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題名：謢理之家機構特性與照護品質相關性研究
書刊名：護理雜誌
作者：陳家容／蘇慧芳 引用關係／謝碧晴 引用關係／王玫
作者(外文)：Chen, Chia-jung／Su, Hui-fang／Hsieh, Pi-ching／Wang, Mey
出版日期：2003
卷期：50:3
頁次：頁62-70
主題關鍵詞：護理之家；機構特性；照護品質；組織層級分析；Nursing home；Facility characteristics；Quality of care；Organizational-level analysis
原始連結：連回原系統網址new window
相關次數：
  • 被引用次數被引用次數:期刊(1) 博士論文(2) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:13
  • 點閱點閱:19
　　　　　本研究目的在探討護理之家機構特性（經營型態、規模、佔床率、護理人員護理時數、病患服務員照護時數）與照護品質（壓瘡率、跌倒率、轉╱住至急性照護機構率、感染率、使用身體約束率）的相關性。參考Donabedian品質管理理論模式，採描述相關性設計，以隨機分層抽樣方式，自全臺123家立案護理之家抽取39家，以郵寄結構式問卷方式共進行3個月的資料收集，計32家護理之家全程參與。以組織層級為分析單位，採描述性統計及邏輯斯迴歸進行資料分析。結果顯示經控制住民特性後，獨立型態護理之家比醫院附設型態護理之家傾向有低跌倒率與低感染率，且機構床位數大於45床者傾向有較高跌倒率。本研究結論是護理之家機構的經營型態及機構規模與機構所提供的照護品質（跌 率及感染率）有關。討論與建議在文內有詳細描述。
　　　　　The purpose of this study was to examine the relationship between the facility characteristics (ownership, size, occupancy rate, registered-nurse hours per patient day, nursing-assistant hours per patient day) and the quality of care (pressure ulcer rate, falls rate, rate of transfer/discharge to inpatient acute care, infection rate, rate of use of physical restraint) in nursing homes. Based on Donabedian's quality management framework, a descriptive correlational design was used. Stratified random sampling was adopted to select 39 homes from 123 licensed nursing homes. Thirty-two nursing homes returned the structured questionnaires by mail over a three-month period. Data were analyzed using descriptive statistics and logistic regression at the organizational level. The results of this study revealed that after controlling for characteristics of residents, independent nursing homes had lower falls and infection rates than hospital-affiliated homes. Facilities with over 45 beds had higher falls rates. The study concludes that the ownership and size were associated with the quality of care (falls and infection rates) in nursing homes. Discussion and suggestions are described.
期刊論文
1.Zimmerman, D. R.、Karon, S. L.、Arling, G.、Clark, B. R.、Collins, T.、Ross, R.、Sainfort, F.(1995)。Development and Testing of Nursing Home Quality Indicators。Health Care Financing Review，16(4)，107-128。  new window
2.Anderson, R. A.、Hsieh, P. C.、Su, H. F.(1998)。Resource Allocation and Resident Outcomes in Nursing Homes: Comparisons Between the Best and Worst。Research in Nursing & Health，21(4)，297-313。  new window
3.Greene, V. L.、Monahan, D. J.(1981)。Structural and operational factors affecting quality of patient care in nursing homes。Public Health，29(4)，399-415。  new window
4.Spector, W. D.、Selden, T. M.、Cohen, J. W.(1998)。The impact of ownership type on nursing home outcomes。Health Economics，7(7)，639-653。  new window
5.Rubenstein, L. Z.、Josephson, K. R.、Osterweil, L. D.(1996)。Falls and fall prevention in the nursing home。Clinics in Geriatric Medicine，12(4)，881-902。  new window
6.吳聖良、張瑛玿(19951000)。臺灣省12縣市未立案療養機構數量及其服務現況之調查研究。公共衛生，22(3)，147-162。  延伸查詢new window
7.行政院衛生署防疫處(19920300)。臺灣地區醫院院內感染管制工作概況調查報告。院內感染控制通訊，2(1)，2-5。  延伸查詢new window
8.曲佩芬、李聰明(20020400)。長期照護機構之重要一環--院內感染管制。院內感染控制雜誌，12(2)，118-127。  延伸查詢new window
9.陳顯昌(19930100)。中華民國臺灣地區準區域以上醫院無障礙環境之調查研究。公共衛生，19(4)，329-344。  延伸查詢new window
10.黃恆峻、詹瑞棋(19980800)。老年人常見之問題。臨床醫學，42(2)=248，112-116。new window  延伸查詢new window
11.黃子庭、廖秀珠(19931000)。臺北市北投區社區居家老人跌倒的情形及其相關因素之探討。公共衛生，20(3)，234-246。  延伸查詢new window
12.Aaronson, W. E.、Zinn, J. S.、Rosko, M. D.(1994)。Do for-profit and not-for-profit nursing home behave differently?。Gerontologist，34(6)，775-786。  new window
13.楊漢湶、孫碧雲(19990400)。公立醫院附設護理之家之探討。醫院，32(2)，57-65。  延伸查詢new window
14.Davis, M. A.(1991)。On nursing home quality: A review and analysis。Medical Care Review，48(2)，129-166。  new window
15.Cohen, J. W.、Spector, W. D.(1996)。The effect of Medicaid reimbursement on quality of care in nursing homes。Journal of Health Economics，15(1)，23-48。  new window
16.Castle, N. G.、Fogel, B.(1998)。Characteristics of nursing homes that are restraint free。The Gerontologist，38(2)，181-188。  new window
17.Graber, D. R.、Sloane, P. D.(1995)。Nursing home survey deficiencies for physical restrain use。Medical Care，33(10)，1051-1063。  new window
