主照顧者接受照護指導對居家長期臥床病患照護之影響

Effectiveness of Nursing Instructions Given to Caregivers of Long-Term Bedridden Patients

洪麗珍(Li-Chen Hung) ； 劉千琪(Chien-Chi Liu) ； 郭憲文(Hsien-Wen Kuo) ； 黃美娜(Mei-Nah Hwang) ； 張麗華(Li-Wha Chang) ； 林菊枝(Jyur-Jy Lin)

《護理研究》 7卷4期 (1999/08) Pp. 363-375

https://doi.org/10.7081/NR.199908.0363

摘要

本研究目的在探討長期臥床病患主要照顧者接受照護指導後，對其照護能力及病患照護之影響。以台中縣內其活動能力合於何氏量表(Karnofsky scale)第三、四級之病患，共392名爲研究對象。以病患日常活動自理能力、壓瘡情形及主照顧者照護認知、技術等能力作爲照護指導成效評值項目，由公衛護士每月觀察紀錄，持續三個月。所得資料以SPSS套裝軟體處理，再以描述性統計、Chi-square test、t-test、paired t-test及multiple logistic regression進行分析。結果顯示：主照顧者接受照護指導後，整體照護知識及技術顯著提昇、壓瘡個案中1/3情況改善；經過三個月，病患日常生活活動自理能力平均得分雖有顯著改善，但無法證實其與主照顧者能力有關。經多變項對數迴歸分析，病患之臥病期程及活動能力等級顯著影響其日常生活活動自理能力改善與否。研究者建議應儘早對主照顧者實施照護指導介入，以有效改善病患日常生活活動自理能力。

關鍵字

主照顧者 ； 照護指導 ； 長期臥床病患

並列摘要

The objective of this study was to investigate the effects of nursing instructions given to caregivers of long-term bedridden patients. Subjects included 392 caregivers whose patients met the criteria of grade 3-4 based on the Karnofsky scale. After caregivers were given nursing instructions, the public health nurses monitored the patients' progress once a month for three months. Three criteria were used to determine the instructions' effectiveness: degree of improvement of patients' self-care ability, change in the patient's condition with respect to pressure sores, and overall ability of caregivers (including caregiving knowledge and techniques for general care and care of pressure sores). All data were analyzed by SPSS and statistical methods including frequency, Chi-square test, t-test, paired t-test, and multiple logistic regression. Results showed a significant improvement in the overall ability after caregivers were given instructions. One third subjects with pressure sore was improved. The average score for self-care ability given to patients improved significantly over the three-month period, however this was not found to be related to the caregivers' ability. Based on a logistic regression analysis, bedridden duration and grade of mobility had a significant effect on the patient's self-care ability. The authors suggest that nursing instructions need to be provided to caregivers as early as possible in order to effectively improve the patient's self-care ability.

並列關鍵字

caregiver ； nursing instructions ； long-term-bedridden patients