李淑杏Shu-Hsin Lee王盈丹Ying-Tan Wang護理系長期照護碩職專班2026-10-289999-12-312019https://handle.ncl.edu.tw/11296/yvzj23https://scholars.csmu.edu.tw/handle/123456789/34545背景： 長照機構罹患糖尿病之老人住民，若糖尿病管理不佳，經常導致相關合併症或非計畫性住院增加。發展有效照護模式是一大挑戰。目的: 針對長照機構糖尿病老人住民以共同照護模式介入，對住民的生理健康指標之控制如:身體質量數、糖化血色素、空腹血糖、總膽固醇、三酸甘油脂、高低密度脂蛋白、低密度脂蛋白是否有成效和對住民改善非計畫轉急性住院率是否有成效。方法： 本研究採類實驗性、單組重覆測量的研究設計，每個月為一個觀察追蹤期，共3個月的觀察追蹤期，收案60人。糖尿病住民共同照護模式如下:由護理師每月至少提供1次衛教與共照管理，安排跨團隊照護，提供轉診的共同照護，提供糖尿病自我管理的衛教，依照護指引，如糖化血紅素、空腹血糖、血脂肪和慢性併發症的篩檢，包括微量白蛋白尿檢測、眼底檢查、足部檢查等定期追蹤照護。以(Statistical Product and Service Solutions, SPSS)統計軟體進行統計分析，採用描述性統計分析說明研究樣本人口統計學數據資料分配情形，包括個數、百分比、平均值、標準差；而推論性統計使用廣義估計方程式(Generalized estimating equation, GEE)來檢定介入成效。結果： 機構糖尿病共同照護管理介入後，住民在第3個月時，糖化血色素數值顯著降低(p＜0.05)，空腹血糖有顯著改善(p＜0.05)，且女性改善效果好。高密度膽固醇顯著改善、低密度膽固醇顯著升高(p＜0.05)。住民非計畫轉急性住院率顯著下降為原來的45%(p＜0.05)。結論: 本研究結果指出，經糖尿病共同照護管理介入後，住民的糖化血色素數值、血糖、非計畫轉急性住院率有明顯的改善，建議此相關課程可加入長照2.0訓練課程中推廣。Background: Poor control of DM for residents in LTC facilities increases rates of DM complications and unexpected admission.Purpose: The aim of this study is to evaluate the effectiveness the shared care model on unexpected acute admission by control of health care indicators including HbA1c, fasting glucose, total cholesterol, triglycerides(TG),High-density lipoprotein(HDL) and low density lipoprotein(LDL).Methods: With this quasi-experimental study, a total of 60 subjects will be measured by indicators of shared care each month for totally 3 mouth. The shared care model is performed including health education, shared care management, arrangement of referral, providing DM self-care health education, following clinical guidelines such as screening of HbA1c, fasting glucose, lipid, profiles of complication, proteinuria, fundi examination and pedal examination. All data will be analyzed by SPSS statistical software including descriptive statistics for demographic distribution and inferred statistics for the effectiveness by GEE.Results: After the intervention of the shared care model management,for 3months and the level of HbA1c of subjects decreased significantly, and the level of fasting blood glucose was significantly improved, especially for femle, In the meantime, the levels of high-density cholesterol, and low- density cholesterol were significantly improved, and hospitalization rate was significant deneasef as much as 45.5% (p＜0.05).conclusion: The results of this study point out that after the shared care model management intervention, residents of glycated hemoglobin values, blood sugar, plans to turn non-acute hospitalization rates have improved significantly, suggestions related to this course can be added to long-term care training courses to promote 2.0.長期照護機構糖尿病住民共同照護介入成效LTC facilitiesdiabetic residents in LTC facilitiesthe shared care modelthesis