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研究生:陳世彬
研究生(外文):Shih-Bin
論文名稱:台灣長期人工呼吸器依賴慢性阻塞性肺病患者之主要照顧者對於安寧療護之看法
論文名稱(外文):The Viewpoints about Hospice Care of the Main Caregivers of prolonged Mechanical Ventilator Dependent Chronic Obstructive Pulmonary Disease Patients in Taiwan
指導教授:周希諴周希諴引用關係
指導教授(外文):Hsi-Hsien Chou
學位類別:碩士
校院名稱:中山醫學大學
系所名稱:醫學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
畢業學年度:95
語文別:中文
論文頁數:32
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背景與目的: 末期病患的臨終照護,近來已在世界上顯的日趨重要。政府從民國84年開始主導安寧療護的政策,但在台灣,對於長期人工呼吸器依賴慢性阻塞性肺病病人何時接受安寧療護的決定權,都是操之於照顧者的手裡。過去人們的信念總以為要盡量幫病人延命,然而更重要的是去了解長期人工呼吸器依賴慢性阻塞性肺病病人其主要照顧者對於安寧療護的看法,以改善病人的生活品質。
對象與方法: 利用訪談指引,我們採一對一的訪談,並使用內容分析法來探討接受安寧療護的看法。
結果:共訪談四位主要照顧者。就算病人沒有生活品質,他們都要維持其家人的生命跡象,直到血流動力學變差的情形下,才肯接受安寧療護。然而,若是他們也罹患慢性阻塞性肺病,當呼吸衰竭須插管時,他們都會拒絕插管。
結論: 主要照顧者要維持其家人的生命跡象,直到血流動力學變差的情形下,才肯接受安寧療護。但若是主要照顧者也罹患慢性阻塞性肺病,當呼吸衰竭需被插入氣管內管時,他們會拒絕這種延命治療,而選擇安寧療護。
Background and Purpose: Terminal care for patients with different diseases of end-stage becomes more and more important all over the world. Since 1995, the government had guided the policy of hospice care , but most of the decision making about when the prolonged mechanical ventilator chronic obstructive pulmonary disease (COPD) patients to receive hospice care has been decided by the main caregivers in Taiwan. To prolong life for the patient was a belief in the past. However, it is much more important to understand the viewpoints for these patients to receive hospice care to increase their quality of life.
Patients and method: Using interview guide, we will interview each caregiver. We use content analysis to explore the viewpoints of receiving hospice care of the main caregivers.
Results: Total 4 main caregivers had been interviewed. All of them want to maintain their families’ life rather than receiving hospice care even in poor quality of life until hemodynamics got downhill. However, all of them refuse endotracheal tube intubation when respiratory failure happened if they got COPD.
Conclusion: Main caregivers want to maintain their families’ life and would accept hospice care until hemodynamics got downhill. However, they refuse these life-prolonging treatment if they got COPD with respiratory failure. Instead, they choose hospice care.
中文摘要 …………………………………………………………………2
英文摘要 …………………………………………………………………3
第一章 緒論 ……………………………………………………………4
第二章 研究方法 ………………………………………………………7
第一節 研究對象 ……………………………………………………7
第二節 研究場所 ……………………………………………………7
第三節 研究設計 ……………………………………………………7
第四節 研究工具 ……………………………………………………8
第五節 研究程序 ……………………………………………………10
第六節 資料處理 ……………………………………………………10
第三章 研究結果與討論 ……………………………………………12
第一節 研究結果 …………………………………………………12
第二節 討論 …………………………………………………………15
第四章 結論與展望 ……………………………………………………22
參考資料 ………………………………………………………………24
附錄 ……………………………………………………………………27
參考資料
1.Lopez AD, Shibuya K, Rao C, Mathers CD, Hansell AL, Held LS, et al, Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J 2006;27(2):397-412

2.European Respiratory Society. European Lung White Book: Huddersfield, European Respiratory Society Journals, Ltd; 2003

3.Jansson SA, Andersson F, Borg S, Ericsson A, Jonsson E, Lundback B. Costs of COPD in Sweden according to disease severity. Chest 2002;122(6):1994-2002

4.Wouters EF, Creutzberg EC, Schols AM. Systemic effects in COPD. Chest 2002; 121(5 Suppl):127S-30S

5.Agusti AG, Noguera A, Sauleda J, Sala E, Pons J, Busquets X.Systemic effects of chronic obstructive pulmonary disease. Eur Respir J 2003;21(2):347-60

6.Connors AF, Jr.,Dawson NV, Thomas C, Harrell FE, Jr.,Desbiens N, Fulkerson WJ, et al. Outcomes following acute exacerbation of severe chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments).Am J Respir Crit Care Med 1996;154(4 Pt 1):959-67
7.Gunen H, Hacievliyagil SS, Kosar F, Mutlu LC, Gulbas G,Pehlivan E, et al.Factors affecting survival of hospitalized patients with COPD. Eur Respir J 2005;26(2):234-41

8.Fuso L,Incalzi RA, Pistelli R, Muzzolon R, Valente S, Pagliari G, et al,Predicting mortality of patients hospitalized for acutely exacerbated chronic obstructive pulmonary disease. Am J Med 1995;98(3):272-7

9.Seneff MG, Wagner DP, Wagner RP, Zimmerman JE, Knaus WA.Hospital and 1-year survival of patients admitted to intensive care units with acute exacerbation of chronic obstructive pulmonary disease.JAMA 1995;274(23):1852-7

10.Hansen-Flaschen J.Chronic obstructive pulmonary disease: the last year of life. Respiratory Care.49(1):90-7;discussion 97-8,2004 Jan

11.Glaser B, Strauss A(1968) Time for dying Aldine, Chicago

12.Fox E, Landrum-McNiff K, Zhong A, Dawson N, Wu AW, Lynn J for the SUPPORT Investigators(1999). Evaluation of prognostic criteria for determining hospice eligibility in patients with advanced lung, heart or liver disease. JAMA 282;1638-1645

13.Abrahm JL, Hansen-Flaschen(2002) Hospice care for patients with advanced lung disease. Chest 121:220-229

14.Connors AF, Dawson NC,Thomas C et al(1996).Outcomes following acute exacerbation of severe chronic obstructive lung disease Am J Respir Crit Care Med 154;959-967

15.Heffner JE(2000) Role of pulmonary rehabilitation in palliative care Resp Care, 45, 1365-1375

16.Sullivan KE, Hebert PC,Logan J,O’Connor A,McNeeley PD(1996) What do physicians tell patients with end-stage COPD about intubation and mechanical ventilation? Chest 109:258-264

17.Seymour J,Gott M,Bellamy G,Ahmedzai SH,Clark D(2003) Planning for the end of life:the views of older people about advance care statements Soc Sci Med,59,57-68

18.Heffner JE,Fahry B,Hilling L,Barbieri C(1996) Attitude regarding advance directives among patients in pulmonary rehabilitation Am J Respir Crit Care Med,154, 1735-1740
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