Thông tin tài liệu
BAI BAO NGHIEN C I I COC Hoat a§ng Cong tac xa hoi tai mot so benh vifn tuyen IVung mmg tr§n dia ban ph6 Ha Noi Bui Thi Mai Dong'" M u c tieu: Mo ta thue trang hoat dpng Cong tae xa hfi (CTXH) tai mpt so bfnh vifn tuyen Trung uong (TW) trSn dia ban p h i Ha Noi P h u o n g p h i p nghien cmi: Thi£t k l nghien cuu mo ta ckt ngang, ket hgp nghien curu dinh lugng vd dinh tinh Dfli tugng nghien e ^ : bfnh nhan, ngucri nha bfnh nhan, nhan CTXH, nhfin vien y tk va can bp quan lif cip khoa/phflng Nghien curu tir thing 02-12/2018 tai bfnh vifn: bfnh vifn B?ch Mai, bfnh vifn Nhi Trung uong va bfnh vifn K Tan Trieu K^t qua Dghien ciru: Trong c i c hoat dpng CTXH da vd dang dugc tri^n khai tai ede bfnh vifn thupc dja ban khao sat, cac ho^t dpng ho trg nguoi bfnh den kham bfnh va i ^ thii tyc nh^p vifn, xufit vifn mang tinh gian don, dirge thue hien thudng xuyen va dugc ngudi bfnh danh gifi cao Cac ho^t dpng ket noi, van dong tai trg va ho trg ngudi bfnh cac nhu edu thi^t ylu qua trinh dieu tri cung dirge thue hifn thudng xuygn, lien tye va c6 hi^u qufi Cfie hoat dpng mang tinh d^e thu eiia CTXH, d6i hoi tinh ehuySn mon eao nhu: tham van, tir vfin, tri lifu tam ly, can thifp khung hofing chua dupc quan tam thyc hifn vd cdn thieu chuyen nghifp, hifu qua chua cao Ket luan vh khuyen nghj: CTXH t^i cac bfnh vifn tuyen TW tren dja ban Ha Npi vfin dang giai do?n dau cua qua trinh hinh va phat trien Bp Y te can c6 cac van ban hudng dan phdng CTXH cde benh vifn thue hifn ede gifii phfip nang eao tinh ehuySn nghifp vd hifu qua eae ho^t dpng CTXH Cdc CO sd ddo t^o nguon nhfin luc CTXH benh vifn ean doi mdi npi dung chuong trinh dao t^o vd tang cudng huong dfin ky nang tbyc hanh nghe nghifp cho sinh vien Tur khda: Hotft dpng cong tac xa hgi, B^nh vien tuyen TW Ha Npi DAT VAN DE nhung kien thuc, ky nang dfl vdo vifc ho ti^, giup dd dfli tagng la nhung cd nhan, nhdm, Cflng tae xa hgi (CTXH) frong benh vifn la cdc boat dflng ho fro bfnh nhan, ngudi nhd bfnh nhan vd cdc nhan vifln y tfl (NVYT) frong bfnh vifn giai quyet cdc van dfl xa hoi cflng dflng yeu ttifl bdng edeh eung cap dich vu, tao CO hgi tiflp can vfli cde ngufln lue ho frg dfl tiian chu cd tiifl tang khd nang tir giai quyflt va (mg phfl vdi cde vdn dfl cua minh va tam ly lifln quan dfln bfnh tat vd qud trinh khdm chua bfnh CTXH tix)ng bfnh vifn Td Bfl Y te ban hdnh Dfl an "Phdt triin duoe thi^c hifn bdi dfli ngu nhan vien CTXH, nghe CTXH ngdnh Yti giai dogn 20U - Id nhirng nguoi duoc ddo t^o, co