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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 鍾國彪 | |
dc.contributor.author | Shao-Yu Hsu | en |
dc.contributor.author | 徐紹瑜 | zh_TW |
dc.date.accessioned | 2021-06-15T14:05:04Z | - |
dc.date.available | 2021-11-19 | |
dc.date.copyright | 2015-09-14 | |
dc.date.issued | 2015 | |
dc.date.submitted | 2015-08-20 | |
dc.identifier.citation | . '衛生福利部中央健康保險署.' Retrieved 安寧療護, from http://www.nhi.gov.tw/webdata/webdata.aspx?menu=20&menu_id=712&webdata_id=3650.
Alliance, W. P. C. and W. H. Organization (2014). 'Global atlas of palliative care at the end of life.' Worldwide Palliative Care Alliance, London, United Kingdom) http://www. who. int/nmh/Global_Atlas_of_Palliative_Care. pdf. Balint, E. (1969). 'The possibilities of patient-centered medicine.' British Journal of General Practice 17(82): 269-276. Barry, M. J. and S. Edgman-Levitan (2012). 'Shared decision making—the pinnacle of patient-centered care.' New England Journal of Medicine 366(9): 780-781. Bernat, J. L. (2001). 'Plan ahead: how neurologists can enhance patient-centered medicine.' Neurology 56(2): 144-145. Berwick, D. M. (2009). 'What ‘patient-centered’should mean: confessions of an extremist.' Health affairs 28(4): w555-w565. Bolster, D. and E. Manias (2010). 'Person-centred interactions between nurses and patients during medication activities in an acute hospital setting: qualitative observation and interview study.' International journal of nursing studies 47(2): 154-165. Bowers, B. and B. Lutz (2000). 'Patient-centered care: Understanding its interpretation and implementation in health care.' Philadelphia: WB Saunders Co. Byrne, P. S. and B. E. Long (1976). 'Doctors talking to patients. A study of the verbal behaviour of general practitioners consulting in their surgeries.' Cheng, S.-Y., et al. (2008). 'Good death study of elderly patients with terminal cancer in Taiwan.' Palliative medicine 22(5): 626-632. Chiu, T.-Y., et al. (2000). 'Ethical dilemmas in palliative care: a study in Taiwan.' Journal of Medical Ethics 26(5): 353-357. Committee on Quality of Health Care in America, I. o. M. (2001). Crossing the quality chasm: a new health system for the 21st century, National Academy Press Washington, DC. Davies, P. G. (2007). 'Patient centredness.' Journal of epidemiology and community health 61(1): 39-39. Epstein, R. M., et al. (2010). 'Why the nation needs a policy push on patient-centered health care.' Health affairs 29(8): 1489-1495. Evans, J. M., et al. (2013). The evolution of integrated healthcare strategies. Academy of Management Proceedings, Academy of Management. Gauvin, F.-P., & Abelson, J. (with MacKinnon, M. P., & Watling, J.) (2006). 'Toronto, Ontario, Canada:Health Council of Canada.' from http://healthcouncilcanada.ca/tree/2.31-PublicInvolvementPrimer_EN.pdf. Gomes, B., et al. (2013). 'Effectiveness and cost‐effectiveness of home palliative care services for adults with advanced illness and their caregivers.' The Cochrane Library. Herbert, J. R. and I. Rubin (1995). Qualitative interviewing: The art of hearing data, Thousand Oaks, CA: Sage Publications, Inc. Hibbard, J. H. and J. Greene (2013). 'What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs.' Health affairs 32(2): 207-214. Hibbard, J. H., et al. (2009). 'Improving the outcomes of disease management by tailoring care to the patient's level of activation.' The American journal of managed care 15(6): 353-360. Hobbs, J. L. (2009). 'A dimensional analysis of patient-centered care.' Nursing research 58(1): 52-62. Hudon, C., et al. (2011). 'Measuring patients’ perceptions of patient-centered care: a systematic review of tools for family medicine.' The Annals of Family Medicine 9(2): 155-164. Kennedy, A., et al. (2007). 'The effectiveness and cost effectiveness of a national lay-led self care support programme for patients with long-term conditions: a pragmatic randomised controlled trial.' Journal of epidemiology and community health 61(3): 254-261. Kocher, R., et al. (2010). 