Long-term care needs & their related factors in neurosurgical patients before discharge from the hospital : In case of a Medical Center in northern Taiwan.

• Main Authors: Ju-Yu Yang, 楊如玉
• Other Authors: Shyh-Dye Lee
• Format: Others
• Language: zh-TW
• Published: 2006
• Online Access: http://ndltd.ncl.edu.tw/handle/71954434889830503424

碩士 === 國立台北護理學院 === 長期照護研究所 === 94 === Abstract Neurosurgery is a clinical specialty covering emergent, intensive, acute, subacute, chronic and long-term care fields. Dependency level of daily living is usually higher in patients of this clinical field. Thus practically, it’s important to catch the long-term care need of the patient group in Neurosurgery ward. This study was aimed at showing the long-term care need of patients in the department of Neurosurgery, and rather, some important related factors. This study was a cross-sectional research design, to collect the corresponding information through purposive sampling and structured questionnaires. 201 qualified subjects were recruited from the Neurosurgery wards of a medical center in northern Taiwan. Based on the literature review and clinical experience, two related questionnaires on “Normative Need” & “Felt Need” of long-term care had been organized, trying to evaluate need of the subjects. One was “Scale for the Normative Need of Long-term Care in Patients of the Neurosurgery Department” with 16 questions, and the other was “Scale for the Felt Need of Long-term Care in Patients of the Neurosurgery Department” with 20 questions. Statistic analytic methods/procedures included descriptive statistics, independent samples t-test, one way ANOVA, Pearson r and multiple regression. The results of this study showing the top priotized items of normative long-term care need were several fold: (1)frequency of return to outpatient visit in the first month after discharge, (2)ability to control defecation, (3) ability to control micturition, (4)ability to arrange daily living, (5)ability of self-expression, (6)ability to catch the expression from others, (7)visual function status, (8)co-existed chronic conditions, (9)auditory function status, (10)administering three or more prescribed medication. And top priotized items of felt long-term care need were:(1)knowledge & skill of monitoring and handling abnormality & emergent conditions of the morbid conditions, (2)information about medication prescribed, (3)instruction for physical activity/exercise or rehabilitation, (4)information about physical care, nursing care, wound care and catheter care, (5)message about subsequent progression and complication of the morbid conditions, (6)assistance for transportation, such as Fu-Kang Bus, (7)referring information of home-based physical therapy, (8)assistance for linking social welfare resources, such as certification of catastrophic illness, mental or physical disability, or low-income level, (9) referring information of home-based occupational therapy, (10)information about assistive devices. Factors affecting long-term care need of patients included length-of-stay(LOS), age, ADLs, having received discharge planning or referral services or not, education level…etc. All these need items were on the list of amendable workup, i.e. early detection, evaluation, information providing and even intervention, i.e. providing necessary information about subsequent progression and complication of the morbid conditions, and coping with the emergent situations would be helpful for patient transferring back from acute medical setting to home or other long-term care facility. In addition, with its unique characteristics, patients in the Neurosurgery Department did require much more long-term care. Hence long term care information and related resources should be essential for the staff in Neurosurgery ward. And hospital could set up “Long-Term Care Resource System”, including permanent posters, brochures, instruction sheets, remarkable websites, and mechanism of frequently advice & reminding, to offer madatorily reference for the patients, their families and the staff.