Relationships Among Self-Care Agency, Health Perceptions, and Activities of Daily Living in Patients After Tracheostomy: A Cross-sectional Multisite Study

Abstract

BACKGROUND: Patients who have undergone tracheostomy may feel weak, perceive a change in their health status, and have difficulty performing activities of daily living (ADL) following hospital discharge. PURPOSE: To investigate the relationships among self-care agency, health perception, and ADL in patients after tracheostomy. METHODS: A cross-sectional multisite descriptive study was conducted between December 31, 2019, and March 31, 2020. The sample consisted of 123 patients discharged from 3 hospitals in different regions of Turkey who agreed to participate in the study, were discharged with a tracheostomy, and received home care for at least 1 month (maximum 3 months) after discharge. The Sociodemographic Characteristics Form, the Self-Care Agency Scale (SCAS), Perception of Health Scale (PHS), and Activities of Daily Living (ADL) Scale were used and completed during face-to-face interviews. Descriptive statistics, independent sample t-test, analysis of variance, and Pearson correlation analysis were used to analyze data; P <.05 was accepted as the level of significance. RESULTS: Sixty-three (63) of 123 patients (51.2%) were 65 years and older, 86 (69.9%) were male, and 62 (50%) did not receive regular outpatient care. Most underwent surgery < 45 days ago (69; 56%), had cancer (92; 75%), and spent between zero and 185 US dollars per month on tracheostomy care (94; 76%). Compared with patients who received regular outpatient care, SCAS, PHS, and ADL scores were significantly lower (P < 0.05) in patients who did not receive this care. Overall scores showed moderate self-care agency and health perception, and the average ADL scores (14.92 +/- 3.05) were in the independent range. Statistically significant positive correlations were found between health perception and self-care agency (r = 0.628; P =.001), health perception and ADL (r = 0.238; P =.008), and self-care agency and ADL (r = 0.461; P =.001). CONCLUSION: Patients who underwent tracheostomy had moderate SCAS and PHS scores, were able to perform ADL independently, and the scores were correlated. Patients with access to outpatient care had significantly higher SCAS, PHS, and ADL scores than patients who did not. Follow-up care may affect all dimensions of health and well-being