居家照護病患照護問題相關因素之探討

The Exploration of Related Factors of Nursing Care Problems in Home Health Care Patients

吳淑如(Su-Zu Wu) ； 邱啓潤(Chii-Jun Chiou)

《護理研究》 5卷3期 (1997/06) Pp. 279-289

https://doi.org/10.7081/NR.199706.0279

摘要

本研究採調查研究法，以高雄市8家居家照護單位148名病患進行居家照護病患照護問題之評估，主要目的爲：(1)建立「居家照護病患照護問題分類量表」之信度、效度；(2)了解病患在環境、生理、心理社會、健康相關行爲等四個層面的照護問題及其嚴重程度；(3)探討照護問題嚴重程度之預測因子。研究工具包括有巴氏日常生活活動量表及居家照護病患照護問題分類量表。以皮爾森相關、t檢定、單因子變異數、逐步複迴歸進行統計分析。結果發現：(1)居家照護病患照護問題分類量表之測試者間一致性Kappa值爲0.80，表示具一致性；(2)目前接受居家照護的病患以身體活動功能的問題最嚴重，其次依序爲病患認知功能、溝通能力、排尿功能、照護工作安排；(3)照護問題嚴重程度之預測因子爲病患日常活動能力、使用輔助器材與設備數、照顧者照護能力及家庭社會經濟狀況，可解釋變異量達47.2%。

關鍵字

居家照護病患 ； 照護問題 ； 照護問題分析

並列摘要

This study was designed to assess the nursing care problems of home care patients and involved 148 patients residing in 8 nursing care units in Kaohsiung City. The purpose was (1) to clarify the reliability and validity of the scale ”A classification scale for nursing care problems in home care patients”; (2) to determine the severity of nursing care problems from the environmental, physical, psychosocial and health-related behavior domains; and (3) to find specific factors predicting the severity of nursing care problems. The two instruments used were the ”Barthel scale” and ”A classification scale for nursing care problems in home care patients”. Pearson correlation, t-test, one-way analysis of variance and stepwise regression were used to analyze the data. From the study, we concluded that: (1) the Kappa value of ”A classification scale for nursing care problems in home care patients” was 0.80 indicating the interrater reliability; (2) the dysfunction of mobility was the most severe problem encountered in home care, followed by cognitive defect, communication dysfunction, urinating dysfunction and assignment of the workload of caregiving, and (3) patient's mobility, facility availability, ability of caregivers and patients' socioeconomic status were the most significant predictors of the quality of nursing care. They explained 47.2% of the variance for the severity of nursing care problems.

並列關鍵字

home care patients ； nursing care problem ； classification of nursing care problems