According to Hulme and Groves (1994) review of literature is a systematic identification, location, scrutiny and summary of written materials that contain information on research problems. The review of literature in a research report is a summary of current knowledge about a particular problem of practice and includes what is known and not known about the problem. A literature is an organized, writers presentation of what has been published on a topic by the scholars. The task of reviewing literature involves the identification, selection ,critical analysis and reporting of existing information on the topic of interest.

According to Polit and hunger (1999), review of literature is a critical summary of research on a topic of interest generally prepared to put a research problem on context or to identify gaps and weaknesses on previous studies to justify a new investigation.

The researcher came across with numerous theoretical and empirical literature related to the topic under study. The relevant and related literature that was found useful has been presented as follows.

The literatures found relevant and useful for the present study have been organized under the following heading-

1) Studies related to caregivers role and participation in patient care and feeding.

2) Studies related to knowledge of caregivers regarding patient care.

3) Studies related to the effectiveness of structured teaching on caregivers.

Studies related to caregivers role and participation in patient care and feeding

Elie Azoulay.et,al. (2000) conducted a study to assess the attitude of the families and staff about the family participation in caring their critically ill relatives. He conducted survey in 78 intensive care units in France involves 544 family members and 2754 icu staff . The result shows, among icu staff,88.2% felt that participation in patient care should be offered to the families. Among the family members Only 33.4% of wanted to participate in patient care.

Margaretta ostman(1999) conducted a study on the family burden, participation in care and mental health of the caregivers involved in patient care.. The result showed high levels of family burden and in-sufficient participation of caregivers in patient care. Many relatives expressed the need of care and support from the health worker.

Guat Tin(2008) conducted study among family caregivers who were looking after their sick, aged or disabled relatives in order to sketch the characteristics and their care giving experience. He conducted an extensive survey to capture the basic demographic and care giving experiences among family caregivers. A majority of the caregivers were married and middle aged. Among 323 samples more than half of them were employed and about 40% were retired or home makers and majority of them are with lower incomes. Most of the Care recipients were parents and living with their caregivers. The study point out the need of introducing caregiver’s support services.

Jean M Kruzich.et.al(2002) conducted a study to assess the family caregiver’s perceptions about barriers in participation in their children’s treatment. This study examined the views of family caregivers whose children received out-of-home treatment to determine the amount and types of family caregiver’s participation in their children’s treatment, the caregivers perception about barriers and support to caregiver’s participation. Family caregivers reported lack of communication between staff members of different programmes and negative attitude of the staff members as the barriers for care participation.

Greenburger((2007) conducted a study on effect of caregivers burden and competence as predictors of health care facilitation. The study was aimed to examine caregivers resources, their burden and competence as predictors of health care facilitation in caring of older patients. The data was collected by an interview method from 240 randomly sampled caregivers. The result showed the presence of personal and social resources and their burden levels were positively related to caregiver facilitation in health care.

Jeanie kayser(1990), conducted a study to investigate the attitudes of patients, family members, and nurses, towards the use of nasogastric tube feeding in nursing homes. Findings disclosed were inadequate communication between health care providers ,patients, and families ,and some of the families perceived that the tubes being inserted were for the convenience of the home nursing staff.

Banks,Henwood,& Wexter (1998) Study shows that many of the caregivers were not aware of their rights and responsibilities, majority of caregivers were receive minimal information and advice from medical personals and often poorly prepared for their role.

Mohammed Shinde(2009),conducted a study to assess the effectiveness of demonstration regarding feeding of hemiplegia patient among caregivers. Major finding in the study include majority of the caregivers were in the age group of 28-37yrs.53-63% were females.40-60% were unemployed.70-80% were married.

Studies related to knowledge of caregivers regarding patient care

Elaine wittenberg (2001)conducted a study to assess the knowledge and skills of caregivers regarding the care of the patient. The result showed that many family caregivers do not have the necessary skills and knowledge to provide sustained care for a person with acute or chronic illness, so they lack confidence and felt un prepared. Caregivers reported that they received little guidance from health providers, that they did not know how to assume the caregivers role, that they were not familiar with the type and amount of care expected, and that they did not know how to access and effectively utilize the resources.

Silver H J.et.al(2002) conducted a study to assess the health care outcomes of older adults receiving home enteral nutrition. The purpose of the study was to identify the variables of home health care outcomes related to enteral nutrition in among older adults nursed by informal caregivers. They assessed the relationship among home enteral nutrition regimen prescription, health care outcomes and adherence, provider involvement. They conducted home interview with 30 samples to collect data’s. The results showed that gastrointestinal complications were occurring in up to 63.3% of the patients. One third reported tube tube displacement, clogging and tube leaking. Majority of the samples were poor in their enteral intake, low body mass indexes. Only 6 patients met dietitians in follow up care. The study concluded that caregivers of the patient’s had poor understanding about the enteral nutrition, management and health care outcome.

Wellman N S.et.al (2002) conducted study among family caregivers of older adults on home enteral nutrition. Objectives of the study was to describe specific tasks of family caregivers and their preparedness, competence, effectiveness and health care uses. Home interviews were conducted with 30 family caregivers of home enteral feeding. Result was shown that caregivers providing 6-160 hrs of care weekly. Caregivers were poorly prepared for accomplishing their role. Training needs were identified highly in the areas of technical and nutrition related tasks.

