolve questionnaire, Medical Coping Modes Questionnaire, and Self-efficacy for Chronic Disease 6-item Scale were used to collect the self-reported data. The relationships among the studied variables were studied using spearman correlation and structural equation model. RESULTS The average level of family functioning among stroke patients was 7.87 (SD = 2.32). About 26.8% (n = 76) of patients reported family dysfunction. The structural equation model showed that family resilience directly affected patients' satisfaction with family functioning (r = 0.406, p < 0.001) and indirectly affected the mediating role of patients' self-efficacy and confrontation coping style (r = 0.119, p < 0.001). The model was with good fit (χ2/df = 2.128, RMSEA = 0.065, GFI = 0.956, AGFI = 0.919, NFI = 0.949, and TLI = 0.956). CONCLUSION Family resilience and functioning among patients with first-episode stroke are positively associated with the mediating effects of the patients' confrontation coping style and self-efficacy between family resilience and functioning. The findings indicate that the professionals should pay special attention to families exhibiting poor family resilience or with patients who rarely use confrontation coping styles or with poor self-efficacy since they are more likely to suffer from low functioning.
Collapse
Affiliation(s)
- Wei Zhang
- Department of Clinical Nursing, Nursing SchoolNaval Medical UniversityShanghaiChina
| | - Ya‐Jing Gao
- Department of Clinical Nursing, Nursing SchoolNaval Medical UniversityShanghaiChina
| | - Ming‐Ming Ye
- Department of Clinical Nursing, Nursing SchoolNaval Medical UniversityShanghaiChina
| | - Lan‐Shu Zhou
- Department of Clinical Nursing, Nursing SchoolNaval Medical UniversityShanghaiChina
| |
Collapse
|
2
|
Zhang W, Ye M, Zhou W, Gao Y, Zhou L. Trajectory and predictors of family function in caregivers of stroke survivors: A longitudinal study of the first 6 months after stroke. J Adv Nurs 2024; 80:264-274. [PMID: 37395440 DOI: 10.1111/jan.15749] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 05/04/2023] [Accepted: 06/10/2023] [Indexed: 07/04/2023]
Abstract
AIMS This study aimed to investigate the trajectory and predictors of family function in caregivers of stroke survivors during the first 6 months after the first episode of stroke. DESIGN Longitudinal study. METHODS A total of 288 primary caregivers of patients with first-time stroke were recruited from seven tertiary hospitals in China between July 2020 and March 2021. The following characteristics were assessed by caregivers at hospitalization (T0) and at 1 month (T1), 3 months (T2) and 6 months (T3) after the stroke: family function, general self-efficacy, social support, coping style, caregiver burden, and sociodemographic and clinical data. RESULTS Family function scores among caregivers of stroke survivors were highest in the resolve dimension and lowest in the growth and adaptation dimensions within the first 6 months. The percentages of families with low functioning were 34.7%, 33.3%, 24.8% and 17.7% at T0, T1, T2 and T3, respectively. The generalized estimating equation model revealed that family function in caregivers increased over the first 6 months (Exp(B) = 1.415-2.689, p < .05). The following factors were identified as predictors of family functioning: caregiver's age, education, residential district, self-efficacy, social support utilization and caregiver burden. CONCLUSIONS Family function of caregivers of stroke survivors gradually increased during the first 6 months after stroke. However, some families demonstrated poor functioning. Caregivers' age, education, caregiver burden, self-efficacy and social support utilization could predict family function over time. IMPACT Empirical data on family function in families of stroke survivors are important for developing psychosocial interventions that can help families adapt to stroke. This study found that families of stroke survivors were likely to be dysfunctional in the first 6 months after stroke, particularly in family growth and adaptation. Therefore, reducing caregiver burden and promoting self-efficacy and social support utilization can help restore family functioning early after stroke. PATIENT OR PUBLIC CONTRIBUTION Stroke caregivers from seven hospitals in China were involved in this study and had the right to be informed of the main findings. A few patients were informed of the research results, who contributed to the dissemination.
