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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 羅美芳(Meei-Fang Lou) | |
| dc.contributor.author | Su-Hsia Huang | en |
| dc.contributor.author | 黃素霞 | zh_TW |
| dc.date.accessioned | 2021-06-13T06:13:10Z | - |
| dc.date.available | 2010-08-01 | |
| dc.date.copyright | 2006-03-01 | |
| dc.date.issued | 2006 | |
| dc.date.submitted | 2006-02-08 | |
| dc.identifier.citation | 王水深(2000)．心臟移植．臺灣醫學，4(3)，294-301。
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S., Stern, R. S., & Epstein, A. M. (1994). The impact of patient socioeconomic status and other social factors on readmission: A prospective study in four Massachusetts hospitals. Inquiry, 31(2), 163-172.轉引自Fasken, L. L., Wipke-Tevis, D. D., & Sagehorn, K. K. (2001). Factors associated with unplanned readmissions following cardiac surgery. Progress in Cardiovascular Nursing, 16(3), 107-115. | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/34524 | - |
| dc.description.abstract | 國內心臟移植醫療科技的進步提高了病患的存活率，但病患卻常因種種的術後合併症而再入院觀察治療，顯示病患仍有術後長期照顧上的後續問題，而「非預期性再入院」則較死亡率能反映出出院後的照護品質，本研究旨在探討心臟移植術後病患之非預期性再入院率、原因及其相關因素，以立意取樣的方式選取個案，共收得71位不同移植年數之心臟移植術後病患，採橫斷性描述性的相關性研究方法進行結構式問卷收集資料，包括基本資料問卷、疾病相關資料、藥物使用量表、症狀困擾與處置量表、健康促進生活型態量表，研究結果顯示心臟移植術後病患最近一年內之非預期性再入院率為35.2 %，且移植5(含)年內之非預期性再入院率(52.2 %)顯著高於移植5年以上者(27.1 %)，非預期性再入院原因最主要為感染(31.8 %)、排斥(25.0 %)與同種異體移植心血管病變(18.2 %)，相關因素為症狀出現項目多寡(t = 2.59，p < 0.05)與是否對該症狀感到困擾(t = 2.71，p < 0.05)，而藥物使用方式及健康促進生活型態與非預期性再入院雖未達統計上之顯著差異，但臨床現況則顯示可能的相關性存在，本研究結果可提供相關醫護人員對心臟移植術後病患後續照顧上的參考，未來得以提供此類病患適切的護理措施以提高其存活率及降低非預期性再入院率。 | zh_TW |
| dc.description.abstract | Thanks to advances in medical science with respect to the technology of heart transplantation, patients in Taiwan have shown an increased survival rate. On the other hand, very often patients must nevertheless receive hospitalization for observatory treaments because of a veriety of post-surgical complications. Such facts suggest the subsequent problems of long-term care that still affects patients. An “unanticipated re-hospitalization” rate will better reflect the quality of post-hospitalization care than a mortality rate.
