The effect of family-centered empowerment model on the quality of life of adults with chronic diseases: An updated systematic review and meta-analysis

Effect of Family-Centered Empowerment Model in Home Care of Older Adult Patients After Total Knee Arthroplasty

PURPOSE

In the present study, we investigated the effect of the family-centered empowerment model (FCEM) in the home care of older adult patients after total knee arthroplasty (TKA).

DESIGN

The current study was a randomized controlled study.

METHODS

Two hundred eighty older adult patients who underwent TKA in our hospital from December 2020 to December 2022 were selected. They were divided into intervention and control groups using the random number table method, with 140 cases in each group. After follow-up and attrition, 133 patients were assigned to the intervention group and 130 to the control group. The control group received conventional care, and the intervention group received the care provided using the FCEM. The general characteristics of the study subjects were compiled using a general information questionnaire designed by the researcher. The chi-square test and t-test were used to compare the changes in self-care efficacy, knee function, and the occurrence of postoperative complications in the two groups before and after the intervention.

FINDINGS

The results suggest that the adoption of FCEM improved patient motivation and self-care efficacy, promoted the recovery of knee function in the short term after surgery, and reduced the likelihood of occurrence of complications.

CONCLUSION

The present study highlights the importance of extending the FCEM to multiple domains to fill the gaps in the currently available medical care system for older adults. In addition, the study provides a reference basis for reducing the occurrence of complications and improving patient prognosis.

CLINICAL EVIDENCE

The FCEM model is an effective strategy to improve the effectiveness of home nursing for older adults.

Effectiveness of family centred interventions for family caregivers: A systematic review and meta-analysis of randomized controlled trials

AIMS AND OBJECTIVES

To examine the effectiveness of family-centred interventions among family caregivers.

BACKGROUND

Family-centred interventions are an emerging form of intervention that can be effective at improving physical and mental health outcomes for patients and family caregivers. To date, no reviews have examined the effectiveness of family-centred interventions for family caregivers.

DESIGN

A systematic review, including a meta-analysis, was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA 2020) checklist.

METHODS

Seven English and two Chinese electronic databases were compressively searched from the outset to March 2023. Two researchers independently reviewed the abstracts and full texts, extracted the data and assessed the risk of bias independently by using the Cochrane 'Risk of bias assessment tool'.

RESULTS

This systematic review and meta-analysis included 20 articles. The results of the meta-analysis showed that family-centred interventions could significantly improve caregiver burden (p=0.003), quality of life (p = 0.007), depression (p = 0.0002), and stress (p < 0.0001) but not anxiety or family functioning. According to our subgroup analysis, the family-centred empowerment model (p = 0.009) was superior to the other family intervention (p=0.004) in reducing caregiver burden. Family-centred interventions are more effective at reducing the burden of caregiving on family caregivers of adolescent patients (SMD=-0.79, 95% CI[-1.22,-0.36], p = 0.0003) than on adult patients (SMD=-0.37, 95% CI [-0.61,-0.12], p = 0.004).

CONCLUSIONS

Family-centred interventions could enhance family caregivers' burden, quality of life, stress and depression but had no significant impact on anxiety or family functioning.

RELEVANCE TO CLINICAL PRACTICE

Family-centred interventions have the potential to improve the health status and caregiving burden of family caregivers. Rigorous and high-quality evidence is needed to confirm the long-term effects of these interventions on family caregivers.

TRIAL REGISTRATION DETAILS

The protocol has been registered in the PROSPERO international prospective register of systematic reviews (Protocol registration ID: CRD42023453607).

Cardiac Rehabilitation Using the Family-Centered Empowerment Model is Effective in Improving Long-term Mortality in Patients with Myocardial Infarction: A 10-year Follow-Up Randomized Clinical Trial

INTRODUCTION

Cardiac rehabilitation (CR) play a critical role in reducing the risk of future cardiovascular events and enhancing the quality of life for individuals who have survived a heart attack.

AIM

To assess the mortality rates and stability of the effects in myocardial infarction (MI) survivors after implementing a Family-Centered Empowerment Model (FCEM)-focused hybrid cardiac rehabilitation program.

