Quasi-Experimental Study of Caregiver Training Using the PRECEDE-PROCEED Model for Stroke Home Care

Abstract

Background: Caregivers of home care patients with stroke cope with physical, psychological, social, and economic problems. In addition, their inexperience in patient care affects patient outcomes.

Objectives: This study aimed to evaluate the effect of a training program based on the PRECEDE-PROCEED Model on caregivers of home care of persons with stroke on caregivers' caregiving responses, perceived social support levels, and patient outcomes.

Methods: The study was conducted with 70 stroke patients and 70 caregivers using a quasi-experimental design between July and December 2023. Caregivers were assessed using the "Caregiver Personal Information Form," "Caregiver Reaction Rating Scale," and "Multidimensional Perceived Social Support Scale." Home care patients with stroke were evaluated using the "Patient Personal Information Form," "Braden Pressure Injury Risk Assessment Scale," and "Hospital Admission Follow-up Form."

Results: The caregivers who participated in the study had a mean age of 53 years, and 76% were female. In addition, 84% received care support. Many caregivers simultaneously had a chronic disease, were first-degree relatives of the patient, and required assistance in providing patient care. Over time, a significant improvement was observed in caregivers' responsiveness and perceived social support. Regarding patient outcomes following the intervention, notable improvements were found in the incidence of aspiration/pneumonia, incontinence, constipation, diarrhea, and falls. The risk of pressure injury significantly decreased over time. Furthermore, hospitalization rates showed a marked reduction after the intervention.

Discussion: The training program based on the PRECEDE-PROCEED Model led to positive changes in caregiving responses and the perceived social support of caregivers of stroke patients. The training program was also associated with improved patient outcomes. These findings suggest that the PRECEDE-PROCEED Model can be effectively utilized for caregivers of home care patients with stroke.

Keywords: caregivers; home care services; stroke.