题名

原發性視網膜剝離病人術後醫療品質之研究

并列篇名

A Study of Patients with Postoperative Primary Retinal Detachment on Medical Quality

作者

張琝蓁

关键词

原發性視網膜剝離 ; 醫療品質 ; Primary Retinal Detachment ; Medical Quality

期刊名称

義守大學醫務管理學系學位論文

卷期/出版年月

2016年

学位类别

碩士

导师

馬震中

内容语文

繁體中文

中文摘要

目的:視網膜疾病為流行病學領域及公共衛生的議題。在台灣視網膜剝離為民眾 失明的主要原因,本研究目的為探討接受視網膜剝離手術病人之人口學、 手術方 式對其醫療品質之影響。 方法:本研究採回溯性研究設計,以病歷回顧法收集資料,資料來源於南部某醫 學中心病人住院資料。研究個案為2012年9月1日至2014年8月31日初次接受 視網膜剝離手術的病人,並於病人術後持續追蹤一年,總共列入研究個案共有233 人,統計方法以敘述性統計、卡方檢定及多元羅吉斯迴歸分析方式找出影響術後醫 療品質之相關因素。 結果:男性134人(佔57.5%)、女性99人(佔42.5%),平均年齡51.52歲,教育程 度高中以上143人(佔61.4%),經由多元羅吉斯迴歸統計發現在視力恢復方面為年 齡、職業、近視及手術方式具有統計顯著差異;術後併發症方面為年齡及手術方式 具有統計顯著差異;再住院方面則有年齡、手術方式具有統計顯著差異。 結論與建議:由以上研究結果得知,病人的年齡、職業、近視以及手術方式分別 會對原發性視網膜剝離病人術後醫療品質有影響,尤其是手術方式對於視力恢復、 術後併發症及再住院均有顯著差異,因此研究結果可提供醫院管理者及醫療人員參 考,以提升病人術後醫療品質。

