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題名:住院老人接受預立醫療照護計畫介入之成效--系統性文獻分析
書刊名:安寧療護
作者:柯莉珊王筱珮
作者(外文):Ke, Li-shanWang, Shiao-pei
出版日期:2012
卷期:17:1
頁次:頁48-61
主題關鍵詞:預立醫療照護計畫住院老人預立醫療指示Advance care planningACPHospitalized elderlyAdvance directivesADs
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(2) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:2
  • 共同引用共同引用:28
  • 點閱點閱:24
研究目的:以系統性文獻回顧方式分析預立醫療照護計畫對於住院老人之成效。材料與方法:利用關鍵字和字串,搜尋截至2012年4月發表於華藝線上圖書館、CINAHL、Medline 和Cochrane library等資料庫之文章。結果:納入3篇文章,全部文章都包含由一位專業人員發起或主導預立醫療照護計畫,以及介入措施皆從住院追蹤至社區。統合3篇文章,顯示執行預立醫療照護計畫可以有效提升預立醫療指示(advance directives; ADs)的簽署和提高醫師尊重病人生前期望的醫療照護方式、增加滿意度,以及降低家屬的壓力、焦慮和憂鬱。結論:預立醫療照護計畫需要有位符合資格的專業人員來發起,與病人、家屬和醫師做持續的溝通互動,建議由護理人員擔任協調者(facilitator),以及應開始著手規劃訓練預立醫療照護計畫協調者之相關課程。此外,多數的結果指標著重在家屬或照顧者的感受,建議回歸以病人為中心之考量,畢竟預立醫療照護計畫的精神是希望病人的末期照護符合其期待和被尊重,最後達善終。
Purpose: To analyze effectiveness of ACP for the hospitalized elderly patients with systematic review. Material and Method: Adopting keywords and string to search articles published in Airiti library, CINAHL, Medline and the Cochrane library database before April 2012. Results: We find three articles all randomized controlled trial (RCT). All three articles contain one professional to initiate or led ACP process forward and follow up the patients from the hospital to the community. To summarize these three articles, the implementation of ACP can effectively enhance the advance directives (ADs) signed rate. Proportion of the dead patient's wishes followed by their physicians increased. Patient and family satisfaction of hospitalization rose. As well as the families' stress, anxiety and depression reduced. Conclusion: ACP is a process. It needs qualified professionals to initiate continuous interaction with patients, their families and physicians. We suggest that nursing staff as a facilitator, and started planning training ACP facilitator those of related programs. In addition, the majority of outcome indicators focus on the feelings of family members or caregivers. We think that the focus should return to the consideration of patient-centered. After all, the spirit of ACP is to hope the end of the patient's care meeting their expectations and respect, eventually reaching good death.
Other
1.Tulsky, J. A.(2005)。Beyond advance directives: Importance of communication skills at the end of life.。  new window
2.Brown, B. A.(2003)。The history of advance directives: A literature review。  new window
3.Piers RD, van Eechoud IJ, van Camp S, et al(2011)。Advance care planning in terminally ill and frail older persons。  new window
4.Seal M(2007)。Patient advocacy and advance care planning in the acute hospital setting。  new window
5.Teno J, Lynn J, Wenger N, et al(1997)。Advance directives for seriously ill hospitalized patients: Effectiveness with the patient Self-Determination Act and the SUPORT intervention。  new window
6.行政院衛生署(2012)。公告修正「預立選擇安寧緩和醫療意願書」、「不施行心肺復甦術(Do Not Resuscitate)同意書」、 「醫療委任代理人委任書」及「選擇安寧緩和醫療意願撤回聲明書」等四種表單。  延伸查詢new window
7.In der Schmitten J, Rotharmel S, Mellert C, et al(2011)。A complex regional intervention to implement advance care planning in one town's nursing homes: Protocol of a controlled inter-regional study。  new window
8.Meier DE, Fuss BR, O’Rourke D, Baskin SA, Lewis M, Morrison RS(1996)。Marked improvement in recognition and completion of health care proxies。  new window
9.Public Health Resource Unit, England(2012)。Critical Appraisal Skills Programme (CASP):10 Questions to Help You Make Sense of Reviews。  new window
10.Meier DE, Gold G, Mertz K, et al(1996)。Enhancement of proxy appointment for older persons: Physician counselling in the ambulatory setting。  new window
11.Lorenz KA, Lynn J, Dy SM, et al(2008)。Evidence for improving palliative care at the end of life: A systematic review。  new window
12.Connors AF, Dawson NV, Desbiens NA, et al(1995)。A controlled trial to improve care for seriously ill hospitalized patients: The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT)。  new window
13.Hader R(2005)。Advanced directives: The conversation we all must have。  new window
14.Wissow LS, Belote A, Kramer W, Compton-Phillips A, Kritzler R, Weiner JP(2004)。Promoting advance directives among elderly primary care patients。  new window
15.Kolarik RC, Arnold RM, Fischer GS, Tulsky JA(2002)。Objectives for advance care planning。  new window
期刊論文
1.胡文郁、楊嘉玲(20090200)。生命末期之病情告知與預立照護計畫。護理雜誌,56(1),23-28。new window  延伸查詢new window
2.Detering, K. M.、Hancock, A. D.、Reade, M. C.、Silvester, W.(2010)。The impact of advance care planning on end of life care in elderly patients: Randomised controlled trial。BMJ,340(7751)。  new window
3.Sampson, E. L.、Jones, L.、Thuné-Boyle, I. C.、Kukkastenvehmas, R.、King, M.、Leurent, B.、Blanchard, M. R.(2011)。Palliative assessment and advance care planning in severe dementia: An exploratory randomized controlled trial of a complex intervention。Palliative Medicine,25(3),197-209。  new window
4.Robinson, L.、Dickinson, C.、Rousseau, N.、Beyer, F.、Clark, A.、Hughes, J.、Exley, C.(2012)。A systematic review of the effectiveness of advance care planning interventions for people with cognitive impairment and dementia。Age Ageing,41(2),263-269。  new window
5.楊嘉玲、陳慶餘、胡文郁(20080200)。醫療預立指示。安寧療護,13(1),30-41。new window  延伸查詢new window
6.Bravo, G.、Dubois, M. F.、Wagneur, B.(2008)。Assessing the effectiveness of interventions to promote advance directives among older adults: A systematic review and multi-level analysis。Social Science & Medicine,67(7),1122-1132。  new window
7.Jodad, A. R.、Moore, R. A.、Carroll, D.、Jenkinson, C.、Reynolds, D. J. M.、Gavaghan, D. J.、McQuay, H. J.(1996)。Assessing the quality of reports of randomized clinical trails: Is blinding necessary?。Controlled Clinical Trials,17(1),1-12。  new window
8.Cugliari, A. M.、Miller, T.、Sobal, J.(1995)。Factors promoting completion of advance directives in the hospital。Archives of Internal Medicine,155(17),1893-1898。  new window
研究報告
1.行政院經濟建設委員會。2010年至2060年臺灣人口推計。  延伸查詢new window
 
 
 
 
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