機構內智能障礙者合併特殊疾病之健康管理制度分析

The Provision of Specific Diseases/Disorders Management for Persons with Intellectual Disabilities Living in Institutions in Taiwan

嚴嘉楓(Chia-Feng Yen) ； 林金定(Jin-Ding Lin) ； 羅慶徽(Chia-Hui Loh) ； 卓妙如(Miao-Ju Chwo) ； 徐尚為(Shang-Wei Hsu) ； 唐紀絜(Chi-Chieh Tang) ； 吳佳玲(Jia-Ling Wu)

《身心障礙研究季刊》 4卷1期 (2006/03) Pp. 1-17

https://doi.org/10.30072/JDR.200603.0001

摘要

本研究主要目的在於診斷身心障礙托育養護機構對智能障礙者的特殊疾病：癲癇、精神疾病、營養失衡及口腔疾病之健康管理制度。本研究採取普查之方式，由台灣地區智能障礙托育養護機構負責人填寫結構式問卷，共回收121份有效問卷（回收率77.1%）為本研究之研究對象。研究結果發現大多數的機構針對合併特殊疾病之智能障礙者，紀錄其用藥情形、定期追蹤他們的病情發展和設計健康管理計畫；機構照護合併癲癇的智能障礙院生，遠比照護合併精神疾病及營養失衡的院生還深具信心，進一步分析資料發現：有專任護理人員之機構，在針對癲癇及營養失調疾病管理能力上，自覺具「足夠」能力的比例明顯高於沒有專任護理人員的機構；唯有對於「精神疾病」管理上，不論有無專任護理人員，機構內對於處理精神疾病皆自覺能力略嫌不足；整體而言，從我們的調查顯示機構聘僱有專任護理人員的確對上述三種健康問題的管理有所幫助，但即使是聘有專任護理人員的機構，照顧合併有精神疾病的智能障礙者，仍感到棘手；因此，未來規劃機構式照護合併特殊疾病的智能障礙者之健康管理制度，更應朝上述缺失著手，以確保智能障礙者之健康照護品質。

關鍵字

台灣 ； 疾病管理 ； 智能障礙 ； 健康管理 ； 機構

並列摘要

The purpose of this paper was to examine the healthcare management of special diseases or disorders for persons with intellectual disabilities living in institutions. These diseases or disorders included epilepsy, psychiatric disorder, dental diseases, and nutritious disorder. A structured questionnaire involved 121 stakeholders out of 157 intellectual disability institutions in Taiwan was used to measure the healthcare management provision within the institutions. The study revealed that most of the institutions were capable to manage the special diseases or disorders for persons with intellectual disabilities in institutions. The results also stated that the respondents were more confident with the management of epilepsy than other diseases or disorders due to their practical experiences in institutions. The employment of nursing staff was related to the effective management of epilepsy and nutritious disorder. However, the sound management of psychiatric disorder still out of the staff's imagination even employed the experienced nursing staff in institutions. This study highlights that the welfare and healthcare authorities should work together to overcome the barriers of effective management of special diseases or disorders for persons with intellectual disabilities living in institutions.

並列關鍵字

Health care management ； institution ； intellectual disability ； specific disease ； Taiwan

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