The present study is intended to probe into the rate of unanticipated re-hospitalization of post-surgical heart transplant patients, and the causes and the relevant factors leading to such rates. A descriptive cross-section design with purposive sampling was used in this study. The study proceeded with structural questionnaires to collect data, including demographic information, disease related questionnaire, drug regimen compliance, symptom distress and management questionnaire, and health-promoting lifestyle profile. A total of 71 patients were recruited in different periods after their heart-transplants. The major findings of this study show a rate of unanticipated re-hospitalization at 35.2% within one year. Additionally, they show a rate of unanticipated re-hospitalization at 52.2% within five years (inclusive), significantly higher than those over five years at 27.1%. The leading causes to unanticipated re-hospitalizations include infection (31.8%), rejection (25.0%) and cardiac allograft vasculopathy (18.2%). The relevant factors include whether the number of emerging symptoms (t = 2.59, p < 0.05) and the level of symptoms distress (t = 2.71, p < 0.05). The drug regimen compliance and health-promoting lifestyle data show no statistical significance with the unanticipated re-hospitalization. The clinical status, nevertheless, shows the existence of a possible relationship between them. The findings in the present study might function as a reference to medical professionals on their follow-up care of post-heart-transplant patients. In the future, they will be, in turn, able to provide appropriate medical care toward such patients to maximize the survival rate and rate of unanticipated re-hospitalization. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-13T06:13:10Z (GMT). No. of bitstreams: 1 ntu-95-R92426015-1.pdf: 1222049 bytes, checksum: 347c96d9aec6fe7c1b8d7eef08d18e4b (MD5) Previous issue date: 2006 | en |
| dc.description.tableofcontents | 中文摘要-------------------------------------------------i
英文摘要------------------------------------------------ii 內容目錄-----------------------------------------------iii 圖表目次-------------------------------------------------v 第一章 緒論--------------------------------------------1 第一節 研究動機-------------------------------------1 第二節 問題重要性-----------------------------------2 第三節 研究目的-------------------------------------4 第四節 名詞定義-------------------------------------5 第二章 文獻查證----------------------------------------7 第一節 心臟移植-------------------------------------7 第二節 再入院--------------------------------------21 第三節 自我管理------------------------------------25 第四節 研究架構------------------------------------37 第三章 研究方法---------------------------------------38 第一節 研究設計------------------------------------38 第二節 研究場所與對象------------------------------38 第三節 研究工具及信效度測定------------------------39 第四節 研究步驟------------------------------------46 第五節 資料收集與分析------------------------------47 第六節 倫理考量------------------------------------50 第四章 研究結果---------------------------------------51 第一節 研究對象之基本屬性與各量表之得分情形--------51 第二節 研究對象之非預期性再入院情形與不同心臟移植術 後時段的病患非預期性再入院率之差異----------64 第三節 研究對象基本屬性與非預期性再入院經驗之相關性 與差異性------------------------------------72 第四節 研究對象之藥物使用、症狀困擾與處置以及健康促 進生活型態與非預期性再入院經驗之相關性與差異 性------------------------------------------76 第五節 研究對象之基本屬性與其藥物使用、症狀困擾、健 康促進生活型態間的相關性與差異性------------83 第六節 研究對象之藥物使用、症狀困擾及健康促進生活型 態間的相關性--------------------------------92 第七節 研究對象之症狀處置情形----------------------96 第五章 討論------------------------------------------104 第一節 心臟移植術後病患非預期性再入院情形---------104 第二節 心臟移植術後病患非預期性再入院之相關因素---110 第六章 結論與建議------------------------------------118 第一節 結論---------------------------------------118 第二節 建議---------------------------------------119 