臺灣人文及社會科學引文索引資料庫系統

:::

詳目顯示

回上一頁
第 1 筆 / 總合 1 筆   第一頁 上一頁 下一頁 最後一頁
/1頁
題名：社區醫療照護模式中末期患者家屬參與患者之「預立醫療計劃討論」的心理歷程特徵
作者：何雪綾
作者(外文)：Hsueh-Lin Ho
校院名稱：臺灣大學
系所名稱：心理學研究所
指導教授：吳英璋
林耀盛
學位類別：博士
出版日期：2015
主題關鍵詞：預立醫療計劃；跨理論模式；社會認知理論；預期；社區醫療；advance care planning；transtheoretical model；social cognitive theory；expectancy；community medicine
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:0
  • 點閱點閱:65
目的：由心理歷程角度探討預立醫療計劃的研究經常欠缺明確的理論對應；且偏重預立醫囑簽署與意願調查，對「討論行為」的心理歷程關注相對不足。此外，國內末期醫療決策文件多由病患家屬代理簽署，但以家屬為對象的研究為數仍少。本研究以健康行為理論為視角，探討社區醫療末期患者之家屬參與患者的「預立醫療計劃」的心理歷程特徵。研究問題為：家屬參與患者之預立醫療計劃，其討論行為於不同行為改變階段有何具體表現以及心理歷程特徵。方法：個案研究法；參與者為十位社區醫療居家照護末期病患之家屬；資料收集包含（1）預立醫療計劃討論錄影以及（2）預立醫療計劃討論經驗的個別訪談；兩者分別以互動歷程分析以及主題分析法分析。結果：歸納呈現家屬參與病患之預立醫療計劃的討論行為，在「個人反思與主張表達」、「與病人的溝通」、「與親友的溝通」、「與醫療團隊的溝通」等面向於各行為改變階段的具體表現及行為預期內涵。討論與結論：（1）以改變階段觀點結構「討論行為」除了可具體化行為內涵，亦凸顯行為的複雜性；（2）「結果預期」概念中的「重要性評估」有助於探討「被動的討論行為反應」；（3）「『疾病 vs. 病痛』的生病經驗角度」、「醫病關係」、「關係取向文化脈絡」是未來預立醫療計劃研究值得探討的議題。
Purpose: Past studies of advance care planning (ACP) mostly focused on the inclination and completion rate of advance directives and failed to make a rationale of study connected to health behavior-related theories. In Taiwan, while terminal patients’ advance directives were largely subscribed to family members, studies investigating family members’ experiences were relatively sparse. This study adopted the transtheoretical model (TTM) and social cognitive theory as frameworks and investigated characteristics of the psychological process (including stages of change and behavior expectancy) of terminal patients’ family members participating in patients’ ACP in a home-based caring setting. Method: This study used case-study methods. Ten family members of terminal patients were recruited. The data collected mainly included (1) a video of the course of communicating ACP between family members and medical staff and (2) one-on-one, semi-structured interviews with family members. The above data were analyzed with interaction process analysis and thematic analysis, respectively. Result: Family members’ behavior in discussions unfolded in four aspects, including “reflection and expression of personal viewpoint,” “communication with patient,” “communication with relatives,” and “communication with medical staff.” Concrete behaviors in the above four aspects were classified to depict each stage of change in participating in discussions of ACP, and related experiences that might reflect discussion behavior were also presented. Discussion & Conclusions: (1) The “stage of change” of TTM helped not only to depict behavior in discussing ACP in concrete terms, but also to reveal the complexity of discussion behavior; (2) “passive behavior” in discussion can be characterized by its evaluation result of low importance in outcome expectancy; and (3) “disease-versus-illness” explanatory models of sickness, the “physician-patient relationship,” and the “indigenous relationship-oriented cultural context” are important issues to be considered in future study of ACP.
于連（Jullien, F., 1995/2003）。「迂迴與進入」（杜小真譯）。北京：生活.讀書.新知三聯書店。
余德慧（2004）。「臨終陪伴之倫理與心性互轉機制的探討」。第二屆臺灣本土心理治療學術研討會（花蓮）的口頭報告論文。
余德慧、林耀盛（2012）。生死學在台灣的文化沉思。見廖欽彬（編輯校正）「朝往東亞的生死學：台日國際硏討會特集」，頁47-63。東京：東京大學大學院人文社會系研究科。
汪文聖（2001）。醫護倫理之存有論基礎初探─從海德格走向優納斯。「哲學雜誌」，37，4-34。
吳美幸（2009）。「家屬對病人入住安寧病房的決策經驗」（未發表之碩士論文）。臺南：長榮大學護理學研究所。
吳讚美、薛爾榮、鍾春櫻、劉慧玲、溫怡然、鐘裕燕（2009）。癌症死亡病患不施行心肺復甦術簽署情形與是否簽署之相關因素分析。「安寧療護雜誌」，14，243-253。new window
