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| Title: | 極低體重早產兒出院後居家訪視家長照顧成熟度評估與滿意度分析之研究
The analysis of parental competence for caring the Extreme Very Low Birthweight Premature Infants by home visit after discharge |
| Authors: | 朱世明
Chu, Shih-Ming |
| Contributors: | 李易諭
Lee, Yi-Yu
朱世明
Chu, Shih-Ming |
| Keywords: | 早產兒
居家訪視
滿意度
成熟度 |
| Date: | 2019 |
| Issue Date: | 2019-08-07 16:19:06 (UTC+8) |
| Abstract: | 研究主題：
探討出生體重小於1500公克之極低出生體重早產兒其主要照護者對出院後之居家訪視滿意度相關因素探討
研究背景與動機：
為確保本院早產兒出院後仍有良好的照護，長庚醫療財團法人林口長庚醫院自民國98年起即加入早產兒基金會極低體重早產兒追蹤計畫，林口長庚醫院為追蹤計畫之北四區；本研究就是為了解在醫療機構積極推動計畫輔助下，首次深入剖析早產兒居家訪視服務成效以及對家長居家照護的理解與執行成效，同時了解這項措施所獲致家長的滿意度評估；因為居家照顧一定是整個醫療照顧計畫的延伸，病患最終仍然是必須回到家中持續治療。因此緣故引發筆者的研究動機，希望藉此研究所得到的一些數據與結果，能提供醫院擬定長照政策時的參考，以及加強全國各地醫療院所對早產兒照顧的重視，延伸照顧的深度及廣度，使早產兒持續擁有完整性的醫療專業照護，並提昇早產兒家長之照護品質，這樣直接可以縮短住院天數及減少病患出院後在住院的機會，如此也能直接減少醫療資源的支出，所獲致的無形價值也是無窮的。
研究目的：
基於林口長庚醫院是桃園都會區內之唯一之醫學中心，本院新生兒科與護理部居家護理所從104年起開始聯合進行大規模之極低體重早產兒出院後的居家訪視計畫，將過往104年以前所進行之零星且無整合性計畫的運作予以重新統合，當然這項深具企業社會責任的措施也獲得院方之大力支持與林口社會福利課之贊助。本次研究就是延續本院新生兒科先前的居家訪視計畫，筆者曾代表本院新生兒科於民國105年（西元2016年）台灣兒科醫學會中發表研究報告，主題為「針對林口長庚新生兒科出院後的極低出生體重早產兒，進行過單一機構非隨機的家屬滿意度及照護品質分析探討」；近年來因為整體社會的進步與資源之更為充分，特別是長照議題的推波助瀾，也讓居家訪視的年齡層向下延伸，因此特別再次針對同一極低出生體重之早產兒族群進行研究，檢視家屬對出院後居家訪視滿意度的狀況，當然這也是提升全院性照護品質中持續性監測指標的一環，也冀望能分析出讓醫、護照護品質更向上提升的相關因素，提供醫院未來擬定策略時的參考。
研究範圍：
追蹤探討本院早產兒出院後之主要照顧者對早產兒出院後醫師、護理師的居家訪視滿意度評估，收案日為自民國106年9月1日起至民國107年08月30日期間，收案對象為所有自本院兒童大樓三樓、五樓新生兒科嬰兒病房（NBC, Newborn Care Unit）出院的極低體重早產兒為基礎，符合研究收案條件且家長簽立居家訪視同意書的為居家訪視對象，並將滿意度量表請家長填妥後繳回。
結果：
研究期間總共納入了63個極低體重早產兒主要照顧者之滿意度調查表，結果呈現出對居家醫師滿意度結果總平均達93.3 %。對居家護理師滿意度總平均達99.6 %，除居家護理師對個案或家屬所提出的問題能幫忙解決滿意度為99.2% 外，其餘滿意度均能達100.0%。分析來自不同出院單位 （NBC 1 vs. NBC 2） 的早產兒其主要照顧者對醫師及護理師之滿意度無統計學上之差異，p-value 沒有小於0.05。
Subject:
The Analysis of Parental Competence for Caring the Extreme Very Low Birthweight Premature Infants by Home Visit after Discharge
Introduction and Background:
In order to ensure that the premature infants in our hospital still have good care after discharge, Chang Gung Medical Foundation, Lin-kou Chang Gung Memorial Hospital, has joined the Premature Infant Foundation`s very low-weight premature infant tracking program since 1998. Lin-kou Chang Gung Hospital is the north of the tracking program. “The four district”; this study is to understand the effectiveness of the home visit service for premature infants and the understanding and implementation of parental home care for the first time in order to understand the positive promotion of medical institutions, and to understand the satisfaction of parents in this measure. Assessment is crucial because the home care must be an extension of the entire medical care programs, patients will eventually have to return home to keep continue treatment regimens. Therefore, the reason has led to the author`s research motives.
