Nursing Care of Rehabilitation Stroke Patients in Community: A Comparison of 2 Case Studies.

Abstract

     The purpose of this study is to compare nursing care for 2 stroke patients undergoing rehabilitation in the community. Methods: This study was to compare stroke patients receiving continuous care during rehabilitation in the community, Area of ​​responsibility of Kranuan Crown Prince Hospital, 2 cases. Tools used for the study include: Information from patient medical records, Home visit information recording form according to guidelines IN HOME SSS, Daily routine assessment form, barthel ADL Index (Barthel Activities of Daily Living: ADL), interview and observation, data analysis, compare, pathology, signs and symptom, treatment, health plan, health risk factors that affect the development of disease, problems and diagnoses in nursing and rehabilitation care in the community. By coordinating with multidisciplinary teams both inside and outside the organization. Case Study: Comparing 2 stroke patients, Case 1: 85 -years- old Thai female, major symptoms: trouble speaking, dysarthria and left hemiparesis 40 minutes before coming to the hospital. Diagnosed with Acute Ischemic stroke. Case 2: 83 -years- old Thai female patient with significant symptoms,alteration of consciousness, dysarthria, facial palsy and left hemiparesis 6 hours before coming to the hospital. Diagnosed with Acute Ischemic stroke. Both patients were admitted for treatment at Kranuan Crown Prince Hospital. After passing through the critical period of the disease to the rehabilitation period, doctors discharge and refer them for continued care during the rehabilitation period at home by the continuous care team in the community together with the multidisciplinary team.
     From this study it was found that, patients receive treatment according to their problem. In cases where arrival at the hospital was delayed by more than 4.5 hours. Therefore, the blood clot-dissolving drug rt-PA cannot be administered. Professional nurses play an important role in providing care follow up on symptoms from the beginning, length of stay in hospital, and the period of returning to live in the community for rehabilitation, both physically and mentally. Reduce the anxiety of patients and relatives when the patient returns home. It also encourages relatives, caregivers and networks have knowledge in rehabilitation care, and reduce risk factors for the chance of recurrence, No complications occurred. By following up and visiting patients regularly. And there is a quick and convenient communication channel when patients and relatives need help.