台南地區居家呼吸器依賴個案照顧者之返家決策及其遷移照護經驗探討

Discharge Decision Making and Perception of Transitional Care of Caregiver of Home Ventilator Dependent Client in Tainan

葉莉莉(Lily Yeh) ； 薄景華(Ching-Hua Po)

《胸腔醫學》 15卷2期 (2000/06) Pp. 77-84

摘要

本研究旨在探討台南地區居家呼吸器依賴個案照顧者之返家決策思考與其遷移照護經驗感受。對十二位已返家照顧至少一個月以上之照顧者進行深度訪談，將訪談過程錄音並轉換成文字後進行資料分析。結果顯示照顧者決策返家思考之六項因素為：環境變數―――院醫囑之遵從、後續照護資源取得困難、對後續照護資源提供之照護品質存疑、家庭經濟困窘。個人變數―――體認醫療照護的有限性、為維持家庭系統的平衡因素。對遷移照護之正向感受源於持續性照護經驗，負向感受源於中斷性照護經驗。遷移照護過程中，照護技能的學習大都經歷破碎的指導。沒有照顧者後悔所做的返家決策，亦無照顧者需求長期安置機構。以上現象加深對居家呼吸器依賴個案返家決策與遷移照護經驗之認識，相關結果得以強化健康專業人員對此類個案及其照顧者之服務

關鍵字

居家呼吸器依賴個案 ； 返家決策 ； 遷移照護

並列摘要

Purposes of this qualitative study were to thoroughly explore the discharge decision-making and perception of transitional care of caregiver for Home Ventilator Dependent (HVD) clients. Twelve caregivers that had cared HVD for at least one month were invited to participate. Semi-structured interview was designed to collect the data. The interview was tape-recorded, transcribed as a narrative verbal process recording, and then carefully analyzed. Results showed factors considered for discharge of patients. The environmental variables included compliance to doctor's discharge order, perceived limitation of quantity and quality of the post-care institutions, and perceived restriction of family's economics. Personal variables included perceived limitation of health care and wish to maintain the balance of family system. Those who experienced continuity of care had positive perception to transitional care and vice versa. In transitional care process, most of the caregivers received insufficient and non-structured instructions regarding care, skill, and knowledge. Yet, neither did the caregivers regret going home, nor did they wish to re-institutionalize whom they cared. Results of this study could be used to refine discharge planning for HVD clients and their caregivers

並列關鍵字

home ventilator dependent ； discharge decision making ； transitional care