Donohoe K M, Wineman N M, O'Brien R A
University of Rochester, School of Nursing, New York, USA.
J Neurosci Nurs. 1996 Dec;28(6):373-80. doi: 10.1097/01376517-199612000-00004.
Long-term care planning for middle-aged adults with progressive neurological impairment is a largely unexplored area. The purpose of this study was to examine factors that place individuals with progressive disability at risk for institutional placement and identify whether innovative long-term care preferences would be used if available. The sample of 102 clients with a diagnosis of multiple sclerosis (N = 92) or other progressive illnesses (N = 10) was mostly female, married and Caucasian, with an average age of 48 years. The social support network of family and friends was small; most tangible aid was provided by family members. Seventy percent of the participants used community services, the most common being a home-health aide (44%) and professional nursing services (21%). Medicaid insurance, severity of functional disability and lack of social support were associated with greater use of community services. Participants could foresee using long-term care alternatives such as a community residence (65%), adult day healthcare (63%) and family respite (46%), although these services were regarded with some ambivalence. With their knowledge of community resources, nurses are in a key position to make early assessments of clients' present and future care needs and to suggest needed modifications in living arrangements to avoid premature institutionalization.
针对患有进行性神经功能障碍的中年成年人的长期护理规划在很大程度上是一个未被探索的领域。本研究的目的是检查使患有进行性残疾的个体面临机构安置风险的因素，并确定如果有创新的长期护理选择，他们是否会采用。102名被诊断患有多发性硬化症（N = 92）或其他进行性疾病（N = 10）的客户样本大多为女性、已婚且是白种人，平均年龄为48岁。家庭和朋友的社会支持网络规模较小；大多数实际援助由家庭成员提供。70%的参与者使用社区服务，最常见的是家庭健康助理（44%）和专业护理服务（21%）。医疗补助保险、功能残疾的严重程度以及缺乏社会支持与更多地使用社区服务有关。参与者可以预见会使用诸如社区住所（65%）、成人日间医疗保健（63%）和家庭喘息服务（46%）等长期护理替代方案，尽管他们对这些服务有些矛盾。凭借对社区资源的了解，护士处于关键位置，可以对客户当前和未来的护理需求进行早期评估，并建议对生活安排进行必要的调整，以避免过早进入机构照护。
