頁籤選單縮合
題名 | 移除導尿管時機對病人感受、重插率及泌尿道感染之影響=A Comparison of the Effects of Night and Day Removal of Urinary Catheters on Patient Perceptions, Re-Catheterization Rates and Urinary Tract Infections |
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作者 | 白玉珠; 江琳瑩; 葉純宜; 陳美娟; 童惠芳; 柯秀錦; | 書刊名 | 護理暨健康照護研究 |
卷期 | 9:1 2013.03[民102.03] |
頁次 | 頁33-41 |
分類號 | 419.73 |
關鍵詞 | 移除; 導尿管; 自我感受; 泌尿道感染; Removing; Urinary catheter; Self-perception; Urinary tract infection; |
語文 | 中文(Chinese) |
中文摘要 | 背景:病人常因泌尿道感染而疾病惡化,延長住院天數及增加醫療成本,嚴重時可能導致死亡,故若能於適當時機儘快順利移除導尿管,對減少泌尿道感染相當重要。目的:比較不同時機移除導尿管後病人自解時間、解尿尿量、重插管率、尿路感染率、症狀困擾及自我感受之差異並分析影響因素。方法:本研究採類實驗研究設計,以成年內科留置導尿管住院病人為研究對象,採方便取樣,日間組收案43人、夜間組41人,研究工具為病人移除導尿管監測量表,收集兩組病人移除導尿管後之相關資料及自我感受,並以描述性及推論性之統計分析。結果:移除導尿管後首次自解尿液時間,夜間組251.3分鐘顯著長於日間組177.9分鐘(p < .05),自解尿量及泌尿感染率均無顯著差異,夜間組導尿管重插率為24.4%顯著高於日間組7.0%(p < .05)。導尿管留置天數每增加一天,重插率增加1.06倍。導尿管移除後,所有病人之症狀困擾皆有緩解趨勢,且負面感受均顯著降低,而正向感受亦顯著提昇(p < .05)。結論:就日間組與夜間組比較,病人之自解尿量及泌尿道感染率在移除導尿管後並無顯著差異,而重插率則呈夜間組比較高,且導尿管留置天數愈長,重差率愈高,而所有的病人在移除導尿管後症狀困擾降低且提昇正面自我感受。建議當移除導尿管醫囑開立後,無論日夜均應儘早移除導尿管,以增進病人之舒適及睡眠品質。 |
英文摘要 | Background: Patients with urinary tract infection (UTI) face increased risks of disease deterioration, prolonged hospitalization stays, higher healthcare costs, and mortality. Thus, it is important to select the proper time to remove unnecessary catheterization in order to reduce UTI incidence. Purpose: This study compares the time‐of‐day effects of urinary catheter removal on patient void times, void volumes, re‐catheterization rates, urinary tract infection rates, symptom distress levels, and self‐perception then analyzes their influential factors. Methods: Using a quasi‐experiment study design, patients were distributed into two urinary catheter removal time groups. The day group included 43 and the night group included 41 participants. Data related to urinary catheter removal and patient perceptions were collected and analyzed using descriptive and inferential statistics. Results: The night group had longer void times (251.3 vs. 177.9 mins, p < .05) and a higher rate of re-catheterization (24.4% vs. 7.0%, p < .05) than the day group. There were no differences in voided volume and UTI rate between the two groups. The odds ratio of re‐catheterization rate was 1.06 for per urinary day. After removing urethral catheterization in the two groups, the disturbance syndrome for all patients went into gradual remission, their negative perceptions were significantly reduced, and positive emotions such as comfort, relaxation and pleasure were significantly improved (p < .05). Conclusion: Catheter removal timing did not result in significant differences in inter‐group void volumes or UTI rates. However, the night group had a higher re‐catheterization rate. Increased number of urethral catheterization days also correlated with increased re‐catheterization rate. The removal of the urinary catheter reduced syndrome disturbance and improved self‐perception. Therefore, we suggest that the urinary catheter removal order be implemented as soon as possible without considering the potential different effects of day / nighttime removal in order to maximize patient comfort and sleeping quality. |
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