護理人員與主要照顧者評估出院後氣切留置病患照顧需要之探討研究

Perceived Needs for Nurses and Caregivers of Patients with Tracheostomy after discharge

陳櫻云(Ying-Yun Chen)

指導教授 ： 葉玲玲

亞洲大學/健康學院/長期照護研究所/碩士(2005年)

摘要

前言：居家照顧氣切留置病患必須具備照顧知識、技能，及學習使用輔具，同時還要安排全天候的照顧人力，因此氣切留置病患主要照顧者常感到壓力。護理人員若能評估主要照顧者照顧氣切留置病患的需要，教導並提供其所需知識、技能及資源，可滿足主要照顧者需要，提升氣切留置病患的照顧品質。
研究目的：了解主要照顧者與護理人員評估照顧出院後氣切留置病患的需要，更進一步探討主要照顧者與護理人員評估照顧出院後氣切留置病患需要不一致的情形，並探討其影響因素。
研究方法：本研究採問卷調查法。研究對象為南部某區域教學醫院氣切留置病患主要照顧者，及照顧患者之護理人員。符合研究收案條件之病患共97人。研究工具採用結構性問卷兩份，一為主要照顧者評估出院後照顧氣切留置病患需要問卷，另一為護理人員評估主要照顧者出院後照顧氣切留置病患需要問卷。問卷資料採SPSS 12.0英文版套裝軟體進行描述性統計及卡方檢定統計分析。
研究結果：主要照顧者評估照顧氣切留置病患需要，以疾病照顧知識需要(72.2%)、病情改變處置知識需要 (72.2%)比率最高；以傳染疾病防治知識需要比率(32%)最低。護理人員評估主要照顧者照顧患者需要，以了解社會組織資源需要比率(89.7%)最高，以傳染疾病防治知識需要比率(33%)最低。主要照顧者與護理人員評估主要照顧者照顧需要不一致比率最低者為疾病照顧知識需要(25.8%)，不一致比率最高者為照顧自我照顧能力缺失之病患技能需要(47.4%)。主要照顧者與護理人員對評估主要照顧者需要不一致的影響因素，主要照顧者為病患配偶、教育程度為國中、小以下者，評估有無需要不一致比率最高(53.8%~88.9%)。護理人員工作年資為10~15年、已婚、能力進階層級為N.N1者，評估有無需要不一致比率最高(35.6%~84.8%)。
結論：評估主要照顧者照顧氣切留置病患需要，提供所需的指導，對主要照顧者出院後照顧氣切留置病患應該有所助益。本研究探討氣切留置病患主要照顧者照顧病患需要，及護理人員評估主要照顧者需要間之不一致，有助於作為臨床照護工作參考，以提昇病患照護品質。

關鍵字

氣切留置病患 ； 主要照顧者

並列摘要

Introduction: It is stressful for caregivers to learn knowledge, technique and practicing the supplemental equipment for taking care of patients with tracheostomy and excute full day care for those patients at home.The needs for health care of the tracheostomy patients after discharge will be assessed by nurse primarily. The caregivers of the tracheostomy patients should be teached about knowledge, technique and supplied with resources for taking care of the out-hospital tracheostomy patients to meet the needs of care and escalate the quality of tracheostomy patients care.
Purpose: The purpose of this study is to evaluate the needs for caregiver taking care of the tracheostomy patients after discharge, concerned by caregivers and nurses and the variation of the needs perceived by the caregivers and the nurses. And then to evaluate the related factors to the difference of needs between the caregivers and the nurses.
Method: The material of the study is the caregivers and the nurses for health care of the tracheostomy patients at a southern regional teaching hospital. There is a total of 97 patients involving in this study. Two types of structure-questionnaire were used.The first one is questionnaired for the caregivers taking care of the tracheostomy patients who discharge from hospital, the other questionnaired is for the nurses who care the same tracheostomy patients. SPSS 12.0 software was used to analyzed our data by the way of descriptive analysis and chi-square test.
Result: The proportion of need about knowledge for caregivers taking care of the tracheostomy patients is 72.2%; and the proportion of need about knowledge for managing the change of patient’s condition is 72.2%, and both exhibit hightest proportion of needs. The proportion of need of knowledge about prevention of the infection disease is 32%, and demonstrate the lowest proportion for the caregivers. The proportion of need of understanding the society resource is 89.7%, exhibit the hightest proportion of needs for the nurses,and the need of knowledge for prevention of the infection disease has the lowest proportion (33%) for the nurses who take care of the tracheostomy patients.About the major differences of perceived needs between the tracheostomy patient’s caregivers and the nurses, the need of knowledge of health care of the tracheostomy patients has the lowest difference proportion (25.8%),and the differences of perceived need on the technique of taking care of the unable self-care tracheostomy patients has the highest difference proportion (47.4%).Many factors can affect the differences of perceived needs between the caregivers and the nurses. The relationship of spouse-caregiver and caregiver’s education level under juvenile high school exhibit the highest difference proportion (53.8%~88.9%).About nurses clinical working year more than 10~15 years, married status,and clinical nursing ladder of N & N1 exhibit the highest differences proportion (35.6% ~84.8%).
Conclusion: Perceiving the needs of caregivers of patients with tracheostomy after discharge ,and teaching caregivers about the necessary instruction may be beneficial to caregivers who take care of the tracheostomy patients. The option of this study is designed to estimate the differences of perceived needs of the caregivers and nurses of patients with tracheostomy. The study demonstrate some informations for clinical care and improvement of quality of health care of tracheostomy patients.

並列關鍵字

Patients with Tracheostomy ； Caregiver

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