Abstract
As societal aging progresses globally, the number of people with Parkinson's disease (PD) is expected to increase worldwide. Accordingly, the need for home health nursing care for homebound patients with PD will continue to expand. We aimed to clarify the clinical care provided by nurses to homebound patients in each Hoehn and Yahr (HY) stage of the disease. We analyzed the visiting nursing records of patients and observed the clinical care provided by nurses in patients' homes and nursing homes to compare the attributes of patients and differences in nursing care by HY stage. All 21 patients surveyed were at or above HY stage III. The nurses visited each patient nine times per month, on average. The number of visits was positively correlated with HY stage. All stage III patients were homebound, and medication dosage and dispensation assistance were quite common. Several stage IV patients were admitted into nursing homes. In stage V, assistance with hygiene, bedsore management, urine withdrawal/bladder catheters, and other excretory aids were among the most common forms of nursing care provided. As patients' stages progressed, guidance/educational care meant to encourage self-care decreased and direct physical care increased. Clear differences in nursing care were observed between HY stages, suggesting that stage-based protocols regarding the nature and frequency of nursing visits may be useful for ensuring consistent, effective care of patients with PD.
Highlights
Parkinson’s disease (PD) is a neurodegenerative disease with no radical cure
When calculated using the Japanese population, the adjusted prevalence of the disease is 166.8 per 100,000 individuals [1]. It is important for patients with PD in long-term medical treatment to receive physical therapy to maintain bodily functions and pharmacotherapy, centering primarily on L-Dopa, to achieve symptomatic relief; both of these efforts require effective care protocols
Eligible patients who provided their consent to participate were included in the study. We collected both the visiting nursing records of these patients and the researcher-administered observation records of the nursing care provided by visiting nurses to these patients, either at their own home or in a nursing home. e attributes of the nurses that provided visiting care were polled via a questionnaire
Summary
Parkinson’s disease (PD) is a neurodegenerative disease with no radical cure. In Japan, patients above stage III on the Hoehn and Yahr (HY) scale are eligible for public medical expense subsidies. When calculated using the Japanese population, the adjusted prevalence of the disease is 166.8 per 100,000 individuals [1]. It is important for patients with PD in long-term medical treatment to receive physical therapy to maintain bodily functions and pharmacotherapy, centering primarily on L-Dopa, to achieve symptomatic relief; both of these efforts require effective care protocols. Programs that involve counseling, medication information, and collaboration with local organizations during hospitalization and discharge are known to be effective for supporting patients with PD. Due to the need to enhance the effectiveness of nursing care provided to patients with PD, the movement to maintain and further improve the quality of care is increasing globally
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