Nakai Michiko, Narita Yugo, Tomimoto Hidekazu
1 Suzuka University of Medical Science, Suzuka, Mie, Japan.
2 Mie University Hospital, Mie, Japan.
J Prim Care Community Health. 2017 Jul;8(3):163-168. doi: 10.1177/2150131917696940. Epub 2017 Mar 8.
Amyotrophic lateral sclerosis is a progressive disease with rapid degeneration. Respite care is an essential service for improving the well-being of both patients with this disease and their family caregivers, but accessibility of respite services is limited. This study investigates perspectives on respite admission among people living with amyotrophic lateral sclerosis and the hospitals supporting them.
We conducted semistructured interviews among 3 patients with amyotrophic lateral sclerosis and 12 family members, exploring demographic information and their awareness and experience of respite admission. We also interviewed 16 representatives from hospitals about awareness of and preparation for respite admission for patients with this disease, the role of regional networks for intractable diseases, and knowledge about communication support schemes.
We found significant differences in the revised Amyotrophic Lateral Sclerosis Functional Rating Scale between patients who had and had not received respite admission. Qualitative analysis of the data indicated that respite admission was a contributory factor in continuing and stabilizing home care. Limited provision of social services and hospital care quality were barriers to respite admission.
Respite admission was essential to continued home care for patients with amyotrophic lateral sclerosis. Severe-stage patients were eligible for respite admission. Its accessibility, however, was limited, especially for patients living in rural areas. Supporting hospitals had limited capacity to respond to patients' needs. Individualized care and communication were internal barriers to respite admission.
肌萎缩侧索硬化症是一种进行性疾病,病情迅速恶化。喘息服务对于改善该疾病患者及其家庭护理人员的福祉至关重要,但喘息服务的可及性有限。本研究调查了肌萎缩侧索硬化症患者及其所就诊医院对喘息住院的看法。
我们对3例肌萎缩侧索硬化症患者和12名家庭成员进行了半结构化访谈,探讨人口统计学信息以及他们对喘息住院的认知和经历。我们还采访了16名医院代表,了解他们对该疾病患者喘息住院的认知和准备情况、难治性疾病区域网络的作用以及沟通支持方案的相关知识。
我们发现接受过和未接受过喘息住院治疗的患者在修订版肌萎缩侧索硬化症功能评定量表上存在显著差异。对数据的定性分析表明,喘息住院是持续和稳定居家护理的一个促成因素。社会服务提供有限和医院护理质量是喘息住院的障碍。
喘息住院对于肌萎缩侧索硬化症患者的持续居家护理至关重要。重度患者符合喘息住院条件。然而,其可及性有限,尤其是对于农村地区的患者。支持医院满足患者需求的能力有限。个性化护理和沟通是喘息住院的内部障碍。