The Effects of a Neurological Special Nursing and Early Rehabilitation Program on the Early Recovery of Patients with Acute Spontaneous Intracranial Hemorrhage and on the Level of Satisfaction of Patients' Families

Song, Mi Sook; Cho, Kyung Gi

Abstract

This study was performed to evaluate the effects of a special nursing program on the recovery of patients with spontaneous intracranial hemorrhage, and on the level of satisfaction of their families. The experimental group comprised twenty patients selected from A university medical center, and the control group, nineteen patients selected from B university medical center. Patients with cormorbidity were not included. Between 1 October, 1995 and 30 April, 1996, personnel specialized in neurosurgical nursing provided the experimental group with a special nursing program, while the control group was offered general nursing services. The key elements of this special nursing program were close observation to identify potential risk factors ; crisis intervention to prevent gaps in medical service delivery ; patient-centered care emphasizing early recovery, including specific protocols for the prevention of disability and for rehabilitation ; and patient education and counseling to maximize satisfaction. The average length of stay in ICU, neurological status, functional status, impact of complications, and satisfaction level were measured through medical records, the Glasgow Coma Scale, Functional Independence Measurement, patient assessments, and questionnaires, respectively. These data were analyzed by paired t-test, independent-samples t-test, and ANOVA, and the results were as follows : 1) The average length of stay in ICU of the experimental group was significantly shorter than that of the control group. 2) The degree of neurological recovery of the experimental group between admission and the second week after operation was not significantly different from that of the control group. 3) The impact of complications on the control group was greater than on the experimental group. 4) Between the first and second week after operation, the functional status of the experimental group changed more noticeably than that of the control group. 5) The degree of satisfaction with the nursing services was higher among the families of patients in the experimental group than among the other families. These findings indicate that a special nursing program might improve the recovery of patients with spontaneous intracranial hemorrhage and increase the satisfaction of their families. It is therefore suggested that in order to provide comprehensive medical services to patients with spontaneous intracranial hemorrhage, personnel such as neurosurgical nursing specialist be appropriately utilized. In addition, the current medical insurance fee schedule especially in relation to the cost of rehabilitation, should be adjusted to cover broader services.