Care, communication and educational needs of primary care nurses to treat disabled patients.

Abstract

Background: 129,021 disabled patients (DP) are living in the northern part of Belgium of which 21,518 were waiting to receive residential care (in 2013). The care for DP is organized by the Flemish agency for persons with disabilities, called VAPH. Due to the waiting lists for these patients, Belgian government promotes a shift towards primary care. Primary care is a highly accessible care in Belgium. Accessibility has proven positive effects on health outcomes and mortality for DP. However, this shift to primary care results in specific needs for primary care professionals (general practitioners, primary care nurses (PCN) and informal caregivers). Aim: The objective of this research is to detect nursing care, communication and educational needs of PCN to treat their DP and take care of their informal caregivers. Methods: A questionnaire was constructed by a multidisciplinary team of primary care professionals (4 general practitioners and 20 PCN). Disabilities are defined as a physical and/or intellectual impairment. These can be congenital or non-congenital. Sensory disabilities and impairments attributed to the normal ageing process are excluded. The questionnaire was sent electronically to participants. Analysis is performed using SPSS 22.0. Results: In total, 1547 questionnaires were mailed, 617 PCN responded, representing a response rate of 40%. PCN are delivering daily care to on average 16 patients (10) with a mean of 5 DP (6). 408 PCN have contact with the informal caregiver in 50– 100% of time. Most PCN (n = 582) experience an overburdening in significant percentage of informal caregivers mostly due to an overload of tasks (72%). Hygienically care and administering medication (injections) are the most frequent administered care. The communication with the DP and other primary healthcare professionals is evaluated as very good. Most reported educational needs are dealing with behavioral problems (84%), functional loss (84%) and acquired brain injury (74%). There is no significant difference in educational need for PCN nursing exclusively at home versus both at home and in residential care facilities. A significant number of PCN declare a lack of knowledge about different aspects of the Flemish Agency for persons with disabilities (‘VAPH’). Conclusion: There is a significant need for education of PCN to nurse DP. These results will be used to design educational programs to provide PCN with skills to provide high quality care to DP.