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題名:探討中老年人於非正規教育機構參與善終課程後之DNR觀點轉化
書刊名:生命教育研究
作者:羅耀明
作者(外文):Lo, Yao-ming
出版日期:2014
卷期:6:1
頁次:頁87-117
主題關鍵詞:中老年人不施行心肺復甦術善終觀點轉化Elder peopleDo-not-resuscitateDNRGood deathTransformative learning
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:34
  • 點閱點閱:80
我國社會與醫療環境存在著善終障礙,據研究發現,高齡者「不施行心肺復甦術」(do-not-reSliscite, DNR)的自主權常被忽略,而簽署DNR有助善終。本研究於非正規教育機構針對中老年人實施善終課程,以Mezirow(1991)之轉化學習理論為基礎,研究目的為探討中老年人一、參與課程前對DNR的認識,二、經歷親友急救與死亡經驗對DNR的反思與參與課程後對DNR的反思,三、參與課程後之DNR觀點轉化情形。研究對象為參與研究者於樂齡中心開設的善終課程之7位中老年人,採質性研究法,以半結構式深度訪談蒐集資料,輔以觀察筆記進行資料分析。本研究獲致3項結論、中老年人於參與課程前對DNR缺乏正確且完整的認識,二、從經歷親友急救與死亡的經驗,以及參與課程後的反思而對DNR產生新觀點,知其有權主張DNR;三、於參與課程後依據新觀點採取立即或延遲行動,包括決定簽署DNR與將DNR自主權的概念向親人、他人分享。
There are still many obstacles in current medical and social environment for the elders to achieve end well/good death. The autonomy of Do-Not-Resuscitate (DNR) for the elders has been often neglected, and good death can be better fulfilled by signing DNR. In the study, the author implemented the Good Death course for the elders in non-formal education institute. This study was based on the transformative learning theory proposed by Mezirow and the research purposes included: (1) exploring the elder participants' understanding on DNR before the course; (2) exploring the reflection of the experience of expiring relatives' death of the elders and the reflection after attending the course; (3) exploring the perspective transformation of the elders after attending the course. The research subjects are seven elders who attended the Good Death course in the Senior Active Learning Center. Qualitative methodology was applied and semi-constructive in-depth interview was conducted for data collection, and observation note was used for supplement to data analysis eventually. Major conclusions shown in the study with three folds: (1) The elders' understanding to DNR is not enough in general before attending the course. (2) The elders came to have new perspectives through the reflection of experiencing the relatives' death and the reflection of attending the course, and then they knew they have right to dominate DNR. (3) Based on new perspectives of DNR to sign DNR and share the autonomy of DNR with families or others, they have immediate or delayed action after attending the course.
期刊論文
1.劉明超(20120100)。新北市樂齡學習資源中心實施現況與評鑑指標權重之初探。學校行政,77,1-26。  延伸查詢new window
2.李明芬、張德永、洪櫻純(20121100)。臺灣非正規教育課程認證的系統性分析與未來展望:從政策的單向接軌到多元發展。教育政策論壇,15(4)=44,25-62。new window  延伸查詢new window
3.黃明月(20080600)。非正規教育認證之探討。研習資訊,25(3),29-34。  延伸查詢new window
4.Cheng, S. Y.、Hu, W. Y.、Liu, W. J.、Yao, C. A.、Chen, C. Y.、Chiu, T. Y.(2008)。Good death of elderly patients with terminal cancer in Taiwan。Palliative Medicine,22(5),626-632。  new window
5.Downar, J.、Luk, T.、Sibbald, R.、Santini, T.、Mikhael, J.、Berman, H.(2011)。Why do patients agree to a “Do Not Resuscitate” or “Full Code” order? Perspectives of medical inpatients。Journal of General Internal Medicine,26(6),582-587。  new window
6.Moreland, R.、Lovett, T.(1997)。Lifelong learning and community development。International Journal of Lifelong Education,16(3),201-216。  new window
7.Miyashita, M.、Morita, T.、Sato, K.、Hirai, K.、Shima, Y.、Uchitomi, Y.(2008)。Factors contributing to evaluation of a good death from the bereaved family member's perspective。Psycho-Oncology,17(6),612-620。  new window
