暑假作業
班級:護四甲 學號:1045101048 姓名:游可青
書名:台灣家庭醫學雜誌
文章:安寧病患之困難出院分析：個案報告
資料出處說明(參考文獻): 1. Gonçalves-Bradley DC, Lannin NA,
Clemson LM, Cameron ID, Shepperd S:
Discharge planning from hospital. Cochrane
Database Syst Rev 2016; (1): CD000313.
2. Benzar E, Hansen L, Kneitel AW, Fromme
EK: Discharge planning for palliative care
patients: a qualitative analysis. J Palliat Med
2011; 14: 65-9.
3. Slieper CF, Hyle LR, Rodriguez MA: Difficult
discharge: lessons from the oncology setting.
Am J Bioeth 2007; 7: 31-2.
4. Temel JS, Greer JA, Muzikansky A, et
al: Early palliative care for patients with
metastatic non-small-cell lung cancer. N Engl
J Med 2010; 363: 733-42.
5. Daveson BA, Harding R, Higginson IJ, et al:
The real-world problem of care coordination:
a longitudinal qualitative study with patients
living with advanced progressive illness and
their unpaid caregivers. PLoS One 2014; 9:
e95523.
6. Hall S, Kolliakou A, Petkova H, Froggatt K,
Higginson IJ: Interventions for improving
palliative care for older people living in
nursing care homes. Cochrane Database Syst
Rev 2011; (3): CD007132.
7. National Consensus Project for Quality
Palliative Care: Clinical Practice Guidelines
for Quality Palliative Care. 3rd ed.
Pittsburgh, PA: National Consensus Project
for Quality Palliative Care, 2013.
8. Detering KM, Hancock AD, Reade MC,
Taiwan J Fam Med
Silvester W: The impact of advance care
planning on end of life care in elderly
patients: randomised controlled trial. BMJ
2010; 340: c1345.
9. Shah N, Homel P, Breznay J: Use of Medical
Devices in Hospice for Symptom Management.
Am J Hosp Palliat Care 2016; 33: 929-34.
10. Lind R, Lorem GF, Nortvedt P, Hevroy O:
Family members’ experiences of “wait and
see” as a communication strategy in end-oflife
decisions. Intensive Care Med 2011; 37:
1143-50.
11. Shepperd S, Lannin NA, Clemson LM,
McCluskey A, Cameron ID, Barras SL:
Discharge planning from hospital to home.
Cochrane Database Syst Rev 2013; (1):
CD000313.
12. 賴維淑、楊婉萍、施雅蘭、趙可式：運用
安寧療護理念於癌末病人之出院準備服務
。護理雜誌 2009；56：94-100。
書名:台灣家庭醫學雜誌
文章:神經性厭食症併發急性肝炎：個案報告
資料出處說明(參考文獻): 1. Diagnostic and statistical manual of mental disorders: DSM-5 5. Washington: American Psychiatric Publishing. 2013: 338-45. 2. Smink FR, van Hoeken D, Hoek HW: Epidemiology of eating disorders: incidence, prevalence and mortality rates. Curr Psychiatry Rep 2012; 14: 406-14. 3. 黃韵捷、周桂如：運用全民健康保險資料 庫分析台灣地區神經性厭食症患者之住院 醫療利用。榮總護理 2015；32：121-7。 4. Mehler PS, Brown C: Anorexia nervosa – medical complications. J Eat Disord 2015; 3: 11. 5. Strumia R: Dermatologic signs in patients with eating disorders. Am J Clin Dermatol 2005; 6: 165-73. 6. Kamal N, Chami T, Andersen A, Rosell FA, Schuster MM, Whitehead WE: Delayed gastrointestinal transit times in anorexia nervosa and bulimia nervosa. Gastroenterology 1991; 2018 Vol. 28 No.2 101: 1320-4. 7. Narayanan VGaudiani JL, Harris RH, Mehler PS: Liver function test abnormalities in anorexia nervosa--cause or effect. Int J Eat Disord. 2010; 4: 378. 8. De Caprio C, Alfano A, Senatore I, Zarrella L, Pasanisi F, Contaldo F: Severe acute liver damage in anorexia nervosa: two case reports. Nutrition 2006; 22: 572-5. 9. Mehanna HM, Moledina J, Travis J: Refeeding syndrome: what it is, and how to prevent and treat it. BMJ 2008; 336: 1495-8. 10. Hofer M, Pozzi A, Joray M, et al: Safe refeeding management of anorexia nervosa inpatients: an evidence-based protocol. Nutrition 2014; 30: 524-30.
