Clients' Outcomes of Home Health Nursing in Taiwan

居家護理服務之個案成果

葉莉莉(Lily Yeh)；溫敏杰 (Miin-Jye Wen)

居家護理 ； 成果 ； home health nursing ； outcome

The Journal of Nursing Research

9卷4期（2001 / 09 / 01）

83 - 94

英文

台灣地區居家護理服務的需求正快速增加中，為確認接受居家護理服務的個案成果，本研究以接受台南地區居家護理服務的個案為對象，探討其在收案以後的六個月期間的個案成果；成果指標包括 1.服務利用情形（包括居家護理服務日數、入急診及再住院次數），2.生理指標變化（管路狀態、意識狀態、傷口嚴重程度－傷口數目及等級），3.功能狀態變化（由巴氏量表得知）。本研究以台南地區初次接受居家護理服務之非癌症病患為收案對象，以前瞻性之研究設計收集資料，並以SPSS 8.0軟體進行統計分析。結果顯示75位個案中，64.0%之個案使用居家護理天數大於180天。個案特質以老年（大於70歲者佔66.6%）、女性（53.3%）、已婚（74.7%)者居多，照顧需求前三項為更換鼻胃管（84.0%）、尿管（45.3%）及傷口護理（38.7%）。Kruscal Wallis Test顯示服務期間不同之群體（半年內是否消案）其使用急診頻率與重複住院次數無顯著差異；Wilcoxon Sign rank test顯示個案半年內成果如下：意識狀態呈顯著差異印（p=.001），而管路使用比率、功能狀態及傷口嚴重程度則無顯著差異。本研究結果可做為台灣地區居家護理服務之政策規劃或服務提供之參考。

The home health nursing movement is expanding rapidly. Home health nursing agencies (HHNAs) are expected to demonstrate that the care provided does make a difference for the client receiving the services. The purpose of this study was to explore client outcomes from home health nursing. Outcome indicators include: Services utilized (emergency services, re-hospitalization), physiological status (catheter indwelling status, consciousness level, wound severity—number and wound stages) and functional status (reflected by Barthel Index). A prospective research design was used to collect the results. Five hospital-based HHNAs were invited to participate in this research. Clients newly admitted to HHNAs and diagnosed as non-cancer patients were recruited, and the researchers gathered outcome indicators over a six-month period. Data were analyzed using SPSS 8.0 computer software. There were 75 clients in this study. Results showed that most of the clients (64.0%) received service for more than 180 days. The client characteristics were dominated by elderly (66.6% age above 70), female (53.3%) and married (74.7%). The three leading care needs were NG tubing service (84.0%), Foley tubing service (45.3%) and wound care (38.7%). The Kruscal Wallis Test revealed that there was no difference in emergency service frequency and re-hospitalization between clients who received service for more than 180 days and those who received service for less than 180 days. The Wilcoxon Sign rank test showed that within one half-year, catheter indwelling status, functional status, and wound severity were not significantly different, with the exception only of conscious level (p = .001). The results of this study can be viewed as preliminary data to assist in shaping home health nursing services in Taiwan.

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