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研究生:邱大源
研究生(外文):Ta-Yuan Chiu
論文名稱:「愛滋個案管理和加強型伴侶服務試辦計畫」成效評估
論文名稱(外文):Evaluation of HIV Case Management and Strengthened Partner Service Program
指導教授:鄭守夏鄭守夏引用關係
口試委員:陳昶勳莊苹
口試日期:2015-07-28
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:健康政策與管理研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:中文
論文頁數:74
中文關鍵詞:愛滋愛滋病個案管理伴侶服務接觸者追蹤民間團體
外文關鍵詞:HIVHIV case managementpartner servicecontact tracingCBO (Commnity-Based Organization)
相關次數:
  • 被引用被引用:1
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背景:
國內愛滋病毒感染人數逐年增加,公共衛生人員個案管理及伴侶服務的負擔日益沉重,然而我國伴侶服務完成率亦亟待提升,有鑑於此,疾病管制署於2013年至2014年委託臺灣愛滋病護理學會於新北市試辦「愛滋個案管理和加強型伴侶服務試辦計畫」,以建構有效之公衛端愛滋病個案管理模式,提升個案管理品質並減輕公衛人員負擔。目前國內多數研究僅針對愛滋病指定醫院辦理之愛滋病個案管理師計畫進行評估,而試辦計畫對於提高就醫率及伴侶服務完成率之成效,亟待進一步探討。
目的:
探討「愛滋個案管理和加強型伴侶服務試辦計畫」的介入,對於HIV感染者之完成伴侶服務及就醫情形之影響
方法:
本研究採取僅有後測之對照組設計(The comparison group posttest-only)設計方式,以「慢性傳染病追蹤管理-愛滋及漢生病子系統」資料庫為研究工具,並以2011年至2014年間全國確診人類免疫缺乏病毒感染個案為研究對象,依個案之確診年份及管理縣市,區分為介入組、新北市對照組及其他縣市對照組,採邏輯斯迴歸及考克斯比例風險模式分析方式,藉以檢視試辦計畫提升個案診斷後完成伴侶服務及就醫之成效。
結果:
研究結果發現,介入組之診斷後4個月內伴侶服務完成率為18.4%,顯著高於新北市對照組的9.5% (p<.0001)及其他縣市對照組的10.3% (p<.0001),在使用多變項分析調整其他影響因素的作用後,介入組相較於新北市對照組,有較高的機會於診斷後完成伴侶服務(OR=2.3, p<.0001; HR=1.625, p<.0001)。
結論:
試辦計畫之介入,使診斷後完成伴侶服務之比例有顯著且正向之提升,顯示委託民間專業護理團體介入之愛滋個案管理模式,能整合醫院、公衛、社會等資源,使介入措施及服務能有效率的輸送,進而顯著提升伴侶服務之完成情形。


Background:
The number of domestic HIV infection increases every year, therefore, the burden of case management and partner services of public health workers increases accordingly. Since the completion rate of partner service needs to be enhanced, Taiwan Centers for Diseases Control commissioned Taiwan AIDS Nurses Association a pilot program “HIV Case Management and Strengthened Partner Service Program” to implemente in New Taipei City during 2013 and 2014. The goal of this pilot program is to construct effective HIV case management model in public health and to enhance the quality of case management. At present, most domestic research only focus on HIV Case Management Program in the designated HIV hospitals, the medical rates and completion rates of partner services of the polit program needs to be further evaluated.
Objectives:
Evaluate the intervention of “HIV Case Management and Strengthened Partner Service Program” on the completion rates of the partner services and rates of seeking medical care in HIV-infected persons.
Methods:
This evaluation research applies a comparison group posttest-only design. This research uses database of “Chronic infectious diseases case management system" as a research tool. Only HIV-infected persons diagnosed during the period from 2011 to 2014 were included in this research. According to year of diagnosis and county of management, we selected two control group: New Taipei Comparision Group and Other Cities and Counties Comparsion Group to compare with Intervention Group. Logistic regression and Cox proportional hazards model analytical methods were conducted to assess the program impact.
Results:
Completion rate of partner service within 4 months is 18.4% in Intervention Group,which is higher than New Taipei Comparision Group (9.5%, p<.0001) and Other City and County Comparsion Group (10.3%, p<.0001). Mutivariate analysis through Logistic regression and Cox proportional hazards model indicated that Intervention Group has higher chance to complete partner service than New Taipei City Comparison Group (OR=2.294, p<.0001; HR=1.625, p<.0001).
Conclusion:
The Intervetion Group has shown significant positive effects on completion rate of partner services after HIV diagnosis. The CBO (Community-Based Organisations) partner service model provided by HIV professional organization could integrate intervention with hospital, local health department and social resources to futher enhance the completion rate of partner services of HIV infected person.


中文摘要 I
Abstract III
目錄 V
表目錄 VII
圖目錄 VIII
第一章 緒論 1
第一節 研究背景 1
第二節 研究動機與重要性 6
第三節 研究目的 7
第二章 文獻探討 8
第一節 個案管理 8
第二節 伴侶服務 12
第三節 民間團體執行個案管理及伴侶服務計畫 15
第四節 文獻探討小結 17
第三章 研究方法 19
第一節 研究架構 19
第二節 研究假說 19
第三節 研究對象 19
第四節 資料來源 20
第五節 資料處理與分析 20
第四章 研究結果 22
第一節 研究對象特質描述性分析 22
第二節 介入組與新北市對照組之介入措施成效評估 27
第三節 介入組與其他縣市對照組之介入措施成效評估 30
第四節 介入組與對照組之介入措施成效評估 33
第五章 討論 36
第一節 研究結果討論 36
第二節 研究限制 37
第六章 結論與建議 39
第一節 結論 39
第二節 建議 40
參考文獻 41



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