台灣地區結核病個案管理失落率相關因素研究

Tuberculosis Case Management and Factors Related to Default Rate in Taiwan

王貴鳳(Kwei-Feng Wang)

指導教授 ： 邱啟潤

高雄醫學大學/護理學院/護理學系研究所/碩士(2004年)

摘要

本研究採用結構式問卷調查法及結核病資訊系統登錄的個案管理資料，來合併探討：1.結核病個案管理人員、病人、組織管理與結核病個案管理失落率的關係。2.影響結核病個案管理失落率的重要預測因子。以2002年台灣地區各鄉鎮（巿）區衛生所及台北巿立慢性病防治院實際從事結核病個案管理之工作人員為母群體，經簡單隨機抽樣1132位，回收有效問卷601份，完成率53.1%。研究工具中的組織承諾量表與專業承諾量表是已建立信、效度的工具，本研究的Cronbach’s α值分別為0.79與0.86，其它問題由研究者自擬。
研究結果：結核病個案管理失落率的重要預測因子為：管理人日及確診新案比率。管理人日271天以上者其結核病個案管理失落率高於平均值36%是管理人日270天者的6.98倍；確診新案比率90%以下者其結核病個案管理失落率高於平均值36％是確診新案比率91％以上者的4.11倍。
經由本研究之發現，期能提供結核病防治個案管理政策訂定、教育訓練之參考，從行政層面改善，進而降低結核病個案管理失落率，提昇結核病防治績效。

關鍵字

結核病 ； 個案管理 ； 失落率

並列摘要

This research adopted the structural questionnaire and the case management data that is logged in the tuberculosis information system by the Center for Disease Control, Taiwan, to investigate collectively: 1.the correlation between the tuberculosis case management staff, the patients, the organizational management, and the default rate of the tuberculosis case management. 2. The significant factors that may influence on the default rate of the tuberculosis case management. The population of this research is the staff that was actually employed in the tuberculosis case management, in Taipei Municipal Chronic Diseases Hospital and in health station of all districts, towns and cities in Taiwan area in 2002. 1132 persons were sampled by the random sampling, and 601 efficient questionnaires were returned. The completion rate is 53.1%. The validity of the organizational commitment scale and the professional commitment scale were well-established. The Cronbach’s αvalues showed the reliability in this research are 0.79 and 0.86, and other questions were collected from the objective facts.
The results：the significant factors that may influence on the default rate of the tuberculosis case management are: person-day and the rate of newly confirmed cases. The default rate of above 271 person-day which is 36% higher than average, is 6.98 times the default rate of 270 person-day. The default rate of that rate of newly confirmed cases is below 90%, which is 36% higher than the average, is 4.11 times the default rate of that rate of newly confirmed cases is above 90%.
The findings propose recommendations for tuberculosis control administrations, especially in the aspect of policy making. Training programs for the case managers will lower the default rate of tuberculosis patients they hold.

並列關鍵字

default rate ； Tuberculosis ； case management

參考文獻

一、中文部分

王妙（1990，8月）．台灣省結核病個案管理．於行政院衛生署、台灣省政衛生處主辦，台灣地區結核病防治研討會報告資料．台北：台大醫院。

王妙（1990，8月）．綜合基層保健服務衛生所之結核病防治工作．於行政院衛生署、台灣省政衛生處主辦，台灣地區結核病防治研討會報告資料．台北：台大醫院。

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