A study on client selection criteria and services for home health care--C.V.A., head and spinal cord injury in patients.

Abstract

This study was done to clarify the types of health care that should be offered. It focus on developing client selection criteria based on the needs of inpatients with cerebral vascular diseases, head injuries and spinal cord injuries. Two research methods were adopted. One was a methodological approach for developing client selection criteria and the other was analytical approach to clarify the types of services to be offered. From the research findings, the following summarized conclusions have been drawn. 1. The problem and item criteria used to select patients requiring home health care, namely, a prototype evaluation tool, consisted of 12 items in four areas; physiological status, functional status, psychological status and environmental status. After assessing each item at three levels, the categorization was done according to the classification criteria. The item internal consistency of the completed tool was .8358, .8390, the interrater reliability was in the range of 84 percent-98 percent and the classification consistency was 92 percent. As external criteria, the relationship of the prototype tool to the Health Status Scale, the Barthel Index of Functional Status Assessing Devices and the number of health problems of the patient was examined and all were found to be statistically significant, verifying the validity of the tool. 2. Using the tool to classify the inpatients according to the established client selection criteria, 84.2 percent were classified as patients requiring home health care, 8.8 percent were assessed as suitable for outpatient care and 7.0 percent were assessed as patients needing to be hospitalized. 3. Clients assessed as requiring home health care had 72 different kinds of health problems, which could be classified into four categories; 54 types of physiological status problems, 8, psychological, 6, functional and 4, environmental status problems. For each problem, the percentage of patients who suffered from the disorders ranged from 2.1 percent-66 percent. More than half of the subjects had problems related to urination, paralysis, contracture or locomotion. For the physiological category, many of the health problems were due to disorders of muscles and bone, whereas skin and breathing disorders were relatively low. The mean number of health problems in this category as 11.1. 4. Reviewing the literature, it was found that home health care consisted of 10 activity areas, namely, sanitation, nutrition, breathing, skin, body temperature maintenance, medication, assessment and observation, education and counselling.(ABSTRACT TRUNCATED AT 400 WORDS)