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Background: Family caregivers are fundamental to the recovery of stroke survivors, yet many lack proper training and confidence. Empowering them through structured education can enhance care quality. Family caregivers play an essential role in the recovery process of stroke survivors, yet many lack adequate skills and confidence to manage their responsibilities effectively. Providing structured training can empower them and improve care delivery. Objectives: This study assessed the effectiveness of a structured caregiver training initiative in improving caregiver competence and explored its link with demographic factors. This study aimed to evaluate the impact of a structured caregiver training program on the perceived competency of caregivers for stroke survivors and to assess its relationship with selected demographic characteristics. Methods: A randomized experimental study design was utilized with 60 caregivers allocated into experimental and control groups (30 each). Participants, aged 18 or above and able to communicate, were selected via random sampling. The training addressed areas like hygiene, mobility, emotional support, and coping skills. Caregiver competency was measured through the Caregiver Competency Scale (CCS) and analyzed using statistical methods. An experimental design was implemented involving 60 primary caregivers, randomly assigned to either an experimental (n = 30) or control (n = 30) group. Eligibility criteria included being 18 years or older, possessing communication ability, and willingness to participate. The intervention group received structured training addressing personal care, mobility, emotional support, and stress coping strategies. Caregiver competency was measured using the Caregiver Competency Scale (CCS), and data were analyzed using descriptive statistics, ANOVA, and non-parametric tests. Results: Post-intervention, caregivers in the experimental group showed a statistically significant improvement in competency scores (Pre-test Mean = 15.83, SD = 15.32; Post-test Mean = 72.20, SD = 9.33; p<0.001). No such change was observed in the control group. Competency was significantly associated with variables such as age, caregiver-patient relationship, presence of illness, and information source (p<0.05). Conclusion: The training significantly enhanced caregivers' perceived competence. Integrating such interventions into rehabilitation services is recommended to strengthen caregiver roles and improve recovery outcomes. Structured training significantly enhanced caregiver competency. Incorporating such programs into stroke rehabilitation can strengthen informal care support and contribute to better patient outcomes.
ABSTRACT:
Background: Family caregivers are fundamental to the recovery of stroke survivors, yet many lack proper training and confidence. Empowering them through structured education can enhance care quality. Family caregivers play an essential role in the recovery process of stroke survivors, yet many lack adequate skills and confidence to manage their responsibilities effectively. Providing structured training can empower them and improve care delivery. Objectives: This study assessed the effectiveness of a structured caregiver training initiative in improving caregiver competence and explored its link with demographic factors. This study aimed to evaluate the impact of a structured caregiver training program on the perceived competency of caregivers for stroke survivors and to assess its relationship with selected demographic characteristics. Methods: A randomized experimental study design was utilized with 60 caregivers allocated into experimental and control groups (30 each). Participants, aged 18 or above and able to communicate, were selected via random sampling. The training addressed areas like hygiene, mobility, emotional support, and coping skills. Caregiver competency was measured through the Caregiver Competency Scale (CCS) and analyzed using statistical methods. An experimental design was implemented involving 60 primary caregivers, randomly assigned to either an experimental (n = 30) or control (n = 30) group. Eligibility criteria included being 18 years or older, possessing communication ability, and willingness to participate. The intervention group received structured training addressing personal care, mobility, emotional support, and stress coping strategies. Caregiver competency was measured using the Caregiver Competency Scale (CCS), and data were analyzed using descriptive statistics, ANOVA, and non-parametric tests. Results: Post-intervention, caregivers in the experimental group showed a statistically significant improvement in competency scores (Pre-test Mean = 15.83, SD = 15.32; Post-test Mean = 72.20, SD = 9.33; p<0.001). No such change was observed in the control group. Competency was significantly associated with variables such as age, caregiver-patient relationship, presence of illness, and information source (p<0.05). Conclusion: The training significantly enhanced caregivers' perceived competence. Integrating such interventions into rehabilitation services is recommended to strengthen caregiver roles and improve recovery outcomes. Structured training significantly enhanced caregiver competency. Incorporating such programs into stroke rehabilitation can strengthen informal care support and contribute to better patient outcomes.
