Abstract
Amaç: Çocuk hastalar için yürütülen evde bakım hizmetlerinin durumunu ve sonuçlarını değerlendirmek, böylece hastaların tıbbi gereksinimlerini belirleyerek daha kaliteli bir hizmet sunumu için yapılabileceklere ışık tutmaktır.Gereç ve Yöntemler: Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji Eğitim ve Araştırma Hastanesi Evde Sağlık Hizmetleri Birimine (ESHB) kayıtlı olan ve en az bir yıldır izlemde olan çocuk hastalar çalışmaya dahil edildi. ESHB’nin kayıt defteri ve bilgisayar kayıtları esas alınarak Kasım 2012-Aralık 2013 tarihleri arasında geriye dönük taranarak elde edilen veriler kaydedilerek tanımlayıcı istatistikleri yapıldı.Bulgular: Çalışmaya toplam 63 hasta dahil edildi. Hastaların yaş ortalaması 8.87±4.6 olarak tespit edildi. Hastaların % 58.7’si serebral palsi (SP) ve motor mental retardasyon (MMR) tanıları ile takipliydi. Hastaların %34.9 (n=22)’unun trakeostomisi mevcuttu. On üç hasta (%20.6) kronik solunum yetersizliği nedeniyle ev tipi ventilatör kullanıyordu. Ev tipi ventilatör, nasal kanül veya maske ile oksijen, nasogastrik sonda, perkütan enteral gastrostomi (PEG), tekerlekli sandalye v.b. en az bir tıbbi cihaza bağımlı hasta oranı %71.4(n=45)’di. Doktor ziyaret sayısı bir hasta için ortalama 1.89±1.23 (ortanca:2) kez/yıl olarak tesbit edildi. Evde bakım hizmetinde görevli doktor dışı sağlık personeli ziyaret sayısı ise her hasta için ortalama 13.7±14.8 (ortanca:10) kez/yıl olarak hesaplandı. Çalışmamızda hastaların birincil olarak bakımı ile ilgilenen kişi %95.2 oranında anneydi.Sonuç: Evde bakım hizmetleri sayesinde özel sağlık bakım ihtiyaçları olan çocukların eve taburculuğu kolaylaşmakta ve hastane yatışlarının azalması maddi ve sosyal açıdan birçok avantajı beraberinde getirmektedir. Eksikliklerin belirlenmesi gelecekte daha kaliteli hizmet verilmesini sağlayacaktır. Bu hizmetin özellikle çocuk yaş grubunda kapsamlı bir ekip ile sosyal hizmetleri de içine alacak şekilde geliştirilmesi gereklidir.
Keywords
References
- Özer Ö, Şantaş F. Kamunun sunduğu evde bakım hizmetleri ve fi nansmanı. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2012;3:96-103.
- American Medical Association/American Academy of Home Care Physicians. Medical Management of the Home Care Patient, Guidelines for Physicians. AMA & American Academy of Home Care Physicians 2004
- Karahan A, Güven S. Yaşlılıkta evde bakım. Türk Geriatri Dergisi 2002;5:155-9.
- Palfrey JS, Sofi s LA, Davidson EJ, Liu J, Freeman L, Ganz ML. The Pediatric Alliance for Coordinated Care: Evaluation of a medical home model. Pediatrics 2004;113:1507-16.
- Willits KA, Platonova EA, Nies MA, Racine EF, Troutman ML, Harris HL. Medical home and pediatric primary care utilization among children with special health care needs. J Pediatr Health Care 2013;27:202-8.
- Mayer ML, Skinner AC, Slifkin RT; National survey of children with special health care needs. Unmet need for routine and specialty care: Data from the National Survey of Children with Special Health Care Needs. Pediatrics 2004;113:e109-15.
- Skinner AC, Slifkin RT. Rural/urban differences in barriers to and burden of care for children with special health care needs. J Rural Health 2007;23:150-7.
- Cady R, Kelly A, Finkelstein S. Home telehealth for children with special health-care needs. J Telemed Telecare 2008;14:173-7.
- Johnson CP, Kastner TA; American Academy of Pediatrics Committee/Section on Children with Disabilities. Helping families raise children with special health care needs at home. Pediatrics 2005;115:507-11.
- Mitchell DB, Hauser-Cram P. The well-being of mothers of adolescents with developmental disabilities in relation to medical care utilization and satisfaction with health care. Res Dev Disabil 2008;29:97-112.
- TC Sağlık Bakanlığınca Sunulan Evde Sağlık Hizmetlerinin Uygulama Usul ve Esasları Hakkında Yönerge Ankara: 2011: Madde 16.
- McPherson M, Arango P, Fox H, Lauver C, McManus M, Paul W. Newacheck PW, et al. A new defi nition of children with special health care needs. Pediatrics 1998;102:137-40.
