A post-discharge service for brain injury patients in Hong Kong

Abstract

Objective:To establish an affordable and easily accessible post-discharge telephone follow-up service for people with brain injuries and their caregivers, and thus to provide an evidence base for developing cost-effective continuous care,region-wide.Method:Thirty-five adult patients with brain injuries and 26 caregivers were recruited from Neurosurgical Unit at Queen Mary Hospital in this study.Participants were administered a structured telephone interview at the fourth week post-discharge,and again at the twelfth week post-discharge. Patients and caregivers at risk of poor adjustment were referred for further medical consultation or psychological intervention. Patients' physical and cognitive functioning were investigated while both patients and caregivers' emotional functioning and perceived social support were explored. Satisfaction of the current service provided was also examined. Result: Majority of patients reported significant improvement in physical condition. A sizable number of patients experienced cognitive difficulties and reported insufficient psychosocial support received following discharge from hospital. Majority of caregivers reported compromising health, emotional and social functioning in caregiving. Both patients and caregivers reported satisfaction with the service with caregivers reported higher satisfaction. Conclusion: Findings from current study showed that both patients of brain injuries and caregivers benefited from the post-discharge telephone follow-up service. Both of them agreed that such service helped to identify people at risk of poor adjustment, provide timely advice and emotional support. Our findings also indicated that caregiving significantly impairs caregivers' physical, emotional, and social functioning, suggesting a need to offer them advice on care skills, role or living adjustments, and stress management.

目的:建立針對腦損傷患者及其看護者的可負擔、易獲取的出院后電話跟進服務,并為發展區域內有成本效益的連續監護體制提供實證基礎。方法:本研究從香港大學瑪麗醫院腦外科招募35名成年腦損傷患者和26名看護者。參與者在出院后第4周和第12周各接受一次結構化的電話訪談。有調整能力不足風險的患者與看護者將被送交進一步的醫療咨詢或心理干預。患者的生理和認知功能,以及患者與看護者的情感功能、知覺到的社會支持和對當前所提供的服務的滿意程度都被列入調查。結果:大部分患者報告他們的生理狀況有明顯改善。相當多的患者在出院后經歷過認知困難并報告所接受到的社會心理支持不足。大多數看護者報告在看護期間健康、情感功能和社會生活受損。患者與看護者都對服務表示滿意,看護者的滿意程度更高。結論:腦損傷患者及其看護者都受益于出院后電話跟進服務。兩者都同意該項服務有助于識別有調整能力不足風險的個體,并提供及時的建議和情感支持。看護工作會明顯損害看護者的生理、情感功能和社會生活,提示需要為他們提供關于看護技巧、生活調整和壓力管理的意見與建議。