李秋香白香菊LEE,CHIU-HSIANGPAI,HSIANG-CHU劉玉嬌LIU,YU-CHIAOLIU護理學系長期照護碩士在職專班2026-10-282024-01-3020242024-01-17https://handle.ncl.edu.tw/11296/f2daeyhttps://scholars.csmu.edu.tw/handle/123456789/34587研究背景：當患者長期依賴呼吸器時，隨著病程進展及時間的推移，呼吸器相關併發症發生機率逐漸提高，進而增加了脫離呼吸器的困難度，因此積極呼吸器訓練脫離是相當重要的。研究目的：探討應用「WEANSNOW」評估介入於呼吸器脫離過程是否有助提高呼吸器脫離率、改善病患呼吸困難程度，並探討「WEANSNOW」評估中有無成功脫離呼吸器之相關因素，期望研究結果能為臨床實務提供參考。研究方法：本研究採類實驗研究設計（Quasi-experimental design），以使用呼吸器患者為研究對象。收案期間是2022年4月1日至2023年5月30日。對照組以常規呼吸訓練模式，實驗組則以常規呼吸訓練模式之外介入「WEANSNOW」評估，兩組以呼吸脫離率為成效指標，並以前、後測探討呼吸困難程度之成效，進而探討「WEANSNOW」評估項目與成功脫離呼吸器是否有關。研究結果：應用「WEANSNOW」評估介入於呼吸器訓練脫離過程，相較於常規呼吸器脫離過程，實驗組比對照組呼吸器使用天數減少了4.95天，脫離率提高了2.5%，但兩組未達統計意義（p ＞ .05）。兩組呼吸困難程度以配對t檢定檢測做組間比較，顯示兩組後測皆有進步且達統計上意義（p ＜ .05）。最後發現實驗組所介入的「WEANSNOW」評估項目與脫離呼吸器與否並無相關。影響呼吸困難後測相關性因素分析發現，格拉斯哥昏迷指數越高與呼吸器使用天數越少，自我呼吸困難程度就越覺得改善，而年紀越大則自我呼吸困難感受度就越明顯。結論：本研究發現個案格拉斯哥昏迷指數越高與呼吸器使用天數越少，則自我呼吸困難程度就越覺得改善。年紀越大則自我呼吸困難感受度就越明顯。「WEANSNOW」評估項目與脫離呼吸器與否無相關性，但多元邏輯式回歸分析發現呼吸器使用天數越久越不容易脫離呼吸器。Background: When patient has been relying on mechanical ventilator for a long time, with the time passing by, the happenness percentage of related complication will graduately increase; furthermore, incresing the difficulty to weaning from ventilators, Therefore positive training of how to weaning from mechanical ventilators is very important.Purpose: The purposes of this study were to explore the applying WEANSNOW to evaluate of intermeeting patients weaning from mechanical ventilators whether or not increasing the weaning percentage of mechanical ventilator improving the percentage of difficult for patient to breath. And for the discussion of the related factors that successfully weaning from mechanical ventilators from WEANSNOW. It is expected that the research findings can provide clinical care application.Methods: The research is quasi-experimental design. The object of research is for patient who using mechanical ventilators. Study was conducted from April 1, 2022 to May 30, 2023. Experimental group and control group are proceeding pre-, post-test by degree of dyspnea, and use WEANSNOW assessment as the intervention measures for experimental group.Results: The application of WEANSNOW to evaluate of intervention patient weaning from mechanical ventilators compare to weaning process of regular training. Although the experimental group has used ventilators to reduce 4.95 days, weaning percentage has risen 2.5% compared to control group. But two groups have not yet meet the statistical significance（p ＞ .05）. Two groups’extent of dyspnea has being found out by matching Student’s t-test examine to do comparison between groups, it shows that the post test of two groups are both improving and reach the statistical significance（p ＜ .05）. Lastly, the result has found out that the WEANSNOW’s assessment item intervened by experimental group has no relation with whether or not to weaning from mechanical ventilators. Analysis of factors affecting the post-test correlation of dyspnea found that the higher the Glasgow Coma Index and the fewer days of using a respirator, the more the self-reported dyspnea improved, and the older the patient, the more obvious the self-perceived dyspnea.Conclusion: This study found that the higher of Glasgow coma index and the less of the days of use of mechanical ventilator, the better of self dyspnea sensitivity. The older of the age and the more obvious of the self dyspneasensitivity. The assessment item of WEANSNOW and whether or not weaning from mechanical ventilators have no relation but multiple logistics regression analysis has found out that the longer of the days of use of mechanical ventilators, the more difficulty to weaning from mechanical ventilators.呼吸衰竭呼吸器脫離WEANSNOW評估Respiratory failureVentilator weaningWEANSNOW assessmentthesis