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來源文獻資料
摘要
外文摘要
引文資料
題名:
實證護理之系統性文獻查證
書刊名:
護理雜誌
作者:
胡文郁
作者(外文):
Hu, Wen-yu
出版日期:
2003
卷期:
50:1
頁次:
頁34-43
主題關鍵詞:
實證護理
;
系統性文獻查證
;
批判性評價
;
Evidenced-based nursing
;
Systematic review
;
Critical appraisal
原始連結:
連回原系統網址
相關次數:
被引用次數:期刊(
8
) 博士論文(0) 專書(0) 專書論文(0)
排除自我引用:
7
共同引用:
3
點閱:116
「實證護理」的內涵與實證醫學在定義上有某種程度的關聯性,其強調要具有臨床專家的實務經驗,並運用適當的資源以及了解病人的個人喜好,加上經系統性文獻查證而得到有證據的研究知識,最後,能將實證研究結果回饋到臨床上,產生以研究為基礎的臨床實務,以提昇病人的照顧品質,其中系統性文獻查證扮演著極重要的角色。系統性文獻查證有清楚的九個步驟,其與傳統敘事性文獻查證不同,對於研究品質的評量,可以從「研究品質的優良程度、研究結果於臨床的適用性以及研究結果對病人的意義」等三方面進行批判性評價,其中研究品質可依證據的強度而分為五個層級。由於護理研究的典範,包括量性與質性研究,量性研究重視隨機對照試驗,並對一系列之研究文獻進行統合分析;而質性研究品質的批判,不似量性研究有一定的評量標準,而應依其研究的哲理、目的及知識植根的基礎作判斷,並從質性研究文章的「確實性、推廣性、信賴性以及確認性」的嚴謹度去批判質性研究的品質,因此,實證護理應顧及質性研究與量性研究對護理專業發展的價值,此是實證護理未來發展的一項反思與挑戰。
以文找文
In practicing evidence-based nursing, a nurse has to decide whether the evidence is relevant for the particular patient. The incorporation of clinical expertise should be balanced with the risks and benefits of alternative treatments for each patient and should take into account the patient's unique clinical circumstances including preferences. Systematic review of literature is an important element of evidence-based nursing. There are nine explicit steps in the procedure of systematic review. Systematic review differs from the traditional narrative review in that systematic, explicit methods are used to identify, assess and synthesize the information obtained. Systematic reviews use rigorous methods to reduce bias and can provide reliable summaries of relevant research evidence. The hierarchy of evidence used has five levels and emphasizes the evidence about the effectiveness of interventions. Therefore, it is better that evidence-based nursing should be based on systematic reviews of randomized controlled trials, as well as meta-analysis. Critical appraisal is necessary in systematic reviews to ensure that they are conducted to rigorous standards. The purpose of critical appraisal for evidence-based practice is to decide whether the quality of a research study is good enough for the results it provides to be used to answer a question posed by a health care practitioner or patient. Critical appraisal can be broken down into three distinct but related parts which: (1) Whether the quality of the study is good enough; (2) The application of the study result in my setting; (3) What the results mean for my patients. The paradigms of nursing research are qualitative and quantitative research. Meta-analysis is a statistical technique used in systematic reviews and it must be a rigorous process in quantitative research. It can answer two main questions about an intervention: "Does this intervention have a beneficial (or harmful) effect?" and if so, "What is the size of that effect?" No algorithmic criteria can be produced that can unpro-blematically judge the quality of qualitative research. It is necessary to avoid a checklist approach to evaluating qualitative research. The quality of qualitative research is assessed based upon a critical assessment of how well the issues of credibility, transferability, dependability and confirmability are addressed. Therefore, by combining qualitative and quantitative approaches, the ability to produce applicable clinical evidence is greatly increased in future.
以文找文
期刊論文
1.
Siwek, J.、Gourlay, M. L.、Slawson, D. C.、Shaughnessy, A. F.(2002)。How to write an evidence-based clinical review article。American Family Physician,65(2),251-258。
2.
Bradley, A. L.、Field, J.(1995)。Evidence-based medicine。Lancet,346,838-839。
3.
王秀紅(19990400)。統合分析的概念及其在護理的應用。護理研究,7(2),183-192。
延伸查詢
4.
French, P.(1999)。The development of evidence-based nursing。Journal of Advanced Nursing,29(1),72-78。
5.
Dixon-Woods, M.、Fitzpatrick, R.(2001)。Qualitative research in systematic reviews. Has established a place for itself。British Medical Journal,323(7316),765-766。
6.
Dixon-Woods, M.、Fitzpatrick, R.、Roberts, K.(2001)。Including qualitative research in systematic reviews: Opportunities and problems。Journal of Evaluation in Clinical Practice,7(2),125-133。
7.
Dicenso, A.、Cullum, N.、Ciliska, D.、Marks, S.(2000)。Evidence-Based Nursing: Past, present, and future。Evidence Based Nursing,3(1),7-8。
8.
