Development and validation a nursing care protocol with educational interventions for family caregivers of elderly people after stroke

Abstract

Objective: development and validation the content of a nursing care protocol with educational interventions for family caregivers of elderly people after stroke. Methods: a methodological study conducted in three stages: (1) protocol development through literature review; (2) pretest with multidisciplinary team, analyzed with literature articulation; (3) protocol validation by the Delphi Technique. Results: the protocol was structured in the following areas: Disease Guidelines; Emotional Support; Using the Health Care Network; Diet; Airways; Medications; Hygiene; Skin Care; Disposal; Dressing/Undressing; Positioning and Transfer; Fall Prevention. In the pretest, eight experts assessed protocol clarity and content. In validation, there were two rounds by the Delphi Technique. The validated protocol consisted of 12 domains, containing 42 items and 240 care guidelines. Conclusion: the protocol qualifies the transition of care after hospital discharge assisting nurses in home care practice.

Construction and Validation of an Educational Manual for Family Caregivers of Older Adults After a Stroke

“…The elaboration of manuals based on literature reviews has been mentioned in other studies. 10,14,[23][24] Similarly, in the present research, a guidance protocol for nurses 17 was used as support, being elaborated from an integrative literature review.…”

“…A protocol was also used as support, built by a member of the research group in a previous study, based on an integrative review on the topic, whose purpose was to equip the nurse who works in the care of the caregiver of an older adult with a stroke. 17 Six nurses participated in this stage, members of the research group, and selected for convenience. The criteria for inclusion were the following: nurses with experience in research, care and management for aged stroke patients and working in the research group during the study period.…”

The capacity of informal caregivers in the rehabilitation of older people after a stroke

“…This is a fundamental care for the rehabilitation of patients with hemiparesis after stroke and which should be reinforced in hospital discharge planning. ( 7 ) There was a low number of caregivers who performed feeding tube diets due to the few older people using it. Returning to the home with a feeding tube diet implies several changes in the life of the family, the individual, and the caregiver, requiring adequate guidance for those who will provide this care.…”

“…Patients with neurological disorders are more dependent on care, such as changing the position, hydrating the skin, nutritional assessment, and frequent intimate hygiene, and the lack of this care exposes the older person to a greater risk for the occurrence of pressure injuries. ( 7 , 30 ) The dressing was among the main activities that caregivers demonstrated the ability to perform. In the care of the older adult after a stroke, this activity requires skill, as it demands that caregivers pay attention to the use of comfortable clothing, start to wear it for the body member with the greatest dependence and, to undress, for the healthy body member.…”

“…( 5 , 6 ) In Brazil, the government has reduced responsibilities to supporting the older population, attributing to the family the responsibility for most of the home care to dependent people. ( 7 ) Also in Brazil, informal care has not yet entered into the public policies,( 8 ) making the family to provide care of the older adult without the necessary information and resources. However, at an international level, the support networks for the older people and their informal caregivers seem to be more strengthened, mitigating the negative repercussions of dedication to caring for dependent older people after stroke.…”