應用個案管理於消化性潰瘍合併出血病患照護品質及成本
效益之成效探討.
Application of Nursing Care Map in Caring for Stroke
Patients at Home
盧美秀;魏玲玲;廖美南;徐美玲
摘要
本研究旨在探討運用“護理照護藍圖”於居家腦中風病患照護之適用性；採縱切
式研究法，於 87 年 2-5 月共收案 31 位沒有合併其他疾病之腦中風病人及家屬。
研究結果：(l)護理照護藍圖軌行過程有 97.2%項目可被完成，有 2.8%之變異量，
變異原因與個案病情及家庭經濟壓力有關。(2)護理照護藍圖的介入能有效改善
個案之合併症(odds ratio=17，p<0.001)，尤其是壓瘡；且主要照顧者獨立照顧能
力有顯著進步。(3)病患家屬對服務之滿意度爲 4.13 分（滿分爲 5 分）
。(4)影響照
護品質之因素有：個案病情、主要照顧者教育程度合影響其照顧能力，並影響病
患合併症改善及預防其發生；家庭經濟對滿意度會有影響。所以護理照護藍圖若
能再考量照顧品質影響因素作修訂特是一適用的腦中風病患居家護理照護藍圓
圖之個案照護模式。
Abstract
The aim of the study was to utilize the “nursing care map” (NCM) for home care stroke patients. A longitudinal research model was used in this study. The sample consisted of 31 stroke patients and their care- givers. The findings of the study indicated: (1) 2.8% variance was
found. Patient condition and family financial stress were major facfors for variance in employing NCM (92%). (2) Patient complications were improved significantly by applying the
nursing care map (OR=17, p<0.001). Incidence of pressure sores was most significantly decreased. The caregivers’ competence in caring were also significantly improved, (3) Families’ average satisfaction toward the nursing care was 4.13 (M=4, range 1-5) Significant factors influencing quality of home health care included: preexisting complications, caregiver’s
educational level and family income. In conclusion, the nursing care map could provide a suitable patient care model for home care stroke patients.
