以『護理之家照護品質觀測性指標』量表測量護理之家照護品質-以台中市為例

Using “ The Observable indicators of Nursing Home Care Quality”instrument to measure quality of nursing home care– in Taichung City

陳麗娟(Chen Li-Chuan)

指導教授 ： 朱僑麗

亞洲大學/健康學院/長期照護研究所/碩士(2008年)

摘要

中文摘要
長期照護是人口老化國家重要的議題，台灣在2006年底老年人口比率已達總人口數之10%，隨著老年及失能人口的增加，長期照護需求遽增，護理之家機構數目也大幅增加。在護理之家數量快速成長同時，確保護理之家照護品質是當前之要務。
本研究是以台中市立案之護理之家為對象，以『護理之家照護品質觀測性指標量表』為工具，採結構式問卷及實地觀測方式進行資料收集，研究目的是檢視『護理之家輔導訪查量表』與『護理之家照護品質觀測性指標量表』評測結果之一致性。研究結果共評測12家護理之家，以『護理之家照護品質觀測性指標量表』測得結果最高是172分，最低是115分，平均為139.33分。在品質量表各面向之得分排序由高至低依序為“工作人員界面”、“環境界面”、“照護界面”、“溝通界面”、“居家情境及家人參與界面”。
統計方法以kappa一致性係數檢定『護理之家輔導訪查量表』與『護理之家照護品質觀測性指標量表』評測結果之一致性，kappa值為0.167，未呈顯著意義，即『護理之家輔導訪查量表』與『護理之家照護品質觀測性指標量表』評測結果不一致。但觀測指標量表之“照顧界面”與訪查量表之“健康照護”、“生活照顧”評測結果一致；“工作人員界面”與訪查量表之“健康照護”、“生活照顧”評測結果一致；“環境界面”與訪查量表之“安全與環境設置”界面評測結果一致；“居家情境/家人參與界面”與訪查量表之“安全與環境設置”界面評測結果一致。觀測量表之“溝通界面”與訪查量表之“健康照護” 界面評測結果不一致；“工作人員界面”與訪查量表之“機構與人員管理”界面評測結果不一致。
本研究建議要應用『護理之家照護品質觀測性指標量表』評量護理之家照護品質時，須合併其他評量工具方能週全性評論護理之家照護品質；機構主管可運用此量表定期或不定期評測機構之照護品質，做到持續性品質管理。

關鍵字

護理之家 ； 照護品質

並列摘要

Abstract
Long term care is an important issue of a country with aged population, and the old age population in Taiwan reached 10% at the end of 2006. Due to the increase of aged and disabled population, the need for long-term care increases as well, and so does the number of nursing homes. Therefore, how to ensure the quality of nursing home care is an important task today.

The registered nursing homes in Taichung City is what the research aimed at, and “the observable indicators of nursing home care quality” instrument was used as a tool, and the researcher used structural questionnaires and on-site observation method to collect the data, and the purpose of this research is to evaluate the level of consistency between “the accreditation survey for nursing homes” instrument and “the observable indicators of nursing home care quality” instrument. The total number of nursing home evaluated is 12, and the highest, the lowest and the average scores measured by “the observable indicators of nursing home care quality” instrument are 172, 115 and 139.33 respectively. The average scores for dimensions of instrument from the highest to the lowest are in the order of “staff”, “environment”, “care ”, “communication ” and “home/family involvement”.

The level of consistency between ““the accreditation survey for nursing homes” instrument and “the observable indicators of nursing home care quality” instrument was evaluated by 0.167 kappa value, and it does not have an significant meaning, and it means that the result measured from “the accreditation survey for nursing homes” instrument is not consistent with the result from “the observable indicators of nursing home care quality” instrument. But the measured result of “staff” dimension in OIQs is consistent with the result of “health” and “daily life care”; the result of “staff” dimension in OIQs is consistent with the result of “health” and “daily life care”; the result of “environment” dimension in OIQs is consistent with the result of “safety and environment setting”; the result of “homelike/family involvement” dimension in OIQs is consistent with the result of “safety and environment setting”. The result of “communication” dimension in OIQs is not consistent with the result of “health”; the result of “staff” dimension in OIQs is not consistent with the result of “institute and staff management”.

This research suggests that when the quality of a nursing home care is measured by “the observable indicators of nursing home care quality” instrument, other evaluation tools should be also used to ensure a complete and comprehensive evaluation. And the supervising authorities could use this instrument to evaluate the quality of a nursing home care periodically in order to continuously control the quality.

並列關鍵字

Nursing Home ； Care Quality

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