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研究生(外文):Chang, Chingwei
論文名稱(外文):Investigation of the long-term institutional care requirements of patients with dementia and their families by qualitative and quantitative analysis
指導教授(外文):Chi, YenpingFnag, Kwoting
外文關鍵詞:Senile dementia careEthnographic decision tree modelOntology-based fuzzy clustering
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Over the past decade, the number of long-term care (LTC) residents has increased, and many have accepted treatments such as medication, rehabilitation and occupational therapy. This study employs both qualitative and quantitative techniques in order to discuss senile dementia patient care in long-term care institutions, and we use a supply and demand viewpoint to explore what services are really necessary for the patient and their family.
In qualitative method, the main purpose of this stage is to use the ethnographic decision tree model to understand and explore the decision criteria of the subject. Our study found that the degree of dementia of the patient always affects the decisions made by family members – in fact, this is the most important of all criteria elicited from the interviews with family members. There are also ethical constraints, care burden, norm of filial obligation, patient need professional medical care and institutional environment, etc. which mentioned by families. We linked together the decision criteria considered most important in accounting for the decision-making sequence of family members to be the ethnographic decision tree model which predictive power is 92%.
In quantitative stage, our study discussed the effectiveness of occupational therapy when given to dementia patients of different contexts. The results of this stage showed that patients of a good condition in the first stage present a more positive attitude towards participation in the occupational therapy designed by the institution; therefore, they have a greater chance of their condition improving or remaining the same. However, patients of an average condition have a more passive attitude towards taking part in any therapy; therefore, they have a greater chance of their condition deteriorating, because of their violent tendencies and their resistance to care, the task of caring for these patients is more difficult than caring for patients in the other groups. Above all, we suggest that families adopt the therapies no matter in homecare or institutionalization, as early as possible in order to improve the likelihood of being able to control the patient’s condition. It is understandable that accepting more therapies and interaction in the early stage of dementia, having higher chance to go well, however, by waiting until then they also miss the best opportunity to attempt to improve the patient’s condition, it is really not the good way we suggest to be.
Abstract I
Chinese Abstract II
Chinese Acknowledgements III
Tables of Contents IV

CHAPTER 1 Introduction 01
1.1. Background 01
1.2. Senile Dementia Diseases 01
1.3. The Impact of Senile Dementia 04
1.3.1 Worldwide 04
1.3.2 Society 05
1.3.3 Medical Resources 05
1.3.4 Family Members 06
1.4. Long-term Care Institutionalization 06
1.5. The Current Situation 07
1.6. Goals of the Study 07
1.7. Research structure or framework 09

CHAPTER 2 Related Work 10
2.1. Theory of Qualitative Method 10
2.1.1 Ethnography 11
2.1.2 Objective of Ethnography 11
2.2. Theory of Quantitative Method 12
2.2.1 Formal Concept Analysis 12
2.2.2 Concepts Similarity 13
2.2.3 The Fuzzy Set 19
2.2.4 Clustering 20
2.2.5 Mathematical Principle of Fuzzy 21

CHAPTER 3 Methodology 23
3.1. Qualitative Methodology 23
3.1.1 Interviews for Data Collection 23
3.1.2 Subject 23
3.1.3 Model Building 23
3.1.4 Model Verification 25
3.1.5 Objective of the Qualitative Approach 26
3.2. Quantitative Methodology 27
3.2.1 Data Field 27
3.2.2 Formal Concept Analysis 27
3.2.3 FCA Tool 30
3.2.4 Process of Fuzzy Clustering 31
3.2.5 Scenario analysis Method 36
3.2.6 Process of Scenario Analysis 36

CHAPTER 4 Results 39
4.1. Qualitative Results 39
4.1.1. Data Collection 40
4.1.2. Elicitation of decision criteria 40
4.1.3. Profile of the elicited decision criteria 53
4.1.4. Formalization of the decision model 61
4.1.5. Verification of the Predictive Power of the Model 63
4.1.6. Aims of future study 65
4.1.7. Discussion 66
4.2. Quantitative Analysis 68
4.2.1 Quantitative Analysis Procedure 68
4.2.2 Sample and Data Field 68
4.2.3 Formal Concept Analysis 69
4.2.4 Concept Similarity Counting 70
4.2.5 Fuzzy Clustering 74
4.2.6 Scenario Analysis 80
4.2.7 Discussion 84

CHAPTER 5 Conclusion 86
5.1. Qualitative Stage 86
5.1.1. Suggestions for families 86
5.1.2. Suggestions for institutions 87
5.1.3. Suggestions for government 87
5.2. Quantitative Stage 88
5.2.1. Suggestions for families 88
5.2.2. Suggestions for institutions 88
5.3. Limitations 89
5.4. Acknowledgements 90
References 91
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