(18.206.238.77) 您好!臺灣時間:2021/05/18 05:59
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果

詳目顯示:::

: 
twitterline
研究生:邱奕綺
研究生(外文):Yi-Chi Chiu
論文名稱:探究中期照護為老年病患復原創造之偶然力效應
論文名稱(外文):Explore Serendipity-creating effect by intermediate-care for Geriatric patients
指導教授:李聲吼李聲吼引用關係
指導教授(外文):Shang-Hou Lee
學位類別:碩士
校院名稱:國立屏東科技大學
系所名稱:社會工作系所
學門:社會服務學門
學類:社會工作學類
論文種類:學術論文
論文出版年:2014
畢業學年度:102
語文別:中文
論文頁數:63
中文關鍵詞:中期照護偶然力周全性老年評估量表
外文關鍵詞:intermediate careserendipitycomprehensive geriatric
相關次數:
  • 被引用被引用:0
  • 點閱點閱:129
  • 評分評分:
  • 下載下載:3
  • 收藏至我的研究室書目清單書目收藏:1
目的:探究社區醫院推動中期照護模式,對於整體臨床照護上,所形成的偶然力(serendipity)效應。
  方法:本研究採用周全性老年評估量表(comprehensive geriatric assessment, CGA)為基測,用以評估偶然力指數,各項檢測指數包含:A.活用大腦、B.當機立斷、C.個人資產、D.人際關係等四個構面。
  結果:從2009年2月至2012年3月共收集283例,排除23例轉介急性醫療之個案,以及資料不完整65例後,共計195例選入為本次探究之對象,參與者平均年齡為80.4±11.5歲。A.活用大腦(GDS由1.62±2.1分進步到0.55±1.1分、MMSE22.30±4.0分進步為24.89±3.2分)、B.當機立斷(TUG從26.05±5.3分進步到20.35±6.1分、NRS則是從1.43±2.0分進步到0.50±0.9分)、C.個人資產(BI由50.59±17.5分進步到72.95±16.4分、MNA從10.33±1.8分進步到22.67±2.3分)D.人際關係(IADL從1.84±1.6分提升到3.33±2.1分)。從整體施測的各項功能評估中,證實在接受中期照護服務介入後,各項偶然力指數均有顯著提升。
  結論:中期照護模式經照護團隊,以短期性介入治療後,對患者的偶然力評值上,均有顯著之成效,證實中期照護為具有創造高附加價值之照護模式。

Objective: To evaluate serendipity index on the total clinical effectiveness of intermediate care (IC) in a community hospital.
Method: This study compared the effectiveness of CGA (comprehensive geriatric assessment) data to evaluated the serendipity index, including A. Utilize the brain cognition , B. Make a prompt decision, C. Personal assets, and D. Interpersonal relation.
Results: Data of 283 recruited patients were collected during the period from February 2009 to March 2012; 88 of them were excluded due to incomplete data or unplanned readmission to acute ward. Mean age of the 195 eligible patients was 80.4±11.5 years old. serendipity index including A. Utilize the brain cognition (GDS from 1.62±2.1 to 0.55±1.1,MMSE from 22.30±4.0 to 24.89±3.2), B. Make a prompt decision(TUG from 26.05±5.3 to 20.35±6.1,NRS from 1.43±2.0 to 0.50±0.9) , C. Personal assets(BI from 50.59±17.5 to 72.95±16.4, MNA from 10.33±1.8 to 22.67±2.3), and D. Interpersonal(IADL from 1.84±1.6 to 3.33±2.1).
Conclusion: The results indicated that the high value-added care Model was significantly improved the clinical outcomes.

中文摘要....................................................i
英文摘要..................................................iii
謝誌.......................................................v
目錄......................................................vi
表目錄..................................................viii
圖目錄.....................................................x
第一章 緒論................................................1
第一節 研究背景與動機...................................1
第二節 研究目的.........................................3
第三節 名詞釋義.........................................4
第二章 理論與文獻探討.......................................5
第一節 中期照護界定之相關探究................................5
第二節 診斷關聯群...........................................9
第三節 偶然力效應..........................................14
第三章 研究設計............................................17
第一節 研究資料來源........................................17
第二節 研究對象入住的流程與特性..............................18
第三節 研究架構與研究工具...................................21
第四節 資料分析............................................27
第四章 資料分析與結果......................................29
第一節 樣本數基本變項......................................29
第二節 相依樣本重複量數t檢定................................31
第三節 線性相關分析........................................36
第四節 研究結果成效分析.....................................40
第五章 研究結論與研究建議...................................44
第一節 研究結論............................................44
第二節 研究限制與後續研究之建議..............................46
參考文獻...................................................47
壹、中文部份...........................................47
貳、西文部份...........................................49
參、網站資料...........................................53
附錄一:周全性老年評估量表...................................54
表目錄
表2-3-1...................................................16
表4-1-1...................................................30
表4-2-1...................................................31
表4-2-2...................................................32
表4-2-3...................................................32
表4-2-4...................................................33
表4-2-5...................................................33
表4-2-6...................................................34
表4-2-7...................................................35
表4-3-1...................................................36
表4-3-2...................................................37
表4-3-3...................................................37
表4-3-4...................................................38
表4-3-5...................................................38
表4-3-6...................................................38
表4-4-1...................................................40
表4-4-2...................................................41
表4-4-3...................................................41
表4-4-4...................................................42
表4-4-5...................................................42
表4-4-6...................................................42
表4-4-7...................................................43
圖目錄
圖2-3-1...................................................15
圖3-2-1...................................................19
圖3-3-1...................................................21
圖3-3-2...................................................23