書名:內科學誌
文章: 免疫不全患者之退伍軍人桿菌肺炎重症：個案報告暨文獻回顧
資料出處說明(參考文獻): 1.Burillo A, Pedro-Botet ML, Bouza E. Microbiology and epidemiology
of legionnaire’s disease. Infect Dis Clin North Am
2017; 31: 7-27.
2.Edelstein PH, Roy CR. Legionnaire’s Disease and Pontiac
Fever. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell,
Douglas and Bennett’s Principles and Practice of Infectious
Diseases. 8th ed. Philadelphia, PA; 2015; 2633-44
3.Cunha CB. Legionnaire’s disease and its mimics: a Clinical
perspective. Infect Dis Clin North Am 2017; 31: 95-109.
4.Lanternier F, Ader F, Pilmis B, et al. Legionnaire’s disease
in compromised hosts. Infect Dis Clin North Am 2017; 31:
123-35.
5.Chahin A, Opal SM. Severe pneumonia caused by Legionella
pneumophila: differential diagnosis and therapeutic Considerations.
Infect Dis Clin North Am 2017; 31: 111-21.
6.台灣衛生福利部疾病管制署(Taiwan CDC)網站. Retrieved
23 April, 2017 from Http://www.cdc.gov.tw.
7.Magira EE, Zakynthinos S. Legionnaire’s disease and influenza.
Infect Dis Clin North Am 2017; 31: 137-53.
8. Rodrı´guez AH, Avile´s-Jurado FX, Dı´az E, et al. Procalcitonin
(PCT) levels for ruling-out bacterial coinfection in ICU
patients with influenza: A CHAID decision-tree analysis. J
Infect 2016; 72: 143-51.
9.Rizzo C, Caporali MG, Rota MC. Pandemic influenza and
pneumonia due to Legionella pneumophila: a frequent underestimated
coinfection. Infect Dis Clin North Am 2010; 51:
115.
10.Renner ED, Helms CM, Johnson W, et al. Coinfections of
mycoplasma pneumoniae and Legionella pneumophila with
influenza a virus. J Clin Microbiol 1983; 17: 146-8.
11.Liu J, Ai H, Xiong Y, et al. Prevalence and correlation of
infectious agents in hospitalized children with acute respiratory
tract infections in central China. PLoS One 2015; 10:
e0119170.
12.Kunisaki KM1, Janoff EN. Influenza in immunosuppressed
populations: a review of infection frequency, morbidity, mortality,
and vaccine responses. Lancet Infect Dis 2009; 9: 493-
504.
13.George MR. Hemophagocytic lymphohistiocytosis: review of
etiologies and management. J Blood Med 2014 12; 5: 69-86.
14.Rosado FG, Kim AS. Hemophagocytic lymphohistiocytosis:
an update on diagnosis and pathogenesis. Am J Clin Pathol
2013; 139: 713-27.
讀後心得(500字):安寧療護所強調之全人、全家、全程與全隊的理念於一位癌末且困難出院病人之出院準備服務，協助其順利出院並能得到持續性照顧直至平安往生。一、全人面向包括症狀未獲控制，令病人家屬對出院缺乏安全感、
案主不被瞭解的孤獨和家中照顧人力與支持系統不足；二、全家面向包括決策關鍵者不明且意見紛歧與案兄照顧負荷過重而身心俱疲；三、全程面向為欠缺適切且持續性的安寧療護計畫；以及四、全隊面向為家屬對醫療處置缺乏信任，導致醫病關係的緊張。困難出院，一直是醫療團隊於住院病患即將辦理出院準備服務之際，常面臨的潛在問題。安寧病患常因自身處於癌症末期或合併其他嚴
重的共病，而比一般住院病患更容易因急性症狀反覆發作而出入安寧病
房，並且在治療方面因需考量許多不同面相而更加複雜，也因此常發生
病患或家屬拒絕出院，要求繼續住院治療的情形。一個患有乳癌末期合併腦部及其他多重器官轉移，癲癇頻繁發作，也常因許多急性問題而住院，住院後期病情穩定時，家屬多次拒絕醫療團隊提出的出院計畫。想出院的時候但又因突發的身體狀況逼不得已的住院，這個時候就需要運用各領域的專業人員解決困難，然後提升病患返家後居家照護的質與量，也需要建立團隊與家屬建立信任及溝通管道，去整合居家安寧醫療再善用出院準備服務。
書名:台灣家庭醫學雜誌
文章:安寧病患之困難出院分析：個案報告
資料出處說明(參考文獻): 1. Gonçalves-Bradley DC, Lannin NA,
Clemson LM, Cameron ID, Shepperd S:
Discharge planning from hospital. Cochrane
Database Syst Rev 2016; (1): CD000313.