李欣慈、陳慶餘、胡文郁（2012）。華人孝道與家庭主義文化脈絡下談長照機構住民執行預立醫療照護計畫與老人自主權。「安寧療護雜誌」，17，187-199。new window
林慧美、楊嘉玲、陳美妙、邱泰源、胡文郁（2011）。住院病人簽署預立醫療指示的意願及接受宣導的意向。「安寧療護雜誌」，16，281-295。new window
洪淑美、尹玓、陳婉君、劉淑皎、釋德行、陳佳宏. . . 朱德明（2013）。某離島醫院執行安寧共照之成效。「安寧療護雜誌」，18，14-23。new window
陳榮基（2004）。安寧緩和醫療條例的實施與困境。「臺灣醫學」，8，684-687。
陳榮基（2008）。DNR不等於安寧緩和醫療。「臺灣醫界」，51（4），36-39。
曾怡萍（2011）。「護理之家老年住民不施行心肺復甦術之決策意向影響因素探討」。（未發表之碩士論文）。臺北：國立臺灣大學護理學研究所。
曾淑倩、余美嬅、謝伶瑜、陳鼎達（2009）。南部某區域醫院醫療從業人員簽署預立醫囑之意願探討。「安寧療護雜誌」，14，141-155。new window
黃光國（1988）。人情與面子：中國人的的權力遊戲。見楊國樞（主編）「中國人的心理」，頁289-318。臺北：桂冠。new window
黃光國（1999）。也談 “人情” 與 “關係” 的構念化。「本土心理學研究」，12，215-248。new window
黃麗續、魏書娥（2013）。加護病房裡生命末期的醫療決策：以簽署不施行心肺復甦術意願（同意）書的決策分析為例。「生命教育研究」，5（1），25-56。new window
張惠雯、顏啟華、林鵬展、劉立凡（2011）。病人對預立醫囑的看法－以彰化某醫院家庭醫學科門診病人為例。「安寧療護雜誌」，16，296-311。new window
張榮哲、林耀盛（2012）。家庭醫學中的醫病關係與人性關懷。「臺灣醫學」，16，660-666。
楊國樞（1993）。中國人的社會取向：社會互動的觀點。見楊國樞：中國人的心理與社會行為-理念及方法篇，頁87-142。臺北：桂冠。new window
劉彩娥、王萬琳、應立志（2014）。醫師與病患對醫病關係模式之看法分。「管理實務與理論研究」，8（3），54-66。new window
蔡甫昌、潘恆嘉、吳澤玫、邱泰源、黃天祥（2006）。預立醫療計畫之倫理與法律議題。「臺灣醫學」，10，517-536。
蔡淑華（2010）。「重症末期病患家屬簽署DNR心路歷程之敘事分析」（未發表之碩士論文）。臺中：中國醫藥大學。
謝至鎠、王淑貞、王英偉（2013）。符合社區民眾預立醫療自主計劃文化觀點之介入模式－台灣花蓮地區之經驗。「安寧療護雜誌」，18，1-13。new window
Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179-211. http://dx.doi.org/10.1016/0749-5978(91)90020-T
Ajzen, I. (2005). Attitudes, personality and behavior (2nd ed.). Berkshire, GBR: McGraw-Hill Education.
Apatira, L., Boyd, E. A., Malvar, G., Evans, L. R., Luce, J. M., Lo, B., & White, D. B. (2008). Hope, truth, and preparing for death: Perspectives of surrogate decision makers. Annals of Internal Medicine, 149, 861-868.
Bales, R. F. (1950). Interaction process analysis: A method for the study of small groups. Chicago: The University of Chicago.
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191-215. doi: 10.1037/0033-295X.84.2.191
Bandura, A. (2004). Health promotion by social cognitive means. Health Education and Behavior, 31, 143-164. http://dx.doi.org/10.1177/1090198104263660
Barnes, K. A., Barlow, C. A., Harrington, J., Ornadel, K., Tookman, A., King, M., & Jones, L. (2011). Advance care planning discussions in advanced cancer: Analysis of dialogues between patients and care planning mediators. Palliative and Supportive Care, 9, 73-79. http://dx.doi.org/10.1017/S1478951510000568
Barnes, K., Jones, L., Tookman, A., & King, M. (2007). Acceptability of an advance care planning interview schedule: A focus group study. Palliative Medicine, 21, 23-28. http://dx.doi.org/10.1177/0269216306073638
Boyd, E. A., Lo, B., Evans, L. R., Malvar, G., Apatira, L., Luce, J. M., & White, D. B. (2010). “It’s not just what the doctor tells me:” Factors that influence surrogate decision-makers’ perceptions of prognosis. Critical Care Medicine, 38, 1270-1275.
Braun, K. L., Onaka, A. T., & Horiuchi, B. Y. (2001). Advance directive completion rates and end-of-life preferences in Hawaii. Journal of the American Geriatrics Society, 49, 1708-1713.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77-101. http://dx.doi.org/10.1191/1478088706qp063oa
Cugliari, A. M., Miller, T., & Sobal, J. (1995). Factors promoting completion of advance directives in the hospital. Archives of Internal Medicine, 155, 1893-1898.
Dobbs, D., Emmett, C. P., Hammarth, A., & Daaleman, T. P. (2012). Religiosity and death attitudes and engagement of advance care planning among chronically ill older adults. Research on Aging, 34, 113-130. http://dx.doi.org/10.1177/0164027511423259