第三節 研究限制-----------------------------------121 參考文獻----------------------------------------------122 中文部份--------------------------------------------122 英文部分--------------------------------------------124 附錄--------------------------------------------------131 附錄一 研究對象同意書-----------------------------132 附錄二 專家效度名單-------------------------------134 附錄三 基本資料問卷-------------------------------136 附錄四 疾病相關資料-------------------------------140 附錄五 藥物使用量表-------------------------------144 附錄六 症狀困擾與處置量表-------------------------146 附錄七 健康促進生活型態量表-----------------------150 附錄八 健康促進生活型態(第二版)英文版同意書-------155 附錄九 健康促進生活型態(第二版)中文翻譯版同意書---157 附錄十 研究倫理委員會審查同意書-------------------159 圖表目次 圖2-1 心臟移植術後病患非預期性再入院因素之研究架構圖-37 圖4-1 不同心臟移植時段之非預期性再入院率-------------69 圖4-2 研究對象移植5(含)年內與移植5年以上之非預期性再 入院率-----------------------------------------70 表2-1 常見免疫抑制劑的副作用-------------------------12 表3-1 藥物使用量表之內在一致性-----------------------41 表3-2 症狀困擾與處置量表的內在一致性-----------------43 表3-3 健康促進生活型態量表之內在一致性---------------46 表4-1 研究對象之基本資料-----------------------------53 表4-2 研究對象接受衛教之來源-------------------------56 表4-3 研究對象接受之衛教項目-------------------------57 表4-4 研究對象在藥物使用量表的得分情形---------------61 表4-5 研究對象在症狀困擾與處置量表的得分情形---------62 表4-6 研究對象出現之症狀與症狀困擾之人數百分比-------62 表4-7 研究對象在健康促進生活型態量表的得分情形-------63 表4-8 研究對象之非預期性再入院資料-------------------65 表4-9 研究對象非預期性再入院的原因-------------------66 表4-10 研究對象不同移植術後年數的再入院率-------------68 表4-11 移植年數非預期性再入院之差異性分析-------------70 表4-12 移植術後5(含)年內與5年以上者在藥物使用、症狀困 擾及健康促進生活型態之差異性-------------------71 表4-13 研究對象基本屬性與非預期性再入院經驗之差異性分 析(一)-----------------------------------------73 表4-14 研究對象基本屬性與非預期性再入院經驗之差異性分 析(二)-----------------------------------------73 表4-15 研究對象生理指標值與非預期性再入院經驗之差異性 分析-------------------------------------------75 表4-16 研究對象生理指標正常與否與非預期性再入院經驗之 差異性分析-------------------------------------75 表4-17 有無再入院經驗者在藥物使用量表的得分情形與差異 性分析-----------------------------------------79 表4-18 有無再入院經驗者在症狀困擾與處置量表的得分情形 與差異性分析-----------------------------------80 表4-19 有無再入院經驗者之症狀出現項目人數百分比-------80 表4-20 有無再入院經驗者之症狀困擾人數百分比-----------81 表4-21 有無再入院經驗者在健康促進生活型態量表的得分情 形與差異性分析---------------------------------83 表4-22 研究對象之基本屬性與其藥物使用間的相關性-------87 表4-23 研究對象之基本屬性與其症狀困擾間的相關性-------87 表4-24 研究對象之基本屬性與健康促進生活型態間的相關性-87 表4-25 研究對象之基本屬性與其藥物使用的差異性---------88 表4-26 研究對象之基本屬性與其症狀總數的差異性---------89 表4-27 研究對象之基本屬性與其症狀困擾總分的差異性-----90 表4-28 研究對象之基本屬性與其健康促進生活型態的差異性-91 表4-29 研究對象之藥物使用、症狀困擾及健康促進生活型態 間的相關性-------------------------------------95 表4-30 研究對象對症狀的處理情形－身體外觀-------------98 表4-31 研究對象對症狀的處理情形－活動能力缺失--------100 表4-32 研究對象對症狀的處理情形－生理不適------------101 表4-33 研究對象對症狀的處理情形－精神心理層面--------103 表5-1 因同種異體移植心血管病變而再入院的病患之健康促 進生活型態量表的得分情形----------------------110 | |
| dc.language.iso | zh-TW | |
| dc.subject | 自我管理 | zh_TW |
| dc.subject | 心臟移植 | zh_TW |
| dc.subject | 再入院 | zh_TW |
| dc.subject | 症狀困擾 | zh_TW |
| dc.subject | 生活型態 | zh_TW |
| dc.subject | lifestyle | en |
| dc.subject | heart transplant | en |
| dc.subject | self-management | en |
| dc.subject | re-hospitalization | en |
| dc.subject | symptom distress | en |
| dc.title | 心臟移植術後病患非預期性再入院之因素探討 | zh_TW |
| dc.title | Factors related to the unplanned readmission for the heart transplant recipients | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 94-1 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 王水深(Shoei-Shen Wang),戴政(John-Jen Tai) | |
| dc.subject.keyword | 心臟移植,再入院,症狀困擾,生活型態,自我管理, | zh_TW |
| dc.subject.keyword | heart transplant,re-hospitalization,symptom distress,lifestyle,self-management, | en |
| dc.relation.page | 160 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2006-02-08 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 護理學研究所 | zh_TW |
| 顯示於系所單位： | 護理學系所 | |
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