【摘要】：目的:研究大型醫(yī)院患者出院后對中期照護的需求及評價杭州市現有以社區(qū)為基礎的中期照護模式"家庭病房"的效果。方法:選取杭州市三家三甲醫(yī)院的神經內科、外科、老年及康復科共107位住院患者為對象,發(fā)放需求分析問卷并統(tǒng)計;選取杭州市兩家社區(qū)衛(wèi)生院家庭病房共19位患者為對象,在照護前后用SF-36量表進行生活質量評分同時也記錄照護過程及內容。結果:所有的患者在出院時都有至少1項以上的需求,平均需求數為4.78個。日常生活能力評定得分(Barthel評分)與需求量呈顯著性負相關(r=-0.30,p0.05),接受態(tài)度與需求量顯著性相關(p0.05)。神經內科以藥物指導,后遺癥認識,生活方式指導,康復指導,復發(fā)風險識別;外科以受損部位恢復,藥物指導,相關外科操作,飲食營養(yǎng)指導、復診指導;康復及老年醫(yī)學科以康復指導,藥物指導,基礎疾病管理,急救常識,社會需求為前5位需求。"家庭病房"中期照護模式可顯著性提高患者的生活質量總分、生理機能、一般健康狀況、精力、社會功能(p0.05),生理職能、軀體疼痛、情感職能、精神健康無顯著改變(p0.05)結論:日常生活能力評定得分及接受態(tài)度是影響需求的重要因素。不同科室、病種的需求排序不同,但藥物需求的地位很高,老年患者還應關注其社會需求。杭州市現有的"家庭病房"中期照護模式可提高患者的生活質量。
[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.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.2

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