Enhanced self-efficacy training for informal cancer caregivers

在家庭护理中，症状管理是必不可少的。然而，许多非正式的照顾者并不是 他们相信自己有能力在家中帮助亲人解决癌症症状。低水平的 自信或自我效能感可能会对照顾者的心理健康产生负面影响，而这种影响已经 由于照顾他人而变得脆弱。因为照顾者和病人之间的互惠关系， 照顾者的减少很可能与患者的减少有关。提高照顾者的自我效能感以管理他们的 亲人的癌症相关症状可能会缓解他们的心理衰退，并可能对 通过减轻患者的症状痛苦来提高患者的幸福感。此外，自我管理压力的培训 可能会促进照顾者的应对，因为许多数据表明，照顾者的压力是巨大的。 这项研究将检验增强的护理员培训方案对非正式护理人员的影响 癌症患者出院前的照顾者。主要目的是测试培训的效果 照顾者在癌症症状管理中的自我效能感和在压力自我管理中的自我效能。 这项研究还将考察这种培训对照顾者结果的影响(抑郁、焦虑、质量 生活、照顾者压力)和患者结局(症状困扰和强度、抑郁、焦虑、质量 生活)。这项研究将使用一组治疗和注意力控制组。治疗组的受试者将接受 个性化体验式护理员在管理患者症状的策略和使用方面的培训 令人愉快的图像和肌肉放松来管理压力，而受试者在注意力控制中 该小组将收到一个关于癌症和护理资源的信息会议。将收集数据 训练前、训练后、出院后2周、4周。描述性统计和 数据分析将使用包括混合模型在内的多变量分析 这项研究可能会对护理界如何有效地准备 出院前在家照看癌症的非正式照顾者。我们的长期目标是改进 并扩大培训范围，使其能够用于教育和支持患者的非正式照顾者 预防其他慢性病，并确定这项培训的成本效益

Symptom management is essential in home caregiving. However, many informal caregivers are not confident of their ability to assist their their loved ones with their cancer symptoms at home. A low level of confidence or self-efficacy may negatively affect a caregiver's psychological well-being which is already vulnerable as a consequence of caregiving. Because of the reciprocal nature in a caregiver-patient dyad, caregiver decline is likely associated with patient decline. Improving caregivers' self-efficacy to manage their loved ones' cancer-related symptoms may mitigate their psychological decline arid may positively affect patients' well-being by alleviating their symptom distress. Additionally, training in self-management of stress may promote coping among caregivers as many data show that caregiver stress is overwhelming. This study will examine the effects of an Enhanced Caregiver Training protocol delivered to informal caregivers of cancer patients before hospital discharge. The primary aim is to test the effects of the training on caregivers' self-efficacy in cancer symptom management and self-efficacy in self-management of stress. The study will also look at the effects of this training on caregiver outcomes (depression, anxiety, quality of life, caregiver stress) and patient outcomes (symptom distress and intensity, depression, anxiety, quality of life). The study will use a treatment and attention-control group. Subjects in the treatment group will receive an individualized experiential caregiver training in strategies for managing patient's symptoms and in the use of pleasant imagery and muscle relaxation to manage stress, whereas subjects in the attention-control group will receive an informational session about cancer and resources for caregiving. Data will be collected before and after the training, and at 2 and 4 weeks after hospital discharge. Descriptive statistics and multivariate analysis including mixed models will be used for data analysis This study could have important implications for the nursing community on how to effectively prepare informal cancer caregivers for home caregiving prior to hospital discharge. The long term goal is to refine and expand the training so that it can be used to teach and support informal caregivers of patients suffering from other chronic illnesses, and to determine the cost-effectiveness of this training