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題名:Exploring the Associations between Long-Term Care and Mortality Rates among Stroke Patients
書刊名:The Journal of Nursing Research
作者:莊坤洋吳淑瓊張媚陳育慧吳振龍
作者(外文):Chuang, Kun-yangWu, Shwu-chongYeh-Chang, MeiChen, Yu-huiWu, Chen-long
出版日期:2005
卷期:13:1
頁次:頁66-74
主題關鍵詞:長期照護死亡率中風Long-term careMortalityStroke
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(1) 博士論文(0) 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:32
  • 點閱點閱:35
中風病人出院後使用長期照護服務模式的情形,是規劃長期照護資源政策的重要資訊,比較不同長期照護服務的使用結果,可提供患者選擇服務時作為參考。本研究之目的在描述中風病人出院後使用長期照護服務的情形,並探討不同服務模式對患者出院後之死亡率的影響,採縱貫式類實驗性研究設計,收集714位中風病人出院後第一個月、第三個月及第六個月期間使用長期照護服務等相關資料。結果顯示,出院後第一個月時有4.5%的病患死亡,22.1%的患者恢復健康且能獨立從事日常生活活動及工具性日常生活活動,病患使用機構式服務、居家或社區式服務及完全由家庭照顧的比例分別為:10.4%、22.4%、40.7%;第三個月時服務使用的比例分別為:11.2%、18.7%、38.0%;第六個月時服務使用的比例分別為:10.3%、19.4%、30.9%。控制年齡、性別、中風疾病史和身體功能,多變項分析結果指出:使用居家或社區式服務的患者比使用機構式服務的患者有較低的死亡率(OR = 0.39, 95%; CI = 0.15-0.97)。為何使用居家或社區式服務的患者死亡率較低的原因並不清楚,但不同服務使用者照顧品質與生活品質的差異應該被深入探討,同時需要更多的研究來評估何種原因造成不同服務之間的死亡率的差異。
Information on types of long-term care received by stroke patients after hospital discharge is essential for the formulation of long-term care resource development policy. Comparisons of outcomes resulting from different types of long-term care can provide important considerations in the selection of long-term care services. The purpose of this study is to describe the patterns of long-term care received, and to explore if associations exist between long-term care services and mortality status among stroke patients after hospital discharge. Using a longitudinal quasi-experimental study design, this study collected information on the type of long-term care received at 1, 3, and 6 months after discharge for 714 patients. At one month after discharge, 4.5% had died, and 22.1% had regained all functions in activities of daily living and instrumental activities of daily living. The percentage of patients receiving institutional care, home or community-based care, and family care only were 10.4%, 22.4%, and 40.7% respectively. The respective percentages at 3 months after discharge were 11.2%, 18.7%, and 38.0%, and, at 6 months after discharge, 10.3%, 19.4%, and 30.9%. After adjusting for age, sex, previous incidence of stroke, and physical functions, the odds of dying within 6 months after discharge for stroke patients receiving home or community-based care was significantly lower than those in institutions (OR = 0.39; 95% CI = 0.15 to 0.97). It is not clear why a lower mortality rate was observed among patients receiving home or community-based services. Differences in quality of care and quality of life among users of different types of long-term care services should be investigated. More research is needed to assess the causes of the disparity in mortality rates among users of different types of long-term care services.
期刊論文
1.Petty, George W.、Hass, Steven、Leibson, Cynthia L.、Whisnant, Jack P.、O'Fallon, W. Michael、Brown, Robert D.、Ransom, Jeanine(1999)。Use of Nursing Home after Stroke and Dependence on Stroke Severity: A Population-based Analysis。Stroke,30(5),924-929。  new window
2.Kosloski, Karl、Montgomery, Rhonda J. V.(1995)。The Impact of Respite Use on Nursing Home Placement。The Gerontologist,35(1),67-74。  new window
3.吳淑瓊、徐慧娟、莊媖智、張明正(19961200)。功能評估在估計臺灣社區老人長期照護需要之應用。中華公共衛生雜誌,15(6),533-545。new window  延伸查詢new window
4.Mayo, Nancy E.、Wood-Dauphinee, Sharon、Ahmed, Sara、Gordon, Carron、Higgins, Johanne、McEwen, Sara、Salbach, Nancy(1999)。Disablement Following Stroke。Disability and Rehabilitation,21(5/ 6),258-268。  new window
5.Andersen, Hanne Elkjær、Schultz-Larsen, Kirsten、Kreiner, Svend、Forchhammer, Birgitte Hysse、Eriksen, Karen、Brown, Anne(2000)。Can Readmission after Stroke Be Prevented? Results of a Randomized Clinical Study: A Postdischarge Follow-up Service for Stroke Survivors。Stroke,31(5),1038-1045。  new window
6.Chiu, Lian、Shyu, Woei-Cherng、Chen, Jayne Tchen-Ru(1997)。A Cost-effectiveness Analysis of Home Care and Community-based Nursing Homes for Stroke Patients and Their Families。Journal of Advanced Nursing,26(5),872-878。  new window
7.Crawford, V. L.、Beringer, T. R.、Stout, R. W.(1999)。Comparison of Residential and Nursing Home Care before and after the 1993 Community Care Policy。British Medical Journal,318(7180)。  new window