18.Freiman, M. P.、Murtaugh, C. M.(1993)。The determinants of the hospitalization of nursing home residents。Journal of Health Economics，11(3)，349-359。  new window
19.Donabedian, A.(1966)。Evaluating the quality of medical care。Milbank Memorial Fund Quarterly，44(Suppl. 3)，166-206。  new window
20.Harrington, C.、Zimmerman, D.、Karon, S. L.、Robinson, J.、Beutel, P.(2000)。Nursing home staffing and its relationship to deficiencies。Journals of Gerontology. Series B, Psychological Sciences & Social Sciences，55(5)，S278-S287。  new window
21.Harrington, C.、Kovner, C.、Mezey, M.、Kayser-Jones, J.、Burger, S.、Mohler, M.、Burke, R.、Zimmerman, D.(2000)。Experts recommend minimum nurse staffing standards for nursing facilities in the United States。The Gerontologist，40(1)，5-16。  new window
22.Harrington, C.、Carrillo, H.、Mullan, J.、Swan, J.(1998)。Nursing facility staffing in the states: The 1991 to 1995 period。Medical Care Research and Review，55(3)，334-363。  new window
23.Halbur, B. T.、Fears, N.(1986)。Nursing personnel turnover rates turned over: Potential positive effects on resident outcomes in nursing homes。Gerontologist，26(1)，70-76。  new window
24.Intrator, O.、Castle, N. G.、Mor, V.(1999)。Facility characteristics associated with hospitalization of nursing home residents: Results of a nation study。Medical Care，37(3)，228-237。  new window
25.Johnson-Pawlson, J.、Infeld, D. L.(1996)。Nurse staffing and quality of care in nursing facilities。Journal of Gerontological Nursing，22(8)，36-45。  new window
26.Langmore, S. E.、Skarupski, K. A.、Park, R. S.、Fries, B. E.(2002)。Predictors of aspiration pneumonia in nursing home residents。Dysphagia，17(4)，298-307。  new window
27.Nyman, J. A.(1988)。Improving the quality of nursing home outcomes: Are adequacy-or incentive-oriented policies more effective?。Medical Care，26(12)，1158-1171。  new window
28.Peters, D. A.(1989)。An overview of current research relating to long-term care outcomes。Nursing and Health Care，10(3)，132-136。  new window
29.Phillips, C. D.、Hawes, C.、Mor, V.、Fries, B. E.、Monies, J. N.、Nennstiel, M. E.(1996)。Facility and area variation affecting the use of physical restraints in nursing home。Medical Care，34(11)，1149-1162。  new window
30.Porell, F.、Caro, F. G.(1998)。Facility-level outcome performance measures for nursing homes。Gerontologist，38(6)，665-683。  new window
31.Sainfort, F.、Ramsay, J. D.、Monato, H., Jr.(1995)。Conceptual and methodological sources of variation in the measurement of nursing facility quality: An evaluation of 24 models and an empirical study。Medical Care Research and Review，52(1)，60-87。  new window
32.Zinn, J. S.、Aaronson, W. E.、Rosko, M. D.(1993)。Variations in the Outcomes of Care Provided in Pennsylvania Nursing Homes: Facility and Environmental Correlates。Medical Care，31(6)，475-487。  new window
33.Spector, W. D.、Takada, H. A.(1991)。Characteristics of nursing home that affect resident outcomes。Journal of Aging and Health，3(4)，427-454。  new window
34.徐慧娟、吳淑瓊(19980800)。提供社區式家庭支持方案能否減少機構式長期照護服務之使用意願？。中華公共衛生雜誌，17(4)，326-336。new window  延伸查詢new window
學位論文
1.李偉立(2000)。醫院附設與獨立型護理之家住民特質與健康狀況之比較(碩士論文)。高雄醫學大學。  延伸查詢new window
2.臧麗琳(1999)。台灣地區護理之家院內感染管制現況及相關危險因子探討(碩士論文)。國防醫學院。  延伸查詢new window
圖書
1.中華民國長期照護專業協會(2000)。台閩地區長期照護機構名冊。台北：中華民國長期照護專業協會。  延伸查詢new window
2.蕭淑貞、李世代(1999)。長期照護。台北：藝軒。  延伸查詢new window
3.Department of Health and Human Services(2001)。Health, United States, 2001 with urban and rural health chartbook。Hyattsvill, MD：Department of Health and Human Services。  new window
4.戴玉慈、陳美津、陳惠姿、王祖琪、楊清姿、劉紋妙(1998)。老人護理學。台北：國立空中大學。  延伸查詢new window
其他
1.Association of Maryland Hospitals & Health Systems(20000608)。Maryland Hospital Association: Quality indicator project，http://www.qiproject.org/publicData/LTC/Index。  new window
2.Institute of Medicine(1996)。Nursing staffing in hospitals and nursing homes: Is it adequate?，http://www.nap.edu/openbook/0309053986/html。  new window
圖書論文
1.陳順宇(2000)。二元資料迴歸模式。迴歸分析。台北：華泰。  延伸查詢new window
2.Polit, D. F.、Hungler, B. P.(1993)。Advanced statistical procedures。Nursing research: Principles and methods。New York：J. B. Lippincott。  new window
 
 
 
 
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