Providing Care Beyond the Hospital: Perspective of a Tertiary Care Hospital from a Developing Country

World Neurosurg. 2016 Apr:88:370-373. doi: 10.1016/j.wneu.2015.12.086. Epub 2016 Jan 2.

Abstract

Background: Neurorehabilitation is an important aspect of continuing care for neurosurgical patients with functional disability. In developing countries, where formal home nursing frequently is unavailable, ensuring care after discharge is a difficult task. Training attendants to provide nursing care is an alternate option. In this study, we compared the outcomes of patients nursed by family members versus those looked after by a professional nurse.

Methods: This was a retrospective observational study conducted at the Aga Khan University Hospital Karachi. The study consisted of 2 groups. Group 1 (consisting of patients cared for by a professional nurse) included 94 patients and group 2 (patients cared for by family members) included 102. All these patients had activity of daily living score of ≥3. Glasgow Outcomes Scale score, time to decannulation, development/worsening of bedsores, and mortality were recorded and compared between the groups at follow-up.

Results: The study included 196 patients. Traumatic brain injury was the most common diagnosis. Nursing requirements were similar between the 2 groups and included tracheostomy care, percutaneous endoscopic gastrostomy tube care, peripherally inserted central catheter line care, care of patients with no bone flap, and log-rolling. The outcomes of the 2 groups were comparable and included bedsore development/worsening of grade, Glasgow Outcomes Scale score at follow-up, time to decannulation, and 30-day mortality.

Conclusions: There was no statistically significant difference in outcomes of patients nursed by family members compared with the patients looked after by professional nurses.

Keywords: Disability; Neurosurgery; Nursing; Rehabilitation.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Ambulatory Care / statistics & numerical data
  • Brain Injuries / diagnosis
  • Brain Injuries / rehabilitation*
  • Brain Injuries / surgery
  • Caregivers / statistics & numerical data*
  • Developed Countries / statistics & numerical data
  • Female
  • Home Care Services / statistics & numerical data*
  • Humans
  • Male
  • Neurological Rehabilitation / statistics & numerical data*
  • Neurosurgical Procedures / rehabilitation*
  • Nursing Care / statistics & numerical data*
  • Pakistan / epidemiology
  • Prevalence
  • Tertiary Care Centers / statistics & numerical data
  • Treatment Outcome