急診病人自評傷情嚴重度、檢傷分級認知與候診感受之相關性探討—以南部某區域醫院急診室為例

Explore The Slef Assessment Disease-Severity、Public Awareness of Triage and the Feeling of Waiting for Treatment of Emergency Patient in a General Hospital in Southern Taiwan

周嘉徽(Chia-Hui Chou)

指導教授 ： 李逸

義守大學/醫學院/護理學系/碩士(2022年)

摘要

背景：最常發生的急診糾紛是未能立即獲得醫師診療及護理照護，細究原因多源於民眾對於急診的作業流程不清楚。實際上急診以檢傷級數來決定看診順序，並依此分級級數安排就診的先後順序，所以「檢傷級數=救命順序=看診順序」。
目的：探討南部某區域醫院急診室：（一）瞭解急診病人對檢傷分級的認知、（二）瞭解急診病人的候診感受（情緒反應及等待時間與感受）、（三）瞭解急診病人自評檢傷與專業人員實際檢傷的一致性、 (四)瞭解急診病人檢傷分級認知與自評/實際檢傷分級的關係、（五）瞭解急診病人自評檢傷分級與候診感受的關係。
方法：本研究採橫斷式調查法，以自擬問卷為測量工具，CVI值介於.83～1，選取南部某區域教學醫院135位急診病人為研究樣本，運用SPSS套裝軟體19.0進行描述性統計、獨立樣本t檢定、單因子變異分析各變項關係。
結果：研究顯示急診病人中，男性略高於女性；就醫年齡層以青壯年人口居多；學歷以高中至大專程度為多數；除因特殊或意外狀況等不可抗力因素而必須使用急診資源外，大多數使用急診的原因為自評傷情嚴重、或因非門診時段希望獲得迅速的醫療照護；自評與實際傷情評估方面，前三項皆為「我覺得疼痛」、「其他慢性病史」、「我覺得噁心、嘔吐、腹瀉」；可接受等候看診時間「60分鐘以內」為最多，自覺等候時間以「30分鐘以內」居多數，實際等候時間則是「30分鐘以內」為多；就醫當下感覺焦慮、無助的情緒；急診病人「檢傷分級認知」與「自評/實際傷情檢傷分級」沒有顯著的關聯；急診病人不同自評檢傷分級與情緒反應的關係無顯著差異情形。
結論/實務應用：綜言之，急診病人的自評傷情嚴重度、檢傷分級認知與候診感受沒有顯著關聯。從研究者的臨床經驗觀察，民眾遇到緊急事件時往往手足無措，直覺是直奔急診尋求醫療協助，因此除了提升民眾對檢傷分級認知，醫護人員也要給予急診病人更多同理心。研究結果可作為未來護理實務、行政及教育等方面參考。

關鍵字

檢傷分級 ； 自評傷情 ； 實際傷情 ； 等候時間 ； 情緒反應

並列摘要

Background：the most common emergency dispute is the failure to obtain doctors' diagnosis, treatment and nursing care immediately. The detailed reasons are mostly due to the public's concern about. The emergency operation process is not clear. In fact, the order of emergency treatment is determined by the number of injury levels, and the level is safe according to this level. The order of medical treatment is arranged, so "triage level=life-saving order=visiting order".
Purpose：To explore the emergency room of general hospital in Southern Taiwan (1) to understand the cognition of emergency patients on triage classification, (2) to understand the waiting feelings of emergency patients (emotional reaction and waiting time and feelings), (3) to understand the self-assessment of emergency patients Consistency between triage and the actual triage of professionals, (4) Understand the relationship between emergency patient triage grading cognition and self-assessment/actual triage grading, (5) Understand the relationship between emergency patient self-assessed triage grading and waiting experience.
Methods：a cross-sectional survey was adopted in this study. A self-designed questionnaire was used as the measurement tool. The CVI from .83 to 1. A region of general hospital in Southern Taiwan was selected 135 emergency patients were used as research samples, and SPSS Windows 19.0 was used for descriptive statistics and single analysis, t-test and ANOVA.
Results：The results of this study, among emergency patients, males are slightly higher than females. Most of the medical age group is young and middle-aged population. The majority of education backgrounds are from high school to junior college. Except for special or unexpected conditions In addition to force majeure factors that necessitate the use of emergency department resources, most of the reasons for using emergency department are self-evaluation of serious injuries or non-outpatient periods, and instead hope to obtain rapid medical care to meet their own needs. Self-evaluation and actual injury In terms of evaluation, the first three items are "I feel pain", "Other chronic medical history", "I feel nausea, vomiting, and diarrhea". Acceptable waiting time "within 60 minutes" is the maximum, and conscious waiting time "Within 30 minutes" is the majority, and the actual waiting time is "within 30 minutes". "Evaluation/Actual Injury Inspection Grading" has no significant correlation. There is no significant difference in the relationship between different self-evaluation injury grading and emotional response of emergency patients.
Conclusions/Implications for Practice：There is no significant difference in self aassessment dusease severity, triage leveal and the feeling of waiting for emergency patients. The relationship between from the clinical experience of researchers, people are often at a loss when they encounter an emergency, and their intuition isgo straight to the emergency department for medical assistance. Therefore, in addition to improving people's awareness of disease-severity, nurses should also give emergency treatment. Patients are more empathetic. The results can be used as a reference for nursing practice, administration and education in the future.

並列關鍵字

Triage Leveal ； Slef Assessment Disease-Severity ； Acute Disease ； the Time of Waiting ； Emotional Response

參考文獻

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世界衛生組織（1948）．世界衛生組織對健康的定義．取自http://www.who.int/suggestions/faq/zh/index.html. [World Health Organization (1948). Definition of health. Retrieved from http://www.who.int/suggestions/faq/zh/index.html.