METHODS

This double-blind randomized controlled clinical trial, conducted at Shariati Hospital, an academic teaching hospital in Tehran, Iran (2012-2023), involved 70 MI patients and their families. Participants were randomly assigned to an FCEM intervention group or standard CR control group. The intervention commenced after the MI patient's safe discharge from the CCU and continued for the entire 10-year follow-up period. Various questionnaires were utilized to collect data on mortality rates and health-related quality of life (HRQoL).

RESULTS

The 10-year follow-up period revealed lower mortality rates in the intervention group (5.7%, 11.4%, and 17.1% at 5, 7, and 10 years, respectively) compared to the control group (20%, 37.1%, and 48.9%). After adjusting for age, gender, and BMI, the control group had a four times higher mortality risk (HR: 4.346, 95% CI 1.671-7.307, P = 0.003). The FCEM-focused program demonstrated a significant and sustained positive impact on participants' quality of life for 48 months, with greater improvement compared to the control group.

CONCLUSION

This study highlights the effectiveness of FCEM-based hybrid CR programs in enhancing long-term patient outcomes and reducing mortality rates among MI survivors. Further research is needed to explore the potential benefits in larger samples and diverse populations.

TRIAL REGISTRATION

This study (Identifier: NCT02402582) was registered in the ClinicalTrials.gov on 03/30/2015.

Effect of support based on family centered empowerment model on care burden in family caregivers of patients with multiple sclerosis

Introduction

Family caregivers of patients with multiple sclerosis (MS) are at risk of care burden that may lead to a detrimental effect on their quality of life (QoL), physical and mental well-being. This study aimed to determine the effect of the family-centered empowerment model (FCEM) on the care burden of caregivers of patients with MS.

Methods

This quasi-experimental study was conducted using convenience sampling on 60 caregivers of patients referring to the Multiple Sclerosis Clinic in Ghaem Hospital, Mashhad, Iran. The participants were assigned to FCEM and control groups based on the days they were referred to the MS clinic. Data collection tools included the Zarit Caregiver Burden Inventory (CBI), completed in the intervention and control groups before and 1 month after the intervention. The support based on FCEM was provided during eight 45-60-min sessions, and the control group received the medical center's routine training. Data were analyzed by Chi-square, independent t-test, analysis of covariance, and repeated measure tests.

Results

The results of the present study showed that all demographic characteristics were homogeneous at the baseline. Before the intervention, no significant difference was observed between the two groups regarding mean scores of care burden. Based on the repeated measure test, there was no significant treatment and time interaction in changes in care burden.

Conclusion

The FCEM has no significant effect in alleviating the care burden. It is recommended to observe the necessary considerations regarding the context of this type of intervention and to carry out further investigations in different intervals.

Application of family-centered empowerment model in primary caregivers of premature infants: A quasi-experimental study

Objective

To explore the effect of the family-centered empowerment model (FECM) on reducing anxiety, improving care ability, and readiness for hospital discharge of main caregivers of preterm infants.

Methods

The primary caregivers of preterm infants who were admitted to the Neonatal intensive care Unit (NICU) of our center from September 2021 to April 2022 were selected as the research objects. According to the wishes of the primary caregivers of preterm infants, they were divided into group A (FECM group) and group B (non-FECM group). The intervention effects were evaluated with the Anxiety Screening Scale (GAD-7), the Readiness for Hospital Discharge Scale-Parent Version (RHDS-Parent Form), and the Primary Caregivers of Premature Infants Assessment of Care Ability Questionnaire.

Results

Before the intervention, there was no statistically significant difference in the general information, anxiety screening, the scores of each dimension, and total score of the comprehensive ability of the main caregivers, and the score of caregiver preparedness between the two groups (P > 0.05). After the intervention, there were statistically significant differences in the anxiety screening, the total score and total score of each dimension of the care ability, and the score of caregiver preparedness between the two groups (P < 0.05).

Conclusions

FECM can effectively reduce the anxiety of primary caregivers of premature infants and improve their readiness for hospital discharge and care ability. To improve the quality of life of premature infants by implementing personalized training, care guidance, and peer support.