Impact of a mobile application-based home care nursing program on patients' quality of life and family burden.

OBJECTIVE: This study aims to identify the effectiveness of a mobile application-based home care nursing service in improving patient quality of life and healthy lifestyle and reducing the family burden. METHODS: This study was a clinical trial with a pre- and post-test control group design. The accessible population in this study was post-discharge patients from general hospitals in West Kalimantan and East Kalimantan, Indonesia, who required home care nursing. We allocated a selected sample of 40 people to the intervention group and 40 people to the control group using a randomized block design. We gave mobile application-based home care nursing to the intervention group and community health nursing care to the control group. This study was conducted in 10 months (January-October 2022). We measure the patient quality of life, healthy lifestyle, and family burden before and 3 months after the intervention. RESULTS: There was no significant difference in the post-test quality of life between the two groups (p = 0.187), but there was a significant difference in the psychological (p = 0.014) and environmental health (p = 0.021) domain of quality of life. There was no significant difference in the post-test of a healthy lifestyle between the two groups (p = 0.083). There was a significant difference in the post-test family burden between the two groups (p = 0.015). CONCLUSION: Mobile Application-Based Home Care Nursing is effective in improving patient quality of life in the psychological and environmental health domains and reducing the family burden for post-discharge patients.

The factors that influence the adaptation process 6 months after a stroke: A path analysis.

OBJECTIVE: The purpose of this study was to identify the determinant factors that influence the adaptation process and quality of life after a stroke. METHODS: This study is an observational study using a cross-sectional design. Respondents were patients who were 6 months post-discharge after non-hemorrhagic strokae and their family caregivers. Information about respondents was taken from medical record data at two regional general hospitals in West Kalimantan Province, Indonesia. A total of 80 patients were selected using a consecutive sampling method. Theoretical models of patient and caregiver factors that influence adaptation responses and post-stroke quality of life were tested using path analysis. RESULT: Caregiver coping, self-efficacy, and illness acceptance had a direct effect on the post-stroke psychosocial adaptation response by 58.1%, with self-efficacy contributing the most (ß = 0.668, P < .0001). Self-efficacy, illness acceptance, and healthy behavior had a direct effect on the physiological adaptation response by 24.3%, where self-efficacy also contributed the most (ß = 0.272, P < .014). Psychosocial adaptation and physiological adaptation had a direct effect on the quality of life by 54.6%, where psychosocial adaptation showed the largest contribution (ß = 0.63, P < .0001). CONCLUSION: Self-efficacy contributes the most to both psychosocial and physiological adaptations 6 months after stroke. Psychosocial adaptation and self-efficacy have been proven to be the determinant factors that contribute the most to the quality of life of patients 6 months after stroke.

[The effective post-stroke adaptation behavior model requires a family support system]. / El efectivo modelo de comportamiento de adaptación postapoplejía requiere un sistema de apoyo familiar.

PURPOSE: This study aimed to explain the effective post-stroke adaptation behavior based on the Roy's adaptation model (RAM) through the patient experiences when undergoing the adaptation process after stroke. METHODS: This study was qualitative used a phenomenological approach. The participants were patients undergoing post-stroke recovery at home with the following inclusion criteria: post-discharge from the hospital 2-3 months, and in stable medical condition. The data were collected through in-depth interviews. The data analysis was performed through content analysis. We used Lincoln and Guba's criteria to establish the trustworthiness of the study. RESULTS: Three thematic categories structured the meaning of the stroke survivor's experience: (1) Problems after stroke; (2) Adaptive coping strategies and (3) Effective adaptation response. CONCLUSION: A thematic analysis integrated with Roy's adaptation model generated an effective post-stroke adaptation model. We recommend the development of a family empowerment intervention framework to improve the adaptation behavior of stroke survivors.

Los factores que influyen en el proceso de adaptación 6 meses después de un ictus: un análisis de trayectoria / The factors that influence the adaptation process 6months after a stroke: A path analysis

