研究目的:本研究目的在於探討個案管理模式應用於心臟衰竭病患照護之成效,包括自我照顧認知、態度及行為、病患服務滿意度及急診就診率。 研究方法:採類實驗研究法,以便利取樣分配至實驗組及對照組,研究期間為2009年10月至2010年03月,實驗組26位接受個案管理照護方案,對照組26位接受一般常規性照護,研究資料來源經病患收案資料表、心臟衰竭病患自我照顧量表、病患服務滿意度調查表收集取得,共收案52位。於實施照護方案前收集兩組病患之基本資料及進行病患自我照顧之前測問卷調查,後測資料於實施照護方案3個月後,採用同一份問卷對兩組病患再進行問卷調查。病患服務滿意度於出院時,採直接進行後測問卷。探討兩組照護成效於自我照顧認知、態度及行為、病患服務滿意度和急診再就診率之差異。 結 果:研究結果發現實施個案管理後,對提昇病患自我照顧認知(14.72 vs 11.29, p= .005),具有正向成效。雖然在自我照顧態度(43.13 vs 41.77, p= .596)及行為(57.00 vs 56.31, p= .678 )、病患服務滿意度方面(4.24 vs 4.09, p=.247)及急診再就診率( 50% vs 73%, p= .111)未達無統計上顯著差異,但實驗組於自我照顧態度及行為有提昇、急診再就診率有下降,且病患服務滿意度有提高。 結 論:本研究顯示個案管理有助於提昇病患自我照顧與照護品質,亦可作為臨床推展心臟衰竭病患個案管理照護之參考。
Objectives: To determine the effectiveness of healthcare in heart failure patients with and without case management care by comparing the collected datae regarded the self-care knowledge scale (recognition, attitude and behavior), patients' satisfaction questionnaires and emergency revisit rate. Methods and Materials: Fifty two patients diagnosed as heart failure in this Medical center were divided into two groups (26 each) by randomization in a 6-month period (from Dec. 2009 to March 2010). In addition to regular medical treatment for heart failure, group A received an extra case management care protocol as compare to group B without case management for control group. We evaluated the collected datae (the self-care knowledge scale, after discharge satisfaction questionnaire and emergency revisit rate). In each group to see any existed improvement the quality of care. Results: The datae collected were as following , the self-care knowledge scale: recognition 14.72 vs 11.29(p= .005), attitude 43.13 vs 41.77 ( p= .596), behavior 57.00 vs 56.31, (p= .678), after discharge satisfaction questionnaire was 4.24 vs 4.09(p= .247), and the emergency revisit rate was 50% vs 73%(p= .111) in group A and group B, respectively. Conclusions: Heart failure patients underwent case management care protocol presented improve effectiveness of healthcare by increasing self-care knowledge scale, especially recognition, and can be applied as a reference to promote the heart failure case management.