Emeran, Nurul Ain Mohd
(2018)
Satisfaction towards domiciliary care services and the unmet needs among stroke patients in Kota Bharu District.
Masters thesis, Universiti Sains Malaysia.
Abstract
Domiciliary care is a multidisciplinary rehabilitation care which provides the
continuity of care at the community setting. It requires the involvement of caregivers
in providing continuous care at home with guidance by the health professionals. This
study examined the factors associated with caregivers’ satisfaction towards provided
domiciliary care services and the unmet needs for care among patients who are not
eligible to receive domiciliary care in Kota Bharu district as perceived by the caregiver.
This study was divided into three parts, the retrospective record review of stroke
patients from HRPZ II and Hospital USM, a caregiver satisfaction survey for patients
who received domiciliary care, and an unmet needs survey as perceived by the
caregiver of stroke patients who were not eligible to receive domiciliary care services.
Caregiver satisfaction was measured using the validated FAMCARE questionnaire.
The unmet need was measured using the UN CARE questionnaire. Multiple linear
regression was used to identify the determinants of satisfaction and the unmet needs.
Seventy nine (23.9%) of the randomly selected 330 stroke patients received
domiciliary care services, whereas others received either nursing care visit 121
(36.7%) or outpatient service 130 (39%). Out of those 219 (66.4%) who were referred
to be assessed for eligibility to receive domiciliary care services, only 79 (36.1%) fulfil
the eligibility criteria. Most eligibility criteria were fulfilled by most of the patients
except availability of caregiver during therapy visit. Caregiver’s satisfaction in
general, towards provided domiciliary care services was found to have association with
the family conference prior to discharge (adjusted b= 0.51, 95%CI 0.31,0.69,
p<0.001). Satisfaction in term of information giving and physical care were associated
with only family conference prior to discharge. Besides family conference prior to
discharge, satisfaction subscale on psychosocial care was also determined by duration
of illness. Satisfaction in term of availability of care was also associated with care
giver income and strain index. The unmet needs in general, among non-recipient of
domiciliary care services was found to be associated with age of caregivers (adjusted
b= -0.002, 95%CI -0.004,-5.34×10-5, p = 0.044), caregivers with own income (adjusted
b= 0.11, 95%CI 0.03,0.19, p = 0.008), high caregiver’s burden (adjusted b= -0.13,
95%CI -0.18,-0.07, p<0.001), and family conference prior to discharge (adjusted b= -
0.19, 95%CI -0.25,-0.14, p<0.001). Unmet needs on support was associated with
impairments, activity limitations, and patient-caregiver who stayed together. Unmet
needs on engagement of care was associated with age of caregivers, caregivers with
own income, high caregiver’s burden, and family conference prior to discharge. Unmet
needs on benefit of care was associated with activity limitations, high caregiver’s
burden, and family conference prior to discharge. The study found that the domiciliary
care services in Kota Bharu generally met the purpose to those who received. The
family conferences were important for those who were not eligible to receive the
services.
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