[Effectiveness of a Multimodal Nursing Intervention for Primary Caregivers in Preventing Medical Adhesive-Related...

Although medical adhesive products are routinely used in clinical settings, research into both the medical-adhesive-associated skin outcomes of patients and the caregiving practices of patients and their primary caregivers remains limited.

The primary aim of this study was to evaluate the effectiveness of a multi-strategy nursing educational program in improving knowledge of medical adhesive-related skin injury (MARSI), health beliefs, self-efficacy, and skin care behaviors among primary caregivers of ostomy patients. In addition, peristomal transepidermal water loss (TEWL) and MARSI incidence rate were assessed as secondary outcomes.

A randomized experimental design was employed, and 50 patient-caregiver pairs (comprising a patient undergoing their first enterostomy and their primary caregiver) were randomly assigned to either the experimental or control group (25 pairs per group). The experimental group received the multi-strategy nursing educational program, while the control group received standard nursing education. The outcome variables, including MARSI knowledge, health beliefs, self-efficacy, caregiving behavior, and TEWL from the peristomal skin, were assessed on postoperative days 1, 7, 30, 60, and 90. Generalized estimating equations were utilized to analyze the between-group differences in outcome variables at each postoperative time point.

At all postoperative time points (days 7 through 90), the experimental group showed significantly greater improvements than the control group (p < .05) in terms of primary caregivers' MARSI prevention knowledge (B = 1.230 to 1.680), health beliefs regarding severity (B = 1.280 to 1.608) and perceived benefits (B = 1.160 to 2.169), perceived barriers (B = -3.383 to -2.240), self-efficacy (B = 4.073 to 4.828), and skin care behavior (B = -5.085 to -4.592). However, no statistically significant between-group differences were observed in terms of patients' peristomal TEWL or MARSI incidence (p >.05).

Based on the results, the multi-strategy nursing educational intervention effectively improves primary caregivers' knowledge, health beliefs, self-efficacy, and skin care behaviors related to MARSI prevention and peristomal skin care compared to standard care. Future studies should include patients with various types of MARSI and implement extended longitudinal monitoring of TEWL to strengthen evidence-based preventive strategies.