Identifying Required Skills to Enhance Family Caregiver Competency in Caring for Individuals With Spinal Cord Injury Living in the Community

Explaining the challenges of Iranian caregivers in provision of home health care to spinal cord injury patients: a qualitative study

BACKGROUND

The incidence of spinal cord injury (SCI) is increasing across the globe. The caregivers of patients with spinal cord injuries experience many problems during providing care to these patients. Identifying the problems experienced by caregivers can facilitate the process of care provision to these patients. So, the aim of this study was to explore the challenges of caregivers in provision of home health care to SCI patients.

METHODS

This study was conducted by qualitative description approach in Iran from Apr 2021 to Dec 2022. The participants included the caregivers of SCI patients recruited by purposive sampling. The data were collected by face-to-face interviews and analyzed using the method proposed by Lundman and Graneheim.

RESULTS

Two themes emerged from the data analysis, including burnout (with the categories of physical challenge and psychological challenges) and coping strategies (with the categories of social support and professional support).

CONCLUSION

Resolving the obstacles and problems faced by home caregivers can improve the circumstances of care provision so that they can be relieved of their own physical and psychological conundrums and deliver suitable home care to SCI patients.

TRIAL REGISTRATION NUMBER

Not applicable.

The Learning Transfer of Dementia Training Program Participants: Its Antecedents and Mediating Effect on the Job Competency of Geriatric Caregivers

This study examined how learning transfer and its antecedents impacted job competency among geriatric caregivers who underwent dementia training. The dementia training program of the National Health Insurance Service of South Korea was selected for this study. The participants included caregivers who provided care to patients with dementia at 3-12 months post-training. A hierarchical regression analysis was used to verify the research model. The results are summarized as follows: First, transfer opportunity and transfer intention were antecedent variables with a statistically significant positive effect on the near transfer of learning. Second, self-efficacy, the instructor's role, and transfer intention were antecedent variables with a statistically significant positive effect on the far transfer of learning. Third, the near transfer of learning had a statistically significant effect on all six competency variables (communication, problem solving, interpersonal relationships, skills, self-development, and work ethics). Fourth, the far transfer of learning had a statistically significant static effect on all six competency variables, although the size of the influence on competency enhancement was relatively small compared with the near transfer of learning. This study confirmed the effects of various transfer climate-related variables in a training program on job competency, suggesting that the learning transfer of caregivers who underwent dementia training is a significant mediating variable. The limitations of this study and directions for future research are also discussed. The learning transfer of caregivers who underwent this training enhanced their job competencies.

Investigating the Effectiveness of a Family Intervention after Acquired Brain or Spinal Cord Injury: A Randomized Controlled Trial

(1) Background: Acquired brain injury (ABI) or spinal cord injury (SCI) constitutes a severe life change for the entire family, often resulting in decreased quality of life (QoL) and increased caregiver burden. The objective of this study was to investigate the effectiveness of a family intervention in individuals with ABI or SCI and in their family members. (2) Methods: An RCT of a family intervention group (FIG) vs. a psychoeducational group (PEG) (ratio 1:1) was performed. The FIG received an eight-week manual-based family intervention, and the PEG received one psychoeducational session. Self-reported questionnaires on QoL with the Mental Component Summary (MCS) and on caregiver burden with the Caregiver Burden Scale (CBS) were the primary outcomes. The data analysis involved linear mixed-effects regression models. (3) Results: In total, 74 participants were allocated randomly to the FIG and 84 were allocated randomly to the PEG. The FIG had significantly larger improvements on the MCS and significantly larger reductions on the CBS at the two-month follow-up than participants in the PEG (mean differences of 5.64 points on the MCS and -0.26 points on the CBS). At the eight-month follow-up, the between-group difference remained significant (mean difference of 4.59 points) on the MCS, whereas that on the CBS was borderline significant (mean change of -0.14 points). (4) Conclusions: Family intervention was superior to psychoeducation, with larger improvements in QoL and larger reductions in caregiver burden.

Family caregiving research: Reflecting on the past to inform the future

OBJECTIVE

Family caregiving research has evolved since its inception in the late 1970s. The objective of this brief report was to summarize the research areas and findings to date with the goal of highlighting directions for future research.

DESIGN

Narrative review.

SETTING

Not applicable.

PARTICIPANTS

Published scientific articles in neurological populations including spinal cord injury, traumatic brain injury, and stroke.

INTERVENTIONS

Not applicable.

OUTCOME MEASURES

Not applicable.

RESULTS

Caregiving research began with a description of the impact of providing care on caregiver health and wellbeing. Intervention research followed to support caregivers in their role and improve caregiving outcomes. Recent reviews conclude a "one size fits all" intervention will not be sufficient to support caregivers. New research suggests caregivers have different patterns of adjustment to the caregiving role highlighting heterogeneity in the caregiving population. Research is also advancing to support patients and families as they transition across care environments by enhancing the timing of intervention delivery. Health care systems do not routinely adopt evidence-based caregiver interventions. As a result, recent research has begun to identify factors that influence the adoption of evidence-based caregiver interventions by health care systems. Ultimately, family centered care that addresses the needs of not only the patient but also the caregiver may be the best way to meet the needs of a heterogeneous group of caregivers across the care continuum.

CONCLUSIONS

Family caregivers make an important contribution to the health and wellbeing of individuals with spinal and other neurological conditions. Ultimately, system changes, like family centered care, may be best suited to meet the complex needs of this heterogeneous group of caregivers.