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The Level of Caregiving Knowledge And Self-Efficacy Among Caregivers of

Stroke Patients

Conference Paper · October 2017

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 THE LEVEL OF CAREGIVING KNOWLEDGE
AND SELF-EFFICACY AMONG CAREGIVERS
OF STROKE PATIENT
Fathin Alyaa MF, Hi MY, Nur Khairina I, Nur Sarah Aisyah A, Tan CE, Aznida Firzah AA
Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre (UKMMC)

Introduction
• In Malaysia, family members are often the informal caregivers for stroke patients. Caregivers need to have adequate knowledge to provide care for stroke
patients at home.1 Unfortunately, most caregivers do not receive formal caregiving training. If at all, training is provided for specific tasks only.
• Bandura defined self-efficacy as “one's belief in one's ability to succeed in specific situations or accomplish a task”.2 Better caregiver self-efficacy would
represent better preparedness to provide care for stroke patients.
• This study aimed to determine the level of caregiving knowledge and self-efficacy among caregivers for stroke patients in UKMMC.

Methodology Table 4: Caregiver self-efficacy and its association

• Study design : Cross- sectional study Variables Mean FCAT scores (±s.d.) Test p
• Study setting : Department of Medical Rehabilitation Services UKMMC Age r = 0.34 <0.001*
Gender
• Sample size, n : 128 caregivers of stroke patients.
Male 48.9 (6.1) t=1.036 0.302
• Study sample : Convenience sampling Female 50.1 (4.9)
• Study instruments : Sociodemographic data, functional status, Race
evaluation, the newly validated Caregiving Knowledge Questionnaire Malay 50.2 (5.6) F= 0.782 0.46
(CKQ) and Family Caregivers Activation Transition tool (FCAT). Chinese 48.8 (7.0)
• FCAT :10 Likert-scale questions measuring caregivers’ level of Indian and 48.7 (5.8)
confidence in managing various aspects of patient care such as others
medications, appointments and health services. Marital status
Single 46.9 (5.6)
• CKQ : 41 items with multiple choice questions and pictures, measures
Married 59.0 (5.0) F=6.423 0.002*
caregivers’ knowledge regarding positioning, and feeding. Previously 48.1 (5.8)
• Statistical analysis: Descriptive and bivariate inferential statistics were married
used for data analysis with IBM SPSS version 24. Education
None or 52.6 (4.5) F=3.11 0.048*
Result primary
Table 1 : Baseline Characteristics of Participants Secondary 49.9 (6.3)
Tertiary 48.0 (5.3)
Variables n (%) Mean (sd) Variables n (%)
Household income
<Rm1000 49.3 (7.3)
Age (years) 45.78 Caregiver Status RM1000-4999 49.6 (5.1) F=0.358 0.783
(16.81) Primary 77 (60.2) RM5000-RM10000 50.7 (5.9)
Gender Secondary 51 (39.8) >RM10000 48.5 (8.7)
Male 45 (35.2) Duration of stroke diagnosis Caregiver status
Female 83 (64.8) 0 – 5 years 94 (72.6) Primary 50.6 (5.7) t= 2.093 0.038*
6 – 10 years 24 (18.8) Secondary 48.3 (6.2)
Race
>10 years 11 (8.6) Caregiver training
Malay 83 (64.8)
MRS Yes 52.1 (5.5) t= 2.673 0.009*
Chinese 34 (26.6)
Independent to 59 (46) No 48.9 (6.0)
Others 11 (8.6)
moderately dependent Duration of caregiving
Marital status MRS 1 – 3)
Single 36 (28.1)
≤5 years 49.3 (5.7) F=3.586 0.031*
Severely dependent to 69 (54)
Married 85 (66.4) 5-10 years 49.8 (7.3)
totally dependent
Divorced/ 7 (5.5) > 10 years 55.4 (4.7)
(MRS 4 – 5)
Widowed Received Training Functional status
Yes 31 (24.2) MRS 1-3 50.2 (6.0) t= 0.853 0.395
Education
No 97 (75.8) MRS 4-5 49.3 (6.0)
Primary level 14 (11)
Information source
Secondary 80 (62.5)
