香港脑损伤患者的出院后服务(英文)

A Post-Discharge Service for Brain Injury Patients in Hong Kong

目的:建立针对脑损伤患者及其看护者的可负担、易获取的出院后电话跟进服务,并为发展区域内有成本效益的连续监护体制提供实证基础。方法:本研究从香港大学玛丽医院脑外科招募35名成年脑损伤患者和26名看护者。参与者在出院后第4周和第12周各接受一次结构化的电话访谈。有调整能力不足风险的患者与看护者将被送交进一步的医疗咨询或心理干预。患者的生理和认知功能,以及患者与看护者的情感功能、知觉到的社会支持和对当前所提供的服务的满意程度都被列入调查。结果:大部分患者报告他们的生理状况有明显改善。相当多的患者在出院后经历过认知困难并报告所接受到的社会心理支持不足。大多数看护者报告在看护期间健康、情感功能和社会生活受损。患者与看护者都对服务表示满意,看护者的满意程度更高。结论:脑损伤患者及其看护者都受益于出院后电话跟进服务。两者都同意该项服务有助于识别有调整能力不足风险的个体,并提供及时的建议和情感支持。看护工作会明显损害看护者的生理、情感功能和社会生活,提示需要为他们提供关于看护技巧、生活调整和压力管理的意见与建议。

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.