Evans S.et.al (2008)conducted study on home safety issues in children receiving enteral feeds. Objective of the study was to assess the safety aspect of the caregiver’s enteral feeding technique when patient receivingl tube feeding .Out of fourty samples 50% of the samples were fed by gastrostomy and other 50% were on nasogastric tube feeding. A questionnaire and practical assessment was administered to the caregivers. The main issues identified were poor hygiene practices(78%),Poor or no hand washing(25%),inadequate tube flushing(50%),Irregular checking of tube’s position(40%),Poor knowledge on how to clear the feeding tube blockages(80%),Untrained caregivers (43%).

Studies related to effectiveness of structured teaching on caregivers

According to WORLD HEALTH ORGANIZATION health education is a major mode of teaching & it is assumed that teaching helps in changing the behavior through cognitive &affective behavioral changes. Each individual is responsible for maintaining his own health. Health education will influence individual, community& social health and devolopment.

Mohammed Shinde(2009),conducted a quasi-experimental study to assess the effectiveness of demonstration regarding feeding of hemiplegia patient among caregivers. Objectives of the study was to assess the practices of feeding among caregivers before and after demonstration and determine the association of selected socio-demographic characteristics with feeding skills. The study was done on 60 samples with pre-test post-test design to assess effectiveness in oral and nasogastric feeding. Out of sixty 30 samples were selected for assessing oral feeding and other 30 were selected for nasogastric tube feeding. Result showed was that in both oral and nasogastric feeding group significant improvement in skill score of caregivers about feeding of hemiplegic patients after demonstration, no significant relationship was shown with regard to age, sex, education, occupation and marital status.

Nancy L. Goldstein MPH(1991)conducted study on patient learning center and patient readmissions. This study examines the effectiveness of a teaching Center in preparing patients to go home with a right atrial catheter. The aim of the study was to minimize re-admission and catheter related complications. Patient questionnaires, retrospective chart audit and staff surveys were used to gather the data. The result showed learning Center participation not only resulted in patients and families achieving more learning outcomes, but also minimized hospital readmissions for re-insertion or catheter-related complications.

Scheinmann.et.al(2010) conducted a study to assess the effect of an educational video to improve infant feeding knowledge and behaviour among nursing mothers. In the study an educational video was distributed for home viewing. The study was consisted both experimental and control group. Both experimental and control group mothers were in similar age, education and parity. At the six month follow up video assisted group showed a greater increase(1.7 times) in knowledge between baseline and six months.

Jeanie Kayser (1998)studied the effect of promoting family caregiver’s participation in caring for AIDS patient on family caregivers knowledge and caring ability. She conducted a quasi- experimental research on 30 family caregivers who took care of AIDS patient were recruited by purposive sampling method and were divided into experimental and control with 15 in each. The experimental group participated in a five day training programme on caring the patients, whereas the other group received only a booklet for reading. The result showed that more than half(66.7%)of all participants were females with mean age of 36years.After intervention, the experimental group showed a significantly higher level of knowledge and caring ability than before. The experimental group demonstrated higher ability and skills in management of symptoms and in providing psychological support.

Shieh S J.et.al(2004) conducted a study to assess the effectiveness of structured discharge teaching on maternal confidence, caring knowledge among the parents of premature newborns. In this study mothers with preterm babies were randomly assigned to both control and experimental group. A pre test administered to both groups. After pre-test, a structured discharge teaching programme was provided to the mothers of experimental group. The control group mothers only received informal traditional discharge education. Mothers of experimental and control group received a post test on the day before discharge and one month after the discharge. Result showed that the mothers of experimental group were significantly high in their confidence and caring knowledge.

ArslantaÅŸ S.et.al(2009) conducted a study to assess the effectiveness of a brochure to prevent pressure ulcers in patient and caregivers. The study group consisted of 33 hospitalized patients and their 33 caregivers. Among the samples half of the subjects (54.5%) were women and 60.5% were more than 65 years of age. In the group, slightly more than 60% were diagnosed as moderate risk and 39.4% were diagnosed as high risk for getting pressure ulcer. The samples were categorized on the basis of Braden Scale scores. Eighteen percent of patients had a previous history of pressure ulcer , but only 6.1% of the patients had received education regarding prevention of pressure ulcer. The group was provided with verbal educational intervention followed by educational brochure. The result showed that the knowledge level among patient and their relatives were markedly improved after the intervention.

Hudson P.et.al(2009) conducted a study to assess the effectiveness of teaching family carer’s about home-based palliative care. The program was aimed to prepare family carer’s for the role of supporting a relative with advanced, non-curable cancer at home. A total of 156 participants underwent the psycho-educational programme consisted of three consecutive weekly sessions. The study was conducted at six home-based palliative care services. The following dependent variables were measured at three specific time intervals: carer’s competence, preparedness, rewards, and information related needs. The three time points were: starting of the programme (Time 1), upon completion (Time 2), and two weeks after completion (Time 3).The result showed that the intervention had significant effect on the areas of preparedness, competence, rewards, and information related needs during the interval. Outcomes were maintained at Time 3 also. This study demonstrated that a group education program to prepare family care giver’s for the role of supporting a sick relative at home was effective.

CONCLUSION

The review of literature enlightened the investigator to develop an insight into the teaching and its effectiveness. This review helped the investigator to gain a deeper knowledge of the research problem and guided in designing the study.