Eliott, J., & Olver, I. (2008). Choosing between life and death: Patient and family perceptions of the decision not to resuscitate the terminally ill cancer patient. Bioethics, 22, 179-189. http://dx.doi.org/10.1111/j.1467-8519.2007.00620.x
Eliott, J. A., & Olver, I. (2011). Dying cancer patients talk about physician and patient roles in DNR decision making. Health Expectations, 14, 147-158. http://dx.doi.org/10.1111/j.1369-7625.2010.00630.x
Emanuel, E. J., & Emanuel, L. L. (1992). Four models of the physician-patient relationship. Journal of the American Medical Association, 267, 2221-2226. http://dx.doi.org/10.1001/jama.1992.03480160079038
Emanuel, E. J., Weinberg, D. S., Gonin, R., Hummel, L. R., & Emanuel, L. L. (1993). How well is the patient self-determination act working?: An early assessment. The American Journal of Medicine, 95, 619-628. http://dx.doi.org/10.1016/0002-9343(93)90358-V
Emanuel, L. L., Barry, M. J., Stoeckle, J. D., Ettelson, L. M., & Emanuel, E. J. (1991). Advance directives for medical care - A case for greater use. New England Journal of Medicine, 324, 889-895. http://dx.doi.org/10.1056/NEJM199103283241305
Emanuel, L. L., Danis, M., Pearlman, R. A., & Singer, P. A. (1995). Advance care planning as a process: Structuring the discussions in practice. Journal of the American Geriatrics Society, 43, 440-446.
Evans, L. R., Boyd, E. A., Malvar, G., Apatira, L., Luce, J. M., Lo, B., & White, D. B. (2009). Surrogate decision-makers'' perspectives on discussing prognosis in the face of uncertainty. American Journal of Respiratory and Critical Care Medicine, 179, 48-53.
Evans, N., Bausewein, C., Menaca, A., Andrew, E. V., Higginson, I. J., Harding, R., . . . Gysels, M. (2012). A critical review of advance directives in Germany: Attitudes, use and healthcare professionals'' compliance. Patient Education and Counseling, 87, 277-288. http://dx.doi.org/10.1016/j.pec.2011.10.004
Fins, J. J., Miller, F. G., Acres, C. A., Bacchetta, M. D., Huzzard, L. L., & Rapkin, B. D. (1999). End-of-life decision-making in the hospital: Current practice and future prospects. Journal of Pain and Symptom Management, 17, 6-15.
Fried, T. R., Bullock, K., Iannone, L., & O''Leary, J. R. (2009). Understanding advance care planning as a process of health behavior change. Journal of the American Geriatrics Society, 57, 1547-1555. http://dx.doi.org/10.1111/j.1532-5415.2009.02396.x
Fried, T. R., Redding, C. A., Robbins, M. L., Paiva, A., O''Leary, J. R., & Iannone, L. (2010). Stages of change for the component behaviors of advance care planning. Journal of the American Geriatrics Society, 58, 2329-2336. http://dx.doi.org/10.1111/j.1532-5415.2010.03184.x
Gross, M. D. (1998). What do patients express as their preferences in advance directives? Archives of Internal Medicine, 158, 363-365.
Hanson, L. C., & Rodgman, E. (1996). The use of living wills at the end of life: A national study. Archives of Internal Medicine, 156, 1018-1022.
Huang, C., Hu, W., Chiu, T., & Chen, C. (2008). The practicalities of terminally ill patients signing their own DNR orders － A study in Taiwan. Journal of Medical Ethics, 34, 336-340. http://dx.doi.org/10.1136/jme.2007.020735
Kahana, B., Dan, A., Kahana, E., & Kercher, K. (2004). The personal and social context of planning for end-of-life care. Journal of the American Geriatrics Society, 52, 1163-1167. http://dx.doi.org/10.1111/j.1532-5415.2004.52316.x