KEYWORDS: Stroke, Informal caregiver, Competency, Training program, Rehabilitation.
INTRODUCTION:
Stroke is one of the leading contributors to long-term disability globally. In India, the prevalence of stroke is estimated between 84 and 262 per 100,000 individuals, highlighting its significant public health impact1'. Stroke survivors often experience persistent physical, psychological, and cognitive challenges that require long-term support and care from family members2'.
In most Indian households, family members become the primary caregivers without any formal training. This lack of preparedness contributes to feelings of inadequacy, emotional burden, and physical strain, which can negatively affect both the caregiver and the stroke survivor3'. Studies indicate that caregiving competence is closely linked to better patient adherence to therapy, reduced complications, and improved rehabilitation outcomes4'.
Structured training interventions have shown potential in improving caregivers' preparedness, skill levels, and self-efficacy5'. However, such interventions are underexplored in the Indian context6'. The need for culturally appropriate and context-specific training programs is evident to enhance caregiving effectiveness and reduce caregiver strain.
This study was conducted to assess the effectiveness of a structured caregiver training program in improving the perceived competency of caregivers for stroke survivors. Additionally, it aimed to explore the association between competency levels and selected demographic variables.
MATERIALS AND METHODS:
Study Design and Approach:
This study employed a quantitative experimental design to evaluate the effectiveness of a structured caregiver training program. The research was conducted in selected panchayath of Thrissur District, Kerala, an area with a rising number of stroke survivors requiring homebased care support7'.
Sample and Sampling Technique:
A total of 60 primary caregivers of stroke survivors were selected using simple random sampling from a list maintained by Accredited Social Health Activists (ASHAs). Eligible participants were aged 18 years or older, able to communicate effectively, and willing to provide informed consent. Participants were then randomly assigned to either the experimental group (n = 30) or the control group (n = 30).
Intervention:
The experimental group received a structured five-day caregiver training program that focused on essential caregiving areas, including personal hygiene assistance, mobility support, communication techniques, problem-solving, and organizational planning.
Each training session lasted between 45 to 60 minutes and was delivered through interactive lectures, demonstrations, and practice sessions. The control group continued to receive routine guidance provided by healthcare professionals.
Measurement Tool:
Caregiver competency was measured using the Caregiver Competence Scale (CCS), which consists of 34 items distributed across five core domains: personal care, mobility, communication, dealing with problems, and planning and organization. Each item is rated on a 4-point Likert scale ranging from 0 (not competent) to 3 (very competent). Based on total scores, competency was classified as low (0-33), moderate (34-67), or high (68-102)9'.
Data Collection Procedure:
Baseline (pre-test) data were collected prior to the intervention, and follow-up (post-test) data were obtained one month after the completion of the training. Both experimental and control groups were assessed using the CCS tool. Ethical considerations, including confidentiality and informed consent, were strictly maintained throughout the study.
Statistical Analysis:
Descriptive statistics (mean, standard deviation, frequency) were used to describe the demographic and outcome variables. Inferential statistics, including Analysis of Variance (ANOVA) and non-parametric tests (Kruskal-Wallis and Mann-Whitney U tests), were applied to compare groups. A p-value < 0.05 was considered statistically significant10'.
RESULTS:
Demographic Characteristics of Caregivers:
The demographic profile of caregivers in both the experimental and control groups showed comparable characteristics. A majority of caregivers in both groups were female and within the age range of 46 to 55 years. Most caregivers had secondary education and were unemployed, reflecting the typical profile of informal caregivers in low- to middle-income households7'. In both groups, the majority were spouses of the stroke survivors, with many spending more than 15 hours a day on caregiving activities.
Effect of the Intervention on Caregiver Competency:
Caregiver competency was assessed at two points: pre-intervention and one month post-intervention. In the experimental group, the mean competency score showed a substantial increase from M = 15.83, SD = 15.32 at pre-test to M = 72.20, SD = 9.33 at post-test. This indicates a statistically significant improvement in caregiving ability following the structured training program. In contrast, the control group's scores remained largely unchanged, with pre-test M = 15.67, SD = 14.43 and post-test M = 15.77, SD = 14.33.
