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外文摘要
引文資料
題名:
醫病共享決策及決策輔助工具之發展--以「失智末期吞嚥困難之進食方式選擇」為例
書刊名:
榮總護理
作者:
劉建良
/
林乃玉
作者(外文):
Liu, Chien-liang
/
Lin, Nai-yu
出版日期:
2019
卷期:
36:2
頁次:
頁170-177
主題關鍵詞:
醫病共享決策
;
決策輔助工具
;
末期失智症
;
失智進食問題
;
失智吞嚥困難
;
Shared decision making
;
Patient decision aids
;
Advanced dementia
;
Eating problems
;
Swallowing difficulties
原始連結:
連回原系統網址
相關次數:
被引用次數:期刊(
1
) 博士論文(0) 專書(0) 專書論文(0)
排除自我引用:
1
共同引用:
4
點閱:7
臨床推行醫病共享決策是將實證醫學獲得的最佳與最適宜的治療方式,藉由醫病雙方透過良好的溝通過程,交換彼此的意見和迷思,一旦病方經由共享決策做出符合其價值觀與偏好的選擇,醫療端必須尊重其醫療決策;而醫病共享決策執行需要以中立的立場去進行,不可引導病方往醫療端所要的方向進行。失智症是緩慢進行疾病,而吞嚥與進食問題影響86%的末期失智者,一旦家屬將之送醫,臨床提供的醫療選項是否符合失智者的價值觀與偏好,或臨床人員確實提供末期失智者所有相關進食選項。我們期待失智者在尚有自我決策能力時,透過醫病共享模式為自己的未來醫療照護做出決策,若失智者已無能力為自己做決策,家屬亦可透過家庭會議的模式進行醫病共享決策,為失智者做出最符合其偏好的醫療照護。
以文找文
The clinical implementation of shared decision making is the most effective and appropriate approach for communication in daily practice. Doctors, patients, and caregivers can communicate and discuss their understanding regarding the disease and opinions regarding the choice of medical care. Shared decision making involves providing reliable, balanced, and evidence-based information outlining treatment, care or support options, outcomes, and uncertainties considering patients' preferences. Dementia is a slow progressive disease. However, patients with advanced dementia may not have the ability to express their willingness. In advanced dementia, swallowing and eating difficulties are major problems, noted in approximately 86% of the patients. After they undergo emergent medical care owing to swallowing and feeding difficulties, patients with advanced dementia may not have be able to express their willingness to receive appropriate treatment. Therefore, we recommend that patients with early dementia-who still can to select their treatment options-should make decisions regarding their own further medical care plan by using shared decision making. The following are the principles of shared decision making used for resolving swallowing and eating problems: early discussion with the family, regular assessments and rethinking decisions, appropriate measures to prevent swallowing problems, rehabilitation for swallowing problems, and consideration of advanced care planning.
以文找文
期刊論文
1.
Feinberg, L. F.、Whitlatch, C. J.(2001)。Are persons with cognitive impairment able to state consistent choices?。The Gerontologist,41(3),374-382。
2.
Cole, D.(2012)。Optimising nutrition for older people with dementia。Nursing Standard,26(20),41-48。
3.
Chang, C. C.、Roberts, B. L.(2008)。Cultural perspectives in feeding difficulty in Taiwanese elderly with dementia。Journal of Nursing Scholarship,40(3),235-240。
4.
Mitchell, S. L.、Teno, J. M.、Kiely, D. K.、Shaffer, M. L.、Jones, R. N.、Prigerson, H. G.、Hamel, M. B.、Volicer, L.、Givens, J. L.(2009)。The clinical course of advanced dementia。The New England Journal of Medicine,361(16),1529-1538。
5.
王守訥、張佳琪、李碧霞(20160800)。失智患者進食困難探討。護理雜誌,63(4),128-134。
延伸查詢
6.
李宜恭(20160700)。醫病共享決策經驗分享。醫療品質雜誌,10(4),32-35。
延伸查詢
7.
張佳琪、林佳靜(20091000)。失智患者拒食行為之倫理相關議題。新臺北護理期刊,11(2),63-70。
延伸查詢
8.
張耀懋、楊欣潔、侯文萱、徐約翰(20160700)。醫病共享決策--如何讓民眾聽得懂、看得懂。醫療品質雜誌,10(4),36-39。
延伸查詢
9.
Candy, B.、Jones, L.、Sampson, E. L.(2009)。Enteral tube feeding in older people with advanced dementia: Findings from a Cochrane systematic review。International Journal of Palliative Nursing,15(8),396-404。
10.
Miller, L. M.、Whitlatch, C. J.、Lyons, K. S.(2016)。Shared decision-making in dementia: A review of patient and family carer involvement。Dementia,15(5),1141-1157。
11.
Scholl, I.、Hahlweg, P.、Lindig, A.、Bokemeyer, C.、Coym, A.、Hanken, H.、Härter, M.(2018)。Evaluation of a program for routine implementation of shared decision-making in cancer care: Study protocol of a stepped wedge cluster randomized trial。Implementation Science,13(1)。
12.
Chenel, V.、Mortenson, W. B.、Guay, M.、Jutai, J. W.、Auger, C.(2018)。Cultural adaptation and validation of patient decision aids: A scoping review。Patient Prefer Adherence,12,321-332。
13.
Chen, Y. H.、Ho, C. H.、Huang, C. C.、Hsu, Y. W.、Chen, Y. C.、Chen, P. J.、Wang, J. J.(2017)。Comparison of healthcare utilization and life-sustaining interventions between elderly patients with dementia and those with cancer near the end of life: A nationwide, population-based study in Taiwan。Geriatrics & Gerontology International,17(12),2545-2551。
其他
1.
Agency for Healthcare Research and Quality(2018)。The SHARE Approach,https://www.ahrq.gov/professionals/education/curriculum-tools/shareddecisionmaking/index.html。
2.
National Institute for Health and Care Excellence(2018)。Dementia: Assessment, management and support for people living with dementia and their carers,https://www.nice.org.uk/guidance/ng97/chapter/recommendations#palliativecare。
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