| Summary: | 碩士 === 高雄醫學院 === 護理學研究所 === 86 === Delphi technique was used in de signing questionnaire for
this study. Ofthe 100 obstetric experts who completed the
questionnaires of this study were39 cheif nurses from district
teaching hospitals or bigger hospitals, 37physicians and 24
nursing teachers of nursing colleges or universities.Three
rounds of questionnaires were used in the study to collect
andintegrate experts'' opinions concerning "the care needs for
preparatoryservice for discharge after delivery and its
evaluating indicators" into a consensus. The first
questionnaire used open-ended questions to define thecontent of
this study. The second and third questionnaires were
constructedby analyzing the answers of the first one, utilizing
the weighed selectionof experts and sorting them in accordance
with their importance, therationale of the answers had to be
stated. The study used the mean of the rank, its
standard deviation, T score and6 statistical criteria of the
selected items to define the following: (I) 8 important
items out of 20 care needs of mothers were selected,
they are: (1) Evaluation of uterine contraction and lochial
amount. (2) Determining patients'' self-care ability.
(3) Care for perineum and wound self-care instruction.
(4) Monitoring patients'' urine output, bowel
movement and care for hemorrhoid. (5) Balanced
puerperal nutrition instruction through consultation, pamphlet
and open discussion. (6) Instructing
postpartum exercise. (7) Breast- feeding
instruction and care for breast and nipple. (8) Breast-
feeding problem management. (II) 8 important items out
of 15 care need of the newborns were selected , they
are: (1) Educating mothers and the relatives (fathers in
particular) about their infants'' developmental milestones. (2)
Instructing mothers to identify and manage the problems
inrearing their infants. (3) Informing the mothers to
follow the infants'' vaccination schedule, infant health
examination, infant metabolism screen test and the
follow-ups. (4) Demonstrate newborn bathing skill.
(5) Umbilical cord care and infection prevention
instruction. (6) Identifying neonatal jaundice. (7)
Emphasizing early parent-child interaction and help
establish the relationship. (8) Assist puerperal
follow-ups and provide relevant health care resources.
(III) 4 important items out of 7 evaluating indicators regarding
the case and her family, they are: (1) The evaluation
and satisfaction of self-care ability before and after
discharge. (2) The evaluation and satisfaction of
infant-care ability before and after discharge. (3) The
recognition, acceptance and the comparison of the content
of preparatory service for discharge. (4) The satisfaction,
opinion and the practice of the mothers and their families to
preparatory service for discharge. (IV) 7
evaluating indicators regarding health care delivery system were
identified, they are: (1) Hospitalized days of mothers and
infants, readmission and the causes, the incidence
rate, length of stay or outpatient visit frequency
and the causes. (2) The rates of postpartum OPD check-
up, well baby check-up and infant vaccination. (3) The
health condition of the mothers and newborns. (4) The
satisfaction of baby-delivery service, the willingness to return
for next delivery and the increase of the number of delivery in
the hospital. (5) The availability of follow-up
service provided by the hospital, the utilization and
satisfaction of cases using consultation
service. (6) The periodical KAP evaluation of the
relevant health care personnel. (7) Efficient administration,
clinical pathway monitoring and family-centered nursing care.
So called important items are the consensus reached by
the experts participated in the study, which has
strictly abided the spirit of Delphi technique. The
result of this study can help clarify the mothers'' needs for
preparatory service before discharge from hospital, indicate
importantcontent of puerperal stage care and establish
indicators for service qualitymonitoring. It can also provide
scholars and clinical practitioners withvery useful guideline
for prior and in-service training programs. Ultimately, it can
help mothers obtain quality service they deserve. Keywords:
Discharge planning, The need for care, Evaluating indicators,
Delphi technique
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