Establishment of a daily living support system for home care patients that utilizes nurses' patient discharge summaries

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With the aim of establishing a daily living support system that uses nurses' patient discharge summaries, we conducted a questionnaire survey of nurses (n = 173) and interviews of patients re-hospitalized after home care. We then developed a "recuperation notebook" for use in home care. The questionnaire survey revealed that 17% of nurses had experienced difficulty in gathering information on the use of social resources appropriate to patients, while the interviews showed needs for information on daily living activities such as bathing that is suited to patients' circumstances. Using these results, we prepared a notebook consisting of 7 chapters. The first chapter is a box to write "Things to be careful about after leaving the hospital" that the patient is told during hospitalization. The remaining chapters give space for writing things related to bathing and other daily living activities, taking medicines, how to use social resources, and other matters that patients should note.