NGO 2(1.6)
Discussion
level
Tertiary level 34 (26.6) Hospital 23 (18) Better knowledge in feeding may be attributed to opportunities for caregivers to
Books/Other formal source 4 (3.1) observe nurses performing tube feeding for the patients while in the hospital.
Income Internet/Informal source 24 (18.8) Feeding method is simple and can be learnt via observation.3
< RM1000 34 (26.6) Doctors 50 (39.1) Most respondents had poor knowledge about positioning stroke patients, similar
RM1000– 65 (50.8) Nurses 27 (21.1) to the previous study done in Korea.4
RM4999 Other caregivers 10 (7.8) Older caregivers had better self-efficacy, whereas younger caregivers had other
>RM5000 29 (22.6) Others 8 (6.3) family and financial obligations to cope with.5 Being married contributed better
Table 2 : The Level of Caregiving Knowledge and Self-Efficacy social support to the caregiver, and hence improved self-efficacy.5 Lower
n (%) Mean scores education was unexpectedly associated with better self-efficacy. This again could
(+s.d.)
be due to their employment status, freeing them to provide care for the
Knowledge for positioning (N=126) Poor knowledge (<20) 110 (87.3) 14.9(± 4.32)
patients.5
Good knowledge(>20) 16 (12.7)
Provision of caregiver training helps to improve self-efficacy.6
Knowledge for feeding (N=80) Poor knowledge (<10) 7 (8.8) 13.3(±1.70)
Good knowledge (>10) 73 (91.2)
Longer duration of caregiving was associated with better self-efficacy as
FCAT (Range of scores 10-60) 49.7(±6.0) caregivers learn with experience.7
Table 3 Association between caregiving knowledge and self-efficacy Conclusion
Correlation with self-efficacy Spearman’s Rho p Caregivers’ knowledge on positioning of stroke patients was poor. Intervention
Knowledge on positioning 0.563 0.052 programs and training for caregivers of stroke are recommended to improve
Knowledge on feeding 0.273 0.010 caregivers’ self-efficacy.
This study received ethical approval from UKMMC Medical Research Ethics Committee (FF-2017-196) and is self-funded. The authors would like to thank the Dept of Rehabilitation Medicine Service of UKMMC for permission to collect data, Dr Su-Jin Choi for permission to use her caregiver’s knowledge survey, as well
as Prof Dr Eric Coleman for permission to use the FCAT for this study.
REFERENCES 16:364
1. Hafsteinsdóttir TB et al. Educational needs of patients with a stroke and their caregivers: a systematic review of the literature. Patient Educ. Couns. 2011, vol. 85 (1):14–25 6. Van den Berg M et al. Early supported discharge by caregiver-mediated exercises and e-health support after stroke: a proof of concept trial. Stroke 2016. Vol 47
2. Bandura A. Self-efficacy: toward a unifying theory of behavioural change. Psychological Review 1977, Vol 84 (2): 191-215 http://doi.org/10.1161/STROKEAHA.116.013431
3. Shinde M. et al. Effectiveness of Demonstration Regarding Feeding of Hemiplegia Patients among Caregivers. Int J Sci Res, 2014, Vol 3 (3):19-27 7. Huang HL et al. Caregiver self-efficacy for managing behavioural problems of older people with dementia in Taiwan correlates with care receiver’s behavioural problems. J Clin
4. Lee KW, et al. A Survey of Caregiver Knowledge About Caring for Stroke Patients. Ann Rehabil Med. 2015, Vol 39 (5): 800-815 Nurs 2009, Vol 18 (18):2588-95
5. Bucki B et al. Health capability of family caregivers: how different factors interrelate and their respective contributions using a Bayesian approach. BMC Public Health 2016 Vol
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