The Healthcare Needs at Home after Stroke Hospitalization

Tuesday, 14 July 2009

Tan-Ying Chiu, MS, RN
Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

Learning Objective 1: identify the home care needs of stroke patients after hospitalization

Learning Objective 2: understand the gap of the continuum of care in the current health care system

Purpose: The purpose of this precedant study is to explore the needs of hospitalized stroke patients before discharge home and to identify the resouces that hospital nurses and home care nurses may provide after discharge at home.

Methods: An observation study design using survey questionnaire were used.  The selection criteria of participants are stroke patients who were going to be discharged home and had Barthel Index less than 100.  Twenty one patients agreed to be visited either by phone or in person.  There were five surveys per patients at the time before discharge, three days after discharge, and two weeks, one month, and two months after discharge.  The survey questionaire has been well-developed and used commonly in Taiwan. 

Results: The healthcare needs of stroke patients before discharge were mostly, in order, activities of daily living, emergent management, medication, auxiliary devices, and medical information.  The phone or home visits after discharge revealed that most of the patient needs could be satisfied.  The follow-up evaluation of patient needs showed that most needed assistance and consultation were the management of emergent situations,  of complications, and of nutrition through naso-gastric tube.  The needs after discharge obviously decreased if the nursing care had been well implemented while stroke patients were still in the hospital. 

Conclusion: The healthcare needs of stroke patients were different at various stages after discharge.  Health care providers should establish care plan based on the various needs of stroke patients.  The study provide evidence in terms of patient needs at different stages of stroke recovery.