kifln thuc, ky 202ff\ phdng CTXH dugc tiidnh ldp g hdu hflt nang nghfl nghiep vfl CTXH vd biflt su d\mg cde bfnh vifn vfli nhiflu ho^t dflng ho frg ngudi ^Si& 'Tie gid lien hf: Bdi Thj Mai Dong {•'[^JSivil Email: builhimaidong@vwa.edu.vn ^^fer^ 'Hpc vi^n Ph^ nu Vi4t Nam Ngdy nhgn bai: 02/01/2020 Ngdy phan biin: 24/02/2020 Ngdy ddng bdi: 24/03/2020 ii Khoa hpc Nghien cuu Sue khde vd Phdt tnen (Tap 04, Sd 01-2020) Joumal cf Health and Development Studies (Vol.04, No.01-2020) bfnh khdm vd diflu tri benh; ho frg nhan vien y tfl (NVYT) cham sde bfnh nhan vd gidi quyflt cdc mau thudn phdt sinh cdc mfli quan hf, gop phdn ndng cao chat lugng, hieu qud cong tde cham soc sue khoe nhan dan Ben canh nhimg kflt qud dat dugc, cdc boat dong CTXH ttong bflnh vifn vdn cfln nhiflu kho khan, ban ehe nhieu nguyen nhan, cfl nguyen nhdn td dpi ngu nhan vien CTXH Nhan thde dugc tdm quan trgng eua CTXH frong bfnh vifn, nhiflu dfl tdi nghien cdu thuge Ittih vvre da vd dang dugc ede tac gid frong vd ngodi nuoc trien khai nghifln cdu nhu: nghien cdu: "Cong tdcxd hgi Benh vien" cua tde gid Trdn Dinh Tudn, nam 2015 da chi tdm quan frgng cua CTXH frong bfnh vifln dflng thdi khang djnb bflnh vifln vd nhd truang chmh Id edu nfli frong vifc hfl frg sinh vifln thvre t^p ciing nhu tang ca hoi nghe nghifp cho sinh vifln trudng (1) Nghifln cdu: "Nhu cdu vd ndng lyre cung cap dich vu CTXH cho benh nhdn ung thu tgi Binh vign Ung thu Qudc gia Viet Nam" cua Pham Tien Nam vd cdc cflng su da mfl td cdc dac diflm eua benh nhan ung thu t^i Bfnh vifn Ung thu Quoc gia \^et Nam (VNCH), phdc thdo nhu eau vfl cdc dich vu CTXH dya ttfln cac dac diflm eiaa cdc bfnh nhan ung thu va nang luc eung cap ede dich v\i CTXH cdn thiflt cho bfnh nhan ung thu eua VNCH Ngodi nhieu nghifln cuu khde phdn anh cdc gdc dp khde cua CTXH tiong bfnh vifn, dang tren cde t^p chi khoa hgc, ky yflu Hgi thdo Idioa hoc Hdu het cdc nghifln cdu deu di sau tim hieu cde khia canh cua CTXH ttong bfnh vifln nhu: nhu eau frg giup cua cdc nhdm dfli tagng tiong bflnh vifln, vai tro vd ede yflu tfl dnh huomg dfln viee hfl trg cua nhan vifln CTXH dfli vdi cde nhom bfnh nhan khde w td chi sy can thiet vd khd nang phdt trifln nghfl CTXH bflnh vien Tuy nhifln, sau nhieu nam thyc hifn De an phat trifln CTXH frong lihb vyc Y tfl giai doan 2011-2020 cdc nghien cuu mang tinh tflng quan vfl boat dgng CTXH ede bfnh vifn cdn ban ehfl Nham nang cao chat lugng ddo tao ngufln nhan luc CTXH, ddp ung nhu cau ngdy cdng cao cua cae nhom dfli tagng frong