DEVELOPMENT OF CARE SYSTEM FOR STROKE PATIENTS FROM HOSPITAL CONTINUING TO COMMUNITY, CHUMPHON PROVINCE

Abstract

Stroke patients in Chumphon province will be attended by a multidisciplinary team of hospitals, but when was discharged to home with the problem that some patients had no caregiver and undergoing delayed care. This research was aimed to development of care system for stroke patients from hospital continuing to community, Chumphon province. This cross sectional descriptive research, samples were 247 personnel, 203 local networks, 94 stroke Patients and 94 caregivers. Data collected during June - July 2018, consisting of personnel questionnaire (alpha0.89), network questionnaire (alpha0.84), Barthel’s index of activities daily living (ADL) (alpha0.85), capacity of caregiver questionnaire (alpha0.91) and quality of life assessment (alpha0.94). Data were analyzed by percentages, means standard deviation and chi-square test.

The results after development the quality service of home visit was better than before the development, there were demographic data, patient problems assessment and care, referral system, report form and home visit schedule. The participation of local network was at moderate level 85.7% (mean=50.94; SD=10.45), overall ADL of patient was moderate level 51.1% (mean=48.03; SD=33.41), overall patient’s quality of life was moderate level 53.2% (mean=8.81, SD=1.50). Factors had statistically significance related to patient’s quality of life were as follows gender, residence style, ADL score of patient were as follows Feeding, Transfer, Grooming, Toilet Use, Bathing, Mobility, Stairs, Dressing, Bowels and Bladder. Overall work capacity of caregivers was high level 84.0% (mean=45.48; SD=15.88), overall quality of life of stroke patient’s caregiver was moderate level 81.9% (mean=6.63; SD=1.02), factors had statistically significance related to caregiver’s quality of life were as follows overall capacity of caregivers, type of caregivers, emergency transit management, training, income, overall quality management of patient’s service. Factors had no affecting to caregiver’s quality of life were as follows gender, age, education, work, population survey, coordinating with family care team, planning, consulting, patient’s healthcare with other organizations, patient information file and reporting. Conclusion: after development the quality of service was better than before development. The ability of patients to improve daily routine to the quality of life of the patients was significantly improved at p-value<0.05.