以照顧者需求爲導向的出院計劃對腦中風老人照顧準備度及照顧結果成效之探討

Evaluation of Carer Readiness and Care Outcome Following a Caregiver Needs Directed Discharge Program for Elderly Stroke Patients

邵榮華(Jung-Hua Shao) ； 葉湘芬(Hsiang-Fen Yeh)

《長期照護雜誌》 10卷3期 (2006/09) Pp. 238-256

https://doi.org/10.6317/LTC.200609_10(3).0005

摘要

近年來由於殘病老人的比例急速增加，衍生出極嚴重的醫療成本不當使用與繼續性照護問題，為尋求解決之道，出院準備服務便應運而生，以提高健康照護品質與減少醫療資源浪費。本研究旨在探討以照顧者需求為導向的出院準備服務對腦中風老人照顧結果及準備度之成效。採類實驗性研究設計(Quasi-Experimental Research Design)，並以臨床實驗方式(clinical trial)進行，共選取44位某醫學中心神經科病房之腦中風老人，其中實驗組與控制組各22位，收案方式於同時間內A、B病房收取實驗組，給予提供出院準備服務介入措施和常規出院護理；C、D病房收取控制組，僅提供常規出院護理，經過一個月後評估住院老人的照顧結果及照顧準備度之成效。結果發現經出院準備服務介入措施後，能有效改善腦中風老人的照顧結果及提昇照顧的準備度。藉此研究發現出院準備服務對腦中風老人具有增進照顧品質之效能，為一項值得推廣的護理措施。

關鍵字

腦中風老人 ； 出院準備服務 ； 照顧結果 ； 照顧準備度 ； 成效

並列摘要

Recent rapid increase in the number of disabled elderly people has produced several critical national health issues. The most important of which are the inadequate allocation of medical costs to meet the increasing demand for health services and the provision for the provisions of the long term of these patient. Discharge services have been created to deal with these problems. The aims of discharge planning programs are to promote the quality of health care and reduce medical costs. This study investigates the effectiveness of caregiver-oriented discharge program for older people with stroke through experimental design, and further examines care outcomes and readiness through the clinical trial. It adopts a purposed sampling method to select 44 elderly patients from four neurological wards in a medical center. Twenty-two of them from ward A and ward B were assigned to the experimental group, which received both discharge planning and routine outpatient services time at the same time. The other 22 elderly patients from ward C and ward D were assigned to a control group, which received only routine outpatient services time. One month later, the effectiveness of the interventions, including stroke elders' outcomes of care and caregivers' readiness for care for 1-month discharge planning were assessed.
The results of this study indicate that the intervention of caregiver-oriented discharge planning could improve the outcomes of care and promote the caregivers' readiness for care for a 1-month discharge program. To sum up, the effectiveness of caregiver-oriented discharge planning for stroke elders and caregivers was evident. It is worth special of consideration for wide application in the routine nursing care of elderly discharge patients who still require some from of medical supervision and support.

並列關鍵字

stroke elders ； discharge planning ； care of outcome ； care of readiness ； effectiveness