The Effect of Home Care Planned According to Orem in Patients With Primary Brain Tumor and Their Caregivers

TC Erciyes University

Status: Completed

Conditions: Caregiver Burden; Self Care; Primary Brain Tumor

Treatments: Other: home care

Study type: Interventional

Funder types: Other

Identifiers

NCT05328739

2019/179

Details and patient eligibility

About

This study was conducted to evaluate the effect of home care planned according to Orem on self-care agency and care burden in brain tumor patients and their caregivers. The study was performed with patients who underwent surgery for a brain tumor and their caregivers in the neurosurgery clinic of a tertiary hospital. Ethical committee approval, institutional permission, patients and their caregiver verbal and written consent were obtained. According to Orem's nursing theory, home care practice combining education, counseling and nursing care started with pre-operative education in the hospital for the patients and caregivers in the intervention group and continued at home with 5 home visits in a 6-month period. Self-Care Agency Scale, MD Anderson Symptom Inventory Brain Tumor-Turkish Form and Caregiver Burden Scale were used as measurement tools in the study.The value of p<0.05 was accepted statistically significant in the data analyses.

Full description

In this randomized controlled experimental study, it was aimed to determine the effect of home care planned according to Orem on self-care agency and care burden in brain tumor patients and their caregivers. The study was performed with patients who underwent surgery for a brain tumor and their caregivers in the neurosurgery clinic of a tertiary hospital. Ethical committee approval, institutional permission, patients and their caregiver verbal and written consent were obtained. According to Orem's nursing theory, home care practice combining education, counseling and nursing care started with pre-operative education in the hospital for the patients and caregivers in the intervention group and continued at home with 5 home visits in a 6-month period. Self-Care Agency Scale, MD Anderson Symptom Inventory Brain Tumor-Turkish Form and Caregiver Burden Scale were used as measurement tools in the study. In addition, measurement tools used in patients and caregivers were applied to an average of 6 month: before surgery preoperative assessment at hospital (Time 1), after surgery 1st month at home (Time 2) after surgery 3rd month at home (Time 3) and after surgery 6th month at home (Time 4). Data were analyzed with descriptive statistics, two-way analysis of variance. Bonferroni correction was applied when comparing the main effects and comparisons between categorical variables and groups were evaluated with Fisher's exact test, p<.05 value was considered statistically significant.

Enrollment: 36 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

inclusion criteria for patient;

• living within the borders of the region,
• being over 18 years old,
• being at least literate, being able to communicate in Turkish,
• being oriented to person, place and time, not having hearing and speaking problems,
• having primar brain tumor (glial or meningeal) surgery,
• taking part in grade I, II, III
• and having Karnovsky Performance Scale (KPS) score above 50 points.

exclusion criteria for patient;

• being under the age of 18,
• illiterate, unable to communicate in Turkish,
• being diagnosed with a neurological and psychiatric disorder that may affect the cognitive status,
• not being oriented to the person, place and time, having hearing and speaking problems,
• having surgery for a metastatic brain tumor,
• having surgery for a pituitary adenoma, to have undergone emergency surgery, to have a biopsy,
• to be in grade IV,
• to have a KPS score below 50 points.

Criteria for terminating the research process;

• wanting to leave the research process,
• meeting one of the criteria for exclusion from the sample after the surgery,
• spending the home care and follow-up process in another province, and/or not being able to reach the individual.

inclusion criteria for caregiver;

• being over the age of 18,
• being literate, being able to communicate in Turkish, and not having hearing and speaking problems,
• caring for a patient who had primary brain tumor surgery.

exclusion criteria for caregiver ;

• being under the age of 18,
• illiterate, unable to communicate in Turkish,
• being diagnosed with a neurological or psychiatric disorder that may affect the cognitive status,
• and having hearing and speech problems.

Criteria for terminating the research process;

• wanting to leave the research process,
• meeting one of the criteria for exclusion from the sample after the surgery,
• spending the home care and follow-up process in another province, and/or not being able to reach the individual.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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36 participants in 2 patient groups

Home care group

Experimental group

Description:

The home care program included education, counseling and nursing care to determine and meet the self-care/dependant care needs of patients and caregivers at home after brain surgery. At preoperative period (PRP) an average of 90-120 minutes of training was given to both the patient and the caregiver until the patient was discharged. At this stage, the training was carried out in order to prepare the patient and caregiver for the transition to home. At postoperative period (POP) two home visits were made within the first month following the discharge, planned for education, counseling and nursing care. The first home visit was made in the first week after discharge (10-18 days after surgery), and the second home visit was made 30-40 days after surgery. Then, in the home visits made once in the 2nd, 3rd and 4th months.No home visits were made between the 4th-month attempt and the 6th month, but telephone counseling was provided when necessary. Home visits ranged from 60 to 120 minutes.

Treatment:

Other: home care

Control group

No Intervention group

Description:

The patient received routine care in the hospital until discharge. Three home visits were made to collect the data of patients and caregivers in the 1st and 3rd and 6th months of POP after discharge, but no intervention was made. The visits took about 30-45 minutes.