Development of a nursing care manual for supporting the caregiving careers of families of patients with cerebrovascular disease or senile dementia

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The objective of the present study was to develop a nursing intervention method for supporting caregiving careers by determining the care activities of family members living with patients with cerebrovascular disease or senile dementia and elucidating the causal and background factors that promote or hinder the progress of caregiving careers. Based on a caregiving career model for families providing care for patients with cerebrovascular disease or senile dementia, we used a five-stage process, which included the extraction of conditions affecting the establishment of the caregiving careers of families, comparison of the caregiving careers of families for different diseases, and the assessment and refinement of care guidelines using the focus group method, to determine nursing care that contributes to the establishment and development of the caregiving careers of families and thereby created a "Care guideline for supporting the caregiving careers of families". This guideline comprised … More five items as follows : 1) About the caregiving careers of families, 2) Points for understanding the caregiving careers of families, 3) Formation of relationships involving care in the family, 4) Selection of nursing intervention that supports the caregiving careers of families based on the family empowerment model, and 5) Materials. The following types of nursing care were found to be effective for promoting the caregiving careers of families : "nursing that promotes the value of caregiving" for "nursing that supports the foundation of caregiving careers" ; "nursing that supports the development of the wisdom accumulated in the family" and "nursing that promotes the formation of open-minded communication" for "nursing that supports the establishment of caregiving careers" ; "nursing that supports the maintenance of the personality of the patient", "nursing that supports the maintenance of the characteristics of the family", "nursing that solidifies one's position as a caregiver through acquisition of the power to control", "nursing that supports the establishment of grounds for self confidence", and "nursing that supports the acquisition of confidence" for "nursing that supports the development of caregiving careers" ; and "nursing that supports the establishment of boundaries", "nursing that enhances the certainty of what has been recognized", and "nursing that enhances the certainty of relationships with patients" for "nursing for breaking vicious cycles". The following factors were identified as nursing interventions that support family empowerment for these types of nursing care : "increasing support for the daily lives and self care of the family", "providing emotional support for the family", "educating family members", "enhancing the coping behavior and ability of the family", "harmonization and enhancement of family relationships and promotion of communication", "management of responsibilities in the family", "utilization of relatives and local social resources", and "support and advocacy for the family's decision-making". Less