BACKGROUND: Most older adults with disabilities in China and across Eastern Asian prefer to age in place, relying on home- and community-based care. Their family caregivers frequently encounter significant challenges, including a pronounced lack of knowledge and skills for providing daily living assistance, highlighting a critical need for accessible, practical training. Furthermore, existing community-based support programmes for caregivers often fail to incorporate an integrated family perspective. This oversight neglects the crucial dynamics and internal interactions within the family unit, which are fundamental to the overall adaptation and resilience of the entire family system. OBJECTIVE: This study aims to develop a nurse-led, family-oriented resilience intervention programme for caregivers of older adults with disabilities. The programme is designed to enhance caregivers' practical competencies and to strengthen overall family adaptation within the context of Chinese community settings. METHOD: We followed the Medical Research Council (MRC) framework for developing and evaluating complex interventions to guide the development process. This involved integrating empirical evidence from our prior studies, identifying relevant theories of family resilience, and validating the preliminary intervention content. We employed a two-round Delphi method with an expert panel to validate the initial programme draft. For each proposed activity, we calculated the coefficient of variation (CV) and Kendall's coefficient of concordance (Kendall's W) to assess expert consensus. RESULT: The two-round Delphi consultation yielded high positive and authority coefficients. In the first round, the mean importance scores for items ranged from 4.19 to 4.96 (overall mean 4.77 ± 0.21), with a coefficient of variation (CV) between 0.04 and 0.16 and Kendall's W was statistically significant (p < 0.01). In the second round, scores ranged from 4.16 to 4.96 (overall mean 4.82 ± 0.19), with a CV between 0.04 and 0.15, and a significant Kendall's W (p < 0.01). Based on this expert feedback, we refined the intervention into an 8-week programme, delivered via weekly home visits, integrating two core components: caregiving skill and family resilience. The weekly themes are (1) Getting to know each other; (2) I am not fighting alone (cleaning care and coping, social support for caregivers); (3) Thank you, embrace you (family resilience and internal support); (4) Love flows through communication (dietary care and coping, family communication and coping); (5) Riding the wind and waves together (excretion care and coping, social support for peers); (6) Community with me (mobile care and coping, social support for community); (7) Supplementing energy (safety protection and basic first aid, social support for external systems); and (8) Radiating the caregiver's radiance (individual self-resilience and self-support). CONCLUSION: Guided by the MRC framework, we developed a theory-driven, culturally appropriate, nurse-led and family-oriented resilience intervention for caregivers of older adults with disabilities. The program's flexible delivery allows adaptation to local resources and caregiver needs, help caregivers overcome practical challenges and enhance family resilience. Future research should utilize a three-arm randomized controlled trial to evaluate the feasibility, acceptability and preliminary effectiveness of this complex intervention. IMPLICATIONS FOR PRACTICE: This nurse-led, family-oriented resilience intervention offers a practical, home-based training programme that equips family caregivers of older adults with disabilities with essential caregiving skills and strategies to strengthen family adaptation, thereby supporting the implementation of community-based aged care services in China and similar Eastern Asian contexts.
Bai et al. (Fri,) studied this question.
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