個案管理模式於某醫學中心燒燙傷病患的照護成效

The Effectiveness of Case Management for Burn Patients in a Medical Center

高淑雰(Shu-Fen Kao) ； 謝碧晴(Pi-Ching Hsieh) ； 蔡秀鸞(Shiow-Laun Tsay) ； 蘇慧芳(Hui-Fang Su)

《醫護科技學刊》 9卷1期 (2007/01) Pp. 24-32

https://doi.org/10.6563/TJHS.2007.9(1).3

摘要

本研究旨在探討個案管理模式於燒燙傷病患照護之成效，包括病患知識、居家自我照護行為、對醫護人員服務之滿意度、平均住院天數、及平均住院醫療費用。
在北台灣某醫學中心進行一個為期16個月針對燒傷病患提供個案管理照護模式的類實驗性研究。以立意取樣的方式將病患分為對照組（n=30人）接收傳統的照護，實驗組（n=40）接受額外的個案管理照護，包括接受自我照護教育及符合治療指引的照護服務。
個案管理介入16個月後實施前後比較均達統計上顯著差異，病患知識在實驗組有明顯地增加由5.95分進步到9.63分，對照組的進步較些微由5.07分增加到7.20分。居家自我照護行為執行正確率實驗組比對照組有明顯地進步（85.50%比70.28%），對醫護人員滿意度亦有明顯高出（108.78分比86.83分）。平均住院天數實驗組比對照組有明顯縮短（16.23天比23.17天），平均住院醫療費用亦有明顯降低（138,467.58元比219,582.23元）。
經個案管理模式實施，提供燒燙傷病患較完整的照護方針，促進多專科團隊合作，建議推展至其他高成本高數量疾病之個案。

關鍵字

燒燙傷病患 ； 個案管理模式

並列摘要

This study investigated how nursing case management impacts patient knowledge, self-care behavior at home, satisfaction with healthcare, average length of stay and costs.
A sixteen-month quasi-experimental design was conducted in the burn unit of a Taipei medical center. A purposive sampling method was used to collect data. Burn patients were assigned to a control group (CG)(n=30) who received standard care from their primary care nurse or an intervention group (IG)(n=40) who received additional management, including education in self-management and implementation of burn guidelines for treating burn victims. After 16 months, patient knowledge scores significantly increased from 5.95 to 9.63 in IG as compared to a slight increase from 5.07 to 7.20 in CG.
Primary outcome scores also improved significantly in IG: self-care behavior at home scores improved from 70.28% to 85.50%, and satisfaction with healthcare improved from 86.83% to 108.78%. Secondary outcomes improved significantly in IG compared to CG: average length of stay improved from 23.17 to 16.23 days, and cost improved from 219, 582.23 to 138,467.58 NT dollars.
Results of this study have major implications for health care management models. First, more comprehensive guidelines for burn patient care can be structured. Still, the findings demonstrate great progress in cooperation between multidisciplinary team members in burn center. Finally, this case management model can be implemented in other high-cost and high-volume patients groups.

並列關鍵字

Burn patients ； case management model

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