医养结合老年科患者自理能力与分级护理、护理时间的相关性研究

目的：定量了解医养结合老年科患者每日所需的护理时间，探讨其与分级护理、患者日常生活自理能力（ADL）之间的关系，为科学完善老年分级护理标准提供参考。方法：采用现场记录法对安徽省某大型综合医院医养结合老年科进行了连续7天、以满足232名老年患者全部护理需要为目的的护理操作内容和时间的调查和分析。结果：不同护理级别、相同ADL分级的老年患者每日所需直接护理时间无统计学差异（P〉0.05）；同一护理级别、不同ADL分级的老年患者每日所需要的直接护理时间及总护理时间差异有统计学意义（P〈0.05）。结论：ADL评分能直接反映老年患者对直接护理的需求，能有效提示老年患者生活自理能力和相应的实际护理需求。建议在老年科由医生确定老年患者分级护理的I、II、III级，再由临床经验丰富的护士应用ADL量表进行A、B、C分级，即将老年患者划分为IA、IB、IC、IIA、IIB、IIC、IIIA、IIIB、IIIC 9项护理等级。

The relationship between ability of daily living,nursing time and nursing grading among elderly patients using treatment-care combination mode

Objectives：To quantitatively understand the nursing time needs among the elderly patients every day, to explore the relationship between nursing time, nursing grading, and the ability of daily living （ADL）, and to provide reference for the scientiifc classiifcation standard of the elderly patients＆#39; care. Methods：Field recording method was used in a large comprehensive hospital in Anhui province for 7 consecutive days. Totally 232 elderly patients with all care needs were investigated and analyzed for nursing time and content. Results：The direct nursing time of elderly patients with different level of nursing grading and same ADL grade had no statistical difference （P〉0.05）. The direct nursing time and total nursing time of elderly patients with same level of nursing grading and different ADL grade were different （P〈0.05）. The nursing time had positive relationship with the severity of ADL. Conclusion：The ADL score could promptly relfect the patients＆#39; direct care needs, self-care ability and the corresponding actual care needs. We recommend that the doctors determine elderly patients＆#39; nursing grading with I, II, III level, and nurses with clinical experiences decide A, B, C level of ADL. Then the elderly patients could be divided into 9 nursing levels ifnally which are IA, IB, IC, IIA, IIB, IIC, IIIA, IIIB, and IIIC.