Current status and issues regarding the start of home care from the perspective of discharged stroke patients

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  • MINOTANI SHINKO
    School of Nursing, Faculty of Medicine, Toho University School of Nursing, Faculty of Medicine, Toho University
  • SATO HIROKO
    Morigaoka Clinic Morigaoka Clinic
  • MIYACHIKA IKUKO
    Denenchohu Medical Association Visiting Nursing Station Denenchohu Medical Association Visiting Nursing Station
  • JINKAWA CHIZUKO
    Kanagawa-ku Medical Center Visiting Nursing Station Kanagawa-ku Medical Center Visiting Nursing Station
  • ONISHI MICHIKO
    Kanagawa-ku Medical Center Visiting Nursing Station Kanagawa-ku Medical Center Visiting Nursing Station
  • FUJIWARA YASUKO
    Formerly Saiseikai Mita Visiting Nursing Station Formerly Saiseikai Mita Visiting Nursing Station
  • HOSHINO SANAE
    Saiseikai Nanbu Visiting Nursing Station Saiseikai Nanbu Visiting Nursing Station
  • YAMAZAKI JUNICHI
    Toho University Omori Medical Center Toho University Omori Medical Center

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Other Title
  • 脳卒中退院患者からみた在宅療養生活開始時の現状と課題
  • ノウソッチュウ タイイン カンジャ カラ ミタ ザイタク リョウヨウ セイカツ カイシジ ノ ゲンジョウ ト カダイ

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Abstract

Objective : It is necessary to provide support in preparation for the start of the home care of stroke patients ; therefore, the present study clarifies the current status of uncertainties and difficulties as well as necessary issues at the time of discharge from the perspective of stroke patients. Methods : Subjects were stroke patients who were initially transferred to their homes after April 2000 and are currently continuing to receive home care in the Tokyo Metropolitan area. Interviews were conducted using an original questionnaire during a four-month period starting December 2005. The questionnaire comprised of approximately 30 items including ADL, mental and physical condition, uncertainties and difficulties, and discharge guidelines at the time of initial discharge following stroke. Analysis included such measures as the chisquare test. Results : A total of 52 (92.9%) valid responses were obtained. The following findings were confirmed : 1) Uncertainties and difficulties were reported in approximately half of the patients, predominantly among those with disabilities in ADL and with mental and physical problems. 2) Patients who had been hospitalized for 3 months were more likely to have disabilities in ADL as well as mental and physical problems. 3) Patients with uncertainties and difficulties were more likely to receive discharge guidelines. 4) Patients who had been hospitalized for 3 months or more received more discharge guidelines and care conferences, and were prepared for discharge. 5) There were no differences between patients hospitalized 3 months or longer and those hospitalized under 3 months with regard to uncertainties and difficulties. 6) Among those hospitalized 3 months or longer, there were more patients who changed to another hospital before transferring to home. 7) Rehabilitation hospitals and wards prepared patients for discharge based on their mental and physical condition as accepted by the patients and their families. Conclusion : Patients hospitalized for 3 months or more had disabities in ADL and mental and physical problems, but were prepared for discharge. Although disabities in ADL and mental and physical problems contribute to uncertainties and difficulties at the time of discharge, the burden of uncertainties and difficulties can be reduced by discharge preparation. The uncertainties and difficulties experienced by patients and their families at the time of discharge result from a lack of physical and mental preparation prior to discharge. Therefore, during hospitalization, it is important to enable patients and their families to prepare for a comfortable discharge.

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