I hope that some of the data and results obtained from this research can provide reference for the hospital to formulate a long-term policy, and strengthen the attention of medical institutions across the country to the care of premature infants, and extend the depth of care. Breadth, so that premature infants continue to have integrity of medical professional care, and improve the quality of care for parents of premature infants, which can directly shorten the length of hospital stay and reduce the opportunity for patients to be hospitalized after discharge, which can directly reduce the expenditure of medical resources. The intangible value obtained is also endless.
Aims and Purpose:
Based on Linkou Chang Gung Memorial Hospital, the only medical center in the Taoyuan Metropolitan Area, the Home Care Center of the Division of Neonatology and Nursing of the Hospital has been cooperating with a large-scale home visit program after the discharge of very low-weight premature infants from the year of 2015. The operation of sporadic and non-integration projects carried out before 2015, Based on the full support of the Chang Gung Memorial Hospital, the program has been re-consolidated. Of course, this measure of corporate social responsibility has also received strong support from the hospital and sponsored by the Linkou Social Welfare Division. This study is a continuation of the previous home visit program of the neonatology department of the hospital. The author once published a research report on the 105th Taiwan Pediatric Medical Association, with title of "For the extremely low-weight premature infants after the discharge of the Chang Gung Neonatal Department of Linkou Chang Gung Memorial Hospital- Analysis of the satisfaction and quality of non-random family members in a single institution" because the overall social progress and resources are more adequate, especially the long-term care issue , and the downward extension of the home visit program, so especially for the same The study of premature infants with very low birth weight was conducted to examine the status of family members` satisfaction with home visits after discharge. Of course, this is a part of the continuous monitoring index of quality care in the hospital. It is also expected to analyze the quality of medical care and passport protection. Relevant factors for upward ascension, providing hospitals with future strategies.
Material and Methods:
Follow-up to the main caregivers of premature infants in our hospital after discharge from hospitals. The assessment of the satisfaction of home-visiting doctors and nursing staffs after discharge from the hospital is from September 1, 2006 to August 30, 2007. During the period, the subjects were based on the very low-weight premature infants discharged from the neonatal care unit on the third and fifth floors of the Children`s Building of the hospital. The study was in accordance with the conditions of the study and the parents signed up a permission for home visit. The consent form is for the home visit, and the satisfaction scale is filled in and returned by the parents.
Results：
A total of 63 primary caregivers` satisfaction surveys for very low-weight preterm infants were included during the study period, and the results showed a total average satisfaction rate of 93.3% for home-visiting pediatric physicians. The average satisfaction rate for home-visiting nursing staffs is 99.6 percent. Except for the questions raised by the home-visiting nursing staffs on the case or family can help solve the satisfaction rate of 99.2%, the rest of the satisfaction can reach 100.0%. There was no statistically significant difference in satisfaction scores between physicians and nurses in preterm infants from different discharge units （NBC 1 vs. NBC 2）, with p-value not less than 0.05. |
| Reference: | 一、中文部分：
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三、網站部分
1.內政部統計處網站 （http://sowf.moi.gov.tw/stat/week/week.doc）
登錄時間 （2010）：2016年1月16日
2.取自兒基金會網站 （http://www.pbf.org.tw/html/c01.asp） （2016）‧認識早產，2016年04月10日；李雅玲、高碧霞、曾紀瑩、駱麗華（2000）．
3. 取自兒基金會網站 （http://www.pbf.org.tw/html/c01.asp）
主要照顧者所關注的早產兒議題；（2010）
4. 世界衛生組織 （WHO） （ http:// www.who.int） （2010）
四、醫學會發表或期刊摘要
1. 朱世明等 （2016） 台灣兒科醫學會105度年會報告，台北市 |
| Description: | 碩士
國立政治大學
經營管理碩士學程(EMBA)
105932181 |
| Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0105932181 |
| Data Type: | thesis |
| DOI: | 10.6814/NCCU201900352 |
| Appears in Collections: | [經營管理碩士學程EMBA] 學位論文
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