'The Affordable Care Act and the future of clinical medicine: the opportunities and challenges.' Annals of internal medicine 153(8): 536-539. Laine, C. and F. Davidoff (1996). 'Patient-centered medicine: a professional evolution.' Jama 275(2): 152-156. McWhinney, I. (1989). The need for a transformed clinical method. Communicating with medical patients. Stewart M, Roter D, editors, London: Sage. Pelzang, R. (2010). 'Time to learn: understanding patient-centred care.' British journal of nursing 19(14): 912. Rittenhouse, D. R. and S. M. Shortell (2009). 'The patient-centered medical home: will it stand the test of health reform?' Jama 301(19): 2038-2040. Ruland, C. M., et al. (2010). 'Effects of a computer-supported interactive tailored patient assessment tool on patient care, symptom distress, and patients' need for symptom management support: a randomized clinical trial.' Journal of the American Medical Informatics Association 17(4): 403-410. Singer, S. J., et al. (2011). 'Defining and measuring integrated patient care: promoting the next frontier in health care delivery.' Medical Care Research and Review 68(1): 112-127. Smith, S., et al. (2014). 'Evidence on the cost and cost-effectiveness of palliative care: A literature review.' Palliative medicine 28(2): 130-150. Song, M.-K., et al. (2010). 'Effects of an intervention to improve communication about end-of-life care among African Americans with chronic kidney disease.' Applied Nursing Research 23(2): 65-72. Steiger, N. J. and A. Balog (2010). 'Realizing patient-centered care: putting patients in the center, not the middle.' Frontiers of health services management 26(4): 15-25. Stewart, M. (2003). Patient-centered medicine: transforming the clinical method, Radcliffe Publishing. Terrien, N., et al. (2012). 'Développement et validation d’une échelle d’auto-évaluation des pratiques de bientraitance des patients ou des résidents par les professionnels de santé.' Gériatrie et Psychologie Neuropsychiatrie du Vieillissement 10(4): 403-411. Wolf, D. M., et al. (2008). 'Effect of Patient‐Centered Care on Patient Satisfaction and Quality of Care.' Journal of nursing care quality 23(4): 316-321. 王博容 (2013). '「以病人為中心照護」之病人感受與信任之相關性研究-以北部某醫學中心之牙科部為例.' 國立臺灣大學健康政策與管理研究所碩士論文: 1-174. 古慧仙、楊朝欽、張彩秀 (2007). '門診病患對「以病人為中心」的照顧感受及其相關因素之探討分析.' 醫院 40(3): 24-36. 吳芝儀 and 李奉儒 (1995). '質的評鑑與研究.' 台北市: 桂冠. 汪如月 (2008). '醫師與病人對 [以病人為中心照護] 之信念, 感受與執行相關研究—以乳癌為例.' 臺灣大學醫療機構管理研究所學位論文: 1-212. 林佳慧, et al. (2012). '以病人為中心照護對臨床的成效.' 護理雜誌 59(6): 104-110. 林博文 (2011). '以病人為中心之認知與達成間的關係探討—--以某精神專科醫院社區復健中心為例.' 臺灣大學健康政策與管理研究所學位論文: 1-144. 翁瑞萱, et al. (2015). '臺灣社區安寧居家療護之現在與未來.' 護理雜誌 62(2): 18-24. 翁瑞萱, et al. (2013). '台灣的末期病人有機會壽終正寢嗎?-在宅往生課題之探討.' 安寧療護雜誌 18(3): 320-329. 張維怡 (2003). '實習醫師對落實 [以病人為中心] 理念之經驗分析研究---以某醫學中心為例.' 高雄醫學大學行為科學研究所學位論文: 1-97. 陳立奇, et al. (2015). '結合安寧療護理念之居家藥事照護.' 北市醫學雜誌 12(1): 21-26. 陳榮基 (2002). '醫療糾紛的預防.' 台灣醫學人文學刊 3(1&2): 103-109. 陳榮基 (2015). '我國安寧緩和照護之相關政策的過去發展與未來展望.' 護理雜誌 62(2): 13-17. 陳慶餘 (2005). '[以病人為中心的末期照護] 之醫學教育─[以病人為中心的末期照顧] 之醫學教育—醫學院學生的核心課程 (2/2).' 曾韻如, et al. (2005). '老年癌末病人善終之評估.' 安寧療護雜誌 10(1): 13-23. 湯美霞 (2000). '全人關懷與醫病關係.' 醫療關懷: 第一章: 啟英出版社. 黃肇明, et al. (2015). '臺北市立聯合醫院安寧療護現況及未來需求分析.' 北市醫學雜誌 12(1): 9-20. 劉燕玲, et al. (2011). '運用安寧療護理念於胰臟癌末期病人之居家照護經驗.' 安寧療護雜誌 16(2): 240-251. 蔡兆勳 (2014). '以病人為中心的安寧療護品質.' 安寧照顧會訊(87): 22. 賴文恩, et al. (2005). '以微軟 EXCEL (上標®) 套裝軟體處理質性研究田野資料.' 臺灣醫學 9(5): 696-702. 謝武吉 (2007). '從醫院管理的角度落實以病人爲中心的醫療照護.' 醫療品質雜誌 1(4): 13-15. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/52045 | - |
dc.description.abstract | 研究背景與目的
不論國內外均有學者在倡導「以病人為中心」照護的概念,美國醫學研究機構(IOM)也將以病人為中心納入21世紀健康照護目標當中。而在病人照護的過程中,末期照顧(end‐of‐life care)強調以病人為中心,追求合乎醫學倫理和醫療適切性的照顧。臺北市立聯合醫院自2015年1月起,各院區開始建立都會型社區安寧照護模式,組成跨專業之醫療照護團隊。醫療團隊成員親身經歷末期病人照護的歷程,並結合各種資源,將安寧療護的概念延伸至社區當中。過程中不僅得到來自病家純樸、溫暖的回響,也得到自我的成長與社區中病人家屬的肯定。本研究期望透過文獻資料蒐集與和社區安寧照護團隊成員進行訪談,藉以瞭解社區安寧照護團隊成員對於「以病人為中心」照護概念的經驗、態度以及落實的實際情形。 研究方法 本研究以質性訪談的方式,採用半結構式深度訪談法,編寫訪談大綱,對某區域醫院社區安寧照護團隊成員進行訪談,並針對相關文獻資料進行蒐集,來完成本研究的資料分析。 研究結果與結論 本研究之訪談收案時間自2015年6月16日至2015年7月16日截止,實際完成訪談的對象共計15名,醫師4名、護理人員7名以及社工師4名。結果發現要落實以病人為中心的概念,必須先瞭解病人本身真正的需求;利害關係人認為沒有辦法去落實以病人為中心的原因為受到醫院政策的限制。在社區安寧中沒有辦法達成以病人為中心理念的障礙是專業人員的不足,利害關係人認為可以透過來向民眾作教育及宣導(含死亡教育),加強對於「以病人為中心」的概念。 | zh_TW |
