看護総合科学研究会誌 = Journal of comprehensive nursing research;vol. 10 no. 3

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大学病院における改訂版退院支援スクリーニング票の妥当性の検証

鷲見, 尚己;奥原, 芳子;安達, 妙子;浅野, 弘恵;佐藤, 由佳

Permalink : http://hdl.handle.net/2115/35485
JaLCDOI : 10.14943/33876
KEYWORDS : discharge planning;screening tool;validity;university hospital;退院支援;スクリーニング;妥当性;大学病院

Abstract

本研究は,高齢患者用退院支援スクリーニング票をもとに改訂版退院支援スクリーニング票を作成し,妥当性を検討したものである。高齢患者用退院支援スクリーニング票は,退院支援のニーズに関連した7つの指標で構成され, 10点以上の患者を退院支援が必要なハイリスク患者と判定するものである。今回,新たに「年齢」の項目を追加し,各項目の選択肢を具体的な表現に変更し改訂版退院支援スクリーニング票を作成した。大学病院に入院した20歳以上の435名を対象にスクリーニングした結果,スクリーニング票のカットオフ値を10点として,ハイリスク患者の特定に対する感度,特異度は77.3%,84.3%であった。また,スコア10点以上の患者は, 10点未満の患者に比べ,自宅外退院や退院支援を受ける割合が有意に高かった。以上より,本スクリーニング票は,ハイリスク患者について判別可能で、あり,臨床活用上で有用なツールであると考えられた。
The purpose of the present study was to examine the validity of a revised screening tool for identifying patients who might require discharge planning at a university hospital. The original screening tool contained the following seven predictors based on elderly patients' needs for discharge planning: functional and mental status, medical treatment, living situation, arrangement for residence after discharge, problems regarding care at home, and application for Long-term Care Insurance. Total scores ranged from 0 to 26 and patients with scores greater than 10 were considered high-risk patients who should be referred to the discharge planning team. In the revised version, an age item was added and the contents of each predictor were modified concretely. The screening tool was completed by 435 patients over the age of 20 years who were hospitalized in a university hospital. The results indicated that among patients who scored more than 10 points, a high proportion were discharged to a place other than their homes or received discharge planning. Furthermore, when the cut-off value of the screening tool was set at 10 points (total score range: 0 to 28), the sensitivity for "high-risk patients", i.e., those who were discharged to places other than their homes or received discharge planning was 77.3%, with as pecificity of 84.3%. The present results suggest that this revised screening tool could be used to identify "high-risk patients" at a university hospital and is valid for clinical use.

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