Unmet nursing care needs of home-based disabled patients

In Taiwan, family members care for 80-90% of disabled people, but most have no professional training or knowledge of care for the disabled. Therefore, the adequacy of care received by the disabled needs to be assessed.

To evaluate the unmet nursing care needs of physically disabled patients and determine the relevant factors.

All 322 subjects were over 18 years of age, had a Barthel Index of less than 80 and became disabled 2 years prior to the commencement of this study. All subjects were outpatients of hospitals in central Taiwan and were contacted by phone to schedule an interview. Based on activity of daily living (ADL) scores, patients were divided into three groups: complete dependency, severe dependency and moderate dependency. After training, nurses evaluated the patients' ADL and completed the 20-item Assessment of Nursing Activity (ANA) questionnaire. Based on the ANA, subjects' unmet needs and caregivers' knowledge requirements were assessed.

The results showed the mean number of unmet needs was approximately five. Percentage of unmet needs was 44.8%. For complete dependency patients, the unmet needs score of patients and the needs score of caregiver's knowledge was highest, followed by the severe dependency group, and the moderate dependency group. Based on multiple linear regression, the factors that affected unmet need were as follows: age of patient, ADL score, education level of the caregivers, average daily duration of care and need of caregiving knowledge. Our findings indicate that the provision of counseling and educational support for family caregivers is required to promote quality of care for the disabled.