- 期刊
思覺失調症住院病人實施臨床路徑之照護品質
Evaluation of Quality of Care in Schizophrenia Inpatients by Clinical Pathways Approach
摘要
目的：比較執行精神分裂症臨床路徑的照護過程及成果的差異與比較醫學中心與專科醫院對精神分裂症病患的照護過程及成果的差異。方法：本研究採立意取樣法；藉由病歷審查來評值照護過程，以個案症狀變化、家屬自覺照護負擔情形、個案社會功能狀況及滿意度作為成果評值。結果：1. 在護理過程方面，有實施臨床路徑的病房顯示在生理、心理社會評估及出院計畫方面分數明顯高於未實施之病房；醫學中心顯示在藥物治療方面分數高於專科醫院。2. 護理成果部份：a. 有實施臨床路徑對病患症狀、家屬自覺負擔、社會功能及滿意度改善沒有顯著影響。b. 在住院天數上以專科醫院住院天數最長。c. 專科醫院之病患在家屬自覺負擔方面較醫學中心明顯減輕。結論：實施臨床路徑在照護過程的評估及出院計畫方面較完整；醫學中心在照護過程中對藥物治療的執行較專科醫院完整，而專科醫院在家屬負擔的改善上優於醫學中心。
並列摘要
Objective: This study compared (1) the caring processes with and without implementing clinical pathways in schizophrenia inpatients and their quality outcomes, and (2) the differences of caring process and quality outcomes between medical center and psychiatric hospital. Methods: This study adopted a purpose sampling and cross-sectional design. The following scales were used: the Brief Psychiatric Rating Scale (BPRS) for monitoring the changes of symptoms, Family Burden Scale for family members' perceived caring burden, Social Function Scale for assess patients' functional states and Satisfaction Scale for patients' satisfaction of caring quality. Results: In the aspect of nursing process, the scores of physical assessment, psychosocial assessment and discharge planning were higher in the units which implemented clinical pathways on schizophrenia inpatients than those without; the score on pharmaceutical treatment was significantly higher in the medical center than the psychiatric hospital. In the aspect of nursing outcome, while no significant differences were found in patient symptoms, perceived burden of the family members, and social function and satisfaction, the days of admission were longer in the psychiatric hospital than in the medical centre. Also, perceived burden of the family members was lower in the psychiatric hospital than in the medical center. Conclusion: Implementation of clinical pathways provides a more comprehensive assessment and discharge planning for the schizophrenia inpatients. While the medical center was more integrated in pharmaceutical treatments, the psychiatric hospital performed better in reducing burden perceived by the family members.
延伸閱讀
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