8.翁益強(20110300)。探討「預立選擇安寧緩和醫療意願書」與「不施行心肺復甦術同意書」 之差異。安寧照顧會訊,79,9-11。  延伸查詢new window
9.黃富順(20060100)。非正規學習與成就認證。成人及終身教育,11,2-13。  延伸查詢new window
10.Taylor, E. W.(2008)。Transformative learning theory。New Directions for Adult and Continuing Education,119,5-36。  new window
11.羅耀明(20111100)。克服善終障礙--我國高齡者之善終教育現況與因應策略。安寧療護,16(3),361-370。new window  延伸查詢new window
12.Mezirow, Jack(1981)。A Critical Theory of Adult Learning and Education。Adult Education,32(1),3-24。  new window
13.魏惠娟、胡夢鯨、陳冠良(20101200)。臺灣樂齡學習中心課程之分析:McClusky需求幅度理論的應用。成人及終身教育學刊,15,115-150。new window  延伸查詢new window
會議論文
1.羅耀明(2012)。中高齡者參與不施行心肺復甦術學習活動之觀點轉化。「2012年成人教育青年願景論壇」研討會,中華民國成人及終身教育學會 。臺北。18-19。  延伸查詢new window
2.胡文郁、楊嘉玲(2011)。從癌症晚期病人進行末期醫療決策的經驗--反思「預立醫療照護計畫」之推展。2011第七屆生命教育《生命意義與臨終關懷》學術研討會,臺大生命教育中心、生命教育學會與臺大哲學系 。  延伸查詢new window
研究報告
1.中華民國衛生福利部(2013)。民國101年主要死因分析。  延伸查詢new window
學位論文
1.曾月華(2006)。生前預囑臨床實施之討論:論臨終老人的醫療處遇「權利」與醫病關係「權力」之探討(碩士論文)。國立中正大學。  延伸查詢new window
2.蔡明昌(1995)。老人對死亡及死亡教育態度之研究(碩士論文)。國立高雄師範大學,高雄。  延伸查詢new window
3.高綺吟(2007)。安寧共同照護模式對提升癌末照護品質之成效(碩士論文)。國立臺灣大學。  延伸查詢new window
4.吳永銘(2009)。高齡教育機構學習者生命態度、生死教育需求及機構因應對策之研究(博士論文)。高雄師範大學,高雄。new window  延伸查詢new window
圖書
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2.Illich, I.(1973)。De-schooling society。London:Penguin Books。  new window
3.Mezirow, J.(2009)。Transformative learning in practice: Insights from community, workplace, and higher education。San Francisco:Jossey-Bass。  new window
4.Heimlich, J. E.(1993)。Non-formal environmental education: Toward a working definition。Columbus, OH:Educational Resources Information Center。  new window
5.Coombs, P. H.、Ahmed, M.(1974)。Attacking rural poverty: How non-formal education can help。Baltimore:John Hopkins University Press。  new window
6.van Manen, M.(1997)。Researching lived experience: Human science for an action sensitive pedagogy。Ontario:The Althouse Press。  new window
7.郭為藩(2003)。成人學習:心理學的探討。台北:心理。  延伸查詢new window
8.Brookfield, S. D.(1987)。Developing critical thinkers: Challenging adults to explore alternative ways of thinking and acting。Open University Press。  new window
9.高淑清(2008)。質性研究的18堂課:揚帆再航之旅。高雄:麗文文化。  延伸查詢new window
10.教育部(2006)。邁向高齡社會:老人教育政策白皮書。教育部。  延伸查詢new window
11.Mezirow, Jack(1991)。Transformative Dimensions of Adult Learning。Jossey-Bass。  new window
其他
1.內政部統計處(2014)。歷年單齡人口數,http://sowf.moi.gov.tw/stat/month/list.htm, 2014/03/11。  延伸查詢new window
2.臺灣安寧照顧協會(2013)。安寧緩和醫療條例條文內容,http://www.tho.org.tw/xms/toc/list.php?courseID=14, 2014/03/11。  延伸查詢new window
3.Rogers, Alan(2004)。Looking again at non-formal and informal education: Towards a new paradigm,http://www.Infed.org/biblio/non_formal_paradigm.htm, 。  new window
4.Smith, M. K.(2005)。Non-formal education,http://www. infed.org/biblio/b-nonfor.htm, 2013/02/26。  new window
5.國家發展委員會(2012)。中華民國2012年至2060年人口推估報告,http://www.ndc.gov.tw/m1.aspx?sNo=0000455&ex=2&ic=0000153, 2014/03/20。  延伸查詢new window
圖書論文
1.蔣玉禪(2005)。非正規學習與社區營造。非正規學習。臺北:師大書苑。  延伸查詢new window
2.Shukla, S. C.(1980)。Social aspects of non-formal education。Non-formal education and the NAEP。New Delhi, India:Oxford University Press。  new window
3.黃富順(2007)。臺灣地區的高齡教育。各國高齡教育。臺北:五南。  延伸查詢new window
 
 
 
 
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