2. Benzar E, Hansen L, Kneitel AW, Fromme
EK: Discharge planning for palliative care
patients: a qualitative analysis. J Palliat Med
2011; 14: 65-9.
3. Slieper CF, Hyle LR, Rodriguez MA: Difficult
discharge: lessons from the oncology setting.
Am J Bioeth 2007; 7: 31-2.
4. Temel JS, Greer JA, Muzikansky A, et
al: Early palliative care for patients with
metastatic non-small-cell lung cancer. N Engl
J Med 2010; 363: 733-42.
5. Daveson BA, Harding R, Higginson IJ, et al:
The real-world problem of care coordination:
a longitudinal qualitative study with patients
living with advanced progressive illness and
their unpaid caregivers. PLoS One 2014; 9:
e95523.
6. Hall S, Kolliakou A, Petkova H, Froggatt K,
Higginson IJ: Interventions for improving
palliative care for older people living in
nursing care homes. Cochrane Database Syst
Rev 2011; (3): CD007132.
7. National Consensus Project for Quality
Palliative Care: Clinical Practice Guidelines
for Quality Palliative Care. 3rd ed.
Pittsburgh, PA: National Consensus Project
for Quality Palliative Care, 2013.
8. Detering KM, Hancock AD, Reade MC,
Taiwan J Fam Med
Silvester W: The impact of advance care
planning on end of life care in elderly
patients: randomised controlled trial. BMJ
2010; 340: c1345.
9. Shah N, Homel P, Breznay J: Use of Medical
Devices in Hospice for Symptom Management.
Am J Hosp Palliat Care 2016; 33: 929-34.
10. Lind R, Lorem GF, Nortvedt P, Hevroy O:
Family members’ experiences of “wait and
see” as a communication strategy in end-oflife
decisions. Intensive Care Med 2011; 37:
1143-50.
11. Shepperd S, Lannin NA, Clemson LM,
McCluskey A, Cameron ID, Barras SL:
Discharge planning from hospital to home.
Cochrane Database Syst Rev 2013; (1):
CD000313.
12. 賴維淑、楊婉萍、施雅蘭、趙可式：運用
安寧療護理念於癌末病人之出院準備服務
。護理雜誌 2009；56：94-100。
書名:台灣家庭醫學雜誌
文章:神經性厭食症併發急性肝炎：個案報告
資料出處說明(參考文獻): 1. Diagnostic and statistical manual of mental disorders: DSM-5 5. Washington: American Psychiatric Publishing. 2013: 338-45. 2. Smink FR, van Hoeken D, Hoek HW: Epidemiology of eating disorders: incidence, prevalence and mortality rates. Curr Psychiatry Rep 2012; 14: 406-14. 3. 黃韵捷、周桂如：運用全民健康保險資料 庫分析台灣地區神經性厭食症患者之住院 醫療利用。榮總護理 2015；32：121-7。 4. Mehler PS, Brown C: Anorexia nervosa – medical complications. J Eat Disord 2015; 3: 11. 5. Strumia R: Dermatologic signs in patients with eating disorders. Am J Clin Dermatol 2005; 6: 165-73. 6. Kamal N, Chami T, Andersen A, Rosell FA, Schuster MM, Whitehead WE: Delayed gastrointestinal transit times in anorexia nervosa and bulimia nervosa. Gastroenterology 1991; 2018 Vol. 28 No.2 101: 1320-4. 7. Narayanan VGaudiani JL, Harris RH, Mehler PS: Liver function test abnormalities in anorexia nervosa--cause or effect. Int J Eat Disord. 2010; 4: 378. 8. De Caprio C, Alfano A, Senatore I, Zarrella L, Pasanisi F, Contaldo F: Severe acute liver damage in anorexia nervosa: two case reports. Nutrition 2006; 22: 572-5. 9. Mehanna HM, Moledina J, Travis J: Refeeding syndrome: what it is, and how to prevent and treat it. BMJ 2008; 336: 1495-8. 10. Hofer M, Pozzi A, Joray M, et al: Safe refeeding management of anorexia nervosa inpatients: an evidence-based protocol. Nutrition 2014; 30: 524-30.