bflnh vifn, nhom nghifln edu trifln khai dfl tdi:"7%«c trgng vd gidi phdp ndng cao hiiu qud CTXH binh vien " vdi muc tieu: Mo td thyc t r ^ g cdc boat dflng CTXH tai mflt sfl bfnh vifn tayfln Trung uong frfln dia bdn thdnh phfl Ha Ngi PHU'ONG PHAP NGHIEN CUtJ Thiet k^ nghiflo cuv: Thiet kfl nghien cuu mfl td cdt ngang Dja dilm va thdi gian nghien cuu: Nghifln cuu dugc thyc hifln ta thang den thdng 12/2018, khao sdt tai bflnh vien tayfln TW: Bfnh vien Bach Mai, Bfnh vifn Nhi TW vd Bfnh vien K ca sd Tan Triflu Ddi tuomg nghien ciru: khdeh thfl chmh Id bfnh nhan vd nguoi nha bfnh nhdn (tiong truomg hgp bflnh nhi dudi tafli khflng thfl trd ldi); Ngodi ra, phdng van sau mflt sfl nhan vien CTXH, NVYT vd mgt sfl cdn bfl lanh dao cap khoa/phong frong bflnh vifln da tung Ibam gia cdc dgt tap huan hoac bfli nghi, hoi tiido vfl CTXH C o miu, each thuc chgn mau: Trong pham vi cua mflt dfl tdi ngliifln cuu cap co sd vd ban hep vfl kinh phi, dfl tdi tifln hdnh phflng vdn bang bdng hdi 151 ngudi benh, tiong dfl: Bfnh vifln Bach Mai: 50 ngudi, Bfnh vien Nhi TW: 49 ngudi; Bflnh vien K ca sd Tan Triiu: Biu T1^ M n Bdng Tgp e Jo'^ntdgfHudlktmdDevelopmemSbtditaltW.u*.'^'^' 52 ngudi; Thyc hifln 30 phflng van sau (mfii bfnh vifn phdng van sdu bfnh nhan, nhan vifln CTXH, NVYT, trudng khoa dieu tx\ vd tiirdng phong CTXH); Tifln hanh eugc thdo lu|n nhdm tai benh vifn (mfli nhdm tii dfln nhan vifln CTXH vd dieu dudng vifln) Vifc chgn mau nghifln cuu Id hodn toan ngau nhifln (Ioai tru nhimg bfnh nhan tam thdn, khdng cfl khd ndng tra loi phiflu, thdi gian dugc phep tiflp xuc ngudi benh, gap dugc bfnh nhan ndo phdng van bfnh nhan do, khflng Idm anh huflng dfln vifc dieu tri eua bfnh nhdn Trong qua trinh tiflp xuc, luu y can bdng ty If vfl gifli, ngudi Ion vd tre em) Phirong phdp thu t h | p s6 lifu: De tdi thiflt ke bo cflng cy khdo sdt gom mdu: 01 mdu phdng van bdng bdng hoi, mdu phflng van sau vd 01 huong dan thao luan nhflm Bdng hdi dung dfl hdi bfnh nhan Cde bien sfl dua vdo bdng hoi gflm boat dflng CTXH hfl frg ngudi bfnh dfln khdm vd Idm thii tyc nhdp vifn, 15 ho?t dflng hfl tig ngudi bfnh diflu trj t^i benh vifn vd boat dgng hfl tig benh nhan xudt vifn, hfli gia Cdc ho^t dgng ndy l^i dugc chia thdnh nhom: Nhflm cdc bo^it dgng nhdn vifln CTXH trye tiep thye hifn; Nhom cdc hogt dgng nhdn vien CTXH kflt nfli, gidi tiiifu ngudi khde thyc hifn vd Nhdm cde hogt dgng nhdn vien CTXH huong din ngudi bfnh thyc hifn Bg cflng cy khdo sdt sau thiflt kfl, dugc thd nghifm tgi Bfnh vifn