影響內科病人主觀出院準備度之相關因素

Factors Associated With Readiness for Discharge Among Medical Inpatients

陳嬿今(Yen-Chin Chen) ； 洪筱瑩(Hsiao-Ying Hung) ； 梁詩欣(Shih-Hsin Liang) ； 楊淑齡(Shu-Ling Yang) ； 柯乃熒(Nai-Ying Ko) ； 張瑩如(Ying-Ju Chang)

《榮總護理》 38卷4期 (2021/12) Pp. 360-371

https://doi.org/10.6142/VGHN.202112_38(4).0004

摘要

背景：出院準備服務可提早協助病人或家屬面對出院後照顧問題，亦可降低再入院率。然而，鮮少研究針對住院病人出院前主觀準備度之狀態及其出院準備度之相關因素進行探討。目的：探討住院病人之出院準備度及其影響因子。方法：採橫斷性研究設計，以方便取樣方式，招募於4小時內準備出院之內科病人，使用中文版短版12題出院準備度量表（Chinese version of readiness for hospital discharge scale, CRHDS），測量病人個人狀態、因應能力以及預期性支持等層面主觀出院準備度感受，以邏輯式迴歸分析影響病人出院準備度之相關因素。結果：共招募354位病人，其中有78.2%主觀認為其出院準備度佳（CRHDS＞7分），在出院準備度次變項中以預期性支持平均得分為最高，出院準備度佳者整體住院天數顯著短少8天。邏輯式迴歸分析結果指出平均住院天數越短［adjusted odds ratio（AOR）=0.96, p=.039］、意識清楚（AOR=2.66, p=.045）、日常生活自理（AOR=1.89, p=.024）及出院後返家者（AOR=3.41, p=.013）與出院準備度有顯著正相關。結論／實務應用：建議應注意出院病人的出院準備度，尤其是住院天數長、意識不清、日常生活無法自理以及出院返回機構的病人，以利協助病人以及家屬順利度過急性疾病治療後出院的過渡期。

關鍵字

準備度 ； 出院 ； 內科住院病人 ； 中文版出院準備度量表

並列摘要

Background: Readiness for hospital discharge has been identified as a crucial part of continuous care and may be related to a reduced risk of readmission. However, research on inpatients self-reporting their readiness for hospital discharge medical inpatients is lacking. Purpose: This study investigated factors related to readiness for discharge among medical inpatients. Methods: This cross-sectional study recruited medical inpatients older than 20 years between February and June 2019. The study employed a 12-item Chinese version of the Readiness for Hospital Discharge Scale (CRHDS), consisting of three dimensions: personal status, coping ability, and expected support. Logistic regression was used to examine the factors associated with the medical inpatients' readiness for discharge. Results: A total of 65.7% (354/539) of the inpatients responded to the CRHDS questionnaire. Of these, 78.2% self-reported a high level of readiness (CRHDS score ＞7). The expected support subscale received the highest score of the three subscales. Inpatients with a high level of readiness had a significantly shorter (8 days) duration of hospitalization than did those with a low level of readiness (p ＜ .001). Shorter hospitalization [adjusted odds ratio (AOR) = 0.96, p = .039], full consciousness (AOR = 2.66, p = .045), living more independently (AOR = 1.89, p = .024), and discharge to home (AOR = 3.41, p = .013) were significantly associated with a high level of readiness for hospital discharge. Conclusions/Implications for Practice: These results suggest that health-care providers should strengthen their assessments of readiness for hospital discharge, especially for those with longer hospital stays or without full consciousness or for those being discharged to home to support patients and their families in the difficult transition from hospital to home.

並列關鍵字

readiness ； hospital discharge ； medical inpatients ； Chinese version of the Readiness for Hospital Discharge Scale

參考文獻

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