Nurses often have difficulties with using interdisciplinary stroke guidelines for patients with stroke as they do not focus sufficiently on nursing. Therefore, the Stroke Nursing Guideline (SNG) was developed and implemented. The aim of this study was to determine the implementation and feasibility of the SNG in terms of changes in documentation and use of the guideline in the care of stroke patients on Neurological and Rehabilitation wards, barriers and facilitators, and nurses' and auxiliary nurses' view of the implementation.
ObjectiveIn this Lesson from the Field, we examine changes in the burden experienced by caregivers of persons who experience homelessness associated with lack employment, employability or education, and mental health challenges when the care recipient receives support from an outreach professional known as a social street worker (herein identified as worker). In addition, we focus on caregivers' perception of change in the quality of their relationship with the person for whom they care and whether the caregivers receive support from the worker.BackgroundIn the Netherlands, due to the transformation toward a participation society, persons living in compromised circumstances must increasingly rely on caregivers for support and shelter instead of relying on services, such as support from social community teams.MethodsWorkers provided by a Dutch organization covering the northwest of the Netherlands gained the consent of their clients to contact the clients' caregivers. Caregivers were invited to participate in the research and completed consent. A total of 111 caregivers of persons receiving support from workers completed surveys.ResultsCaregivers who had more contact with the worker worried less about the person for whom they provided care. No changes were found regarding tension between caregivers and the person for whom they cared. Most caregivers (73%) perceived positive changes in the quality of the relationship with the person for whom they provided care, and 52% received support from the worker.ConclusionMost carers did not perceive changes in their burden, but did perceived positive changes in the quality of the relationship with the person for whom they cared and received support themselves.ImplicationsOur study underpins the need to recognize the caregiver's burden of caregivers who support marginalized people, to connect with these caregivers, and to support them.
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Background: Engaging families in postsurgical care is potentially beneficial for improving cancer patient outcomes and quality of care. The authors developed a family involvement program (FIP) and in this study, the authors aim to evaluate the impact of the FIP on family caregiver burden and well-being. Moreover, the authors aim to assess the fidelity of the program. Materials and methods: This is a preplanned subgroup analysis of a patient-preferred prospective cohort study that included family caregivers of patients who underwent major oncological surgery for gastrointestinal tumors. Only patient-nominated family caregivers could participate in the FIP. Caregivers received structured training in fundamental caregiving tasks from healthcare professionals and then actively participated in these tasks. Caregiver burden and well-being were measured four times (at hospital admission, at hospital discharge, and at 1 and 3 months posthospital discharge) using the Caregiver Strain Index+ (CSI+) and the Care-related Quality of Life instrument (CarerQoL-7D). The fidelity of the FIP was assessed by recording completion of care activities. In addition, family caregivers were asked whether they would participate in the FIP again. Results: Most of the 152 family caregivers were female (77.6%), and their mean age was 61.3 years (SD=11.6). Median CSI+ scores ranged between -1 and 0 and remained below the cutoff point of experiencing burden. CarerQoL-7D results indicated no significant differences in family caregivers' well-being over time. Upon discharge, over 75% of the family caregivers stated that they would recommend the FIP to others. The highest compliance with all fundamental care activities was observed during postoperative days 2-4. Conclusion: The family caregivers of oncological surgical patients who participated in the FIP exhibited acceptable levels of caregiver burden and well-being. These findings suggest that the FIP is a valuable intervention to equip family caregivers with the skills to navigate the uncertain period following a patient's hospital discharge.
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