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Physiological Functional Status and the Levels of Unmet Care Needs after Discharge in Patients with Chronic Pulmonary Disease, Colorectal Cancer, and Strokes

퇴원환자의 신체적 기능상태 및 미충족 간호요구도: 만성호흡기질환, 장루보유 대장암, 뇌졸중 환자를 중심으로

  • Oh, Eui Geum (Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University) ;
  • Sung, Ji Hyun (Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University) ;
  • Park, Young-Su (Department of Nursing, Soonchunhyang University) ;
  • Lee, Hyun Joo (Graduate School, College of Nursing, Yonsei University) ;
  • Kim, Yu Kyung (Korea Armed Forces Nursing Academy)
  • 오의금 (연세대학교 간호대학.김모임간호학연구소) ;
  • 성지현 (연세대학교 간호대학.김모임간호학연구소) ;
  • 박영수 (순천향대학교 간호학과) ;
  • 이현주 (연세대학교 일반대학원) ;
  • 김유경 (국군간호사관학교)
  • Received : 2016.01.31
  • Accepted : 2016.06.24
  • Published : 2016.08.31

Abstract

Purpose: The purpose of this study was to identify physiological functional status and unmet care needs among patients with chronic pulmonary disease, colorectal cancer, and strokes after discharge. Methods: A crosssectional study was conducted with 224 patients diagnosed with aforementioned diseases from January to July in 2014 in two different tertiary hospitals in Seoul and its suburban area. Physiological functional status and unmet care needs were collected using Karnofsky Performance Status (KPS) Scale and Problems After Discharge Questionnaire-English version(PADQ-E) respectively. Data were analyzed using SPSS/WIN 21.0 program. Results: Patients with chronic pulmonary disease and colorectal cancer showed a low level of physiological functional status (mean: 77.20 and 77.60 out of 100 respectively) and a high level of unmet care needs (mean 2.23 and 2.63 out of 4 respectively). Stroke patients showed a high level of unmet care needs in the category of 'counseling', 'physical complaints', and 'instructions'. Physiological functional status was significantly associated with unmet care needs in all three patient groups and it showed a significant effect on unmet care needs in patients with stroke. Conclusion: The results showed that patients after discharge were still having insufficient functional status and various unmet care needs. The results of this study suggest a development of nursing care service for patients with chronic diseases after discharge.