King, S.(2001)。Evidence-based nursing now online at a screen near you: www.evidencebasednursing.com。Evidence-Based Nursing,4(3),70-71。
9.
Holmes, S.(1996)。Systematic search offers a sound evidence base。Nursing Times,92(4),37-39。
10.
French, P.(2002)。What is the evidence on evidence-based nursing? An epistemological concern。Journal of Advanced Nursing,37(3),250-257。
11.
Mulrow, C. D.(1994)。Systematic reviews: Rationale for systematic reviews。British Medical Journal,309(6954),597-599。
12.
Mulhall, A.(1998)。Nursing, research, and the evidence。Evidence-Based Nursing,1(1),4-6。
13.
Morris, M.、Scott-Findlay, S.、Estabrooks, C. A.(2001)。Evidence-based nursing Web sites: Finding the best resources。American Association of Critical-care Nurses Clinical Issues,12(4),578-587。
14.
Sandelowski, M.(1993)。Rigor or rigor mortis: The problem of rigor in qualitative research revisited。Advances in Nursing Science,16(2),1-8。
15.
Zoccali, C.(1999)。Evidence-based medicine: The clinician's perspective。Nephrology Dialysis Transplantation,14(Suppl 3),42-45。
16.
Stone, P. W.(2002)。What is a systemic review?。Applied Nursing Research,15(1),52-53。
17.
Stetler, C. B.、Brunell, M.、Giuliano, K. K.、Morsi, D.、Prince, L.、Newell-Stokes, V.(1998)。Evidence-based practice and the role of nursing leadership。Journal of Nursing Administration,28(7/8),45-53。
18.
Sackett, David L.、Rosenberg, William M. C.、Gray, J. A. Muir、Haynes, R. Brian、Richardson, W. Scott(1996)。Evidence Based Medicine: What It Is and What It Isn't。British Medical Journal,312(7023),71-72。
19.
Jadad, A. R.、Cook, D. J.、Jones, A.、Klassen, T. P.、Tugwell, P.、Moher, M.、Moher, D.(1998)。Methodology and reports of systematic reviews and meta-analyses: A comparison of Cochrane reviews with articles published in paper-based journals。Journal of American Medical Association,280(3),278-280。
圖書
1.
余玉眉(1994)。質性研究。台北:巨流。
延伸查詢
2.
Jacox, A.、Carr, D. B.、Payne, R.(1994)。Management of cancer pain: Clinical practice guideline。Rockville, MD:Agency for Health Care Policy and Research。
3.
Lincoln, Yvonna S.、Guba, Egon G.(1985)。Naturalistic Inquiry。Sage。
圖書論文
1.
Beaven, O.(2002)。Searching the literature。The Evidence-based practice manual for nurses。New York:Churchill Livingstone。
2.
劉淑娟(2000)。嚴謹度。質性研究護理方法。台北:護望。
延伸查詢
3.
Cook, D. J.、Mulrow, C. D.、Haynes, B.(1998)。Synthesis of best evidence for clinical decisions。Systematic reviews-Synthesis of best evidence for health care decisions。Philadelphia:Pennsylvania。
4.
Long, A. F.(2002)。Critically appraising research studies。Evidence-Informed Nursing: A Guide for Clinical Nurses。London:Routledge。
5.
Litva, A.、Jacoby, A.(2002)。Qualitative methods and evidence-based practice。The evidence-based practice manual for nurses。New York:Churchill Livingstone。
6.
Leininger, M. M.(1994)。Evaluation criteria and critique issues of qualitative research studies。Critical issues in qualitative research methods。Thousand Oaks, CA:Sage。
7.
Lau, J.、Ioannidis, John P. A.、Schmid, C. H.(1998)。Quantitative synthesis in systematic reviews。Systematic reviews-Synthesis of best evidence for health care decisions。Philadelphia:Pennsylvania。
8.
McSherry, R.、Simmons, M.、Pearce, P.(2002)。An introduction to evidenceinformed nursing。Evidence-Informed Nursing: A Guide for Clinical Nurses。New York:Routledge。
9.
McQuay, H. J.、Morre, A. R.(1998)。Using numerical results from systematic reviews in clinical practice。Systematic reviews-Synthesis of best evidence for health care decisions。Philadelphia:Pennsylvania。
10.
Newman, M.、Roberts, T.(2002)。Critical appraisal 2: Can the evidence be applied in your context?。The evidence-based practice manual for nurses。New York:Churchill Livingstone。
11.
Newman, M.、Roberts, T.(2002)。Critical appraisal 1: Is the quality of the study good enough for you to use the finding?。The Evidence-Based Practice Manual for Nurses。New York:Churchill Livingstone。
12.
Mulrow, C. D.、Cook, D. J.、Davidoff, F.(1998)。Systematic review: Critical links in the great chain of evidence。Systematic Reviews: Synthesis of Best Evidence for Health Care Decisions。Philadelphia:Pennsylvania。
13.
Smyth, R. L.(2002)。Systematic reviews: What are they and how can they be used?。The evidence-based practice manual for nurses。New York:Churchill Livingstone。
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