Impact of a family caregiver training program in Kolkata, India on post-operative health perceptions and outcomes of cardiothoracic surgical patients

Abstract

# Background Patient and family caregiver education is essential for adequate home care after a cardiothoracic surgical intervention. In resource-poor settings where access to medical care is limited and health literacy is low, pre-discharge caregiver education is frequently overlooked. This study evaluates the effect of the Care Companion Program (CCP), an in-hospital patient family engagement and education program that targets family caregivers to support post-surgical patient recovery. # Methods This study was based on a quasi-experimental design at a tertiary care facility in Kolkata, India, in which 188 patient-caregiver dyads providing support to patients undergoing surgical intervention for cardiovascular disease were selected to participate. One hundred dyads received standard of care (SoC), and 88 dyads received the CCP. Patient-caregiver dyads were evaluated on patient post-discharge complications and physical functional status; Caregiver Activation Measure and health knowledge. Assessments were conducted at baseline, discharge, and post-discharge at 30 days. # Results Post-discharge 30-day complication rates were significantly lower for the CCP group compared to SoC (34.4% vs. 14.5%, respectively, *P*0.003). The CCP group showed a significantly greater increase in their Caregiver Activation Measure scores between baseline and discharge (4.2 ± 9.1 vs. 1.3 ± 7.4, respectively, *P*\<0.001) that were sustained at 30 days post-discharge (7.2 ± 17.4 vs. 1.4 ± 10.4, respectively, *P*\<0.001). Knowledge scores for the CCP group showed significant improvement (*P*\<0.001) between baseline and discharge and were sustained at 30 days post-discharge (*P*0.003). Compared to the SoC group, patients in the CCP group reported a significantly greater increase in their physical functional status (World Health Organization Quality of Life short form assessment (WHOQOL-BREF) physical health domain) between baseline and 30 days post-discharge (*P*=0.018). # Conclusions The results of the study suggest significant associations between participation in the CCP and reduced 30-day complications, increased caregiver activation, and increases in health knowledge. Programs such as the CCP may play an important role in engaging family caregivers to improve health outcomes in settings with limited healthcare resources.