Indian journal of public health · 2025
Home-based Supportive Care Model for Bedridden Patients: A Primary Health Care Approach in Rural Ballabgarh, Haryana, India.
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Chandra Ankit, Misra Puneet, Salve Harshal Ramesh, Kumar Rakesh, Nongkynrih Baridalyne, Prashaath Sathya, Lekkala Harish Kumar Reddy, Gayathri S, Gupta Prakalp
Аннотация
BACKGROUND: Bedridden patients heavily rely on caregivers for daily living activities and accessing care. They have the issues not only with physical health but also psychosocial and spiritual health.
OBJECTIVES: This study implemented a home-based supportive care model based on primary healthcare approach for bedridden patients and assessed its feasibility and effect.
MATERIALS AND METHODS: This model was implemented at a primary health center in rural Ballabgarh, Haryana. Health workers identified the bedridden patients, and medical interns assessed their concerns across physical, mental, social, and spiritual domains. Individual care plans were developed after family meetings, including caregiver training. Health workers conducted monthly home visits for medication refills and supportive care. Baseline and 3-month follow-up assessments used Edmonton symptom assessment scale-revised (ESAS-r) and distress thermometer to assess effect. Feedback was collected from patients, caregivers, and health workers.
RESULTS: Of the 74 identified bedridden patients, 71 were enrolled. The mean age was 52.8 years, with a median bedridden duration of 6.1 years. The common symptoms included pain (91.7%), sleep-related issues (60.4%), and tiredness (56.3%). Postintervention, significant reductions were observed in distress scores (median score reduced from 6 to 4.5, P <0.05), pain (median score 5 to 4, P -value<0.05), tiredness (median score 2 to 0.5, P -value < 0.05), and depression (median score 1.5 to 0, P -value <0.05) on ESAS-r. Feedback from health workers and interns highlighted increased self-confidence, compassion for others, and gained respect in the community.
CONCLUSION: This model of home-based supportive care was feasible and effective in reducing the symptoms and distress among bedridden patients.
OBJECTIVES: This study implemented a home-based supportive care model based on primary healthcare approach for bedridden patients and assessed its feasibility and effect.
MATERIALS AND METHODS: This model was implemented at a primary health center in rural Ballabgarh, Haryana. Health workers identified the bedridden patients, and medical interns assessed their concerns across physical, mental, social, and spiritual domains. Individual care plans were developed after family meetings, including caregiver training. Health workers conducted monthly home visits for medication refills and supportive care. Baseline and 3-month follow-up assessments used Edmonton symptom assessment scale-revised (ESAS-r) and distress thermometer to assess effect. Feedback was collected from patients, caregivers, and health workers.
RESULTS: Of the 74 identified bedridden patients, 71 were enrolled. The mean age was 52.8 years, with a median bedridden duration of 6.1 years. The common symptoms included pain (91.7%), sleep-related issues (60.4%), and tiredness (56.3%). Postintervention, significant reductions were observed in distress scores (median score reduced from 6 to 4.5, P <0.05), pain (median score 5 to 4, P -value<0.05), tiredness (median score 2 to 0.5, P -value < 0.05), and depression (median score 1.5 to 0, P -value <0.05) on ESAS-r. Feedback from health workers and interns highlighted increased self-confidence, compassion for others, and gained respect in the community.
CONCLUSION: This model of home-based supportive care was feasible and effective in reducing the symptoms and distress among bedridden patients.