Nursing Care Activity during the lnitial Phase of Visiting Nursing for Cerebrovascular Patients Residing at Home

Abstract

In order to investigate the initial phase of visiting nursing， the contents of the first two month s of visiting nursing provided by 166 nurses to 172 cerebrovascular patients were analyzed． Nurses had a mean visiting nursing experience of 6.9 （SD3.6） years， while patients had a mean age of 73.9 （SD 12.8） years and a mean care requirement level of （SD 1.19）．

The short-term objectives of nursing included prevention of recurrence， contracture， and prevention of complications. Nursing contents primarily included“observation， evaluation， and adjustment”， “education and guidance”， “psychological support”， and “rehabilitation”， but varied depending on care requirement level. Nursing for patients with a care requirement level of 3 or 4 had stronger emphases on the objective of ADL maintenance（p＝.01） in addition to contents of sihing exercise（p.05， standing exercise （p＝.01）， social interaction support（p＝.01）， and six items of psychological support（p＝.05 to .001）. Nursing for patients with a care requirement level of 5 involved care associ’ated with a bedridden state， such as incontinence care， bed bath and family support．

Through their nursing actions， nurses demonstrated “caring”， which comprised the following four factors （cumulative proponion， 52.38%） ： “creating connections”， “alleviating pain”， “responding promptly”， and “supporting decision-making”．

Nursing care activity during the initial phase was comprised of “monitoimg function”， which aimed to maintain health status and prevent disuse syndrome， as well as “caring”， which contributed to relationships between patients and nurses.

Through these forms of “caring”， nurses gained trust as professionals and supported decision-making by patients.