dc.description.abstract | Background and Purpose
Whether domestically or internationally, scholars have advocated the concept of 'patient-centered care'. Institute of Medicine (IOM) also included patient-centered care in the 21st century health care goals. In the process of patient care, the end-of-life care emphasizes on a patient-centered care that aims to fulfill medical ethics and appropriateness. Since 2015, Taipei City hospital has provided hospice care in urban communities, where each branch began to develop a community-based palliative care model and forming a team of interdisciplinary health care professionals. Personal experiences on the care process of the terminally ill patients and a variety of other resources allows the medical team members to extend the concept of palliative care into the communities. Such process has not only received positive feedback from the patients' family, but it also gave medical team members an opportunity for self-growth and earning recognition from the patients' family. This study aimed to use data collection through literatures and interviews with community-based palliative care team members to understand their experience, attitude and implementation scenarios of the 'patient-centered care' concept. Study Methods In this study, qualitative interviews were conducted using semi-structured in-depth interviews to construct an interview outline, which was used to interview members of an unnamed area hospital's community-based palliative care team. Relevant literature reviews and documents were collected to complete the data analysis in this study. Results and Conclusions This study began from June 16, 2015 to July 16, 2015, where a total of fifteen participants had completed the full interview. These participants included four doctors, seven nurses and four social workers. The result showed that to implement the concept of patient-centered care, understanding the real needs of the patients themselves was crucial; Stakeholders thought that difficulties in the implementation of patient-centered care concept was due to the restrictions from hospital's policy. The lack of professionals was the barrier that made stakeholders unable to achieve patient-centered care in community-based palliative care. Stakeholders also believed that the concept of patient-centered care could be strengthened by education and advocacy (including death education) to the public. | en |
dc.description.provenance | Made available in DSpace on 2021-06-15T14:05:04Z (GMT). No. of bitstreams: 1 ntu-104-R01847050-1.pdf: 3750861 bytes, checksum: 3baccdccf723088ab5659b5ad61043ca (MD5) Previous issue date: 2015 | en |
dc.description.tableofcontents | 第一章 導論 11
第一節 實習單位特色與簡介 11 第二節 研究背景與動機 13 第三節 研究目的 15 第二章 文獻探討 16 第一節 以病人為中心的概念 16 第二節 關於以病人為中心照護之相關研究 18 第三節 關於以病人為中心測量工具之相關研究 23 第四節 臺灣社區居家安寧療護現況 24 第三章 研究方法 27 第一節 研究設計 27 第二節 研究對象 28 第三節 研究工具 28 第四節 研究流程 30 第五節 資料處理及分析方法 30 第四章 研究結果 32 第一節 訪談樣本特性 32 第二節 訪談結果 34 第五章 討論 66 第六章 結論與建議 74 第一節 結論 74 第二節 研究限制 74 第三節 研究成果與實務建議 75 參考文獻 77 附錄一 臺北市立聯合醫院人體試驗委員會計畫執行許可書 附錄二 臺北市立聯合醫院研究計畫受訪者同意書 | |
dc.language.iso | zh-TW | |
dc.title | 以利害關係人的觀點探討以病人為中心之照護-以社區安寧照護為例 | zh_TW |
dc.title | A Research of the Patient-Centered Care Based on Stakeholder's Perspective-Using Community-based Palliative Care as example | en |
dc.type | Thesis | |
dc.date.schoolyear | 103-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 璩大成,程劭儀 | |
dc.subject.keyword | 以病人為中心,利害關係人,社區安寧, | zh_TW |
dc.subject.keyword | Patient-Centered Care,Community-based Palliative Care,Stakeholder's Perspective, | en |
dc.relation.page | 81 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2015-08-20 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 公共衛生碩士學位學程 | zh_TW |
顯示於系所單位: | 公共衛生碩士學位學程 |
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