Kasl, S. V., & Cobb, S. (1966). Health behavior, illness behavior and sick role behavior. Archives of Environmental Health: An International Journal, 12, 246-266. http://dx.doi.org/10.1080/00039896.1966.10664365
Kleinman, A., Eisenberg, L., & Good, B. (1978). Culture, illness, and care: Clinical lessons from anthropologic and cross-cultural research. Annals of Internal Medicine, 88, 251-258.
Kleinman, A. (1988). The illness narratives: Suffering, healing, and the human condition. New York: Basic Books.
Ko, E., & Lee, J. (2010). Completion of advance directives among Korean American and non-Hispanic White older adults. Research on Aging, 32, 618-644. http://dx.doi.org/10.1177/0164027510377310
Levin, T. T., Li, Y., Weiner, J. S., Lewis, F., Bartell, A., Piercy, J., & Kissane, D. W. (2008). How do-not-resuscitate orders are utilized in cancer patients: Timing relative to death and communication-training implications. Palliative and Supportive Care, 6, 341-348. http://dx.doi.org/10.1017/S1478951508000540
Liu, J. M., Lin, W. C., Chen, Y. M., Wu, H. W., Yao, N. S., Chen, L. T., & Whang-Peng, J. (1999). The status of the do-not-resuscitate order in Chinese clinical trial patients in a cancer centre. Journal of Medical Ethics, 25, 309-314. http://dx.doi.org/10.2307/27718327
Lyons, E., & Coyle, A. (2007). Analysing qualitative data in psychology. London: SAGE.
Madden, T. J., Ellen, P. S., & Ajzen, I. (1992). A comparison of the theory of planned behavior and the theory of reasoned action. Personality and social psychology Bulletin, 18, 3-9.
Mead, N., & Bower, P. (2000). Patient-centredness: A conceptual framework and review of the empirical literature. Social Science and Medicine, 51, 1087-1110.
Menaca, A., Evans, N., Andrew, E. V., Toscani, F., Finetti, S., Gomez-Batiste, X., . . . Gysels, M. (2012). End-of-life care across Southern Europe: A critical review of cultural similarities and differences between Italy, Spain and Portugal. Critical Reviews in Oncology/Hematology, 82, 387-401. http://dx.doi.org/10.1016/j.critrevonc.2011.06.002
Morrison, R., & Meier, D. E. (2004). High rates of advance care planning in New York City’s elderly population. Archives of Internal Medicine, 164, 2421-2426. http://dx.doi.org/10.1001/archinte.164.22.2421
Morrison, R., Zayas, L. H., Mulvihill, M., Baskin, S. A., & Meier, D. E. (1998). Barriers to completion of health care proxies: An examination of ethnic differences. Archives of Internal Medicine, 158, 2493-2497. http://dx.doi.org/10.1001/archinte.158.22.2493
Oh, D.Y., Kim, J.H., Kim, D.W., Im, S.A., Kim, T.Y., Heo, D., . . . Kim, N. (2006). CPR or DNR? End-of-life decision in Korean cancer patients: A single center’s experience. Supportive Care in Cancer, 14, 103-108. http://dx.doi.org/10.1007/s00520-005-0885-5
Piers, R. D., van Eechoud, I. J., Van Camp, S., Grypdonck, M., Deveugele, M., Verbeke, N. C., & Van Den Noortgate, N. J. (2013). Advance care planning in terminally ill and frail older persons. Patient Education and Counseling, 90, 323-329. http://dx.doi.org/10.1016/j.pec.2011.07.008
Polanyi, M. (1958). Personal Knowledge: Towards a Post-Critical Philosophy. Chicago: University of Chicago Press.
Prochaska, J. O., & Velicer, W. F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12, 38-48. http://dx.doi.org/10.4278/0890-1171-12.1.38
Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21, 95-103. http://dx.doi.org/10.1037/h0045357