英文摘要

none

主题分类 醫藥衛生 > 醫院管理與醫事行政
醫學院 > 醫務管理學系
社會科學 > 管理學
参考文献
  1. 江嘉祥(2013)。建構術後再住院預測模型-以裂孔性視網膜剝離為例(未
    連結:
  2. 胡朝乾(2007)。裂孔性視網膜剝離手術後再住院之危險因子(未出版之碩士
    連結:
  3. 張麗春、吳佩昌、牛玉珍、陳敏麗、廖梨伶(2016)。台灣校園近視防治軌
    連結:
  4. 莊宗憲(2014)。視網膜剝離簡介。臺灣醫界,57(6),18-20。
    連結:
  5. 黃峻峰、鄭俊彥、陳珊霓(2006)。智障兒童的兩側裂孔性視網膜剝離-病例
    連結:
  6. 鄭仁豪、邱弘毅、羅琇瓊、呂大文(2006)。臺灣視網膜病變盛行率與危險因
    連結:
  7. detachment. Acta Ophthalmol Scand, 85(5), 540-545.
    連結:
  8. of uncomplicated retinal detachments: the European
    連結:
  9. vitreo-retinal society retinal detachment study report
    連結:
  10. 1. Ophthalmology, 120(9), 1804-1808.
    連結:
  11. Ducournau, D., & Group, E. V.-R. S. R. D. S. (2013).
    連結:
  12. Strategy for the management of complex retinal
    連結:
  13. retinal detachment study report 2. Ophthalmology, 120
    連結:
  14. G. (2010). [Retinal detachment in pediatrics: Etiology
    連結:
  15. Deutschen Ophthalmologischen Gesellschaft, 107(2), 165-
    連結:
  16. Chou, S., Yang, C., Lee, C., Yang, C., Ho, T., Huang,
    連結:
  17. rhegmatogenous retinal detachment in Taiwan. Eye, 21
    連結:
  18. Cheng, S., Yang, C., Lee, C., Yang, C., Huang, J., Ho,
    連結:
  19. retinal detachment among manual workers, non-manual
    連結:
  20. Occup Environ Health, 87(5), 539-545.
    連結:
  21. Donabedian, A. (1988). The quality of care: How can it be
    連結:
  22. D., & Robertson, D. M. (2006). Risk of retinal
    連結:
  23. detachment after cataract extraction, 1980-2004: a
    連結:
  24. postoperative endophthalmitis: Taiwan experience. Eye,
    連結:
  25. 20(8), 900-907.
    連結:
  26. Feltgen, N., & Walter, P. (2014). Rhegmatogenous Retinal
    連結:
  27. Detachment—an Ophthalmologic Emergency. Deutsches
    連結:
  28. J. (2013). Rhegmatogenous retinal detachment treatment
    連結:
  29. following a visit to a doctor in a primary care unit.
    連結:
  30. buckling versus primary vitrectomy in rhegmatogenous
    連結:
  31. rhegmatogenous retinal detachment: a 9-year nationwide
    連結:
  32. repairing sim-ple rhegmatogenous retinal detachments.
    連結:
  33. M., & Johnston, R. L. (2014). United Kingdom National
    連結:
  34. Ophthalmology Database study of vitreoretinal surgery:
    連結:
  35. report 3, retinal detachment. Ophthalmology, 121(3),
    連結:
  36. Kaarniranta, K., & Petrovski, G. (2015). Ageing of the
    連結:
  37. vitreous: From acute onset floaters and flashes to
    連結:
  38. retinal detachment. Ageing research reviews, 21, 71-77.
    連結:
  39. Physical exertion (lifting) and retinal detachment
    連結:
  40. Singh, J. (2010). The epidemiology of rhegmatogenous
    連結:
  41. retinal detachment: geographical variation and clinical
    連結:
  42. associations. British Journal of Ophthalmology, 94(6),
    連結:
  43. The epidemiology and socioeconomic associations of
    連結:
  44. retinal detachment in Scotland: a two-year prospective
    連結:
  45. visual science, 51(10), 4963-4968.
    連結:
  46. Laterality and gender imbalances in retinal detachment.
    連結:
  47. Graefes Arch Clin Exp Ophthalmol, 249(7), 1109-1110.
    連結:
  48. retinal detachment repair: results from the Scottish
    連結:
  49. Miller, J. B., Papakostas, T. D., & Vavvas, D. G. (2014).
    連結:
  50. Complications of emulsified silicone oil after retinal
    連結:
  51. Hemo, I. (2007). Paediatric vs adult retinal
    連結:
  52. Soheilian, M., Ramezani, A., Malihi, M., Yaseri, M.,
    連結:
  53. (2009). Clinical features and surgical outcomes of
    連結:
  54. pediatric rhegmatogenous retinal detachment. Retina, 29
    連結:
  55. Sanabria, M. R., Fernandez, I., Sala-Puigdollers, A.,
    連結:
  56. Llopis, M. (2011). A propensity score matching
    連結:
  57. European journal of ophthalmology, 22(2), 244-253.
    連結:
  58. management of rhegmatogenous retinal detachment: a meta-
    連結:
  59. analysis of randomized controlled trials.
    連結:
  60. Ophthalmology, 120(7), 1440-1447.
    連結:
  61. factors for idiopathic rhegmatogenous retinal
    連結:
  62. Awareness and Knowledge of Emergent Ophthalmic Disease
    連結:
  63. Among Patients in an Internal Medicine Clinic. JAMA
    連結:
  64. ophthalmology, 134(4), 424-431.
    連結:
  65. S. V. (2014). Prevalence and causes of low vision and
    連結:
  66. Study. Indian journal of ophthalmology, 62(4), 477.
    連結:
  67. understanding medical record
    連結:
  68. 一、 中文部分
  69. 尤瑞鴻(2014)。醫療品質管理學。臺北市:華杏。
  70. 出版之碩士論文)。虎尾科技大學,雲林市。
  71. 李惠玲(2013)。眼睛與耳朵疾病之護理。成人類外科護理(六版,199-295
  72. 頁)。臺北市:華杏。
  73. 沈麗君(2005)。視網膜病。眼病學(176-199頁)。臺北市:宏欣。
  74. 論文)。臺北醫學大學,臺北市。
  75. 張家慈(2011)。台灣地區視網膜剝離及缺損住院患者之醫療利用及其相關
  76. 因素(未出版之碩士論文)。國防醫學院,臺北市。
  77. 跡。臺灣公共衛生雜誌,35(1),17-30。
  78. 報告。中華民國眼科醫學會雜誌,45(2),135-139。
  79. 趙子傑(2013)。實用醫療品質管理學。臺北市:華杏。
  80. 子研究。中華民國眼科醫學會雜誌,45(3),171-177。
  81. 二、英文部分
  82. Azad, R. V., Chanana, B., Sharma, Y. R., & Vohra, R. (
  83. 2007). Primary vitrectomy versus conventional retinal d
