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研究生:余家杰
研究生(外文):Chia-Chieh Yu
論文名稱:遠距居家照護系統之創新架構與實務應用
論文名稱(外文):Practical Application and Innovation of a Home Telehealth System
指導教授:徐業良徐業良引用關係
學位類別:博士
校院名稱:元智大學
系所名稱:機械工程學系
學門:工程學門
學類:機械工程學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:中文
論文頁數:133
中文關鍵詞:遠距居家照護分散式遠距居家照護糖尿病遠距居家照護成效評估
外文關鍵詞:Home telehealth systemhealth caredecentralized home telehealth systemdiabetes careevaluation
相關次數:
  • 被引用被引用:10
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  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:5
利用遠距居家照護技術將醫療照護延伸至居家環境,藉由持續追蹤使用者(高齡者、病患等)長期的健康記錄,讓使用者能夠有尊嚴地留在家中居住、生活,維持的時間越久越好,同時也能接受到完整、高品質的健康照護,已經是高齡化社會中健康管理與照護上重要的潮流。
本研究首先整理國內外已經進行商業化營運的遠距居家照護服務,歸納出遠距居家照護系統的典型架構,並探討典型的遠距居家照護系統面臨的問題,同時以「分散式遠距居家照護系統(Decentralized Home Telehealth System)」的創新架構,試圖解決目前遠距居家照護系統面對的問題。
本研究也提出遠距居家照護系統有組織的建置程序,提供遠距居家照護廠商建置系統服務的依據,並依照此程序與敏盛醫院共同建置40人規模、分散式遠距居家照護系統架構下的糖尿病遠距居家照護系統,完整執行從建置到系統服務整體的服務練,詳實紀錄、整理每一項建置與服務的資料,進行系統使用成效評估分析,堪稱目前國內首次針對遠距居家照護系統,執行整體服務鍊的評估報告,並提出系統服務的各項建議。於研究的過程中,同時修正現行分散式遠距居家照護系統架構,僅能使用固定IP與專屬硬體所遭遇的問題。
Home has become the centerpiece of health delivery system today. Intensive monitoring of health parameters in the home environment has been an important trend for health care and management. The advantage of using the telehealth systems for people (chronic, elderly, etc.) has been widely recognized. This thesis first presents a survey of 18 representatives commercialized home telehealth systems worldwide, and then a generalized model of telehealth systems is concluded. A discussion of overcoming the present difficulties and future challenges of home telehealth systems are also presented.
In this study, an innovative structure of Decentralized Home Telehealth System is proposed in an attempt to overcome the difficulties and challenges for current home telehealth system. An structured process of how to develop a home telehealth system is also presented, and a home telehealth system for diabetes patients based on the decentralized structure was constructed in cooperation with Ming-Sheng Hospital.
40 diabetic patients selected by Ming-Sheng Hospital participated in this pilot project for a complete assessment of its user acceptance, economic evaluation and clinical outcome. This evaluation results provide a reference for home telehealth service providers. The current structure of Decentralized Home Telehealth system was also modified.
書名頁 i
論文口試委員審定書 ii
授權書 iii
中文摘要 iv
英文摘要 v
誌謝 vi
目錄 vii
表目錄 xi
圖目錄 xii
第一章 研究背景與目的 1
1.1 高齡化社會現象與健保制度的改變 1
1.2 資通訊技術對醫療照護形式的轉變 4
1.3 研究目的 7
第二章 國內外遠距居家照護系統案例介紹 10
2.1 個人緊急救援服務 10
2.2 日常生活活動監測 13
2.3 生理訊號長期監測 16
2.4 典型的遠距居家照護系統架構 28
第三章 分散式遠距居家照護系統 32
3.1 分散式遠距居家照護系統架構 32
3.1.1 遠距居家照護系統的創新架構 32
3.1.2 分散式健康資料伺服器 34
3.2 分散式遠距居家照護系統應用 36
? 生理訊號監測 37
? 環境參數監測 38
? 活動力參數監測 39
? 睡眠品質評估 41
? 遠端臨場機器人 – Telepresence Interactions 42
第四章 分散式遠距居家照護系統-生理訊號監測應用 44
4.1 生理訊號監測應用之軟硬體建置 44
4.1.3 遠端應用照護服務設定 48
4.2 分散式遠距居家照護系統功能 52
4.2.1 一般遠距居家照護系統提供的服務功能 52
4.2.2 分散式遠距居家照護系統提供的服務功能 55
4.3 DDS內檔案儲存架構 63
第五章 遠距居家照護系統的建置考量與成效評估架構 67
5.1 遠距居家照護系統之建置考量 67
5.1.1 相關文獻回顧 67
5.1.2 遠距居家照護系統之建置考量 71
5.2糖尿病患遠距居家照護系統之建置規劃 73
5.3 遠距居家照護系統之成效評估架構 75
5.3.1 評估對象的人口統計分析 75
5.3.2 成效評估的架構 77
第六章 分散式遠距居家照護系統使用評估結果與分析 80
6.1 系統使用評估結果 80
6.1.1 系統的性能 80
6.1.2自我健康管理的態度和行為 83
6.1.3慢性病控制的效果 85
6.1.4 系統的建置與服務成本 88
6.2 系統服務執行意見反應 94
6.3 Call Center醫療與照護人員之觀點 96
6.4 評估結果討論 99
(1) 系統的性能 99
(2) 自我健康管理的態度和行為 99
(3) 慢性病控制的效果 100
(4) 系統的建置與服務成本 100
第七章 分散式遠距居家照護系統之修正架構 103
7.1 現行架構所遭遇的問題與系統架構之修正 103
7.2 分散式遠距居家照護系統修正架構之技術細節 106
第八章 結論與未來工作 111
8.1 結論 111
8.2 未來工作 115
附件A:敏盛醫院糖尿病遠距居家照護服務-系統裝設標準作業流程 116
附件A:遠距居家照護系統與服務使用滿意度問卷調查 122
附件1 123
附件2 124
附件3 125
附件4 126
附件5 127
附件6 128
附件7 129
附件8 130
附件9 131
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