099NTCN doc

Size: px

Start display at page:

Download "099NTCN doc"

妊镕替溥
5 years ago
Views:

1 % % (2009)

2 2 (2010) 1990 ( 2007)

3 (National Hospice and Palliative Care Organization) % 25% 41% (debility unspecified) (2009) 2003 Institute of Medicine, IOM IOM,

4 (2006) (2010) (terminal care) ( ) (accepting death)

5 5 vegetative patient) extraordinary Right to Die euthanasia natural death (Cardiac-Pulmonary Resuscitation, CPR)

6 % 16% (Ministry of Health, Welfare and Sport, 2008) (Ministry of Health, Welfare and Sport, 2009) (Ministry of Health, Welfare and Sport, 2007) 7 3 6

7 Do Not Resuscitate, DNR 2010 Dirk (2010)

8 8

9 9

10 10 Hospice HospiceCicely Sau St. Vincent de Paul Sisters of Charity Baron Von Stein Fliedner Kaiserswerth Sunders St. Christopher

11 11 Hospice 2008 (World Health Organization)1990 (hospice care) 2002

12 (WHO, 2009) palliative care palliative medicine 1987 (Saunders, Baines & Dunlop, 1995)Palliate 2001 Palliative care World Health Organization, WHO WHO,

13 13 (NHPCO, 2010) Hospice Palliative Care

14 (2007) (National Hospice Organization)1993 (in the last phases of incurable disease ) (2000) 2002 (bereavement) 14

15 (WHO, Karnofsky > Primary palliation Early palliation < Late palliation <1-2 <10 Imminently dying (Kaasa S, Loge JH, 2003) (Higginson, 2003) 1970 (terminal care) 15

16 16 (2009)Kinzbrunner2002 (2010) 1976 (Natural Death Act) 1983

17 (Durable Power of Attorney Act) (the National Conference of Commissioners on Uniform State Laws)1985 (Uniform Right of the Terminally Ill Act) 1989 ( 2006)

18 , Steen et al., OECD, % 23% Carlson,

19 Wowchuk, McClement, & Bond, % Shah, 2007 cognitive impairment 2009 (primary caregiver) ( ) ()

20 20 () () () () () () () () () () () () () ( 2006)

21 21 (2005) () () () () () (2007) (2001) (2002) (2001) (2001) 2000

22 advance directives, ADs 2008 ( 2009 (2007) 1960 (cardiopulmonary resuscitation, CPR) 1970 (Advanced Cardiac Life Support ACLS) (2006) CPR CPR

23 23 2-5% (2009) (2007Saundra ) (2006) ( )DNR (Thelen, 2005)DNR(do not resuscitate) ( ) DNR

24 24 (2001)DNR CPR (2007) () (2000) (die in dignity) (peaceful death) (2006) 2006Huang et al., DNR80% DNR 0%

25 % 82.1% Huang et al., % DNR 37.5% 2003 ADs (1) (2) (3) (4) (5) (6) (7)

26 26 ADs ACP (8) ADs ACP (2009)

27 27 () () () () () () (2008) (conversation) (2009) (semi-structured) (interview guide) (2008) ( ) ( )

28 28 (subjective theories)( 2010)

29 29 ( ) - ( 2008) () () (in- depth interview) () ()

30 () () () 2 () 48 30

31 (A~ J) D I CJ ADEFGH C CPR GI C 31

32 4-1 32

33 4-1 ( ) A 98 / B 79 / C 55 / ( DN ( ) D E 74 / ( ) F 94 / ( ) (63) ( ) G 87 / ( ) H 88 / ( ) ( ) I 77 / ( ) J

34 34 () () () () () ()

35 35 (A) ECMO

36 36 ( ) (B) ( 6.5~7.5 mm

37 37 (A) ()

38 38 (A) (F) (A) (A) ( )

39 39 (I) (G) 90 (A) (DNR)

40 40 (C (A) (G)

41 41 (G) G (A) (G) (J) () () DNR () () ()

42 42 (A) (C)

43 43 (J)

44 44 endo (I) DNR (A).. (A)

45 45 ( ) (A) (A) ( ) 20 (B)

46 46 E (E) ( ) (A) (C) DNR (A)

47 47 (A) (A) 70~80% (E)

48 48 (A) (G) () (E) ()

49 49 (E) (C) (G) (A) (A) A (A) (B)

