骨科病人連續性照護與生活品質之相關性研究

The Relationships Between Continuity of Care and the Quality of Life Among Orthopedic Patients

目的：探討醫院骨科病人對於施行連續性照護之情形，連續性照護與生活品質之相關性，以及影響生活品質之重要預測因子。方法：採橫斷式、相關性研究設計，以社會人口學特徵、健康狀況、連續性照護量表及生活品質量表等結構式問卷收集資料；方便取樣二十歲以上且診斷為骨科手術後之病人，於中部某區域醫院之骨科病房，收案150 人；所得資料以SPSS 17.0 套裝軟體進行統計分析。結果：骨科病人連續性照護平均分數為3.94-4.26 分，生活品質問卷測量結果平均得分為55.91 分；病人在連續性照護6 個範疇上與生活品質達顯著相關。從逐步迴歸分析的結果來看，整體迴歸模式可以解釋生活品質39％的變異情形。生活品質與生活費用是否足夠（19％）、出院欲回家休養者（5％）、日常生活能力（activities of daily living, ADL）（5％）、疾病數目（8％）及醫療團隊在住院期間的關係（2％）均達顯著差異。結論：經濟狀況、ADL、疾病數目、與醫療團隊在住院期間的關係，是影響骨科術後病人生活品質的預測因子。對這些因子的認識，不但可增進醫療專業人員對骨科手術病人之連續性照護狀況、生活品質及其相關因素的實證性資訊之了解，亦可作為未來相關議題長期追蹤研究奠定基礎，並為相關介入方案的發展提出建議。

Purposes: This study explored the status of continuity of care in orthopedic patients in the hospital, the correlation between continuity of care and QoL (quality of life), and the important predictors affecting QoL. Methods: A cross-sectional and correlational design was used. Structured questionnaires including socio-demographic characteristics, health status, continuity of care, and Quality of Life Scale were employed. Convenience sample of 150 orthopedic patients aged 20 years or more after the surgery were recruited from the orthopedics ward of a Regional Hospital Center in Taichung, Taiwan. SPSS 17.0 package software was utilized for statistical analysis of the collected data. Results: The average score of the continuity of care among the orthopedic patients was between 3.94 and 4.26 points, while that of the QoL questionnaire was 55.91 points. Six aspects in continuity of care of patients were significantly correlated with QoL. Results of stepwise regression analysis showed that overall regression model explained about 39% of the variance of QoL. Significant difference was seen in Whether QoL and living expenses are sufficient (19%), those who wanted to recuperate at home after being discharged from the hospital (5%), activities of daily living (ADL) (5%), number of diseases (8%), and the relationship with the medical team during hospitalization (2%). Conclusions: The predictive factors that affect the postoperative quality of life of the orthopedic patients include the economic status, ADL, the number of diseases, and the relationship with the medical team during hospitalization. These results help understand the important factors determining QoL of patients receiving orthopedic surgery. This can improve the orthopedic health care providers’ continuity of care of patients, their understanding of the patients’ QoL, and the relevant factors of empirical information. The results can also serve as a basis for long-term follow-up study on related issues in the future and proposal of recommendations for related intervention projects.