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Abstract

Delphi technique was used in designing questionnaire for this study. Of the 100 obstetric experts who completed the questionnaires of this study were 39 chief nurses from district teaching hospitals or bigger hospitals, 37 physicians and 24 nursing teachers of nursing colleges or universities. Three rounds of questionnaires were used in the study to collect and integrate experts' opinions concerning "the care needs for preparatory service for discharge after delivery and its evaluating indicators" into a consensus. The first questionnaire used open-ended questions to define the content of this study. The second and third questionnaires were constructed by analyzing the answers of the first one, utilizing the weighed selection of experts and sorting them in accordance with their importance, the rationale of the answers had to be stated.

The study used the mean of the rank, its standard deviation, T score and 6 statistical criteria of the selected items to defme the following:

( I) 8 important items out of 20 care needs of mothers were selected, they are: (1) Evaluation of uterine contraction and lochial amount. (2) Determining patients' self-care ability. (3) Care for perineum and wound self-care instruction. (4) Monitoring patients' urine output, bowel movement and care for hemorrhoid. (5) Balanced puerperal nutrition instruction through consultation, pamphlet and open discussion. (6) Instructing postpartum exercise. (7) Breast-feeding instruction and care for breast and nipple. (8) Breast-feeding problem management.

( II ) 8 important items out of 15 care need of the newborns were

selected, they are: (1) Educating mothers and the relatives (fathers in particular) about their infants' developmental milestones. (2) Instructing mothers to identify and manage the problems in rearing their infants. (3) Informing the mothers to follow the infants' vaccination schedule, infant health examination, infant metabolism screen test and the follow-ups. (4) Demonstrate newborn bathing skill. (5) Umbilical cord care and infection prevention instruction. (6) Identifying neonatal jaundice. (7) Emphasizing early parent­ child interaction and help establish the relationship. (8) Assist puerperal follow-ups and provide relevant health care resources. (m) 4 important items out of7 evaluating indicators regarding the case

and her family, they are: (1) The evaluation and satisfaction of self­ care ability before and after discharge. (2) The evaluation and satisfaction of infant-care ability before and after discharge. (3) The recognition, acceptance and the comparison of the content of preparatory service for discharge. ( 4) The satisfaction, opinion and the practice of the mothers and their families to preparatory service for discharge.

(N) 7 evaluating indicators regarding health care delivery system were

identified, they are: (1) Hospitalized days of mothers and infants, readmission and the causes, the incidence rate, length of stay or outpatient visit frequency and the causes. (2) The rates of postpartum OPD check-up, well baby check-up and infant vaccination. (3) The health condition of the mothers and newborns. (4) The satisfaction of baby-delivery service, the willingness to return for next delivery and the increase of the number of delivery in the hospital. (5) The availability of follow­ up service provided by the hospital, the utilization and satisfaction of cases using consultation service. (6) The periodical KAP evaluation of the relevant health care personnel. (7) Efficient administration, clinical pathway monitoring and family -centered nursing care. So called important items are the consensus reached by the experts participated in the study, which has strictly abided the spirit of Delphi technique.

The result of this study can help clarify the mothers' needs for preparatory service before discharge from hospital, indicate important content of puerperal stage care and establish indicators for service quality monitoring. It can also provide scholars and clinical practitioners with very useful guideline for prior and in-service training programs. Ultimately, it can help mothers obtain quality service they deserve.

Keywords: Discharge planning, The need for care, Evaluating indicators, Delphi technique

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