  84. etachment surgery in phakic rhegmatogenous retinal
  85. Adelman, R. A., Parnes, A. J., Ducournau, D., & Group, E.
  86. V.-R. S. R. D. S. (2013). Strategy for the management
  87. Adelman, R. A., Parnes, A. J., Sipperley, J. O.,
  88. detachments: the European vitreo-retinal society
  89. (9), 1809-1813.
  90. Bier, C., Kampik, A., Gandorfer, A., Ehrt, O., & Rudolph,
  91. and risk factors]. Der Ophthalmologe: Zeitschrift der
  92. 174.
  93. J., . . . Shih, Y. (2007). Characteristics of primary
  94. (8), 1056-1061.
  95. T., . . . Chen, M. (2008). Anatomical and functional
  96. outcome of surgery of primary rhegmatogenous retinal
  97. detachment in high myopic eyes. Eye, 22(1), 70-76.
  98. Curti, S., Coggon, D., Baldasseroni, A., Cooke, R. M.,
  99. Fresina, M., Campos, E. C., . . . Mattioli, S. (2014).
  100. Incidence rates of surgically treated rhegmatogenous
  101. workers and housewives in Tuscany, Italy. Int Arch
  102. assessed? Jama, 260(12), 1743-1748.
  103. Erie, J. C., Raecker, M. E., Baratz, K. H., Schleck, C.
  104. population-based study. Trans Am Ophthalmol Soc, 104,
  105. 167-175.
  106. Fang, Y., Chien, L.-N., Ng, Y., Chu, H., Chen, W., Cheng,
  107. C., & Wu, S. (2006). Association of hospital and
  108. surgeon operation volume with the incidence of
  109. Ärzteblatt International, 111(1-2), 12.
  110. García-Arumí, J., Martínez-Castillo, V., Boixadera, A.,
  111. Blasco, H., Marticorena, J., Zapata, M., . . . Rafart,
  112. guidelines. Archivos de la Sociedad Española de
  113. Oftalmología (English Edition), 88(1), 11-35.
  114. Haddad, S., Potvin, L., Roberge, D., Pineault, R., &
  115. Remondin, M. (2000). Patient perception of quality
  116. Family practice, 17(1), 21-29.
  117. Heimann, H., Bartz-Schmidt, K. U., Bornfeld, N., Weiss, C.,
  118. Hilgers, R. D., & Foerster, M. H. (2007). Scleral
  119. retinal detachment: a prospective randomized
  120. multicenter clinical study. Ophthalmology, 114(12),
  121. 2142-2154.
  122. Ho, J.D., Liou, S., Tsai, C., Tsai, R. J., & Lin, H.C.
  123. (2009). Trends and outcomes of treatment for primary
  124. population-based study. Eye, 23(3), 669-675.
  125. Hatef, E., Sena, D., Fallano, K., & Crews, J. (2015). Do
  126. DV. Pneumatic retinopexy versus scleral buckle for
  127. status and date: New, published in(5).
  128. Haritoglou, C., & Wolf, A. (2015). [Surgical managment of
  129. retinal detachment]. Klin Monbl Augenheilkd, 232(5),
  130. 669-675.
  131. Holden, B., Sankaridurg, P., Smith, E., Aller, T., Jong,
  132. M., & He, M. (2014). Myopia, an underrated global
  133. challenge to vision: where the current data takes us on
  134. myopia control. Eye, 28(2), 142-146.
  135. Jackson, T. L., Donachie, P. H., Sallam, A., Sparrow, J.
  136. 643-648.
  137. Lumi, X., Hawlina, M., Glavač, D., Facskó, A., Moe, M. C.,
  138. Mattioli, S., De Fazio, R., Buiatti, E., Truffelli, D.,
  139. Zanardi, F., Curti, S., . . . Bonfiglioli, R. (2008).
  140. among people with myopia. Epidemiology, 19(6), 868-871.
  141. Mitry, D., Charteris, D. G., Fleck, B. W., Campbell, H., &
  142. 678-684.
  143. Mitry, D., Charteris, D. G., Yorston, D., Siddiqui, M. R.,
  144. Campbell, H., Murphy, A.-L., . . . Singh, J. (2010).
  145. population-based study. Investigative ophthalmology &
  146. Mitry, D., Tuft, S., McLeod, D., & Charteris, D. G. (2011).
  147. Mitry, D., Awan, M. A., Borooah, S., Siddiqui, M. A.,
  148. Brogan, K., Fleck, B. W., . . . Yorston, D. (2012).
  149. Surgical outcome and risk stratification for primary
  150. Retinal Detachment study. Br J Ophthalmol, 96(5), 730-
  151. 734.
  152. detachment repair. Semin Ophthalmol, 29(5-6), 312-318.
  153. Rumelt, S., Sarrazin, L., Averbukh, E., Halpert, M., &
  154. detachment. Eye, 21(12), 1473-1478.
  155. Saidkasimova, S., Mitry, D., Singh, J., Yorston, D., &
  156. Charteris, D. G. (2009). Retinal detachment in Scotland
  157. is associated with affluence. Br J Ophthalmol, 93(12),
  158. 1591-1594.
  159. Ahmadieh, H., Dehghan, M. H., . . . Peyman, G. A.
  160. (4), 545-551.
  161. Rojas, J., Alfaiate, M., Elizalde, J., . . . Diaz-
  162. application: indications and results of adding scleral
  163. buckle to vitrectomy: The Retina 1 Project: Report 3.
  164. Soni, C., Hainsworth, D. P., & Almony, A. (2013). Surgical
  165. The Eye Disease Case–Control Study Group (1993). Risk
  166. detachment. American journal of epidemiology, 137(7),
  167. 749-757.
  168. Uhr, J. H., Mishra, K., Wei, C., & Wu, A. Y. (2016).
  169. Vijaya, L., George, R., Asokan, R., Velumuri, L., & Ramesh,
  170. blindness in an urban population: The Chennai Glaucoma
  171. Worster, A., & Haines, T. (2004). Advanced statistics:
  172. review (MRR) studies. Academic Emergency Medicine, 11
  173. (2), 187-192.