壹、中文部分
中央健康保險局(2008)。全民健康保險住院診斷關聯群相關檔案資料。台北:中央健康保險局。
阮子凌、藍忠孚(1999)。診斷關聯群在我國之引進與發展。全民健康保
險,19,10-13。
李偉強(2007)。健保DRG/PPS 制度對醫院的影響與因應。行政院衛生署
署立醫院共管會講議,52-53。
林富滿、黃瑞美(2005)。台灣版DRG 支付制度對醫界之影響與因應。健
康保險雜誌,2(1),58-72。
吳風鈴、陳晶瑩、 劉文俊、 陳慶餘(2011)。中期照護:架構老年健
康服務的關鍵。台灣老人醫學雜誌,6(3),176-189。
吳肖琪(2008)。急性醫療與慢性照護的橋樑—亞急性與急性後期照護。
護理雜誌,55(4),5-10。
陳亮恭、黃信彰(2007)。中期照護:架構老年健康服務的關鍵。台灣老人醫學雜誌,3(1),1-11。
陳建立、黃瑞典(2006)。組織理論與醫院DRGs 因應準備作業。健康保
險雜誌,2(2),4-7。
陳亮恭、黃信彰(2007)。中期照護:架構老年健康服務的關鍵。台灣
老人醫學雜誌,3(1),1-11。
國家衛生研究院(2008)。 2020健康國民白皮書技術報告-老年人。Healthy People,670-726。
單小懿(2009)。「好運!可以練習」。商業周刊,1131,90-93。
勝間和代(2010)。培養商業腦的7種組織力。台北:商周出版。
詹清旭等(2005)。行政院衛生署中區醫院聯盟對診斷關聯群(DRGs)第一版之因應經驗談;健康保險,1(2),14-22。
蔡依珍、黃偉堯(2004)。醫院對診斷關聯群之因應行為-以美國為例。醫院,37(3),23-31。
賴憲堂、韓揆、張鳳智(1996)。DRGs 償付制度與醫院疾病編碼取巧行為之可能性。醫院,29(3),31-46。
韓揆(2005)。診斷組合在台推行問題(上)-DRGs 之支付精神、支付邏輯及侷限。醫務管理,6(1),1-17。
藍忠孚(1989)。勞保實施診斷關係群(DRG)制度之研究。台北:行政院勞工委員會。
貳、英文部分
Abrams, W.B., Beers, M.H., Berkow, R., eds. (1995). Anonymous: Comprehensive geriatric assessment (2th ed., pp.224-35). The Merck Manual of Geriatrics. New Jersy: MERCK.
Campbell, S.E., Seymour, D.G., Primrose, W.R. (2004). A systematic literature review of factors affecting outcome in older medical patients admitted to hospital. Age Ageing.
Carcia, P. (2009).Discovery by serendipity: a new context for an old riddle. Found Chem , 11(1), 33-42.
Carpenter, I., Gladman, J. R. F., Parker, S. G., &; Potter, J. (2002).Clinical and
research challenges of intermediate care. Age and Ageing, 31(2), 97-100.
Covin, J.G., Miles, M.P. (1999) .Corporate entrepreneurship and the pursuit of competitive advantage. Entrepreneurship Theory and Practice, 23(4), 47-63.
Department of Health. Shaping the future NHS: long term planning for
Hospital services. 2000.
Fetter, R.B, Brand, D.A.,&Gamache, D.(1991). DRGs-their design and
development.Michigan:Health Administpredetermined payment.
Fleming, K.C., Jonathan, M., Weber, D.C.(1995).Practical functional
assessment of elderlypersons: a primary-care approach. Mayo Clin Proc,70,890-910.
Gallo, J.J., Reichel, W., Anderson, L.M. (1995).Handbook of Geriatric
Assessment: Functional assessment. Aspen Publishers,69-103.
Gallo, J.J., Reichel, W., Anderson, L.M. (1995). Mental status assessment. Aspen Publishers,11-68.
Green, J., Young, J., Forster, A., et al.(2005). Effects of locality based community hospital care on independence in older people needing rehabilitation: randomized controlled trial. BMJ, 331, 317-22.
Griffiths, P., Edwards, M., Forbes, A., &; Harris, R. (2005). Postacute
intermediate care in nursing-led units: A systematic review of
effectiveness. International Journal of Nursing Studies, 42(1), 107-116.
Harris, R., Wilson-Barnett, J., &; Griffiths, P. (2007). Effectiveness of
nursing-led inpatient care for patients with postacute health care needs:
Secondary data analysis from aprogramme of randomized controlled
trials. Journal Evaluation Clinical Practice, 13(2), 198-205.
Hazzard, W.R., Blass, J.P., Ettinger, W.H.J.R.( 1999). Principles of geriatric assessment.Principles of Geriatric Medicine and Gerontology,467-81.
Kaambwa, B., Bryan, S., Barton, P., Parker, H., Martin, G., Hewitt, G., et al.
(2008).Costs and health outcomes of intermediate care: Results from five
UK case study sites.Health and Social Care in the
Community,16,573-81.