A repeated measures ANOVA showed a significant within-group effect in the experimental group (F = 409.33, p < 0.001), suggesting the training program effectively enhanced caregiver competency. No significant change was observed in the control group (F = 3.22, p = 0.08). Between-group analysis at post-test confirmed the impact of the intervention, with a statistically significant difference (F = 77.53, p < 0.001).
Level of Competency After the Intervention:
At follow-up, 83.3% of the caregivers in the experimental group attained a high level of competency (scores between 68-102), while the majority of caregivers in the control group remained within the low to moderate competency range. These findings reinforce the value of structured caregiver education in enhancing practical caregiving skills8'.
Association Between Demographic Variables and Competency Scores:
Analysis using non-parametric tests revealed significant associations between caregiver competency and several demographic variables. The Kruskal-Wallis test indicated a statistically significant relationship between competency and caregiver age (H = 18.606, p < 0.001) and caregiver-patient relationship (H = 8.425, p = 0.015). The Mann-Whitney U test found significant differences in competency scores based on the presence of any health condition in the caregiver (U = 604.50, p < 0.001) and the source of information used for caregiving (U = 755.50, p < 0.001).
These associations suggest that caregiver characteristics can influence the effectiveness of training and readiness to provide quality care.
Descriptive statistics:
Effect of intervention on Caregiver-Competency
DISCUSSION:
This study demonstrated that a structured caregiver training program significantly improved the perceived competency of informal caregivers supporting stroke survivors. The marked increase in competency scores among caregivers in the experimental group, compared to the control group, underscores the effectiveness of targeted training interventions.
These findings are consistent with previous research indicating that educational and skill-based training enhances caregivers' confidence, preparedness, and ability to provide effective care9'. The structured program in this study addressed core areas such as hygiene, mobility support, emotional interaction, and planning all of which are fundamental to daily caregiving responsibilities3'.
Caregivers of stroke patients often experience multifaceted challenges, including managing mobility limitations, administering medications, and providing emotional support-all while coordinating with healthcare systems6'. Without proper training, these tasks can lead to physical fatigue, emotional burnout, and reduced caregiving quality. This study validates the notion that empowering caregivers through education directly improves their ability to manage such demands.
The Caregiver Competence Scale (CCS) used in this study effectively captured multidimensional aspects of caregiving skill. Its application allowed for precise measurement of the intervention's impact, particularly across domains such as problem-solving, personal care, and communication8'.
Significant associations between caregiver competency and demographic factors such as age, caregiver-patient relationship, existing illnesses, and source of caregiving information further suggest that interventions should be personalized. Older caregivers or those without access to professional guidance may benefit most from structured programs.
In community settings, where formal rehabilitation support may be limited, caregiver-focused interventions become even more critical. Nurses, community health workers, and rehabilitation professionals can play a pivotal role in delivering such training, thereby extending support to both caregivers and patients in home-based care environments7'.
CONCLUSION:
This study confirms that structured caregiver education significantly enhances the perceived competency of individuals providing care to stroke survivors. The results demonstrate that even a short-term, focused training program can lead to substantial improvements in caregiving ability, which in turn may contribute to better patient outcomes and reduced caregiver burden.
By equipping caregivers with the necessary knowledge and practical skills, such interventions help foster greater confidence, reduce uncertainty, and ensure more consistent and effective care at home. The strong associations between competency and certain demographic variables also suggest that individualized training approaches may be necessary to meet diverse caregiver needs.
Given these findings, it is recommended that structured caregiver education be incorporated as a routine component of stroke rehabilitation services. Health systems, especially in resource-constrained settings, should prioritize caregiver-focused interventions to support recovery, improve care quality, and promote sustainable home-based care for stroke survivors.
CONFLICT OF INTEREST:
The authors declare that there are no conflicts of interest related to this study.
ACKNOWLEDGMENTS:
The authors express their sincere gratitude to all the caregivers who participated in this study. Special thanks are extended to the faculty and staffof St. James College of Nursing, Chalakudy, for their guidance and assistance throughout the research process.
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