Rosenfeld, K. E., Wenger, N. S., & Kagawa-Singer, M. (2000). End-of-life decision making: A qualitative study of elderly individuals. Journal of General Internal Medicine, 15, 620-625. http://dx.doi.org/10.1046/j.1525-1497.2000.06289.x
Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education and Behavior, 2, 328-335. http://dx.doi.org/10.1177/109019817400200403
Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social learning theory and the health belief model. Health Education and Behavior, 15, 175-183. http://dx.doi.org/10.1177/109019818801500203
Sharf, R. S.(2004). Theories of psychotherapy and counseling: Concepts and cases (3rd ed.) Australia: Brooks/Cole.
Solloway, M., LaFrance, S., Bakitas, M., & Gerken, M. (2005). A chart review of seven hundred eighty-two deaths in hospitals, nursing homes, and hospice/home care. Journal of Palliative Medicine, 8, 789-796. http://dx.doi.org/10.1089/jpm.2005.8.789
Stelter, K. L., Eliottt, B. A., & Bruno, C. A. (1992). Living will completion in older adults. Archives of Internal Medicine, 152, 954-959.
Sudore, R. L., Schickedanz, A. D., Landefeld, C. S., Williams, B. A., Lindquist, K., Pantilat, S. Z., & Schillinger, D. (2008). Engagement in multiple steps of the advance care planning process: A descriptive study of diverse older adults. Journal of the American Geriatrics Society, 56, 1006-1013. http://dx.doi.org/10.1111/j.1532-5415.2008.01701.x
Toombs, S. K. (1992). The meaning of illness: A phenomenological account of the different perspectives of physician and patient. Boston: Kluwer Academic Publishers.
Vig, E. K., Taylor, J. S., Starks, H., Hopley, E. K., & Fryer-Edwards, K. (2006). Beyond substituted judgment: How surrogates navigate end-of-life decision-making. Journal of the American Geriatrics Society, 54, 1688-1693. http://dx.doi.org/10.1111/j.1532-5415.2006.00911.x
Vig, E. K., Starks, H., Taylor, J. S., Hopley, E. K., & Fryer-Edwards, K. (2007). Surviving surrogate decision-making: What helps and hampers the experience of making medical decisions for others. Journal of General Internal Medicine, 22, 1274-1279.
Walczak, A., Butow, P. N., Davidson, P. M., Bellemore, F. A., Tattersall, M. H. N., Clayton, J. M., . . . Epstein, R. M. (2013). Patient perspectives regarding communication about prognosis and end-of-life issues: How can it be optimised? Patient Education and Counseling, 90, 307-314. http://dx.doi.org/10.1016/j.pec.2011.08.009
Wendler, D., & Rid, A. (2011). Systematic review: The effect on surrogates of making treatment decisions for others. Annals of Internal Medicine, 154, 336-346.
World Health Organization. (1989). Constitution. Geneva: World Health Organization.
Yang, C.L., Chiu, T.Y., Hsiung, Y.F. Y., & Hu, W.Y. (2011). Which factors have the greatest influence on bereaved families'' willingness to execute advance directives in Taiwan? Cancer Nursing, 34, 98-106. http://dx.doi.org/10.1097/NCC.0b013e3181f22cac
Young, A. J., Ofori-Boateng, T., Rodriguez, K. L., & Plowman, J. L. (2003). Meaning and agency in discussing end-of-life care: A study of elderly veterans'' values and interpretations. Qualitative Health Research, 13, 1039-1062. http://dx.doi.org/10.1177/1049732303256554


 
 
 
 
第一頁 上一頁 下一頁 最後一頁 top
:::
無相關著作
 
無相關點閱
 
QR Code
QRCODE

臺灣人文及社會科學引文索引資料庫

目前上線人數：546（臺灣：537，外國：9） ／ 本年度總使用人次：1541412 ／ 訪客人次（自102年09月）：67350195
國家圖書館著作權聲明 Copyright © 2013 All rights reserved.
本館地址: 100201臺北市中山南路20號． 本館地圖及交通資訊．
總機：(02)23619132．最佳瀏覽解析度為1024x768以上