Collapse
Affiliation(s)
- Wei Zhang
- Department of Clinical Nursing, College of Nursing, Second Military Medical University, Shanghai, China
| | - Mingming Ye
- Department of Clinical Nursing, College of Nursing, Second Military Medical University, Shanghai, China
| | - Wanqiong Zhou
- Department of Clinical Nursing, College of Nursing, Second Military Medical University, Shanghai, China
| | - Yitian Gao
- Department of Clinical Nursing, College of Nursing, Second Military Medical University, Shanghai, China
| | - Lanshu Zhou
- Department of Clinical Nursing, College of Nursing, Second Military Medical University, Shanghai, China
| |
Collapse
|
3
|
Rasmussen MS, Howe EI, Andelic N, Soberg HL. Associations between protective resources and family functioning after traumatic brain injury: A cross-sectional study using a structural equation modeling approach. NeuroRehabilitation 2023; 52:47-58. [PMID: 36617761 PMCID: PMC9912729 DOI: 10.3233/nre-220131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/13/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND A strength-based approach in the rehabilitation after traumatic brain injury (TBI) is recommended for patients and their families. However, further exploration of the complexity of individual and family factors is needed. OBJECTIVE To explore the associations between individual protective resources in patients and family members and the overall family functioning using a strength-based approach. METHODS Secondary analysis of data collected at baseline in a randomized controlled trial. Structural equation modeling with two latent constructs and six observed variables was performed. Outcome measures included the Resilience Scale for Adults, the Mental Component Summary (SF-36), the General Self-Efficacy Scale, and the Family Adaptability and Cohesion Evaluation Scale-IV. RESULTS Hundred and twenty-two participants (60 patients, 62 family members) with a mean age of 43 years were included at a median of 11 months post-injury. The final model demonstrated a strong covariance (coefficient = 0.61) between the latent Protective construct and Family functioning. Model-fit statistics indicated an acceptable fit to the data. CONCLUSION Higher levels of protective resources (resilience, self-efficacy, and mental HRQL) were positively associated with family functioning. These resources should be further assessed in patients and their families, to identify factors that can be strengthened through TBI rehabilitation intervention.
Collapse
Affiliation(s)
- Mari S. Rasmussen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Emilie I. Howe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Helene L. Soberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Met - Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
4
|
Self-Efficacy and Psychological Well-Being of Family Caregivers of Persons with Spinal Cord Injury. PSYCHOLOGICAL STUDIES 2022. [DOI: 10.1007/s12646-022-00659-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
5
|
Affiliation(s)
- Tomoyuki Kawada
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan,Correspondence to: Tomoyuki Kawada, Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-Ku, Tokyo113-8602, Japan; Ph: 81-3-3822-2131.
| |
Collapse
|
6
|
Baumgartner-Dupuits M, Sep SJS, Verbunt J, Bosma H, van Eijk J. Peer Support to Enhance Social and Emotional Self-Management Following Acquired Brain Injury Rehabilitation: Design of a Pre-post Study With Process Evaluation. Front Neurol 2021; 12:647773. [PMID: 34393968 PMCID: PMC8360636 DOI: 10.3389/fneur.2021.647773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 06/28/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Specialized rehabilitation following acquired brain injury provides intensive multidisciplinary treatment to individuals with complex disabilities for optimizing recovery and supporting a safe transition to the community. Post-specialist rehabilitation, patients and caregivers have reported a need for support. We present the design of an implementation study to evaluate a new self-management support service for individuals with acquired brain injury and their caregivers. Methods: This is a pre–post intervention study with a mixed-method design. The study population comprises individuals aged ≥18 years with acquired brain injury living independently following specialized rehabilitation in the Southern part of the Netherlands. All participants receive a post-rehabilitation support service. The support service consists of several house visits by a peer support volunteer in the first weeks after specialized rehabilitation treatment. The peer support volunteers are trained according to an adapted version of the previously developed Self-Management Support (SMS) program. The SMS program is directed at improving social and emotional self-management. Patient outcomes are assessed by questionnaire pre-, directly post-, and 6 months post-intervention. The primary patient outcome measure is self-efficacy. Secondary outcomes are perceived autonomy, quality of life, and psychological well-being. A process evaluation will be performed to gain insight into barriers and facilitators for the implementation of peer-led SMS by combining both quantitative, questionnaire data and qualitative data derived from focus groups with peer supporters and patients. In a workshop with relevant stakeholders, possibilities for dissemination and sustainability will be explored. Discussion: This paper describes the design of a practice-based study on feasibility, barriers, and facilitators to the implementation of a home-based, peer-led self-management support intervention for patients with acquired brain injury. We will quantitatively and qualitatively evaluate the change in relevant patient outcomes pre- and post-intervention and the barriers and facilitators related to the implementation of the intervention. Following a positive evaluation, the final stage of the study aims to facilitate deployment and utilization of the intervention.