書名:內科學誌
文章: 免疫不全患者之退伍軍人桿菌肺炎重症：個案報告暨文獻回顧
資料出處說明(參考文獻): 1.Burillo A, Pedro-Botet ML, Bouza E. Microbiology and epidemiology
of legionnaire’s disease. Infect Dis Clin North Am
2017; 31: 7-27.
2.Edelstein PH, Roy CR. Legionnaire’s Disease and Pontiac
Fever. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell,
Douglas and Bennett’s Principles and Practice of Infectious
Diseases. 8th ed. Philadelphia, PA; 2015; 2633-44
3.Cunha CB. Legionnaire’s disease and its mimics: a Clinical
perspective. Infect Dis Clin North Am 2017; 31: 95-109.
4.Lanternier F, Ader F, Pilmis B, et al. Legionnaire’s disease
in compromised hosts. Infect Dis Clin North Am 2017; 31:
123-35.
5.Chahin A, Opal SM. Severe pneumonia caused by Legionella
pneumophila: differential diagnosis and therapeutic Considerations.
Infect Dis Clin North Am 2017; 31: 111-21.
6.台灣衛生福利部疾病管制署(Taiwan CDC)網站. Retrieved
23 April, 2017 from Http://www.cdc.gov.tw.
7.Magira EE, Zakynthinos S. Legionnaire’s disease and influenza.
Infect Dis Clin North Am 2017; 31: 137-53.
8. Rodrı´guez AH, Avile´s-Jurado FX, Dı´az E, et al. Procalcitonin
(PCT) levels for ruling-out bacterial coinfection in ICU
patients with influenza: A CHAID decision-tree analysis. J
Infect 2016; 72: 143-51.
9.Rizzo C, Caporali MG, Rota MC. Pandemic influenza and
pneumonia due to Legionella pneumophila: a frequent underestimated
coinfection. Infect Dis Clin North Am 2010; 51:
115.
10.Renner ED, Helms CM, Johnson W, et al. Coinfections of
mycoplasma pneumoniae and Legionella pneumophila with
influenza a virus. J Clin Microbiol 1983; 17: 146-8.
11.Liu J, Ai H, Xiong Y, et al. Prevalence and correlation of
infectious agents in hospitalized children with acute respiratory
tract infections in central China. PLoS One 2015; 10:
e0119170.
12.Kunisaki KM1, Janoff EN. Influenza in immunosuppressed
populations: a review of infection frequency, morbidity, mortality,
and vaccine responses. Lancet Infect Dis 2009; 9: 493-
504.
13.George MR. Hemophagocytic lymphohistiocytosis: review of
etiologies and management. J Blood Med 2014 12; 5: 69-86.
14.Rosado FG, Kim AS. Hemophagocytic lymphohistiocytosis:
an update on diagnosis and pathogenesis. Am J Clin Pathol
2013; 139: 713-27.
讀後心得(500字):安寧療護所強調之全人、全家、全程與全隊的理念於一位癌末且困難出院病人之出院準備服務，協助其順利出院並能得到持續性照顧直至平安往生。一、全人面向包括症狀未獲控制，令病人家屬對出院缺乏安全感、
案主不被瞭解的孤獨和家中照顧人力與支持系統不足；二、全家面向包括決策關鍵者不明且意見紛歧與案兄照顧負荷過重而身心俱疲；三、全程面向為欠缺適切且持續性的安寧療護計畫；以及四、全隊面向為家屬對醫療處置缺乏信任，導致醫病關係的緊張。困難出院，一直是醫療團隊於住院病患即將辦理出院準備服務之際，常面臨的潛在問題。安寧病患常因自身處於癌症末期或合併其他嚴
重的共病，而比一般住院病患更容易因急性症狀反覆發作而出入安寧病
房，並且在治療方面因需考量許多不同面相而更加複雜，也因此常發生
病患或家屬拒絕出院，要求繼續住院治療的情形。一個患有乳癌末期合併腦部及其他多重器官轉移，癲癇頻繁發作，也常因許多急性問題而住院，住院後期病情穩定時，家屬多次拒絕醫療團隊提出的出院計畫。想出院的時候但又因突發的身體狀況逼不得已的住院，這個時候就需要運用各領域的專業人員解決困難，然後提升病患返家後居家照護的質與量，也需要建立團隊與家屬建立信任及溝通管道，去整合居家安寧醫療再善用出院準備服務。
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