ABSTRACT
Objectives: To evaluate coping and the health problems of caregivers at the time of survivor discharge and at one month after discharge and to determine correlations among personal data, coping and health problems of caregivers and disability of survivors. Method: Eighty-five dyads of survivors with traumatic brain injury and their caregivers were included. The instruments employed for data collection were the 27-item Thai version of the Coping and Adaptation Processing Scale-Short Form, the Health Problem Questionnaire for caregivers and the Disability Rating Scale for survivors. The Roy Adaptation Model was used as a conceptual framework for this study. Pearson's product moment correlation coefficient was employed for analysis. Results: No statistical differences were found between coping and health problems among caregivers. The health problems most frequently reported by caregivers were headache on the day of discharge and no health problems after one month of caregiving engagement. The disability level and marital status of the caregivers were correlated negatively with coping (r = -.245, p = .024, r = -.220, p = .043, respectively). Conclusions: The findings delineated that the caregivers remained able to handle the difficulties involved in caring for survivors at home with fewer health problems. Married caregivers were likely to manage this burden better than other caregivers.
Objetivos: Evaluar el afrontamiento y los problemas de salud de los cuidadores en el momento en que el sobreviviente fue dado de alta y un mes después de que el sobreviviente fue dado de alta. Además, determinar las correlaciones entre los datos de carácter personal, afrontamiento y los problemas de salud de los cuidadores y la incapacidad de los sobrevivientes. Método: Fueron incluidos en la investigación ochenta y cinco diadas de supervivientes con lesiones cerebrales traumáticas y sus cuidadores. Los instrumentos utilizados para la recolección de datos fueron la versión tailandesa de la Escala de Medición del Proceso de Afrontamiento y Adaptación - Formato Corto, con 27 ítems, el Cuestionario de Problemas de Salud para los cuidadores y la Clasificación de Escala de Discapacidad para los sobrevivientes. El Modelo de Adaptación de Roy se utilizó como marco conceptual para este estudio. La correlación producto-momento de Pearson se utilizó para el análisis. Resultados: No se encontraron diferencias estadísticas entre los problemas de afrontamiento y de salud en los cuidadores. Los problemas de salud reportados más frecuentemente por los cuidadores fueron dolor de cabeza en el día de alta y ningún problema de salud después de un mes de participación en el cuidado del sobreviviente. El nivel de la discapacidad de los sobrevivientes y el estado civil de los cuidadores se correlacionaron negativamente con el afrontamiento (r = - 0,245 , p = 0,024, r = - 0,220, p = 0,043, respectivamente). Conclusiones: Los resultados demuestran que los cuidadores permanecieron capaces de manejar las dificultades que implica el cuidado de los sobrevivientes en casa con menos problemas de salud. Los cuidadores casados eran propensos a manejar esta carga mejor que otros cuidadores.
Objetivos: avaliar a adaptação e os problemas de saúde dos cuidadores no momento em que o sobrevivente recebe alta e um mês depois disso, e determinar as correlações entre os dados de caráter pessoal, adaptação e os problemas de saúde dos cuidadores e a incapacidade dos sobreviventes. Método: 85 díades de sobreviventes com lesões cerebrais traumáticas e seus cuidadores foram incluídos na pesquisa. Os instrumentos utilizados para a coleta de dados foram a versão tailandesa da Escala de Medição do Processo de Enfretamento e Adaptação - formatação curta, com 27 itens, o Questionário de Problemas de Saúde para os cuidadores e a Classificação de Escala de Deficiência para os sobreviventes. O Modelo de Adaptação de Roy foi utilizado como marco conceitual para este estudo. A correlação produto-momento de Pearson foi utilizada para a análise. Resultados: não se constataram diferenças estatísticas entre os problemas de adaptação e de saúde nos cuidadores. Os problemas de saúde relatados mais frequentemente pelos cuidadores foram dor de cabeça no dia da alta e nenhum problema de saúde depois de um mês de participação no cuidado do sobrevivente. O nível da deficiência dos sobreviventes e o estado civil dos cuidadores se correlacionaram negativamente com o afrontamento (r = - 0,245 , p = 0,024 , r = -0,220 , p = 0,043 , respectivamente). Conclusões: os resultados demonstram que os cuidadores permaneceram capazes de lidar com as dificuldades que implica o cuidado dos sobreviventes em casa com menos problemas de saúde. Os cuidadores casados eram propensos a lidar com essa carga melhor que outros cuidadores.