- Guidelines for home care of infants, children, and adolescents with chronic disease. American Academy of Pediatrics Committee on Children with Disabilities. Pediatrics 1995; 96:161-4.
- Bakım Hizmetleri Stratejisi ve Eylem Planı (2011-2013). Resmi Gazete, Basım tarihi: 19.01.2011, Bölüm 2;119:6:1.
- Kohlen C, Beier J, Danzer G. “A small piece of normal life”. A qualitative study on health care for chronically ill children in home care. Pfl ege 1999;12:309-14.
Abstract
Objective: Home health care services (HHCS), a new concept in our country, aims to increase the quality of life of individuals and their families in their own environment and ensure their ability to continue their daily activities. The aim of our study was to evaluate the status and results of home health care services conducted for pediatric patients in our hospital and to identify the medical needs of patients to deliver higher quality service.Material and Methods: Pediatric patients who were followed-up regularly for at least one year by Ankara Children’s Health and Diseases, Hematology and Oncology Training and Research Hospital, department of HHCS were included in the study. Demographic data were collected retrospectively from the hospital database system. Study data were recorded for descriptive statistics. Results: A total of 63 patients were included in the study. The mean age of the patients was 8.87±4.6 uears and the diagnosis was cerebral palsy (CP) and motor mental retardation (MMR) in 58.7%. A tracheostomy was present in 34.9% of the patients; 13 patients (20.6%) were ventilator-dependent and 71.4% of patients were dependent on at least one medical device. The mean number of doctor visits for a patient were 1.89 ± 1.23 (median: 2) times per year. The mean number of visits of non-physician health care professionals was 13.7 ± 14.8 (median: 10) times per year. Primary care was given by the mother in 95.2% of the patients in our study.Conclusion: Children with special health care needs can be discharged home easier through HHCS. This reduces cost and brings many social advantages. Identifi cation of any defi ciencies of this service will improve quality in the future
Keywords
References
- Özer Ö, Şantaş F. Kamunun sunduğu evde bakım hizmetleri ve fi nansmanı. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2012;3:96-103.
- American Medical Association/American Academy of Home Care Physicians. Medical Management of the Home Care Patient, Guidelines for Physicians. AMA & American Academy of Home Care Physicians 2004
- Karahan A, Güven S. Yaşlılıkta evde bakım. Türk Geriatri Dergisi 2002;5:155-9.
- Palfrey JS, Sofi s LA, Davidson EJ, Liu J, Freeman L, Ganz ML. The Pediatric Alliance for Coordinated Care: Evaluation of a medical home model. Pediatrics 2004;113:1507-16.
- Willits KA, Platonova EA, Nies MA, Racine EF, Troutman ML, Harris HL. Medical home and pediatric primary care utilization among children with special health care needs. J Pediatr Health Care 2013;27:202-8.
- Mayer ML, Skinner AC, Slifkin RT; National survey of children with special health care needs. Unmet need for routine and specialty care: Data from the National Survey of Children with Special Health Care Needs. Pediatrics 2004;113:e109-15.
- Skinner AC, Slifkin RT. Rural/urban differences in barriers to and burden of care for children with special health care needs. J Rural Health 2007;23:150-7.
- Cady R, Kelly A, Finkelstein S. Home telehealth for children with special health-care needs. J Telemed Telecare 2008;14:173-7.
- Johnson CP, Kastner TA; American Academy of Pediatrics Committee/Section on Children with Disabilities. Helping families raise children with special health care needs at home. Pediatrics 2005;115:507-11.
- Mitchell DB, Hauser-Cram P. The well-being of mothers of adolescents with developmental disabilities in relation to medical care utilization and satisfaction with health care. Res Dev Disabil 2008;29:97-112.
- TC Sağlık Bakanlığınca Sunulan Evde Sağlık Hizmetlerinin Uygulama Usul ve Esasları Hakkında Yönerge Ankara: 2011: Madde 16.
- McPherson M, Arango P, Fox H, Lauver C, McManus M, Paul W. Newacheck PW, et al. A new defi nition of children with special health care needs. Pediatrics 1998;102:137-40.
- Guidelines for home care of infants, children, and adolescents with chronic disease. American Academy of Pediatrics Committee on Children with Disabilities. Pediatrics 1995; 96:161-4.
- Bakım Hizmetleri Stratejisi ve Eylem Planı (2011-2013). Resmi Gazete, Basım tarihi: 19.01.2011, Bölüm 2;119:6:1.
- Kohlen C, Beier J, Danzer G. “A small piece of normal life”. A qualitative study on health care for chronically ill children in home care. Pfl ege 1999;12:309-14.
Details
| Other ID | JA87EY97YK |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | April 1, 2015 |
| Submission Date | April 1, 2015 |
| Published in Issue | Year 2015 Volume: 9 Issue: 1 |
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