急性期患者出院后中期照护需求分析及现有照护体系评价

发布时间：2018-12-22 09:37

【摘要】：目的:研究大型医院患者出院后对中期照护的需求及评价杭州市现有以社区为基础的中期照护模式"家庭病房"的效果。方法:选取杭州市三家三甲医院的神经内科、外科、老年及康复科共107位住院患者为对象,发放需求分析问卷并统计;选取杭州市两家社区卫生院家庭病房共19位患者为对象,在照护前后用SF-36量表进行生活质量评分同时也记录照护过程及内容。结果:所有的患者在出院时都有至少1项以上的需求,平均需求数为4.78个。日常生活能力评定得分(Barthel评分)与需求量呈显著性负相关(r=-0.30,p0.05),接受态度与需求量显著性相关(p0.05)。神经内科以药物指导,后遗症认识,生活方式指导,康复指导,复发风险识别;外科以受损部位恢复,药物指导,相关外科操作,饮食营养指导、复诊指导;康复及老年医学科以康复指导,药物指导,基础疾病管理,急救常识,社会需求为前5位需求。"家庭病房"中期照护模式可显著性提高患者的生活质量总分、生理机能、一般健康状况、精力、社会功能(p0.05),生理职能、躯体疼痛、情感职能、精神健康无显著改变(p0.05)结论:日常生活能力评定得分及接受态度是影响需求的重要因素。不同科室、病种的需求排序不同,但药物需求的地位很高,老年患者还应关注其社会需求。杭州市现有的"家庭病房"中期照护模式可提高患者的生活质量。
[Abstract]:Objective: to study the needs of middle stage care after discharge from large hospitals and to evaluate the effect of the existing community-based interim care model "family ward" in Hangzhou. Methods: 107 inpatients from Department of Neurology, surgery, Geriatrics and Rehabilitation in three third Class A Hospitals in Hangzhou were selected as subjects. A total of 19 patients in family wards of two community health centers in Hangzhou were selected. The quality of life (QOL) was evaluated by SF-36 scale before and after care, and the care process and contents were also recorded. Results: all patients had at least one requirement at the time of discharge, with an average of 4.78. The scores of daily living ability (Barthel) were negatively correlated with the demand (r = -0.30), and the receptive attitude was significantly correlated with the demand (p 0.05). Neurology department used drug guidance, sequelae awareness, lifestyle guidance, rehabilitation guidance, recurrence risk identification, surgical site recovery, drug guidance, related surgical operations, dietary nutrition guidance, referral guidance; Rehabilitation and geriatrics are the top five needs for rehabilitation guidance, drug guidance, basic disease management, first aid knowledge, and social needs. " "Medium-term care mode" in family ward can significantly improve patients' total score of quality of life, physiological function, general health status, energy, social function (p0.05), physiological function, somatic pain, emotional function, and so on. There was no significant change in mental health (p0.05) conclusion: the scores of ability of daily living and attitude of acceptance were the important factors affecting demand. The order of demand for disease is different in different departments, but the status of drug demand is very high. Elderly patients should also pay attention to their social needs. The existing mid-term care mode of family ward in Hangzhou can improve the quality of life of patients.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.2

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