Bach Mai, sau dd ehinh sua moi ti&i hdnh diflu tra chinh tiidc Tnioc xudng bfnh v i ^ cac i ^ e o cdu vifln (NCV) dugc t ^ hudn kJ b$ coog cv- T^i cdc bfnh vifn, m§i moi NCV ttyc tiflp phonS ^ ^ til dfln bflnh nhan Ttudc kflt tiiuc bu& phdng vdn, cac NCV soat, kiflm tra cac thflng sfl de dam bao phiflu thu duge cd gid tii su dung; sau dd moi ban giao cho ngudi nh|p du Ufu vdo mdy dfl tinh toan, thflng ke Xir ly & ph£n tich sd U$u: Cac thdng tin dinh lugng thu dugc txt khao sat thyc tifln dupe xu ly bdng chuong trinh SPSS phifln bdn 20.0 danh eho cdc nghifln cuu khoa hgc xa hgi ^ ddm bdo dirge tmh khach quan, khoa hgc D^o dure nghien cuu: Truo^ ti^n hdnh khao sdt tgi cdc bfnh vifn, theo yeu cau eiia phdng NCKH Bflnh vifn Nhi TW, nhdm nghien cuu da tap Ho so ddnh gia dgo due nghifln euu vd duge Hgi dong ddnh gid dgo ddc nghien cuu cua Bfnh vifn Nhi TW tbflng qua KET QUA NGHIEN CUtJ Ddc dilm khdeh t h i tham gia nghifln cihi djnh lugrng Vfl dg tafli, frong ldng sfl 151 khdeh tiifl tham gia trd Idi bdng hdi, phdn ddng dg tudi lao dgng (tii 18 dfln 59 tufli), chiflm 75,2% Xet theo gioi tinh, sfl ngudi dugc phdng van Id nu nhiflu hon nam gidi (70,2% so vdi 29,8%) (Bdng I) Tgp chi Khoa hpc Nghien cdu Sue khde va Phdt triin (Tgp 04, Sd 01-2020 Joumal ofHealth and Development Studies (Vol.04 No.01-2020) Bang M$t sd dac dilm nhan khau - xa hpi cda msm nghien cuu dinh luong Chi tiet Dgc diem Do tufli Dfli tugng Dia ban smh sflng Bfnh dang diflu tri So luong Ty If (%) Bgch Mai 50 33,1 NhiTW 49 32,5 34,4 K Tan Triflu 52 Ngudi eao taoi 18 12,4 Dfl tafli lao dgng (18-59 tufli) 109 75,2 Tre em vd vi didnh nien (dudi 18 tufli) 18 12,4 Bfnh nhan 64 43,2 Nguoi nhd bfnh nhdn 84 56,8 Nam 45 29,8 Nu 106 70,2 Thanh phfl Ha Nfli 13 8,7 Thdnh thi eua tinh/thanh khde 26 17,3 Nong thfln cua cdc tinh/thdnh khde 80 53,3 Mifln nui, vung sau, vung xa tinb/tbdnb khac 31 20,7 Bfnh khoi u 27 18,0 Bfnh ung thu 37 24,7 Bfnh tim 6,0 Benh gan 2,0 Bfnh than 10 6,7 Bfnh phoi 2,0 Bfnh vfl nao 17 11,3 Bfnh vfl mdu 5,3 Bfnh khde 36 24,0 Dang ehu y la phdn ldn nhirng ngudi bflnh tham gia khdo sdt dflu sinh song tgi eac vdng nflng thon, mifln nui thuge cdc tinh ngodi Ha Ngi (74%) Ddc biet, eo dfln 20,7% frong sfl hg thuge cdc vung mien nui, viing sau, vung xa; dieu ndy cd thfl lam hg gap nhiflu kho khan ban ttong qud trinh diflu tri ddi ngdy tgi Bfnh vien tayfln TW Nhiflu nguoi bflnh cd tinh frgng bflnh kha nghiflm frgng nhu: ung thu (24,7%); khfli u (18%); cdc bflnh vfl nao (11,3%), cdc bflnh ve tim, gan, tiian vd mflt sfl bflnh khac chiflm 24% Nhiing ngudi benh ndy thudng phdi diflu tri lau ddi, ddi hdi sy kifln tri vd ldng quyflt tdm tiong qud trinh diflu tri Journal of Health and Development hOiaies troi.