Kane, R.L.,Ouslander, J.G., Abrass, I.B.,eds. ( 1999). Anonymous: Evaluating the geriatric patient (4th ed., pp.43-73). New York:McGraw-Hill.
Marjorie, A. R., &; Mark, J. B. (2001). The Impact of The Inpatient
ProspectivePayment System and Diagnosis-Related Groups : A Survery
of The Literature. NorthAmerican Acturial Journal, 5(4), 84-94.
Martin, G. P., Peet, S. M., Hewitt, G. J., &; Parker, H. (2004). Diversity in intermediate care. Health &; Social Care in the Community, 12 (2), 150-155.
McKee, M., Healy, J. (2002). Hospitals in a changing Europe. Philadelphia:
Open University Press.
Melis, R. J. F., Rikkert, M., Parker, S. G., &; van Eijken, M.I. J. (2004). What
is intermediate care? An international consensus on what constitutes
intermediate care is needed.BMJ: British Medical Journal, 329(7462),
360-365.
Nutefall, J.E., Ryder, P.M. (2010). The Serendipitous Research Process. The
Journal of Academic Librarianship, 36(3), 228-234.
O’Reilly, J., Lowson, K., Young, J., Forster, A., Green, J., &;Small, N. (2006).
A costeffectiveness analysis within arandomised controlled trial of
post-acute care of older people in a community hospital. British Medical
Journal,333(7561), 1-5.
Reuben, D.B. Principles of geriatric assessment. In: Hazzard, W.R., Blass,
J.P.,Ettinger, W.H. Jr., eds. (1999). Principles of Geriatric Medicine and
Gerontology (4th ed., pp.467-81). New York: McGraw-Hill.
Roe, B., Daly S., Shenton, G., &; Lochhead, Y. (2003). Development and
evaluation of intermediate care. Journal of Clinical Nursing, 12 (3),
341-350.
Steiner, A., &; Vaughan, B. (1997). Intermediate care: A discussion paper
arising from the Kings Fund seminar held on 30th October 1996.
London: Kings Fund.
Vaughan, B. (1998 ). United Kingdom: Caring differently:
Intermediatecare—Analternative approach to service provision in
response to client need and workforce changes inthe NHS. International
Journal of Nursing Practice,4(1),62-67.
Weisenfeld, U. (2009). Serendipity as a Mechanism of Change and its
Potential for Explaining Change Processes. Management
Revue,20(2),138-148.
Wennberg, K.(2010). serendipitous entrepreneurship. Frontiers of
Entrepreneurship Research , 30(7),1-16.
Wiles, R., Postle, K., Steiner, A., &; Walsh, B. (2001). Nurseled intermediate
care: An opportunity to develop enhanced role for nurse? Journal of
Advanced Nursing, 34(6), 813-821.
Wiles, R., Postle, K., Steiner, A., &; Walsh, B. (2002). Nurseled intermediate
care: Patients’ perceptions. International Journal of Nursing Studies,
40(1), 61-71.
Woodford, H.J., George, J. (2010). Intermediate care for older people in the
UK. Clinical Medicine,10(2),119-23.
參、網路資料
我國長期照護服務需求評估,2012。行政院經濟建設委員會,取自:
http://www.cepd.gov.tw/m1.aspx?sNo=0012090&;ex=3.
Department of Health. (2001). Intermediate Care. Retrieved December 20,
2009, from http://www.dh.gov.uk/en/Publicationsandstatistics/
Lettersandcirculars/Healthservicecirculars/DH_4003694
Welsh Assembly Government. (2002). Intermediate care guidance.Retrieved
December 20, 2009, from
http://wales.gov.uk/publications/circular/circulars2002/NAFWC
432002;jsessionid=TRyNMqvppwpm1Lps2nys3XDhpfbx
J3dGzz2hwMT92br1W6nmJ3nR!-2135057422?lang=en

連結至畢業學校之論文網頁點我開啟連結
註: 此連結為研究生畢業學校所提供,不一定有電子全文可供下載,若連結有誤,請點選上方之〝勘誤回報〞功能,我們會盡快修正,謝謝!
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top