Development Of The Home Care Service Assessment Scale For The Adult Patients With Chronic Diseases

Objective:To develop the"Home Care Service Assessment Scale"(HCSAS) for the adult patients with chronic diseases, by using it to better assess the home care needs and it's level of the adult patients, and to help allocate limited community health resources more appropriately.Method:1. According to the Orem's self-care theory, literature review, questionnaire survey, Delphi consultant method and pre-survey, then developed the HCSAS for the Adult with chronic diseases.2. The HCSAS was tested with a sample of 230 adults from three communities in ShangHai from October 2008 to December 2008. Professional investigators were involved to collect the data. Then the data was input and analyzed by SPSS 13.0. The statistic methods concluded the test of reliability and validity, in addition to constitute comparison, relevance analyse, and so on.Results1. Develop the HCSAS for the adult with chronic disease. Included 3 parts: functional health assessment sheet with 3 dimentions, 24 items; the part of home health care need with 4 dimentions, 32 items; and the part of classification standard.2. Statistic analysing results:The reliability and validity①reliability:the Cronbach'sαCoefficien of functional health part and home health care need part were 0.720-0.936; Test-retest reliability of the 3 parts were 0.802, 0.866, 0.956 seperately.②validity: the HCSAS was developed based on Orem's self-care theory, literature review, questionaire survey, Delphi consultant, and pre-survey, displays it's satisfactory content vality; Construct validity-after analysis for significance, an 7 factors value greater than 1 was established as the standard for selection of functional health part. They cumulatively explained 68.76% of the variance. In the part of home care service items, 8 factor cumulatively explained 72.444%. The internal relations between items for functional health part, each dimension with r = 0.495～0.982, while the service items part, r =0.501～0.932.3,The feasibility test: the questionnaire's response rate was 92%; The average time to complete the assessment scale was 15.72±7.27min. The health status and home care needs of adults adult with chronic diseases: The findings reveal that 61.3% of the adults are with one disease, 38.7% of the adults are with two or more diseases. The leading diseases are hypertension, diabetes, chronic gastritis, coronary heart disease. According to the needs assessment finding, 95.7% percent of the adults have a certanin degree of needs on home health care, 80.9% of the adults are in the second rank for home care service.ConclusionThe results demonstrated that the HCNAS for the adult with chronic diseases designed in this study has satisfactory scientific nature and feasibility. By using it can help to provide services according to the adults'physical, psychological, social health and their particular needs. There are some limits in this study, such as lack of the scope and the number of the people, futher research should be done to test the HCNAS.