The association between patients'' satisfaction and theeffectiveness of care in Pre-ESRD care plan

• Main Authors: YING-CHUN LIAO, 廖瑛君
• Other Authors: I-Chen Lee
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/22r7jt

碩士 === 高雄醫學大學 === 醫務管理暨醫療資訊學系碩士班 === 102 === Background Chronic kidney disease may by effective health care appropriate health education, delaying disease progression to further reduce the incidence of dialysis, to provide a complete and correct care and monitoring of renal function is performed by the medical team to provide treatment and health education measures, and thus enhance the chronic kidney patient care and quality of life. Currently Pre-ESRD patient care and health education programs are most effective indicators to monitor clinical care compared to other behavioral care plan after the effectiveness of such health education and changes caused by fewer discussion. Because the behavior of patients, continuity and effectiveness of care treatment satisfaction will cause a great impact, this study purport to participate in programs for the Department of depth discussion of patient satisfaction, and the correlation between clinical care indicators. Methods In this study, the data source to a medical center in southern nephrology patients with chronic kidney disease for the study of the population, sample selection between the Republic of China on September 95 from 1 to 103 years of the Republic of February 28, adding, "National Health Insurance pre-stage renal disease (Pre-ESRD) of patient care and health education programs, "half (or more), and regular visits every three months to track the implementation of health education of patients as close cases objects. National Health Department and the Taiwan Society of Nephrology "Kidney Health Promotion Plan" jointly develop patient satisfaction questionnaire, contains five dimensions, eighteen questions of; and respondent data. Statistics using the tool to SPSS for Windows version 20 statistical software for data collection and analysis, the main statistical methods of descriptive statistics (Descriptive analysis), inferential statistics (Inferential analysis): Independent t-test (Independent-t test), single factor analysis of variance (ANOVA), bivariate correlation analysis. Results Demographic characteristics and patient satisfaction, the effectiveness of care differences: the hardware facilities and processes for satisfaction male, college educated, have higher worker satisfaction, satisfaction with care health education are men, there are worker satisfaction GAO Jia, chronic kidney disease care plan overall satisfaction have workers better, higher non-working state by guiding the satisfaction of dietitians, demographic characteristics and eGFR decreased value of the correlation is not obvious. Disease traits in patient satisfaction, the effectiveness of care differences: different disease characteristics (disease stage, disease duration, hospital treatment time) on the hardware facilities and process satisfaction, satisfaction with physician clinics, nursing satisfaction with health education, dietary guidance the evaluation results and overall satisfaction with care plans no significant difference, eGFR decreased value of the primary disease was significant difference in the effectiveness of kidney disease the best care, cardiovascular disease subordination, poor diabetes care results. Correlation between health education status and patient satisfaction and effectiveness of care: nursing health education and hardware flow frequency high correlation satisfaction, nursing health education and dietary guidance to every 10 to 20 minutes maximum satisfaction, satisfaction with the longer worse, the physician clinic satisfaction, satisfaction with care health education, dietary guidance satisfaction and health education time, the time has nothing to dietary guidance significantly associated with the frequency of nursing health education and dietary guidance frequency. Relationship satisfaction and effectiveness of care: Satisfaction with various performance indicators hardware processes of care, physicians clinics, nursing health education, dietary guidance and overall evaluation of decreased eGFR values no significant correlation. The study found that physicians more detailed explanation of the disease, kidney disease patients overall care plan for the hardware facilities and clinics, nursing health education, dietary guidance higher satisfaction with the overall evaluation of a significant correlation. Conclusions Physicians in the process of closing the case carefully explain to patients the purpose of this project and the need for regular visits with patients and other matters, the patient satisfaction on each dimension is significantly higher. The study sample distribution of age groups 65 years and older (n = 628) the majority of the elderly population, the study found no significant difference in eGFR decreased value in the age variable, the average number of samples decreased eGFR value of -0.64 ± 4.47. Most current research of chronic kidney disease mainly focused on drug treatment and pathogenesis in. Less emphasis on appropriate disease management, patient participation and satisfaction whether the impact of self-care management effectiveness. Based on the results of this study, the patients involved in care planning can help improve satisfaction with the implementation of the current program of care plan.