Keywords

References

  1. Korea Institute for Health and Social Affairs. 2014 Patient Survey [Internet]. Seoul; Ministry of Health &Welfare, Korea Institute for Health and Social Affairs; 2014[cited 2016 March 8]. Available from: http://stat.mohw.go.kr/front/statData/publicationView.jsp?menuId=45&bbsSeq=11&nttSeq=21883&searchKey=&searchWord=&nPage=1&topSelect=B00006.
  2. Schneider EB, Hyder O, Brooke BS, Efron J, Cameron JL, Edil BH, et al. Patient readmission and mortality after colorectal surgery for colon cancer: Impact of length of stay relative to other clinical factors. Journal of the American College of Surgeons. 2012;214(4):390-398. http://dx.doi.org/10.1016/j.jamcollsurg.2011.12.025
  3. Lee E, Yu SH, Lee HJ, Kim S. Factors associated with unplanned hospital readmission. Korean Journal of Hospital Management. 2010;15(4):125-142.
  4. Lee JH, Kim YM, Kang SH. A study patient management for both planned and unplanned readmission in a medium-size hospital. Health Service Management Review. 2008;2(1):11-17.
  5. Holland DE, Mistiaen P, Bowles KH. Problems and unmet needs of patients discharged "home to self-care". Professional Case Management. 2011;16(5):240-250. http://dx.doi.org/10.1097/NCM.0b013e31822361d8
  6. Ju AR, Yeoum SG, Park KS. The nursing needs of post-surgical colon cancer patients at discharge. Journal of Korean Academy of Fundamentals of Nursing. 2009;16(4):392-401.
  7. White P, White S, Edmonds, P, Gysels M, Moxham J, Seed P, et al. Palliative care or end-of-life care in advanced chronic obstructive pulmonary disease: A prospective community survey. British Journal of General Practice. 2011;61(587):e362-370. http://dx.doi.org/10.3399/bjgp11X578043
  8. Baker CL, Zou KH, Su J. Risk assessment of readmissions following an initial COPD-related hospitalization. International Journal of Chronic Obstructive Pulmonary Disease. 2013;8:551-559.
  9. Cho KH, Kim KH. A families's burden on a cerebrovascular accident patient and the demand for nursing home. Journal of Korean Academic Society of Nursing Education. 2006;12(1): 95-103. http://dx.doi.org/10.2147/COPD.S51507
  10. Hung MC, Hsieh CL, Hwang JS, Jeng JS, Wang JD. Estimation of the long-term care needs of stroke patients by integrating functional disability and survival. PLoS One. 2013;8(10):e75605. http://dx.doi.org/10.1371/journal.pone.0075605
  11. Bowles KH, Naylor MD, Foust JB. Patient characteristics at hospital discharge and a comparison of home care referral decisions. Journal of the American Geriatrics Society. 2002;50(2):336-342. https://doi.org/10.1046/j.1532-5415.2002.50067.x
  12. Depalma G, Xu H, Covinsky KE, Craig BA, Stallard E, Thomas J III, et al. Hospital readmission among older adults who return home with unmet need for ADL disability. The Gerontologist. 2013;53(3):454-461. http://dx.doi.org/10.1093/geront/gns103.
  13. Altfeld SJ, Shier GE, Rooney M, Johnson TJ, Golden RL, Karavolos K, et al. Effects of an enhanced discharge planning intervention for hospitalized older adults: A randomized trial. The Gerontologist. 2013;53(3):430-440. http://dx.doi.org/10.1093/geront/gns109
  14. Carr DD. Building collaborative partnerships in critical care: The RN case manager/social work dyad in critical care. Professional Case Management. 2009;14(3):121-132. http://dx.doi.org/10.1097/NCM.0b013e3181a774c3
  15. Brubakken K, Grant S, Johnson MK, Kollauf C. Reflective practice: A framework for case manager development. Professional Case Management. 2011;16(4):170-179. http://dx.doi.org/10.1097/NCM.0b013e318216af96
  16. Mitchell SE, Gardiner PM, Sadikova E, Martin JM, Jack BW, Hibbard JH, et al. Patient activation and 30-day postdischarge hospital utilization. Journal of General Internal Medicin. 2014;29(2):349-355. http://dx.doi.org/10.1007/s11606-013-2647-2
  17. Chalmers K. Community health nursing in Canada: Practice under transition. Health & Social Care in the Community. 1995;3(5):321-325. https://doi.org/10.1111/j.1365-2524.1995.tb00033.x
  18. Shin EY. Nursing case management program development for the elderly at hospital. Journal of Korean Community Nursing. 2002;13(3):444-455.
  19. Jang MY, Lee GE. Influencing factors on the need of community care services in the family caregivers of hospital based home care patients. Journal of Korean Academy of Community Health Nursing. 2009;20(4):443-452.
  20. Lee JS, Han EJ, Kang IO. The characteristics and service utilization of home nursing care beneficiaries under the Korean long term care insurance. Journal of Korean Academy of Community Health Nursing. 2011;22(1):33-44. https://doi.org/10.12799/jkachn.2011.22.1.33
  21. Kwon IS, Eun Y. The homecare needs of cancer patients. Journal of Korean Academy of Nursing. 1999;29(4):743-754. https://doi.org/10.4040/jkan.1999.29.4.743
  22. Jacobs V. Informational needs of surgical patients following discharge. Applied Nursing Research. 2000;13(1):12-18. https://doi.org/10.1016/S0897-1897(00)80014-2
  23. Glower DD, Christopher TD, Milano CA, White WD, Smith LR, Jones RH, et al. Performance status and outcome after coronary artery bypass grafting in persons aged 80 to 93 years. The American Journal of Cardiology. 1992;70(6):567-571. https://doi.org/10.1016/0002-9149(92)90192-2
  24. Humphreys J, de la Maza P, Hirsch S, Barrera G, Gattas V, Bunout D. Muscle strength as a predictor of loss of functional status in hospitalized patients. Nutrition. 2002;18(7-8):616-620. https://doi.org/10.1016/S0899-9007(02)00756-6
  25. Mor V, Laliberte L, Morris JN, Wiemann M. The karnofsky performance status scale: An examination of its reliability and validity in a research setting. Cancer. 1984;53(9):2002-2007. https://doi.org/10.1002/1097-0142(19840501)53:9<2002::AID-CNCR2820530933>3.0.CO;2-W
  26. Mistiaen P, Duijnhouwer E, Wijkel D, de Bont M, Veeger A. The problems of elderly people at home one week after discharge from an acute care setting. Journal of Advanced Nursing. 1997;25(6):1233-1240. https://doi.org/10.1046/j.1365-2648.1997.19970251233.x
  27. Hong BE, Shon EJ. A study on the factors affecting the economic cost of cancer. Korean Journal of Social Welfare Studies. 2008;38:193-215.
  28. Oh EG, Kim CJ, Lee WH, Kim SS, Kwon BE, Chang YS, et al. Factors influencing functional status in people with chronic lung disease. Journal of Korean Academy of Nursing. 2002;32(5):643-653. https://doi.org/10.4040/jkan.2002.32.5.643
  29. Kim H, Yi M. Unmet needs and quality of life of family caregivers of cancer patients in Korea. Asia-Pacific Journal of Oncology Nursing. 2015;2(3):152-159. https://doi.org/10.4103/2347-5625.158019

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