Objetivo: El propósito de este estudio fue identificar los factores determinantes que influyen en el proceso de adaptación y calidad de vida después de un ictus. Métodos: Este estudio es un estudio observacional utilizando un diseño transversal. Se encuestaron pacientes 6 meses después de su alta tras un accidente cerebrovascular no hemorrágico y sus familiares cuidadores. La información sobre los encuestados se obtuvo de los datos de registros médicos en dos hospitales generales regionales en la provincia de Kalimantan Occidental, Indonesia. Se seleccionó un total de 80 pacientes mediante un método de muestreo consecutivo. Los modelos teóricos de los factores del paciente y del cuidador que influyen en las respuestas de adaptación y la calidad de vida posterior al accidente cerebrovascular se probaron mediante análisis de ruta. Resultados: El afrontamiento, la autoeficacia y la aceptación de la enfermedad del cuidador tuvieron un efecto directo en la respuesta de adaptación psicosocial posterior al ictus en un 58,1%, siendo la autoeficacia la que más contribuyó (β=0,668, p<0,0001). La autoeficacia, la aceptación de la enfermedad y el comportamiento saludable tuvieron un efecto directo en la respuesta de adaptación fisiológica en un 24,3%, donde la autoeficacia también contribuyó en mayor medida (β=0,272, p<0,014). La adaptación psicosocial y la adaptación fisiológica tuvieron un efecto directo en la calidad de vida del 54,6%, donde la adaptación psicosocial presentó la mayor contribución (β=0,63, p<0,0001). Conclusión: La autoeficacia contribuye más a las adaptaciones psicosociales y fisiológicas 6 meses después del accidente cerebrovascular. La adaptación psicosocial y la autoeficacia han demostrado ser los factores determinantes que más contribuyen a la calidad de vida de los pacientes 6 meses después del ictus.(AU)

Objective: The purpose of this study was to identify the determinant factors that influence the adaptation process and quality of life after a stroke. Methods: This study is an observational study using a cross-sectional design. Respondents were patients who were 6 months post-discharge after non-hemorrhagic stroke and their family caregivers. Information about respondents was taken from medical record data at two regional general hospitals in West Kalimantan Province, Indonesia. A total of 80 patients were selected using a consecutive sampling method. Theoretical models of patient and caregiver factors that influence adaptation responses and post-stroke quality of life were tested using path analysis. Results: Caregiver coping, self-efficacy, and illness acceptance had a direct effect on the post-stroke psychosocial adaptation response by 58.1%, with self-efficacy contributing the most (β=0.668, p<0.0001). Self-efficacy, illness acceptance, and healthy behavior had a direct effect on the physiological adaptation response by 24.3%, where self-efficacy also contributed the most (β=0.272, p<0.014). Psychosocial adaptation and physiological adaptation had a direct effect on the quality of life by 54.6%, where psychosocial adaptation showed the largest contribution (β=0.63, p<0.0001). Conclusion: Self-efficacy contributes the most to both psychosocial and physiological adaptations 6 months after stroke. Psychosocial adaptation and self-efficacy have been proven to be the determinant factors that contribute the most to the quality of life of patients 6 months after stroke.(AU)

El efectivo modelo de comportamiento de adaptación postapoplejía requiere un sistema de apoyo familiar / The effective post-stroke adaptation behavior model requires a family support system

Objetivo: El objetivo de estudio es explicar el comportamiento efectivo de adaptación postaccidente cerebrovascular, basado en el modelo de adaptación de Roy (RAM), a través de las experiencias del paciente que se somete al proceso de adaptación después del accidente cerebrovascular.Métodos: Estudio cualitativo con enfoque fenomenológico. Los participantes fueron pacientes en recuperación postaccidente cerebrovascular, en casa, con los siguientes criterios de inclusión: dos a tres meses tras el alta del hospital y en condición médica estable. Los datos fueron recogidos a través de entrevistas en profundidad. El análisis de datos se realizó a través del análisis de contenido. Usamos los criterios de Lincoln y Guba para establecer la confiabilidad del estudio.Resultados: Tres categorías temáticas estructuran el significado de la experiencia del sobreviviente del accidente cerebrovascular: 1) problemas después del accidente cerebrovascular; 2) estrategias de afrontamiento adaptables y 3) respuesta de adaptación efectiva.Conclusión: Un análisis temático integrado con el modelo de adaptación de Roy generó un modelo de adaptación postaccidente cerebrovascular efectivo. Recomendamos el desarrollo de un marco de intervención familiar para mejorar la adaptación de los supervivientes a un accidente cerebrovascular.

Purpose: This study aimed to explain the effective post-stroke adaptation behavior based on the Roy's adaptation model (RAM) through the patient experiences when undergoing the adaptation process after stroke.Methods: This study was qualitative used a phenomenological approach. The participants were patients undergoing post-stroke recovery at home with the following inclusion criteria: post-discharge from the hospital 2–3 months, and in stable medical condition. The data were collected through in-depth interviews. The data analysis was performed through content analysis. We used Lincoln and Guba's criteria to establish the trustworthiness of the study.Results: Three thematic categories structured the meaning of the stroke survivor's experience: (1) Problems after stroke; (2) Adaptive coping strategies and (3) Effective adaptation response.Conclusion: A thematic analysis integrated with Roy's adaptation model generated an effective post-stroke adaptation model. We recommend the development of a family empowerment intervention framework to improve the adaptation behavior of stroke survivors.