Health and care needs of patients with stroke applied to home health service
Objective: To investigate the health and care needs of stroke patients applying for home health care.
Materials and Methods: This descriptive and cross-sectional study included all stroke patients and caregivers who were applied to Marmara University Pendik Training and Research Hospital Home Health Services (HHS) Unit for the first time in October-December 2017. Home visits were arranged to all patients by the same physician and sociodemographic characteristics, complaints, diseases and medications were evaluated and routine biochemical examinations were performed. In addition, Six-item Cognitive Impairment Test, Barthel Index of Activities of Daily Living, Mini Nutritional Assessment-short form, ECG, Time up and go test and 2-item depression screening test were applied.
Findings: The study included 42 stroke patients (18,75%) from 224 people who applied for home care for first time. The most frequent expectations of the patients from HHS are the treatment and follow-up of their diseases (57%). Physiotherapy, providing patient diaper and medication reports, prescribing of medications, financial aid, blood analysis, wound dressing, INR follow-up, injection and replacing the catheter are the other services expected. Twenty patients (47,6%) had high blood pressure and all patients had LDL above 100 mg/dl. Five patients with atrial fibrillation who were not using antithrombotic or anticoagulant were detected. Falling history (70,8% of the 24 patients who were not fully dependent), risk of falling (21%), malnutrition (35,7%), risk of malnutrition (40,5%), history of aspiration (31%), insomnia (59,5%), depression risk (51,4%) and decubitus ulcer (14,3%) are the other detected problems. After stroke, 60% of the patients were taken to the hospital by a car. The frequency of depression was higher in the caregivers of the patients with depression (p <0.05).
Conclusion: This study suggest that the most essential health and care needs of stroke patients applying for home health care are the prevention of a secondary stroke and stroke complications.
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