以公共衛生護理人員觀點分析探討嘉義縣『醫療到家  健康幸福』執行現況

廖念慈

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以公共衛生護理人員觀點分析探討嘉義縣『醫療到家健康幸福』執行現況

Analysis and Evaluation of "Medical Care Sent Home for Health and Wellbeing"in Chiayi County via the Perspective of Public Health Nurses

廖念慈 , Masters　　Advisor：謝嫣娉　　

繁體中文

『醫療到家健康幸福』；公共衛生護理人員；慢性病防治；『Medical Care Sent Home for Health and Wellbeing』； Public Health Nurses ； Chronic Deceases

Abstract │ Reference (86) │ Times Cited (1) │ Altmetrics

Abstract 〈TOP〉

Parallel Abstract 〈TOP〉

Due to the facts of the increased aged population and chronic diseases, the government has focused on how to reduce the repeated uses of medical resource and how to enhance the quality of health care for the elders.  Therefore, this study is to analyze and evaluate the “Medical Care Sent Home for Health and Wellbeing”which is carried out in Chiayi County for more than one year.  Because “Medical Care Sent Home for Health and Wellbeing”is an innovative service, and the nurses in the public health clinics are the main care takers, and the content of the service is mainly for the follow-up treatments for the elders and chronic patients, therefore,the method for the study is to interview the enforcers of the project, namely, the public health nurses in a thorough manner, and to employ a semi-structural survey and analysis. 
    The researcher conducted a thorough interview from the project plan to 1. find out the relationship between the service activities and the preparation to leave the hospital, 2. conduct a discussion of the relationship between service ideas and service procedures, 3. evaluate the role and functions of a public health nurse, 4. analysis the quality of the service activities and vision of the project,in order to how well the project is carried out.  Furthermore, this study is to analyze the problem faced by the public nurses when they administer the project, and put their views inductively into systematic codes so as to reach a valuable conclusion:
1. The characteristics of “Medical Care Sent Home for Health and Wellbeing”:
(1) The public health nurses can get the lists of specific cases and the data of the hospitalized, and they don’t need to screen the patients in order to reestablish the data. 
(2) Focus on the elders who are not hospitalized and the preventive measures for the chronic diseases in order to raise the healing probability of these two groups so as to reduce the waste of medical resource.
(3) Be able to find out the cases under no medical care services so as to assist the disadvantageous groups and build a appropriate care taking system. 
(4) The project ideals are accepted with enthusiasm by the front line enforcer, namely public health nurses. 
(5) The performance of the project was deeply agreed upon and supported by the citizens of the county, and the image of the local government striving to execute its social welfare policies and taking good care of its citizens is strengthened.  
   (6) The role and functions of public health nurses in the project: 1.Turn passiveness to positiveness, and become a finder of a problematic case. 2.Directly understand the needs of a particular case, and become a supplier of the health care.3.Become a public health educator via this activity.4.Become a health consulter via the acquaintance of the local people through the activity.  
 2. There are certain suggestions of “Medical Care Sent Home for Health and Wellbeing”as follows: 
(1) The accuracy of the data sent by the hospitals or the clinics should
   be improved in order to speed the handling the needs for the cases.

(2) The completeness of the medical history of the patients should be 
      required in order to avoid the mistaken single illness  
      consideration.

(3) The difficult cases due to prolonged treatment and repeated 
      medical care in the re-hospitalization should be resolved.

(4) The continuous education for the nurses’capability to evaluate a  
      case, manage time and take care a chronic patient should be 
      enhances so as to upgrade the professionalism of public health 
      nurses.

(5) Include the other specialists to take part in the project such as  
      social workers, nutritionists, psychiatrists, pharmacists in order to 
      build a comprehensive medical care system.

Reference ( 86 ) 〈TOP〉

方貴英(2007)。衛生所公衛護理人員核心職能自覺評估-以嘉義縣為例。未發表論
連結：
行政院衛生署國民健康局（2006）。2005年臺灣各縣市衛生所統計年報。台北縣，行政院衛生署國民健康局。
連結：
行政院衛生署國民健康局（2006）。2005年臺灣各縣市衛生所統計年報。台北縣：行政院衛生署國民健康局。
連結：
李淑婷、謝臥龍、邱啟潤（2001）。衛生所護理師角色功能之探討－德爾菲研究。護理研究，9（3），269-278。
連結：
李麗傳(1999)。個案管理師角色與功能。護理雜誌，46(5)，55-60。
連結：

Times Cited (1) 〈TOP〉

張維倫(2011)。探討公衛護士與民眾對公衛護士護理能力需求之看法－以臺北巿為例。臺北醫學大學護理學系碩士暨碩士在職專班學位論文。2011。1-156。

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