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None, Conflict of Interest: Neurosurgical patients require special care not only in the hospital but also after their discharge from the hospital.

Many such patients suffer from various co-morbidities. Variable periods of convalescence affect health-related quality of life in these patients.

Case 8 1 discharged for facebook comments found on page 377

Purpose of the Study: To determine the degree of compliance of neurosurgery patients and their family caregivers with the discharge advice given by the consultants To evaluate the quality of life of these patients To know the problems faced by these patients at home.

This cross-sectional interview-based descriptive study was conducted in in Chandigarh. These patients were visited at their home.

A scale was evolved to evaluate comprehension and compliance to the advice given at the time of discharge, according to the criteria developed by Clark et al.

Lawton Brody instrumental activity of daily life and Spitzer quality of life index were used to assess patients' quality of life after the operation. Verbatim responses were recorded for the purpose of qualitative research. Overall, 58 patients and their caregivers were interviewed at home.

Mean age of the patients was Out of 37 patients, 35 showed good comprehension and 33 patients had a good compliance with the instructions given for medication. The condition of It is in the long term that the true complexity and impact of operations become apparent.

  1. The condition of 74. Almost one-third of the cases were due to trauma caused by road traffic injuries, falls, and assaults.
  2. This is an indication of respect for family values in Indian culture. Few of them
  3. Some patients had poor and average QOL despite having good initial relief after the operation. In those cases where overtime class actions have been certified, appeals are pending on the certification decisions, and we have yet to see a case go to trial on the merits.
  4. But cooking and shopping are the most severely affected IADL activities.
  5. Most of the patients appeared calm and had a positive outlook toward life. But it is in the long term that the true complexity and impact of operations become apparent.

After operation, such patients are likely to have a range of physical, emotional, cognitive, behavioral, and social problems, which may result in difficulties for both patients and their family caregivers. Provision of mechanism of prioritized follow-up care to the operated bedridden neurosurgery patients should be made. Comprehension and compliance, home-based care, narrative review, neurosurgery, quality of life How to cite this article: Comprehension and compliance with the discharge advice and quality of life at home among the postoperative neurosurgery patients discharged from PGIMER, Chandigarh, India.

Asian J Neurosurg ; Co-morbidities are common after neurosurgical operations and patients need care for longer time. Home-based care of such patients is a difficult task for the families due to associated co-morbidities. Some of them die due to fatal nature of the disease or due to the injury sustained by them, [2] and many of them who survive, develop various co-morbidities like bedsore, pneumonia, urinary infection, suppuration, etc.

After initial neurosurgical management, the survivors are discharged with instructions. Poor compliance with follow-up instructions can lead to slow or no recovery and ineffective care. Many researchers have found that when patient and family have a better understanding of their diagnosis and treatment, they are more able to cope with their illness, use the health system more effectively, and have less psychological distress. To determine the degree of compliance of neurosurgery patients and their family caregivers with the discharge advice given by the consultants To evaluate the quality of life QOL of these patients To know the problems faced by these patients at home.

Materials and Methods This cross-sectional interview-based descriptive study was conducted in in Chandigarh.

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All patients residents of Tricity Chandigarh, Mohali, and Panchkula discharged from neurosurgical ward PGIMER within last 1 year and patients attending regular follow-up OPD and discharged within last 3 years were included in the study. Non-traceable patients were excluded from the study. Suitable appointments were sought from the patients and respondents prime caregiver for the interviews.

First of all, they were explained about the purpose of the study. Repeated visits were also made as per the need for this purpose. Relevant records of treatment were examined. After filling up demographic data, interview schedule based survey was done. In-depth interview of vocal respondents was done. Verbatim responses were also recorded. Key caregivers of patients were interviewed as proxy respondents in case subject was not in a condition to respond. A scale was evolved to evaluate comprehension and compliance to the advice given at time of discharge, according to criteria developed by Clark et al.

These are internationally validated tools to assess QOL of patients after the operation. An in-depth interview was also conducted with patients and caregivers for the purpose of qualitative research.

The person in the family who was primarily responsible for care of the patient at home was defined as key caregiver for the purpose of study. Textual analysis of the data was done. SPSS version 17 and Excel software were used for the analysis.

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Percentage, mean, standard deviation, tables, and graphs were used for the interpretation of data. The subjects were informed about the purpose of study.

They were assured that all personal information will be kept confidential and used only for research and study purpose. Consent was also taken from patients as well as their key care providers.

Ethical clearance was obtained from the institute's ethical review committee. Results An attempt was made to visit patients' homes. Their addresses were taken from neurosurgery department. Only 61 patients were traceable. Rest 39 patients either were non-traceable or had changed their residence due to retirement from job or some other reasons like marriage of girls, transfer, or were staying with relatives or were on rent for treatment purpose.

Out of the 61 cases, 2 patients died within a month of their operation and 1 patient was not willing to participate due to some personal reason. So, 58 patients were included in the study. Maximum number of patients were in age group of years The mean age was Of the 58 patients, 36 were males and 22 were females.

Maximum number of caregivers were in the age group of years One patient did not have any caregiver resides alone. Among all the age groups, primary caregivers were mainly females 33 out of total The mean age of caregivers was The minimum age among the caregivers was 18 years and maximum age was 73 years. Overall, majority of the care at home was provided by females Majority of the patients were males Out of total 57 1 patient was residing alone caregivers, maximum percentage was of spouse Majority of the patients Many of the patients were graduates and above Majority of the patients contacted from the study areas Almost one-third of the cases were due to trauma caused by road traffic injuries, falls, and assaults.

Out of total 58 patients, 37 were given instructions on follow-up care at home. Rest 21 were either unconscious at the time of discharge or were not able to understand properly. Out of 37 patients, 35 showed good comprehension and 33 patients had a good compliance with the instructions given for medication [Table 1]. Comprehension and compliance status for patients Click here to view Most 54 caregivers were instructed about medication.

  1. First of all, they were explained about the purpose of the study.
  2. They were performing all daily life activities on their own; 8.
  3. Bas tal matol karte hain. After initial neurosurgical management, the survivors are discharged with instructions.

Of them, 52 showed good understanding and 49 caregivers showed good compliance [Table 2]. Comprehension and compliance for the instructions like physiotherapy was found to be very poor. Patients who could not follow the instructions given for physiotherapy revealed a range of problems.

To quote the problem faced due to physiotherapy from one of the narrative in our study: Bas tal matol karte hain. We are advised physiotherapy for 6 hours at least. They were performing all daily life activities on their own; 8. Mean of activity of daily life [ADL] score was Almost half of the patients were found to be independent.

Highest mean score in all dimensions of IADL was in the telephone use 0. In the dimension specific for females, the lowest mean score was for food preparation 0. More than one-third of the patients perceived that they were able to conduct all activities by their own, evaluated by Spitzer QOL index. Most of the patients were able to perform daily life activities on their own Few of them Most of the patients One of the patients felt that he was not supported by family members in his need.

Some of them Almost one-third of the caregivers of the patients Mean score of all the dimensions of Spitzer QOL together was 6. QOL for half of the patients was found to be good. Almost half of the patients and caregivers were apprehensive about the prognosis.

Discussion Neurosurgical operations may improve the patients' condition. Basic lesion may be treated. But it is in the long term that the true complexity and impact of operations become apparent.