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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
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dc.contributor.advisor | 董鈺琪(Yu-Chi Tung) | |
dc.contributor.author | Che-Wei Chen | en |
dc.contributor.author | 陳哲維 | zh_TW |
dc.date.accessioned | 2021-06-08T03:33:38Z | - |
dc.date.copyright | 2019-08-27 | |
dc.date.issued | 2019 | |
dc.date.submitted | 2019-08-06 | |
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/21422 | - |
dc.description.abstract | 背景與目標:腦血管疾病是造成全球人口死亡與失能的主要原因,其伴隨的支出更是沉重負擔。綜觀近年各國指標及臨床應用,跨領域之團隊照護,已成為目前趨勢。本研究藉由腦中風病人之相關指標,探究腦中風整合照護團隊是否增進病人之整體照護成效。
研究方法:以某醫學中心之病歷資料庫、院內資訊系統及個案管理檔案,將2017年1月至2018年6月之個案(566位),作為腦中風整合照護團隊介入前之組別;2018年7月至2019年3月之個案則作為介入後之組別(276位),利用其登錄之腦中風照護指標,進行多變量分析。 研究結果:團隊介入後有改善的照護指標,急診照護方面,包括蜘蛛膜下腔出血中風病人在接受手術前或未接受手術到院6小時內有接受嚴重度評估及美國國家衛生研究院腦中風量表(National Institute of Health Stroke Scale, NIHSS)評估完成率;住院照護方面,包括巴氏量表(Barthel Index, BI)及改良Rankin量表(Modified Rankin Scale, MRS)評估完成率、心房顫動病人使用抗凝血藥物及病人接受復健評估或治療;出院照護方面,包括急性中風病人14日內非計畫性再入院率及NIHSS量表出院評估完成率。 結論與建議:根據研究結果,急性腦中風病人之照護成效與整合照護團隊介入,無論急診、住院或出院照護,均有指標呈現改善。建議未來研究者可增加預後指標、住院天數或費用等項目,以提供更全面之探討。 | zh_TW |
dc.description.abstract | Background: Cerebrovascular disease is one of the primary causes of death and disability worldwide and responsible for significant financial expenditure. Major indicators and clinical applications of countries in recent years show that intergrated team care for patients has become a significant trend. This study uses relevant indicators of patients with acute stroke to discuss whether an integrated care team could improve the holistic efficacy of patient care.
Methods: This study accessed the medical database, the information system, and case management files of a medical center and identified 566 cases from January 2017 to June 2018 as the pre-intervention group, and 276 cases from July 2018 to March 2019 as the post-intervention group. The stroke care indicators registered in the database were used for multivariate statistical analysis. Results: There are significant improvement in multiple care indicators after the intervention of the integrated care team. In emergency care, the severity assessment before operation or unoperated within 6 hours upon arrival of stroke patients caused by subarachnoid hemorrhage, and completion rate of the National Institute of Health Stroke Scale(NIHSS) have improved. In inpatient care, completion rate of Barthes Index(BI), completion rate of Modified Rankin Scale(MRS), using anti-coagulant medication on patients with atrial fibrillation, and taking rehabilitation assessment or treatment have improved. In discharge care, unplanned 14-day readmission rate and completion rate of the National Institute of Health Stroke Scale(NIHSS) have improved. Conclusions: With the intervention of the integrated care team, research results show that indicators of the care efficacy of acute stroke patients increased in emergency care, inpatient care, and discharge care. It is recommended that future researchers can include prognostic indicators, duration of hospitalization, and expenditure for a more comprehensive study. | en |
dc.description.provenance | Made available in DSpace on 2021-06-08T03:33:38Z (GMT). No. of bitstreams: 1 ntu-108-R06847016-1.pdf: 1687840 bytes, checksum: e946ffab18408f008eb4d32bb322a4af (MD5) Previous issue date: 2019 | en |
dc.description.tableofcontents | 致謝 I
中文摘要 III Abstract V 目錄 VII 圖目錄 IX 表目錄 X 第一章 緒論 1 第一節 研究背景與動機 1 第二節 研究目的 2 第三節 實習單位簡介 3 第二章 文獻探討 4 第一節 腦中風之介紹 4 第二節 中風照護品質指標 11 第三節 醫院腦中風品質改善策略 18 第四節 相關實證研究 25 第五節 文獻小結 28 第三章 研究方法 29 第一節 研究設計與架構 29 第二節 研究假說 30 第三節 資料來源與研究對象 30 第四節 研究變項操作型定義 31 第五節 統計分析方法 34 第四章 研究結果 35 第一節 實習機構腦中風整合性照護團隊介紹 35 第二節 描述性統計 37 第三節 雙變項分析 49 第四節 多變項分析 53 第五章 討論 57 第一節 研究方法討論 57 第二節 研究結果討論 59 第三節 研究限制 62 第六章 結論與建議 63 第一節 結論 63 第二節 建議 64 參考文獻 65 附錄:腦中風照護指標定義 68 | |
dc.language.iso | zh-TW | |
dc.title | 整合照護團隊對急性腦中風病人照護成效之探討-以某醫學中心為例 | zh_TW |
dc.title | Exploring the Effect of Integrated Care Team for Patients with Acute Stroke in a Medical Center | en |
dc.type | Thesis | |
dc.date.schoolyear | 107-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 鍾國彪(Kuo-Piao Chung),洪聖惠(Sheng-Hui Hung) | |
dc.subject.keyword | 急性腦中風,整合照護團隊,醫療品質,照護指標,照護成效, | zh_TW |
dc.subject.keyword | Acute Stroke,Integrated Care Team,Quality of Care,Health Care Indicators,Efficacy of Care, | en |
dc.relation.page | 70 | |
dc.identifier.doi | 10.6342/NTU201902419 | |
dc.rights.note | 未授權 | |
dc.date.accepted | 2019-08-07 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 公共衛生碩士學位學程 | zh_TW |
顯示於系所單位: | 公共衛生碩士學位學程 |
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