| Summary: | 碩士 === 國立台北護理學院 === 長期照護研究所 === 92 === The purpose of this study was to investigate the utilization rate and general situations of Assistive Technology (AT) use in patients on the discharge planning program of a hospital in central Taiwan. Factors including gender, age, and the length of hospital stay (LOHS) were evaluated in users and non-users selected from the recipients of the discharge planning program.
The correlation between the 15 items of a high risk-screening tool for the discharge planning program and AT usage was studied to identify the high-risk screening factors for AT usage. The effects of early AT intervention on client satisfaction and length of hospital stay were then compared between a group receiving early discharge planning with special emphasize on AT service and a baseline group receiving discharge planning without emphasis on AT service.The first phase of this study was correlation study and the second phase of this study was a quasi-experimental study.
Two validated research tools, a high-risk screening tool (contains 15 items) with a kappa value of 0.895 for discharge planning and QUEST 2.0 scale (Quebec User Evaluation of Satisfaction with Assistive Technology, contains 12 items) with a Cronbach’s value of 0.827 were used.
Results: 595 participants (342 males and 253 females, average age 60.5) were involved in this study. The AT utility rate was 40% (238). AT was obtained more frequently before the patient was hospitalized than either during hospitalization or after the patient was discharged. Subjects who were female, being older and patients with longer hospital stays were found to have a higher AT utilization rate. Results from the logistic regression analysis indicated that four of the 15 items from the high-risk screen tool of discharge planning, i.e., extremity paralysis, age above 65, hospitalization during the past 2 months, and high potential needs of long-term treatment were the high-risk screening factors for AT usage among subjects receiving discharge planning.
The 80 participants in the quasi-experimental part of this study were divided into two groups, with (experimental group, 40 persons) and without (control group, 40 persons) early intervention of AT. The average AT utility rate was 1.88 items per person. The most common type of AT used in these subjects was ambulating aids. In 84% of the subjects, AT has been used for more than one month. 74% of the subjects obtained their AT from medical supply stores, and 78% of the subjects continued using AT after they were discharged from the hospital. Personnel at the medical supply stores were the most common known instructors for AT application (62.64%). 61.3% of the subjects purchased AT on their own expenses. Using non-parametric analysis, patients with early AT intervention were found to have a significant higher satisfaction score and LOHS than patients without early AT intervention (p＜.001; p＜.05). In particular, the satisfaction score is significantly higher in the experimental group than the control group among questions related to AT services.
In conclusion, this study revealed four items, i.e., extremity paralysis, age above 65, hospitalization during the past 2 months, and high potential needs of long-term treatment significantly related to AT users among the discharge planning recipients. Subjects receiving early discharge planning services with emphasis on AT service scored higher on the satisfaction questionnaire than the control group. Thus this mode of early screening and service provision should benefit patients in the future in hospitals providing discharge planning. A possible explanation to our finding that the LOHS is longer in the experimental group than the control group is that the experimental group averaged higher number of risk factor (4.53) than the control group (average = 2.78) based on the screening tool. Future study is needed to explore further and explain the relationship between AT service and LOHS. In summary, our study showed that our screening tool could be used effectively to select subjects needing AT and thus provides more satisfactory discharge planning with emphasis on AT service.
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