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  • 學位論文

高醫附設醫院特殊需求者牙科醫療服務示範中心之就醫狀況及照護者的滿意度調查

Kaohsiung Medical Hospital Special Needs Dental Services Demonstration Center Medical Care in the Status and Caregiver Satisfaction Survey

指導教授 : 黃純德

摘要


目的:省思藉著回顧前人的照護經驗,探討如何因應未來的照護趨勢,從高醫附設醫院特殊需求者牙科醫療服務示範中心,找出身心障礙者的就醫狀況(交通、門診需求、環境設備、醫療服務態度、服務結果)與最主要照護者對門診病患滿意度的相關因子,給予正向鼓勵與協助,讓患者從悲觀想法中找到支撐點和希望,協助身心障礙者走出口腔疾病的惡夢,生活才能煥發光彩。 研究方法:調查高醫附設醫院特殊需求者牙科醫療服務示範中心,研究對象為身心障礙者與最主要照護者,採門診方便取樣,有效樣本共45份,為橫斷面研究,針對研究對象與就醫狀況;進行社會人口學卡方分析,最主要照護者人口學變項與醫院滿意度因素進行ANOVA分析。 研究結果:最主要照護者以母親28人(62.2%)佔最多數、依性別,照護者以女性居多41人(91.1%),照護者年齡層51~60歲18人(40.0%)佔最多數,最高學歷高中職為19人(42.2%)佔最多數,依職業別,無職業的照護者24人(53.3%)佔最多數,身心障礙者性別:男性26人(57.8%)、女性19人(42.2%),年齡層:19~44歲(含)20人(45.5%)佔最多數,教育程度高中職19人(42.2%)佔最多數,目前就讀學校特殊教育學校15人(33.3%)佔最多數,居住地:高雄市37人(82.2%)佔最多數,意識狀況:意識清楚39人(86.7%)佔最多數,飲食途徑:自己可經口進食26人(57.8%)佔最多數,身心障礙手冊上記載重度18人(40.0%)佔最多數,家庭平均月收入三萬∼四萬元(含)7人(15.6%)佔最多數,持有重大傷病卡:無39人(86.7%)佔最多數,白天主要在何處接受照護:家中22人(48.9%)佔最多數,交通工具的選擇及搭乘:普通,還好12人(35.3%)佔最多數,陪同看牙科:母親26人(76.5%)佔最多數,必須由照護者刷牙42.9 (%)佔最多數。最主要照護者的醫療滿意度很滿意:醫療過程_專業能力24人、75(%)佔最多數。很不滿意的醫療滿意度0人、0(%)。 結論:本研究調查的樣本數中,有關交通工具的選擇及搭乘:非常麻煩1人(2.9%)、有點麻煩12人(35.3%),大多數需要醫院定期提醒回診就醫與增加門診時間;大部分患者不需要全麻醉,且照護者對於全身麻醉的接受度很低;本研究發現,到此中心大多數是中度以上的患者,都能定期回診達到例行性的口腔預防照護;多數認為有待進一步多設立獨立的特殊需求牙科門診,擁有定點又可方便集中身心障礙者時,對不同障礙別的患者與照護者來說,才有可能達到永久性與便利性的既能照護醫療,又兼顧照護口腔預防保健的完美場所,達到身心障礙者都有健康口腔過生活,我覺得這是人生最美好也最重要的一種價值,對整個世界而言也是一種恩典。

並列摘要


Objective: Through a review of previous care experience to explore how to respond to future care trends, from Kaohsiung Medical Hospital special needs dental service demonstration centers to identify the medical conditions of people with disabilities (transportation, out-patient needs, environmental equipment, the attitude of medical services, and service) and the main caregiver outpatient satisfaction factor. Methods: Study providing people with disabilities with the most important caregivers mining outpatient facilitate sampling of 45 valid samples, cross-sectional study, the object of study and medical treatment conditions; conducting socio-demographic chi-square analysis, the main caregiver demographicvariables and hospital satisfaction factors conducted ANOVA analysis Results: The most important care by mother 28 people (62.2%) accounted for the most, the majority of 41 (91.1%) according to gender, care by women, caregivers years age layer 51 to 60 years 18 people (40.0%) accounted for up tonumber, the highest academic qualifications high school grades for 19 (42.2%) accounted for the most, to do by occupational and non-occupational care by 24 people (53.3%) accounted for the most, people with disabilities gender: male 26 people (57.8%), female19 (42.2%), year-on-year age layer: 19 to 44 years old (inclusive) 20 (45.5%) accounted for the most common, level of education high school grades 19 people (42.2%) accounted for the overwhelming majority, currently studying in 15 schools special education schools (33.3%) were the most common, place of residence: Kaohsiung 37 (82.2%) was the most common state of consciousness: clear consciousness and 39 (86.7%) was the most common eating ways: he can eat by mouth 26 (57.8%) was the most common and severe in 18 (40.0%) was the most common disabilities manual records, the average monthly household income to 35,000 million (inclusive) 7 (15.6%) was the most common to hold Catastrophic card:39 (86.7%) was the most common during the day where receiving care: home and 22 (48.9%) was the most common transportation choices and take: Fortunately, 12 (35.3%) was the most commonaccompanied to see dentistry: mothers and 26 (76.5%) was the most common, you must brush your teeth by caregivers 42.9 (%) was the most common. The medical satisfaction of the most important caregivers are satisfied: medical procedure _ professional capacity of 24 people, 75 (%) was the most common. Very dissatisfied with the satisfaction of medical 0, 0 (%) Conclusion: the investigation of the study sample number, relating to transport tools and ride: very troublesome 1 (2.9%), a little trouble 12 (35.3%), most of the number need hospital regularly remind back to the clinic for medical treatment and increased out-patient time; bigSome patients do not need general anesthesia, and caregivers to accept very low level for general anesthesia; this study found that this center most patients with more moderate, regular visits can its routine preventive oral care; majority thinkpending further by the establishment of the special needs of the dental clinic, with fixed-point but also convenient to focus on people with disabilities, other patients with different obstacles and caregivers speaking, be possible to achieve both permanent convenience care medical,both care preventive oral care perfect place to reach people with disabilities have a good teeth lead a healthy life, and I think this is the most beautiful in life and most important kind of value. In terms of the whole world is a grace.

參考文獻


Al Agili, D. E., Roseman, J., Pass, M. A., Thornton, J. B., & Chavers, L. S. (2004).Access to dental care in Alabama for children with special
needs: parents' perspectives. J Am Dent Assoc,135(4), 490-495.
Ananthanarayan C, Sigal M, Godlewski W. (1998).General anesthesia for
the provision of dental treatment to adults with developmental
disability. Anesth Prog, 45(1):12–7.

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