\n, i.- ~ - Cdc hoat dong ho trg^ ngirdi benh d i n kham vd ldm thu tuc nhap vifn Kflt qud khdo sdt bang bdng bdi cho thdy, sfl ngudi benh dugc nhdn vifln CTXH ho tig den khdm vd lam thu tuc nhdp vien chiem ty If td 35,7 - 49,7%; tiong dfl boat dflng Ddn tiep vd ddnh gid nhu cdu khdm, chiea binh dugc cae khdeh tiifl Iya chgn nhiflu nhdt (49,7%) Tiflp theo Id cac hogt dgng: Huang dan quy trinh thd tuc vd vi tri cdc khoa/phong cdn den di khdm b?nh (44,4%); Ho trg cdc quyet dinh lien quan den dieu tri, bdo hiim, quyen lgi w (43%); Hudng ddn lam thu tuc nhgp vi?n (42,4%) Hogt dgng duge khdeh tiifl Iya chgn it nhdt Id Phd bien vatuvanlyra chgn phdc diiu tri, bac si diiu tn (35,7%) (Bang 2) Bang Ho^t dong hd trgr ngufli bfnh den khdm vd Ikm thu tyc nhap vifn (dofn vi tuih: %) Nhan vifln CTXH Cdc hogt dOng CTXH Ket nfli, Tryc tiep ngudi bfnh thyc hifn vdi cdc d{ch vy Hudng din ngudi bfnh thyc hifn Tong so Dfln tiep vd ddnh gid nhu cau khdm, chiia bfnh 19,9 3,3 26,5 49,7 H S trg cap cdu, gidi quyflt khan cap tgi khoa/phflng edp cdu 17,9 6,6 15,2 39,7 Hudng dan quy trinh, thu tuc va vi tri cdc khoa/phflng cdn dfln dfl khdm bfnh 15,9 4,0 24,5 44,4 Hfl ttg ngudi nha dua bflnh nhan vao khoa kham bfnh 13,2 7,9 18,5 39,6 Hudng ddn ldm thii tac nhap vifn (chu y nhiing bfnh nhan c6 giay td uu tien) 12,6 5,3 24,5 42,4 Lugng gid tam ly xa hgi tong the eiia bfnh nhdn/ngudi nhd bfnh nhdn 15,9 6,6 16,6 39,1 Phfl bifln yd ta vdn lya chgn phdc dfl dieu tri, bde si diflu tri 13,2 7,3 15,2 35,7 Phfl bien cdc chinh sdch ciia bfnh vifn dfli vdi ngudi bfnh 17,2 5,3 17,9 40,4 Ho ttg cdc quyflt djnh lien quan den dieu tri, bao hiflm, quyfln lgi w 17,2 7,3 18,5 43,0 Ty ie trung binh 15,9 6,0 Trong cac boat dpng ho try ngudi benh den binh c4c ho?t dgng la 19,7%), tiep theo 14 cic kham v4 14m thu tyc nhap vi?n, cac boat dpng huomg ddn nguoi b?nh thuc hi?n cua nhan vien CTXH dupc lua chpn nhiSu nhit (ty Ip trung boat dpng nhan vien CTXH iruc tiep ihuc hi?n (ty Ip tnmg binh cic bogt dpng li 15,9%) Cic boat dpng kel noi, giai thi(u bpnh nhin vdi |.7_._ Tgp chi Khoa hpc Nghien cuu Sue khde vd Phdt triin (Tip 04, So 01-2020) Joumal ofHealth and Development Studies (Vol.04, No 01-2020) Cdc hoat d$ng hd t r g nguoi bfnh qua trinh dilu tri tai bfnh vien nhat (6,0%) Cy thfl, boat