50 50 90 (G)

51 51

52 52 (2004 (2005) (Do Not Resuscitate) (2009)

53 53 Carlson(2007) 80% (2009)

54 54 C ( )

55 55 DNR

56 56 CPR CPR (2004

57 57

58 58 CD

59 59

60 60

61 61 () () () () () () () () DNR

62 DNR DNR 62

63 63 (2011) (2004) (2004) 4(1)15-21 (2010) 53(1) (2009) (2007) (2005) 3(2) (2010) 14(8) (2009) 56(2)17-21

64 NSC B (2009) (2004) P (2009) 10(2)1-6 (2009) (2006) 11(3) (2010) Uwe Flick ( ) (2009)

65 (2009) (2005) (2006) 25(5) (2007) ( 9-23) (2009)

66 Carlson, A. L. (2007). Death in the Nursing home: resident, family, and staff perspectives. Journal of Gerontological Nursing, 33(4), Francis, J., & Netten, A. (2004). Raising the Quality of Home Care: A Study of Service Users' View. Social Policy & Administration38 (3) Huang, C. H., Hu, W. Y., Chiu, T. Y., & Chen, C. Y. (2008). The practicalities of terminally ill patients signing their own DNR orders A study in Taiwan. Journal of Medical Ethics, 34(5), Kaasa S, Loge JH. (2003). Quality of life in palliative care: principles and practice. Palliat Med January, 17: Saundra, K., Marjorie, A., Evie, S. (2010). Critical Care Nurses Perceptions of Obstacles, Supports, and Knowledge Needed in Providing Quality End- of- Life Care. Dimension of Critical Care Nursing, 29(6), Schmoll, B. L., & Dixon, C.E.(1996). Hospice care setting. In D. C. Sheehan & W. B. Forman (Eds.), Hospice and palliative care: Concepts and practice (PP.51-59). Sudbury, MA: Jones & Bartlett Publishers. Schrijvers D, Fraeyenhove Fv. (2010). Emergencies in Palliative Care. The Cancer Journal, 16(5), Thelen, M. (2005). End- of- life decision making in intensive care. Critical 66

67 Care Nurse, 25(6), Thome, B., Dykes, A-K., & Hallberg, I. R. (2003). Home care with regard to definitioncare recipients, content and outcome, systematic literature review. Ministry of Health, Welfare and Sport (2007), Exceptional Medical Expenses Act, Ministry of Health, Welfare and Sport (2008), Long term care, Ministry of Health, Welfare and Sport (2009), Host Country Report - Long-term care in the Netherlands, untry-paper-_tcm pdf Raulala et al Why Are Social Care Services a Gender Issue? in Social Care Services: The Key to the Scandinavian Welfare Model. Jorma Sipila, ed. Adershot: Ashgate. Steen, E.,Jenny, T.,Gerrit, M., David, R., Marcel, E., & Ribbe, M. (2005). End- of- life decision making in nursing home residents with dementia and pneumonia. Journal of Alzheimer Disease & Associayed Disorders, 19(3),

68 World Health Organization (2009, n.d.). WHO definition of palliative care. Retrieved December 9, 2009, from Wowchuk, S.M., McClement, S., & Bond, J. J. (2007). The challenge of pvoviding palliative care in the nursing home. InternationalJournal of Palliative Nursing, 13(7),

69 69

70 70

71 : : ( ) 71

72 72 (1) ( ) (2) () () ()

73 73 (), ( ) () / / / () ( )

74 74 ( ) () ()

75 75

76 99 -?

內容簡介三十六個真實故事所改編, 大孝與大愛, 並非不計親人痛苦的搶救到底, 而是親切陪伴疾病末期的親人, 協助他坦然接受疾病, 減少他身心靈的痛苦, 協助他放下萬緣, 安

內容簡介三十六個真實故事所改編, 大孝與大愛, 並非不計親人痛苦的搶救到底, 而是親切陪伴疾病末期的親人, 協助他坦然接受疾病, 減少他身心靈的痛苦, 協助他放下萬緣, 安黃勝堅 2010 生死謎藏善終, 和大家想的不一樣 care 06 口述黃勝堅整理二泉印月插畫小瓶仔出版者大塊文化出版股份有限公司初版一刷 2010 年 11 月 ISBN 978-986-213-204-3 作者簡介黃勝堅學歷 : 國立台灣大學物理治療學士畢業