Care Dependency of Post-stroke Patients and Its Affecting Factors / 재활간호학회지

PURPOSE: This study was aimed to identify the care dependency and its affecting factors of post-stroke patients. METHODS: Cross-sectional and correlational descriptive study design was used. The subjects were 106 post-stroke patients who were in or out-patients in a rehabilitation clinic at D city. Demographic, stroke related and post-stroke status variables (paralysis, arthria, verbal expression, visual disturbance, activity intolerance, nutritional status, depression and cognition) were included as affecting factors. Multiple regression was used to identify the affecting factors. Among demographic and stroke-related variables, significant variables such as age, education level, marital status, financial status, location of treatment, and total admission days were entered with post-stroke status variables. RESULTS: Care dependency was still high regardless of disease duration or type of stroke. Overall, approximately 80.5% of total variances in care dependency was explained with all variables. Among those variables, nutritional status, cognition and activity intolerance were the significant affecting factors. CONCLUSION: To reduce the care dependency of post-stroke patients, it is recommended to improve nutritional status, cognition and activity intolerance.

Assessment of the current status and issues in acceptance of clients with high medical acuity at long term care service provider offices and facilities in area B / 日本プライマリ・ケア連合学会誌

<b>Introduction</b> : One of the key challenges in promotion of medical and nursing care collaboration in long term care is the difficulty in understanding the current state of acceptance of clients with high medical acuity by local long term care service providers. This study therefore aimed to clarify the current state and issues regarding such clients.<br><b>Methods</b> : Information was obtained via face to face interviews at 102 facilities out of 105 located in Area B in Prefecture A.<br><b>Results</b> : (1) Most of the facilities, except Long-Term Care Health Facilities, do not have night shift nurses, making it difficult for them to accept anyone who needs a medical procedure, such as tube feedings or sputum suctioning. <br>(2) The number of the facilities accepting elderly clients who require sputum suctioning decreased after the current regulations came into force, due to lack of human resources to provide the time off for training of the staff, and concern regarding costs of training and equipment given the current provider business environment. <br>(3) Lack of understanding by physicians appears to be the largest challenge with regards to end-of-life care, and is a larger factor than lack of understanding and experience of the facilities.<br><b>Conclusion</b> : Collaboration between medical and nursing care needs to be further enhanced based on clear understanding of roles and reality of the facilities.