Long-term care services needs for spinal-cord injury patients in Taiwan.

Abstract

According to official health statistics, accidents and their adverse effects are the third leading cause of death in Taiwan. More accident victims are surviving thanks to treatment using high medical technology, but this results in many disabled patients with irreversible impairments. The demand for long-term care (LTC) services for spinal cord injury (SCI) patients has thus become a major concern. However, homebound SCI patients may easily face exclusion from LTC services because they are often ineligible for benefits under the regulations of National Health Insurance (NHI). The purposes of this study were: 1. To quantify the LTC needs of SCI patients, and 2. To evaluate the correlation between SCI patient health status and LTC needs. A total of 133 samples were visited from Kaohsiung City and Pingtung County. The results of this study showed that the average age of subjects was 43.15, with 72.9% male. The health status of most of the research subjects was fair (M = 2.33). The test of physiological health status was a 20-item scale with a five-point response format. The worst dysfunctions were urination (M = 3.36, SD = 1.06), sexual function (M = 3.30, SD = 0.88), excretion (M = 3.26, SD = 1.06), comfort (M = 3.25, SD = 0.84), and mobility (M = 2.75, SD = 1.11). All of the above items showed higher mean scores than average. More than one third of the subjects (36.8%) used wheelchairs, had better mobility and went out often. However, half of subjects were completely bedridden (45.9%). The mean psychosocial health status was poor with a mean score of 2.80 which showed higher mean score than average. The subjects were less satisfied with role function (M = 2.92), emotional stability (M = 2.92), and application for community resources (M = 2.79). The most needed LTC services for SCI patients was home-making services; referral and monitoring services ranked second. Suggestions derived from this study were to coordinate nursing care services with social support services for LTC patients and to allocate LTC resources based on patients' health status and their need for LTC services.