Development And Application Of The Professional Care Demands Tool For Stroke Survivors Lived In Community Based On ADL

Objective1.To develop Professional Care Demands Questionnaire for Stroke Survivors Lived in Community,and test its psychometric characteristics.2.To understand the status and influence factors of professional care demands in stroke survivors lived in community,and analyze the first need of professional care demands in stroke survivors with different activities of daily living(ADL).MethodsThis study was divided into two parts.The first part was the development and validation of Professional Care Demands Questionnaire for Stroke Survivors Lived in Community.First,conduct qualitative study of professional care demands in stroke survivors lived in community,using method of purposive sampling to extract the stroke survivors lived in community who both met inclusion criteria and exclusion criteria,data were collected and analyzed with semi-structured interviews and Colaizzi's 7 step analysis of phenomenological data respectively.Then,item pool of Professional Care Demands Questionnaire for Stroke Survivors Lived in Community was developed.The first draft was formed according to Maslow's Hierarchy of needs theory and Orrum's Self-care theory.25 patients with stroke in community were taken a preliminary investigation after two rounds of Delphi consultation,then formed the beta version.To test the reliability and validity,318 patients with stroke lived in community and 6 experts were investigated.The second part was the quantitative study of professional care demands in stroke survivors lived in community.Taken Professional Care Demands Questionnaire for Stroke Survivors Lived in Community and Barthel Index Scale as the tools,it tested 428 stroke patients lived in community.Survey data was input and analyzed by IBM SPSS Statistics 21.0,using the statistical methods of descriptive statistics,independent samples t-test,one-way ANOVA and multiple linear regression and so on to understand the status and influence factorsof professional care demands in stroke survivors lived in community;Using the statistical methods of randomized block design analysis to compare the different demand of professional care in stroke survivors lived in community with different ADL.ResultsThere were three themes and nine subthemes according to professional care demands in stroke survivors lived in community.The first theme was physiological demands,including diet instruction and sleep instruction.The second theme was security demands,including disease knowledge,rehabilitation direction,medication guidance,resource information,and index monitoring.The third theme was belonging demands,including return to society,psychological assistance.There were 4 dimensions and 44 items in the formal Professional Care Demands Questionnaire for Stroke Survivors Lived in Community.Every items' t>3.00(P?0.05)in critical ratio,and correlation between item and total score was 0.672~0.872(P?0.01);S-CVI/UA was 0.82,S-CVI/Ave was 0.97,I-CVI were 0.83~1.00;4 factors were identified and the cumulative contribution of variance was 83.894%;The Cronbach's ? coefficient,split-half coefficient and test-retest reliability were 0.987,0.919 and 0.988,respectively.The score of professional care demands in stroke survivors lived in community was(126.73±46.58),and the score of instruct life care,professional knowledge and skills,sequelae and complications care and social support were(31.37±15.62),(35.61±11.73),(29.30±15.26),(30.46±10.54),respectively.It found that ADL and main caregivers were the influence factors of professional care demands scores and every dimension in stroke survivors lived in community.The results of randomized block design analysis showed that instruct life nursing was the first need of professional care in stroke survivors lived in community with heavily dependent,professional knowledge and skills were the first need of professional care in stroke survivors lived in community with moderate dependent,mild dependent and independent.Conclusions1.The Professional Care Demands Questionnaire for Stroke Survivors Lived in Community was a reliable and valid tool for measuring the professional care needs of the patients with stroke in community.2.The professional care demands in stroke survivors lived in community was high,and ADL,main caregivers were its influence factors.In addition,instruct life nursing was the first need of professional care in stroke survivors lived in community with heavily dependent,professional knowledge and skills was the first need of professional care in stroke survivors lived in community with moderate dependent,mild dependent or independent.It showed that the professional care demands in stroke patients with different ADL is different,the community medical staff should treat them with different emphasis at while meeting the demands in order to provide the most needed care.