Subject(s)
Humans , Adaptation, Psychological , Caregivers , Survivors , Brain Injuries, Traumatic , Patient Discharge , Turkey , NursingABSTRACT
The objective of this study was to evaluate the effects of nursing intervention based on clinical nursing practice guidelines for pressure ulcer prevention in orthopaedic patients. 30 orthopaedic patients, aged 15 years and over who had risks of pressure ulcers and were admitted to the male orthopaedic ward at Nopparatrajathanee Hospital between January 1st and March 8th, 2003 were enrolled in this study. These 30 patients were divided into 2 groups; 15 patients in the experimental group who received nursing intervention according to the Clinical Nursing Practic Guidelines for Pressure Ulcer Prevention and 15 patients in the control group who received regular nursing care. Data was collected daily beginning at hospital admission until they were discharged from the hospital, referred to other wards or until the patients with no longer at risk of developing a pressure ulcer. The results revealed that most of the orthopaedic patients with risk pressure ulcers were adolescents to middle age adults (15-59 years). Most of them had multiple fractures. The patients in the experimental group developed no pressure ulcers, while 26.7% (4 patients) of patients who received regular nursing care as given by the nursing staff developed pressure ulcers. The patients who developed pressure ulcers had a low to high risk of pressure ulcers (Braden score 12-16) and most of them had high body temperature at initial admission (3 in 4 patients). Pressure ulcers developed on the 4th - 6th day of hospitalization and the severity of the skin lesions progressed from stage 1 to stage 2 or 3 within 2 weeks. The pressure ulcers were located at the coccyx and buttocks. The results indicated that nursing intervention utilizing the Clinical Nursing practice Guidelines for Pressure Ulcer Prevention could prevent pressure ulcers effectively. Developing strategies to implement these guidelines as standard care for orthopaedic patients as well as developing strategies help make this kind of care part of ongoing treatment are strongly recommended. Patients’ and caregivers’ participation should be promoted. The contribution of this finding is also crucial because these guidelines still require feedback to assist in their further improvement.
ABSTRACT
This study is a hospital based concurrent cohort study with the objectives of investigating the risk factors and the predictive level of the risk factors of pressure ulcers in hospitalized elderly The study was conducted between January 9th and March 12th 2002, in the medical, surgical, and orthopedic wards of Pranangklao Hospital, a 430-bed tertiary hospitsl under the Ministry of Public Health in Nonthaburi Province. The participants in this study were 117 hospitalized elderly patients who were 60 years or older, did not have pressure ulcers on admission, and were hospitalized for at least four days. Data were collected by the researcher and the research assistant who achieved an inter-rater reliability for pressure ulcer risk assessment and skin assessment on the research instrument of 0.905 and 0.954 resprctively. Pressure ulcer risk assessment and skin assessment were conducted daily by utilizing the Braden pressure ulcer risk assessment scale and the Bergstrom’s skin assessment scale throughout the study period. Logistic regres- sion analysis was employrd to analyze the data. The results of the study revealed the greatest frequency of pressure ulcers was found in those aged 70 to 79 years old (41%) and had neurological or spinal problems (30.8%). The assessment of elderly patients’ risk of pressure ulcers on admission correctly predicted 71.8% of pressure ulces. Of the elderly patients who were predicted to have pressure ulcers, 28.2% developed this complication during the hospitalization period. Most pressure ulcers occurred on the second day after admission. Of the elderly who were predicted not to develop this complication, 93.6% were free from pressure ulcers. An increase in friction and shearing (OR=4.592, 95% CI=1.531-13.770) was the risk factor that had the most influence among the participants, where the second most important risk factor was an increase in core temperature (OR=2.760, 95%CI=1.105-6.891). This study indicates the need for pressure ulcer risk assessment at the time of admission and a need for a pressure ulcer education program for the elderly or their caregivers and for all health care providers. In addition, this study also reveals the need for proper management of these elderly patients who are prone to develop pressure ulcers at the time of admission, especially among those who have increases in friction and shear-ing forces and an increase in core temperature.
ABSTRACT
This study is aims to study the risk levels and the occurrence of pressure ulcers in hospitalized patients with limited activity. The study was conducted in a medical setting at Siriraj Hospital from January 15th to May 31st, 2001. One Hundred patients were enrolled into the study. The data collection procedure included the completion of Braden's pressure ulcer risk assessment form and Bergstrom's skin assessment form on day of admission and this continued throughout the study. The results showed that 28 % of the patients had no risk of pressure ulcer development, while 25 % showed a low risk level, 22 % showed a moderate risk level, and 25 % showed a high risk level. The incidence of pressure ulcer was 40 %. Sixty-five % of those who developed pressure ulcers were age 60 and over and 83 % of them had chronic illnesses such as diabetes or hypertension before hospital admission. There were 96 ulcers found in 40 patients. Of these ulcers, 59 ulcers were stage I while 37 ulcers were stage II. The ulcers most frequently occurred during the first week of hospitalization. The average length of hospital stay of patients who had a pressure ulcer was 14 days while in those who did not have pressure ulcer the stay was only 10 days. The occurrence of pressure ulcers on hospitalization and the number of patients at risk of pressure ulcer development highlight the magnitude of the problem. The results support the need for risk assessment and skin assessment at the time of admission and periodically throughout the hospital stay and could contribute to establishment of a pressure ulcer risk assessment tool as a guideline in nursing practice for predicting and preventing pressure ulcers.
ABSTRACT
The aim of this study was to analyse association between the factors ; (the extent of burn, patient’s age, type of micro-organism, severity of infection and patient’s past medical illness) and the length of hospital stay among 147 survived burn patients who were admitted to the Burn Unit, Siriraj Hospital during January 1, 1994 to August 31, 1997. By using analysis of variance (ANOVA) for bivariate analysis. It was found that statistical significant determinants for variance in the length of hospital stay were extent of burn (F=43.130, df=1,145, p-value<0.0001), type of micro-organism (F=40.792, df=1,145, p-value<0.0001). severity of infection (F=24,409, df=1,145, p-value<0.0001), and type of burn (F=12.815, df=1,145, p-value<0.0001). When we entered these 4 influential independent variables in a final multiple classification analysis, the total explained variance in the length of hospital stay was 44.4% whereas the explained variance were 12.25%, 10.24%, 3.61% and 3.61% for extent of burn, type of micro-organism, severity of infection and type of burn, respectively.