Collapse
Affiliation(s)
- Milou Baumgartner-Dupuits
- Care and Public Health Research Institute (Caphri), Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Department of Rehabilitation Medicine, Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands
| | - Simone J S Sep
- Care and Public Health Research Institute (Caphri), Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Department of Rehabilitation Medicine, Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands
| | - Jeanine Verbunt
- Care and Public Health Research Institute (Caphri), Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Department of Rehabilitation Medicine, Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands
| | - Hans Bosma
- Care and Public Health Research Institute (Caphri), Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands
| | - Jacques van Eijk
- Care and Public Health Research Institute (Caphri), Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands.,Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, University Maastricht, Maastricht, Netherlands
| |
Collapse
|
7
|
Wensu Z, Xidi Z, Shaojie L, Baohua Z, Yunhan Y, Huilan X, Zhao H, Xiyue X. Does the Presence of Anxiety and Depression Symptoms Mediate the Association Between Family Functions and Self-Efficacy in Pregnant Women in the Third Trimester?: A Community-Based Cross-Sectional Survey. Front Psychiatry 2021; 12:726093. [PMID: 34803756 PMCID: PMC8599816 DOI: 10.3389/fpsyt.2021.726093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Pregnant women in the third trimester can be more vulnerable to adverse mental health outcomes, but there is limited research on the association between family function and self-efficacy and potential mediation by symptoms of anxiety and depression. Methods: The cross-sectional study enrolled 813 pregnant women in the third trimester from 14 communities of Hengyang city, Hunan province of China. All of the participants completed a battery of self-report measures of family function (Family Adaptation Partnership Growth and Resolve Index, APGAR-family), self-efficacy (General Self-Efficacy Scale, GSES), anxiety (measured by Generalized Anxiety Disorder scale with seven items, GAD-7), and depression symptoms (Patient Health Questionnaire with nine items, PHQ-9). The correlation analysis was performed using Spearman's correlation coefficient. Baron and Kenny's method and multiple mediation models with bootstrapping were used to determine whether the symptoms of anxiety and depression mediated the association between family functions and self-efficacy. Results: There were 22.6% pregnant women in the low level of self-efficacy, with 60.9% in the moderate level and 16.5% of respondents in the high level. Self-efficacy had significant correlations with both anxiety symptoms (r = -0.19, p < 0.05), depression symptoms (r = -0.22, p < 0.05), and family function (r = 0.31, p < 0.05). Anxiety symptoms were significantly associated with self-efficacy (β = -0.016, p < 0.05). Depression symptoms were significantly associated with self-efficacy (β = -0.024, p < 0.05). Anxiety and depression symptoms partly mediated the association between family function and self-efficacy, accounting for 11.4 and 16.4% of total effect, respectively. It was indicated that pregnant women with a high degree of family function are less likely to have emotional symptoms and predicted to have higher levels of self-efficacy. Conclusions: Anxiety and depression show mediating effects in the association between family function and self-efficacy. Improved family function can have a positive impact on pregnant women in the third trimester.
Collapse
Affiliation(s)
- Zhou Wensu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhu Xidi
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Li Shaojie
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zheng Baohua
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yu Yunhan
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xu Huilan
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Hu Zhao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xiong Xiyue
- NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China.,Department of Child Rehabilitation, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
| |
Collapse
|