J Nurs Acad Soc.  1994 Dec;24(4):696-705.

A Case Analysis of Home Health Care for Cesarean Postpartum Women and Their Newborns

• Kim HS
• Choi YS
• Jan EM

Abstract

This study was done to provide a basis for home health care management for women following Cesarean delivery. Furthermore it was initiated as an possible application of home health care in the future. In this study, client selection criteria was developed by the researcher and assessment tools for home health care, recording system and problem oriented recording system were revised from Jun's(1993) methods. The selection criteria tool for home health care for women who had a Cesarean delivery was structured and consisted of five areas: physical status, functional status, psychological-emotional status, educational needs status and environmental status. The structured assessment tool consisted of general items, obstetric history, past medical history, methods of feeding, medications taken before admission, laboratory results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of women and their newborns. The visit note consisted of the date: nursing problems: nursing process including initial assessment: nursing goals: visit plan: health status of the postpartum women and their newborn: nursing diagnoses: nursing implementation: evaluation: summary: next visit plan and revision. The problem oriented recording system consisted of the date, problem numbers, nursing diagnoses, problem appearance date, problem resolution date. The results of the research are as follows: The seven cases having had a Cesarean delivery were discharged on an average on the 5th day after the Cesarean birth. The total number of home visits was 13. According to Gordon's functional health patterns the total possible nursing diagnoses was 34 diagnoses for the mothers and their newborns. Among the 34 diagnoses, there were 13 diagnoses in the health perception/management pattern, 7 in the psychosocial health perception/management pattern, 8 in the psychosocial self-perception, 2 in the nutrition/metabolism pattern of physical function, 2 in the knowledge deficit of newborn management, anxiety related to newborn management, knowledge deficit related to disease process of newborn, anxiety related to disease process of newborn, anxiety related to prognosis of baby's condition, knowledge deficit related to newborn jaundice each appeared once. The changes in the number of nursing diagnoses was related to not the number of visits but to the number of nursing diagnoses decreasing. The content of the home health care was categorized according to assessment, direct care, counseling, education, family care. The recommendation based on the results of this research are: Home health care nurses for Cesarean postpartum women and their neonates requires comprehensive knowledge of pregnancy, delivery, and the postpartum period and of the neonate so that they can provide appropriate care and holistic views. Most of cases terminated after the second visit, this outcome may be related to the subjects being discharged on the 5th day after delivery. Therefore, study done with earlier discharge after delivery may have different outcome. It is very hard to assess psychological aspects that need follow-up and to develop communcation channels.

MeSH Terms

Anxiety
Counseling
Delivery of Health Care*
Diagnosis
Education
Educational Status
Female
House Calls
Humans
Infant, Newborn*
Jaundice
Knowledge Management
Mothers
Nursing
Nursing Diagnosis
Nursing Process
Parturition
Patient Selection
Pedigree
Postpartum Period*
Pregnancy
Prognosis
Self Concept