8.Dewey, H. M.、Thrift, A. G.、Mihalopoulos, Cathy、Carter, Rob、Macdonell, R. A. L.、McNeil, J. J.、Donnan, G. A.(2002)。Informal Care for Stroke Survivors: Results from the North East Melbourne Stroke Incidence Study (NEMESIS)。Stroke,33(4),1028-1033。  new window
9.Geddes, Joanna M. L.、Chamberlain, M. Anne(2001)。Home-based Rehabilitation for People with Stroke: A Comparative Study of Six Community Services Providing Co-ordinated, Multidisciplinary Treatment。Clinical Rehabilitation,15(6),589-599。  new window
10.Hermans, E.、Anten, H. W.、Diederiks, J. P.、Philipsen, H.(1998)。Use of Care by Home-dwelling Stroke Patients during Three Years Following Hospital Discharge。Scandinavian Journal of Caring Sciences,12(3),186-190。  new window
11.Hui, E.、Wong, E. M.、Woo, J.(2004)。Assessing Life Expectancies of Institutionalized Older Persons in Hong Kong。Gerontology,50(3),165-170。  new window
12.Jeng, Jiann-Shing、Lee, Ti-Kai、Chang, Yang-Chyuan、Huang, Zei-Shung、Ng, Sien-Kiat、Chen, Rong-Chi、Yip, Ping-Keung(1998)。Subtypes and Case-fatality Rates of Stroke: A Hospital-based Stroke Registry in Taiwan (SCAN-IV)。Journal of the Neurological Sciences,156(2),220-226。  new window
13.Jørgensen, Henrik S.、Nakayama, Hirofumi、Raaschou, Hans O.、Larsen, Kim、Hübbe, Per、Olsen, Tom Skyhøj(1995)。The Effect of a Stroke Unit: Reductions in Mortality, Discharge Rate to Nursing Home, Length of Hospital Stay, and Cost: A Community-based Study。Stroke,26(7),1178-1182。  new window
14.Rockwood, K.、Stolee, P.、McDowell, I.(1996)。Factors Associated with Institutionalization of Older People in Canada: Testing a Multifactorial Definition of Frailty。Journal of the American Geriatrics Society,44(5),578-582。  new window
15.Legh-Smith, J.、Wade, D. T.、Langton-Hewer, R.(1986)。Services for Stroke Patients One Year after Stroke。Journal of Epidemiology & Community Health,40(2),161-165。  new window
16.Leibson, C. L.、Ransom, J. E.、Brown, R. D.、O'Fallon, W. M.、Hass, S. L.、Whisnant, J. P.(1998)。Stroke-attributable Nursing Home Use: A Population-based Study。Neurology,51(1),163-168。  new window
17.Lin, J. H.、Hsieh, C. L.、Hsiao, S. F.、Huang, M. H.(2001)。Predicting Long-term Care Institution Utilization among Post-rehabilitation Stroke Patients in Taiwan: A Medical Centre-based Study。Disability and Rehabilitation,23(16),722-730。  new window
18.Lotus Shyu, Y. I.、Chen, M. C.、Lee, H. C.(2004)。Caregiver's Needs as Predictors of Hospital Readmission for the Elderly in Taiwan。Social Science & Medicine,58(7),1395-1403。  new window
19.Thorngren, M.、Westling, B.(1991)。Utilization of Health Care Resources after Stroke. A Population-based Study of 258 Hospitalized Cases Followed during the First Year。Acta Neurologica Scandinavica,84(4),303-310。  new window
20.Thorngren, M.、Westling, B.、Norrving, B.(1990)。Outcome after Stroke in Patients Discharged to Independent Living。Stroke,21(2),236-240。  new window
21.Tu, E. J.、Chen, K.(1994)。Changes in Active Life Expectancy in Taiwan: Compression or Expansion?。Social Science & Medicine,39(12),1657-1665。  new window
22.Wilkinson, Peter R.、Wolfe, Charles D.A.、Warburton, Fiona G.、Rudd, Anthony G.、Howard, Robin S.、Ross-Russell, Ralph W.、Beech, Roger R.(1997)。A Long-term Follow-up of Stroke Patients。Stroke,28(3),507-512。  new window
23.Wong, K. S.(1999)。Risk Factors for Early Death in Acute Ischemic Stroke and Intracerebral Hemorrhage: A Prospective Hospital-based Study in Asia。Stroke,30(11),2326-2330。  new window
24.Woo, J.、Yuen, Y. K.、Kay, R.、Nicholls, M. G.(1992)。Survival, Disability, and Residence 20 Months after Acute Stroke in a Chinese Population: Implications for Community Care。Disability and Rehabilitation,14(1),36-40。  new window
學位論文
1.蔡秀霞(2004)。長期照護機構住民口腔健康狀況之研究(碩士論文)。高雄醫學大學。  延伸查詢new window
2.范涵惠(2002)。長期照護機構老人健康狀況、生活適應及生活滿意度相關性之探討(碩士論文)。中國醫藥學院。  延伸查詢new window
3.謝錦鑾(2003)。護理之家老人潛在性不適當用藥之探討,0。  延伸查詢new window
4.郭美瑛(2003)。長期照護機構老人口腔照護與生活品質相關性之探討,0。  延伸查詢new window
5.吳雪玉(2004)。老人接受社區型日間照護計畫之成效評估,0。  延伸查詢new window
圖書
1.吳淑瓊、莊坤洋、王正、呂寶靜、張媚、戴玉慈(2001)。建構長期照護體系先導計畫:實驗介入前社區長期照護現況-嘉義社區。建構長期照護體系先導計畫:實驗介入前社區長期照護現況-嘉義社區。臺北市。  延伸查詢new window
2.吳淑瓊、莊坤洋、王正、呂寶靜、張媚、戴玉慈(2001)。建構長期照護體系先導計畫:實驗介入前社區長期照護現況-三鶯社區。建構長期照護體系先導計畫:實驗介入前社區長期照護現況-三鶯社區。臺北市。  延伸查詢new window
其他
1.行政院勞工委員會。勞動統計:外籍勞工在華人數-按行業分,0。  延伸查詢new window
2.行政院衛生署。臺灣地區歷年主要死亡原因(1984-2003),0。  延伸查詢new window
 
 
 
 
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