Lush M T, Henry S B
Kaiser Permanente Medical Care Program, California Division, Oakland 94612, USA.
Proc AMIA Annu Fall Symp. 1997:136-40.
The purpose of this study was to examine the relationships between the patient's health status at hospital admission and the initial care planned by the nurse. Functional status, engagement in care, and psychosocial well-being were measured by the Health Status Outcome Dimensions(HSOD) instrument. The HSOD is the foundation for developing a computer-based infrastructure for the analysis of health related outcomes. The consecutive, convenience sample of 308 subjects was drawn from five acute clinical populations: pulmonary; cerebrovascular, cardiac; gastrointestinal; and infection. Logistic and multiple regression analyses were used to test the relationships between control (patient and setting) variables, health status, and the dependent variables of type of problem identified, number of problems identified, and the time required to implement interventions ordered for the patient. In seven of ten models, control variables of facility, age, and/or severity of illness contributed to a model at p < .01. In six of ten models, at least one health status measure significantly explained variation beyond the control variables, at p < .01. Study results support using data gathered during the course of care, to evaluate the process of that care. Further work is needed to understand the effects of setting and provider variables on the use of health status data in care planning. Computer-based outcomes infrastructures are essential to support the collection and analysis of health status over time.
本研究的目的是检验患者入院时的健康状况与护士制定的初始护理计划之间的关系。功能状况、参与护理程度和心理社会幸福感通过健康状况结果维度（HSOD）工具进行测量。HSOD是开发用于分析健康相关结果的计算机基础设施的基础。连续抽取的308名受试者的便利样本来自五个急性临床群体：肺部疾病、脑血管疾病、心脏疾病、胃肠道疾病和感染。采用逻辑回归和多元回归分析来检验控制（患者和环境）变量、健康状况与所确定问题类型、所确定问题数量以及为患者实施医嘱干预所需时间等因变量之间的关系。在十分之七的模型中，机构、年龄和/或疾病严重程度等控制变量在p <.01时对模型有贡献。在十分之六的模型中，至少一项健康状况测量指标在p <.01时显著解释了超出控制变量的变异。研究结果支持利用护理过程中收集的数据来评估护理过程。需要进一步开展工作，以了解环境和提供者变量对护理计划中健康状况数据使用的影响。基于计算机的结果基础设施对于长期支持健康状况的收集和分析至关重要。
