腦血管疾病病人出院兩週後之出院準備度及其影響因素探討

An Exploration of the Discharge Readiness of Cerebrovascular Disease Patients and Related Factors Conducted at Two-Weeks Post-Discharge

黃阿美(A‐Mei Huang) ； 林佑樺(Yu‐Hua Lin) ； 張谷州(Ku‐Chou Chang) ； 黃珊(Sahn Huang) ； 陳秀偵(Shiu‐Chen Chen) ； 楊淑玲(Shu‐Ling Yang)

《護理暨健康照護研究》 11卷2期 (2015/06) Pp. 148-160

https://doi.org/10.6225/JNHR.11.2.148

摘要

背　景：出院準備服務提升臨床照護品質及協助病人面對出院後的照護問題已有良好之成效，但較少針對病人出院後對所提供出院相關服務的準備度是否足夠之感受進行探討。目　的：探討腦血管疾病病人感受出院準備度狀況及其相關影響因素。方　法：採橫斷式研究設計，以台灣南部某醫學中心304位缺血性腦血管疾病病人為研究對象，使用結構式問卷「中文版出院準備度量表」進行資料收集。結　果：出院兩週後，有91.4%的病人表示已經按照醫療計劃準備好出院，並達到中等程度之出院準備程度。在各次量表中以預期性支持最好、其次為個人狀態、適應能力居末。顯著之解釋變項為出院後獨居、與家屬同住、肢體無偏癱、改良式中風等級量表無明顯障礙、柯氏量表第0−2級及有管路留置，上述因素可解釋整體出院準備度63%的變異量。結論／實務應用：此研究結果能提供醫療團隊瞭解腦血管疾病病人出院準備度之影響因素，針對不同腦血管疾病病人之需求，醫療團隊在住院時進行評估，適時能提供更多專業衛教指導及資訊，藉以提升出院準備度。建議將病人感受出院準備度列入評量，以確保病人對出院計畫感到有充足的準備。

關鍵字

腦血管疾病 ； 出院準備度 ； 出院準備服務

並列摘要

Background: Discharge planning services have been shown to increase the quality of patient care and to help patients better handle care‐related issues. However, the literature related to patient readiness for discharge and its related factors is scarce. Purpose: This study was designed to explore the discharge readiness of patients with cerebrovascular disease (CVD) and the factors related to this readiness. Methods: Using a cross‐sectional study design, 304 CVD patients were recruited from a medical center in southern Taiwan. The structural questionnaire of the Chinese version of the Readiness for Hospital Discharge Scale (RHDS‐C) was used to collect data. Results: A total of 91.4% participants reported at two‐weeks post‐discharge that they perceived at least a middle level of pre‐discharge preparation for discharge. The top three subscales scores for discharge readiness were: expected support, personal status, and coping ability. The regression model indicated that six predictors, including living alone, living with families after discharge, limb hemiplegia, Modified Rankin Scale score, Karn of sky level 0 to 2, and with tube in dwelling, contributed significantly to discharge readiness, accounting for 63.0% of the total variance. Conclusions / Implications for Practice: The results of the present study assist healthcare professionals to understand the predictors of discharge readiness. Healthcare providers should provide professional education and information to CVD patients and promote discharge readiness among their patients during admission and discharge assessment periods. The present study suggests that the self‐perceived discharge readiness of patients may be used to evaluate patient discharge readiness prior to discharge in order to ensure that patients are well prepared when they are eventually discharged.

並列關鍵字

cerebrovascular disease ； discharge readiness ； discharge planning

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