Development of The Nursing Care for patients and their families during transitional stage

本研究旨在探讨出院后过渡期之护理支援。在操作上，卸货后三个月的时间被定义为过渡阶段。为了解胃切除术后患者及家属照顾者的护理需求，我们开展了相关研究。1.收集术后患者及家属照顾者出院后三个月内的四次资料。患者对消化系统症状的处理，有必要会诊具体方法。患者的心理影响大于胃病，难以应对。家属照顾者帮助患者进行饮食和病情管理，出院后第二周非常焦虑，他们需要对患者的膳食和锻炼内容提出建议。他们表达了不满。2.经济负担方面，出院后1个月内月收入减少，医疗费用最高。出院后1个月药费支出较大，经济负担较大。3.鼓励在门诊部工作的注册护士为患者提供咨询。在此基础上，对护理模式进行了探讨，编制了《胃切除术后患者及家属护理指南》，并对因脑血管疾病致残患者及家属的护理需求进行了初步调查，为该领域的进一步研究奠定了基础。

The purpose of this study is to develop nursing support during the transitional stage after discharge. A period of three months after the discharge was operationally defined as transitional stage. We have carried out some research in order to elucidate nursing requirements of postgastrectomy patients and family caregivers.1.Data was collected four times during three months after the discharge from postgastrectomy patients and family caregivers. The patients coped with the symptoms of digestive apparatus, and there is the necessity of consultation the concrete method. The patients suffered more due to the psychological effects than the gastric condition ; it was difficult for them to cope with this condition.Family caregivers helped with meals and condition management of patients, and they were very anxious during the second week after discharge, and they required advice about the contents of patients' meals and exercise. They expressed complaints. Family caregivers also require health care.2.As for the economic burden, the monthly income decreased and the medical expenses were the greatest during one month after discharge. There was considerable expenditure on medicines and the economic burden on the patients was large for one month after discharge.3.Registered nurses who work in outpatient departments were encouraged to provide consultation for patients. However, these were not provided for every patient, since the physicians had offered consultations to some patients.Based on these results, a nursing model was examined and "the guide-book for the postgastrectomy patients and families" was prepared.Furthermore, preliminary investigation to elucidate the nursing requirements of patients disabled due to cerebrovascular disease and family caregivers was conducted, and this was applied for the further research in this filed.