dflng nhan vifln ^ ^ C H true tiep thuc hiin dugc nhiflu khdeh ^ ^ y a chgn nhat Id: Bdn tiep vd ddnh gid nhu ^ H ^ a m , chua binh (19,9%); sau dd Id hogt ^ ^ H H O trg cap ciru, gidi quyit khdn cap tgi khoa/phong cap cuu (17,9%) Cdc hogt dflng hudng ddn ngu&i b$nh thuc hien cda nhdn vifln CTXH thfl hifln ro nhat eung ttong hogt dgng: Don tiip vd ddnh gid nhu cdu khdm, chiia benh (26,5%) sau Id hogt dgng Hudng dan ldm thu tuc nhgp vign (24,5%) Cdc hogt dgng ket noi, gi&i thiiu ngudi benh vdi cae dich vu cua nhdn vifln CTXH the hifn ro nhdt d hogt dgng Hd trg ngu&i nhd dua binh nhdn vdo khoa kham binh (7,9%) sau Id Phd biin vd tu vdn lua chgn phdc diiu tri, bde si dieu tri va Ho trg benh nhdn cdc quyit dinh Iiin quan din dieu tri, bdo hiim, quyin lgi w Trong giai doan dieu tri tgi bflnh vifn, ty If ngudi bfnh dugc hfl ttg cua CTXH thdp ban so vdi dfln kham va Idm thu tyc nh|ip vifln Hoat dgng CTXH duge nhiflu bfnh nhdn lya chon nhdt Id hogt dflng Hd trg benh nhdn thuc hiin dung lich trinh diiu tri vd yiu cdu cua bac Sl dieu tri cung chi chiflm 37,8% vd boat dflng Hd trg tdi chinh, thudc men, thiit bi y ti (chiem 37,1%) Cfing cdc hogt dgng bfl ttg ngudi benh dieu tri, boat dgng Hda gidi cd mdu thudn, xung dot giita binh nhdn/ngudi nhd bgnh nhdn vdi NVYT dugc it khach thfl lya chgn nhdt, sau Id cac hogt dgng: Thdng tin vi cdc vdn di tdm ly - xa hgi cda binh nhdn cho cdc nhdn viin khde biit vd Hu&ng ddn vdn hda img xu giUa b^nh nhdn vd ngu&i nhd vdo binh viin Cd hai hogt dgng ndy chi dugc frfln duoi 25% khdeh the Iya chgn (Bdng 3): (deu chiem 7,3%) Bang Hogt d$ng hd trff bfnh nhdn/nguoi nhd bfnh nhdn qud trinh dilu tr| tgi bfnh vifln (don vi tfnh: %) Nhan vien CTXH Cdc hoat d9ng CTXH Kflt nfli, Tryc tiep nguoi bfnh thyc hifn vdi cac dich vu Huong dan nguoi bfnh thyc hifln Tdng Chudn dodn cdc vdn dfl sue khde tam th4n cd lifln quan tdi thfl chdt hogc SKTT chuyen bift 10,6 5,3 11,3 27,2 Trj lifu tryc tiep (tham vdn, xu Iy cang thang, can thiep khiing hodng w ) 17,2 4,6 7,3 29,1 Ho tig bfnh nhdn dn djnh noi diflu tii va boa nhgp vfli mfli trudng bfnh vifn 14,6 4,0 17,9 36,5 6,6 14,6 37,8 13,2 6,6 16,6 36,4 15,2 7,3 11,3 33,8 Hfl tig ngufli bfnh thyc hifn diing lich trinh dieu trj vd cdc yflu cau cda y, bde sT Hd tig ngudi bfnh lam quen voi phdn dng tam sinh ly sau chdn dodn vd dieu trj Hfl ti^ NVYT cham sfle bfnh nhdn ndng (an, uflng thudc, ve sinh ed nhan w ) Bdi Thf Mai BSng 'liKhoa hpciVgfii'en cuu^ãcieôaioevarmj
Ngày đăng: 02/11/2022, 15:22
Xem thêm:
