Demand for home care services of people in Ha Long, Quang Ninh in 2020

Nội dung text: Demand for home care services of people in Ha Long, Quang Ninh in 2020

1. RESEARCH ARTICLE DEMAND FOR HOME CARE SERVICES OF PEOPLE IN HA LONG, QUANG NINH IN 2020 Le Thi Thuy Nga1, Pham Hoai Thuong1, Tran An Duong1, Nguyen Thuy Nga1 1Quang Ninh Medical Collge ABSTRACT Objective: To describe the demand for months (70%). In addition, Some services home care services of people in Ha Long, with a low rate of demand from the people Quang Ninh in 2020. Method: A cross- such as: Film photography, ultrasound, sectional descriptive study was conducted electrocardiogram (53.3%), care for to collect data from 450 participants patients at the end of life (55.1%), services representing 450 households at 5 wards in of questioning, reading film, reading test Ha Long City. Data were collected by using results, exploring functions, consulting questionnaire to interview. Results: The from a distance (54.2%). Conclusion: The research results show the most demands people who lives in Ha Long City have the home care services are examination and high demand for home care services. So treatment at home for patients (84.9%), that it is very necessary to enhance care bathing and changing the umbilical bandage services in Ha Long. at home for infants (77.8%), home care Keywords: Demand, home care, support for mothers with children under 6 services 1. INTRODUCTION Similar to the developed countries issue that needs to be resolved sustainably in the previous period, since 2012, Viet [2]. Many diseases, injuries, and accidents Nam has become a country with an aging can be treated at home and are still highly population with a rate of people over 60 effective, even helping to save costs and reaching 10.2% and is forecast to be a reduce the risk of hospital infections for country with a very old population. by patients. It is also considered to be more 2038, the rate of people over 60 years old effective than hospital care [3] .However, will reach 20.1% [1]. This is the reason for the advantages of home care services challenging in caring to improve the health which incorporate advanced science and of population when the need for daily health technology are relatively capable of solving care is becoming a major problem: burden these problems. This solution will bring high of disease, daily care, and quality of life. results in treatment and improve the health In addition, overload of hospital is still an of the people [4]. Ha Long has the highest population in Quang Ninh province. The economic statust of the people in Ha Long city is higher than Cor. author: Le Thi Thuy Nga whole province. So that, people there also Email: lethithuynga.cyq@moet.edu.vn have high demand in health care activities, Received: Jan 06, 2021 especially home care. With the above Revised: Jan 13, 2021 benefits, home care services are capable Accepted: Mar 05, 2021 of meeting the needs of people here about 50 Journal of Nursing Science - Vol. 04 - No. 01
2. RESEARCH ARTICLE medical care and daily life. However, Expected 20% of subjects are absent or home care in Ha Long is still relatively refused to participate in the study. So the spontaneous, not systematically organized. sample size of the study is: 384 + 384x20% For that reason, the study was conducted = 450 with the aim: To describe the demand for : Apply cluster home care services of people in Ha Long, 2.5 Sampling method sampling method. Quang Ninh in 2020 - Make a list of 20 wards of Ha Long City 2. RESEARCH METHOD - Randomly choose 5 wards to study 2.1. Research subjects (Cao Thang, Cao Xanh, Hong Hai, Ha A representative of a family residence in Tu, and Bai Chay). Each ward selects 90 Ha Long can participate in the selection or households. decision to use home care services. - Make a list of areas in the 5 selected 2.2. Setting and research period wards. The 90 households to be selected are divided equally among the areas in the - The study was conducted from ward. One person will be representative to September 2019 to December 2020 one household. - Setting: 20 wards of Ha Long City, 2.6. Data collection and research Quang Ninh. instruments 2.3 Research design: Cross section All data were collected by using description. questionnaire to interview subjects. : 2.4. Sample size The instruments consisted of 3 parts: - Apply the sample size formula: General information questionnaire p(1− p) was developed by researcher. The = Ζ2 × n 1−α / 2 2 questionnaire included 8 questions of age, d gender, occupation, education level, use Inside: health insurance, family members. - n: Sample size required The questionnaire of people’s perceptions of disease patterns, population - p: Percentage of people have demand and health included 14 questions. The for home care. Take p = 0.5. instruments asked their perceptions disease Then 1-p = 0.5 patterns, population and health on a 3-point rating scale, where 1 = agree, 2 = disagree - d: Allowable deviation between the and 3 = don’t know. The total score ranged rate obtained from the sample and the from 14 to 52 which were summed from all proportion of the population. Take d = 0.05 items’ score. - α: Significance level. Take α = 0.05 The questionnaire of demand for home - Value obtained from table Z care services included 25 questions. The corresponding to each selected α value. participants were asked to consider and rate the demand for home care services α = 0.05, = 1.96 with each item on a 3-point rating scale => n = 384. from 1 to 3 (3 = participation and willing to Journal of Nursing Science - Vol. 04 - No. 01 51
3. RESEARCH ARTICLE pay when needed, 2 = not participating, 1 = 3. RESULTS undecided). The total score ranged from 25 3.1. Demand for home care services to 75 points. of people 2.7. Data analysis Table 1. The score of demand for home care services Data were entered using Epi Data 3.1 software. The data were synthesized by Score of Min Max ( X ± SD) using SPSS 16.0 software. demand for 25 75 63,5 ± 10,9 Descriptive statistical including mean, home care percentage, standard deviation were services used to describe general information and Table 1 showed that the average score demand of patients for home care services. of demand for home care services was 63,5 ± 10,9. The lowest score was 25 points, the highest was 75 points. 3.2. Demand of people for services of examining, treating and health monitoring at home The figure 1. indicated that the demand for home care services of people wasquit high such as: examination and treatment at home for patients (84.90%), periodic health examination, management of health records (70.20%), screening for some common diseases (71.80%). The other services were responded by people at an average or low level . Guidance and advice on mental health 57.6% care Management and treatment of 57.3% tuberculosis and psychiatric patients ... Examining, treating and providing care 57.6% instructions for neuropaths Examination, treatment and guidance on 64.2% care for chronic patients Film photography, ultrasound, 53.3% electrocardiogram Take blood, stool, urine ... To do test 65.1% Screening for some common diseases 71.8% Periodic health examination, management 70.2% of health records Examination and treatment at home for 84.9% patients The percentage of people had demand Figure 1. Responding to participation in services of management, medical examination and treatment, and health monitoring at home of the people 52 Journal of Nursing Science - Vol. 04 - No. 01
4. RESEARCH ARTICLE 3.3. Demand for home care services which provided by nurses. Home care support for mothers with children 70,0% under 6 months Bathing and changing the umbilical bandage 77,8% at home for infants Management, monitoring and periodic health 67,3% checks for pregnant women Manage and monitor the health of elderly 66,4% Care for patients at the end of life 55,1% Pain relief care for cancer patients, end- 61,8% stage HIV Nursing in hospital to care for patients in 67,1% substitution Nurses stay with the family to care for 64,2% critically ill patients Nursing home care to the prescription of a 62,0% doctor The percentage of people had demand Figure 2. Demand for home care services which provided by nurses The figure 2. showed that more than two-third of subjects had demand for home care services which provided by nurses such as: bathing and changing the umbilical bandage at home for infants (77.80%), home care support for mothers with children under 6 months (70%), management, monitoring and periodic health checks for pregnant women (67.30%). Other services were responded by the people on average (over 60.0%). End-of- life patient care services had the lowest response rate (55.1%). 3.4. Demand of people for home care services of consuling, supporting and informating The figure 3. indicated that the demand of people for home care services of counseling, supporting and informating in medical examination and treatment was below 70.0% such as: Consulting, providing information channels for drugs and functional foods (67.8), introducing a reputable doctor suitable for examination and treatment of patients (66.4%). The services with the lowest response were services of questioning, reading movies, reading test results, exploring functions, consulting ... from a distance (54.2%). Journal of Nursing Science - Vol. 04 - No. 01 53
5. RESEARCH ARTICLE Services of questioning, reading movies, reading test results, exploring functions, consulting ... from 54.2% a distance Equipment rental to help health workers and 60.7% family members monitor patients remotely Consulting, providing information channels for 67.8% drugs and functional foods Send the health worker with you when the patient needs to go to higher level or overseas medical 58% examination and treatment Assist patients in carrying out examination 66.4% procedures and hospitalization at hospitals Introduce a reputable doctor suitable for 66.4% examination and treatment of patients Introduce the best medical facility for each patient 65.8% The percentage of people had demand Figure 3. Demand of people for home care services of consuling, supporting and informating 4. DISCUSSION were also concerned. People more and more take the initiative in monitoring their 4.1. Demand of people for services health, not waiting until have symptoms of examining, treating and health of disease before going to the doctor as monitoring at home. before. Instead, they want to be managed, Demand of people for services of monitored, periodically health checks, examining, treating and health monitoring screened to detect some dangerous by doctors at home for emergency patients diseases early. were highest rate. The findings are higher Take blood, stool, urine ... to do test at than the study was collected data from home were also responded with a fairly people in urban areas at Me Tri ward, Nam high rate (65.1%). Compared to the study Tu Liem, Hanoi in 2018 by Do Manh Hung in the Tay Ho district in Hanoi, 83.2% of (57.9%) [5]. This can be explained that people have ever used ultrasound services, in Hanoi, this service is no longer new to taking samples test at home, our study the people of Hanoi, since private health shows a much lower response [ 6]. This can services have provided these services very be explained by all subjects of the study in early. Meanwhile, in Ha Long, there is no Tay Ho who are the elderly (> 60 years old) private clinic providing this service. or the guardian of the elderly who should Activities related to periodic examinations go to health facilities to perform diagnostic and screening for early common disesses tests is relatively difficult. In addition, home 54 Journal of Nursing Science - Vol. 04 - No. 01
6. RESEARCH ARTICLE scans, electrocardiography or ultrasound 40 and over, are the age group that can are often performed by technicians whose experience many health problems related paraclinical tests require review, reading to chronic diseases, but in Do Manh Hung’s of results as well as consultation on the study the opposite, more than 2/3 of the direction of the doctor. Therefore, when study subjects are under 40 years old [5]. these services are implemented in the community, it is necessary to attach the 4.3. Demand of people for home care coverage of the doctor when reading test services of consuling, supporting and results and consulting the direction of informating. management, to meet the needs of the For demand of people for home people when using these services. care services of consuling, supporting The service of organization and and informating, Consulting, providing management, sending doctors to examine, information channels for drugs and treat, provide care instructions for chronic functional foods had highest rate (67.8%). patients is also quite high response In the era of information explosion, the lack (64.2%), similar to the results in the study of basic information for health care will lead of Do Manh Hung (62.6%) [5]. to the incorrect choice of drugs or functional foods, causing a lot of economic and health 4.2. Demand for home care services damage. The consultation on choosing which provided by nurses. the right and quality drugs and functional Among the home care services provided foods to treat diseases and improve health, by nurses, bathing and changing the although not direct health care activities, umbilical bandage at home for infants was has a significant impact on people’s health. responded by the people of Ha Long city So that, it is feasible to implement these with the highest rate (77.8%). The result services. of our research is equivalent to the study Services of questioning, reading movies, of Do Manh Hung (78.5%) [5]. This is one reading test results, exploring functions, of the services that needs to be provided consulting ... from a distance had the lowest in home care services, requiring home response rate (54.2%). Other studies have health centers to train well-trained nurses also shown that the response to this service and midwives to meet the high demand of is also quite low [5]. Although telemedicine people. can help people access to specialist For other services such as nursing doctors, at the same time it can save travel home care to the prescription of a doctor, and accommodation costs. However, the pain relief care for cancer patients, end- service is quite new in Viet Nam, there are stage HIV compared to Do Manh Hung’s many reasons why people are hesitant research, The response rate in our study when deciding to participate in this service. is lower. In addition, services for managing 5. CONCLUSION and monitoring the health of the elderly, nurses stay with family to care for critically Some home care services are highly ill patients, hospital nursing to care for demand such as: services are examination patients who replace their family members and treatment at home for patients (84.9%), compared to the study of Do Manh Hung is bathing and changing the umbilical bandage higher [5]. This can be explained because at home for infants (77.8%), home care in our study, the study subjects with more support for mothers with children under 6 than two-thirds of the study subjects aged months (70%). Journal of Nursing Science - Vol. 04 - No. 01 55
7. RESEARCH ARTICLE Some home care services are low Health Canada The Office of Health and demand such as: Film photography, the Information Highway (1998). Tele- ultrasound, electrocardiogram (53.3%), homecare: An Overview. Background care for patients at the end of life (55.1%), Paper for Discussion. services of questioning, reading film, 5. Do Manh Hung (2018). Factors reading test results, exploring functions, related to Demand and response to home consulting from a distance (54.2%). health care services in urban areas Me 6. RECOMMENDATION Tri Ward, Nam Tu Liem Distric, Hanoi city, 2018. Ha Noi Medical University journal. The health care providers in Ha Long city and Quang Ninh province should 6. Tac Pham Van, Hieu Dam Trong, have a plan to prepare a team of family Thu Nguyen Thi Hoai et.al (2016). Home doctors, community nurses, caregivers with health care needs of elderly people in Tay appropriate expertise and practical skills to Ho district, Hanoi, 2016 and related factors. be ready for home care services. Journal of Practical Medicine, 7 (1015), 23. (in VietNamese) A further study with large scale should be conducted in different areas to examine the demand of home care services of people in Viet Nam, then the model can be deployed synchronously throughout of the country. REFERENCES 1. Genaral statistic organization (2016). Population forecast for Viet Nam 2014 - 2049. GSO: News Publishing House, Hanoi. [In VietNamese] 2. Health Strategy and Policy Institute (2011). The situation and solutions for the overload and underload of the level of the hospital system. [In VietNamese] Retrieved from cuu-thuc-trang-qua-tai-duoi-tai-cua--he- thong-benh-vien-cac-tuyen-va-de-xuat- giai--phap-khac-phuc-t85-8128.html (In VietNamese) 3. Lesley Larsen Shirlee Sharkey, Barb Mildon (2003). An Overview of Home Care in Canada: Its Past, Present, and Potential. Home Health Care Management & Practice doi/abs/10.1177/1084822303252401 4. Policy and Consultation Branch 56 Journal of Nursing Science - Vol. 04 - No. 01