四年級暑假作業 9691 2015-09-11 15:45:56
慢性阻塞性肺病門診照護連續性之相關因素探討
The Determinants of Continuity of Care for Patients with Chronic Obstructive Pulmonary Disease
林宜柏(I-Po Lin) ； 吳肖琪(Shiao-Chi Wu)
臺灣公共衛生雜誌 ； 34 卷 4 期 (2015 / 08 / 01) ， P404 - 412
慢性阻塞性肺病(Chronic ObstructivePulmonary Disease, COPD)為多數國家的主要死因或病因，其位居2002年全球死因排名第五位，美國2004年第四大死因，並且是台灣2009年十大死因中第八位。根據WHO統計，全球約有6,500萬人患有中度至重度COPD，若未加強COPD的疾病管理，2030年COPD將躍升至全球死因排名第三位。COPD全球倡議組織(Global Initiative forChronic Obstructive Lung Disease, GOLD)於2011年版的COPD診治指引中建議，規律且持續的藥物治療及良好的疾病管理，有助於COPD病人減緩症狀、提升生活品質和減少急性發作頻率。然而，過去研究卻發現超過半數的COPD病人未持續接受藥物治療。
我認為若要從根本提升病人照護連續性，就必須了解影響病人照護連續性的相關因素。然過去研究多著重於探討照護連續性對於照護結果的影響，較少有研究向前延伸，深入探討影響病人照護連續性的相關因素。據此，本研究目的為測量COPD病人的COPD相關門診照護連續性，並探討相關影響因素。
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照顧一位初次診斷糖尿病年輕患者之護理經驗
Nursing Experience of Caring an Primary Diagnosis of Diabetes in Young Patients
吳敏姿(Min-Tzu Wu) ； 羅婉瑜(Wan-Yu Luo) ； 黃麗霞(Li-Hsia Huang) ； 游淑如(Shu-Ru Yu)
若瑟醫護雜誌 ； 9 卷 1 期 (2015 / 07 / 01) ， P73 - 83
本篇為探討一位初次罹患糖尿病患者之護理經驗。照護期間2013年1月14日至2013年1月21日，運用Gordon十一項功能性健康型態評估，在護理過程中經由會談、觀察、身體評估等方式收集資料，確立個案主要護理問題為：1.營養不均衡：多於身體需要／與偏食及血糖控制不穩定有關；2.無力感／與無法掌握健康及擔心影響工作有關；3.糖尿病自我照顧認知不足／與胰島素注射及及糖尿病合併症、血糖監測之相關知識有關等。在護理過程中發現個案對初發病之無力成及負面觀點，筆者以同理心、傾聽、鼓勵及主動關懷來增強個案對疾病的正確認知及藥物治療正向概念，並結合家屬的力量，讓個案能依醫囑及護理指導，以適切且個別性的護理指導，發揮護理的獨特功能，使個案能學習到如何良好的控制血糖及自我照顧，以預防及延緩糖尿病合併症的發生，並於未來配合治療及自我照顧，進而提升生活品質。
照顧一位學齡前期兒童患急性氣喘之護理經驗
謝宗浩 ； 張稚雯
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本文描述一位學齡前期兒童因第二次急性氣喘發作住院治療之護理經驗，照護期間2012年1月16日至2012年1月20日。筆者透過傾聽、會談、觀察等方式收集資料，並運用理學健康評估及兒童發展理論發現三個護理問題：低效性呼吸型態、潛在危險性感染、焦慮等三項護理問題。期望藉由此個案之照護經驗，瞭解學齡前期兒童的發展及住院壓力，並探討家屬於照護期間面臨的壓力，協助維持正向態度面對及解決問題，提供以家庭為中心之個案照護。
