實施出院準備服務對跌倒後髖部骨折住院老人之成效：自我照顧知識、能力和健康照護滿足程度

The Effect of A Discharge Plan on Hospitalized Elderly Patients with Hip Fracture: Knowledge and Ability of Self-Care, and Health Care Satisfaction

本研究主要在驗證出院準備服務方案於因跌倒致髖部骨折住院老人的成效。本研究為準實驗設計，採立意取樣，對象為因跌倒而造成髖部骨折的住院老人。共招募69位因跌倒而髖部骨折住院於台灣北部某醫學中心的≧60歲的老人，研究對象依入院順序分配，前35位於對照組，後34位於實驗組。出院準備服務包括以照護手冊提供個案和家屬教導、諮詢、支持及協調。研究結果顯示：(1)兩組自我照顧知識程度後測均比前測好(t=15.82, p＜.01)，在後測實驗組的自我照顧知識程度比對照組提升(t=-38.30, p＜.01)。(2)兩組的健康照護滿足程度及自我照顧能力（日常生活及工具性日常生活程度）均隨著時間而滿足(F=90.45, p＜.01；F=165.20, p＜.01)，而且，實驗組又比對照組增加(F=162.94, p＜.01；F=7.07, t=2.05, p＜.05)。本研究結果呈現此出院準備服務方案對因跌倒而髖部骨折的住院老人是有效的，並可作為護理臨床實務的參考，以提升護理照護品質。

The purpose of this study was to examine the effect of a discharge plan on hospitalized elderly patients with hip fracture due to falling. A quasi-experimental design with 69 hip fracture patients aged over 60 years, hospitalized due to falling, and discharge from a medical center in northern Taiwan were sequentially assigned to either usual care (n=35) or a discharge planning intervention (n=34). This discharge planning intervention included a self-care manual for educating and counseling, support for patients and their families, and coordination of an interdisciplinary team of providers. Major finding of the study included: (1) Experimental group had greater improvement in self-care knowledge than control group (t = 15.82, t = -38.30, p< .01); (2) The health care satisfaction and the ability of self-care (Activities of Daily Living (ADL) and Instrumental ADL were improved in both groups (F=90.45, p< .01; F=165.20, p< .01). This study showed that elderly patients with hip fracture could benefit from discharge planning intervention. Such plan could improve quality of care in nursing practices.