2021年行政院核定實施「強化社會安全網第二期計畫」，其第三策略以布建社區心理衛生中心為計畫重點規劃項目，新北市心理健康照護政策發展重點為「個案管理為核心下，三段預防並重」，由社區心理衛生中心多元專業團隊人員，盤點並發展各式心理衛生服務方案，持續強化跨體系、跨專業資源協力合作，提升市民心理健康。 In the second phase of the Executive Yuan’s program to strengthen Taiwan’s social safety net, which began in 2021, the third strategy is to deploy community mental health centers. New Taipei City’s mental health care policy foregrounds case management with equal importance attached to all three levels of prevention. Under this policy, community mental health centers are equipped with professionals of diverse expertise to inventory and develop all types of mental health service schemes and to facilitate intersystem and interprofessional utilization of resources and collaboration, with the objective of improving citizens’ mental health.
2021年行政院核定实施「强化社会安全网第二期计划」，其第三策略以布建社区心理卫生中心为计划重点规划项目，新北市心理健康照护政策发展重点为「个案管理为核心下，三段预防并重」，由社区心理卫生中心多元专业团队人员，盘点并发展各式心理卫生服务方案，持续强化跨体系、跨专业资源协力合作，提升市民心理健康。 In the second phase of the Executive Yuan’s program to strengthen Taiwan’s social safety net, which began in 2021, the third strategy is to deploy community mental health centers. New Taipei City’s mental health care policy foregrounds case management with equal importance attached to all three levels of prevention. Under this policy, community mental health centers are equipped with professionals of diverse expertise to inventory and develop all types of mental health service schemes and to facilitate intersystem and interprofessional utilization of resources and collaboration, with the objective of improving citizens’ mental health.
{"title":"新北市社區心理衛生中心跨域資源整合服務模式","authors":"李韶齡 李韶齡, 杜仲傑 Shao-Ling Lee, 陳玉澤 Chung-Chieh Tu, 高淑真 Yu-Che Chen, 陳潤秋 Shu-Chen Kao","doi":"10.53106/199457952023011701003","DOIUrl":"https://doi.org/10.53106/199457952023011701003","url":null,"abstract":"\u0000 2021年行政院核定實施「強化社會安全網第二期計畫」，其第三策略以布建社區心理衛生中心為計畫重點規劃項目，新北市心理健康照護政策發展重點為「個案管理為核心下，三段預防並重」，由社區心理衛生中心多元專業團隊人員，盤點並發展各式心理衛生服務方案，持續強化跨體系、跨專業資源協力合作，提升市民心理健康。\u0000 In the second phase of the Executive Yuan’s program to strengthen Taiwan’s social safety net, which began in 2021, the third strategy is to deploy community mental health centers. New Taipei City’s mental health care policy foregrounds case management with equal importance attached to all three levels of prevention. Under this policy, community mental health centers are equipped with professionals of diverse expertise to inventory and develop all types of mental health service schemes and to facilitate intersystem and interprofessional utilization of resources and collaboration, with the objective of improving citizens’ mental health.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127223863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.53106/199457952023011701011
盤松青 盤松青
自2019年底，全球遭逢了COVID-19疫情，除了造成全球大量的感染及死亡，醫療機構也面臨重大的考驗。在病人處置中，傳統上於流感之後常見的次發感染為革蘭氏陽性菌，例如：肺炎鏈球菌感染。而在 COVID-19疫情中，自文獻發現有相當多的患者接受了經驗性抗生素療法，但實際上續發或共同感染的比率 並沒有比在流感疫情中來得高。所以在疫情中，立即可見的問題是經驗性抗生素的使用增加，可能的影響 是多重抗藥性菌株隨之增加，而背後的結構性問題是院內抗生素管理系統(antimicrobial stewardship program, AMS)運作的困難，如：AMS的人力挪為防疫人員，無法維繫多團隊溝通，或是基本的院內感染與多重感染 性菌株監測無法進行。因此如何面對現在COVID-19對抗生素管理的影響，為未來可能的新興疫情做準備， 是一個重要的議題。 The COVID-19 pandemic has affected the globe since the late 2019 and caused immense infections and deaths worldwide, thereby posing severe challenges to medical institutions. Regarding patient treatments, a common secondary infection following influenza is associated with symptoms induced by gram-positive bacteria such as streptococcus pneumoniae. A review of relevant literature suggests that the during the COVID-19 pandemic, numerous patients have received empiric antimicrobial therapy. However, the incident rates of secondary diseases or coinfection during the COVID-19 pandemic are not higher than those during influenza epidemics. Consequently, an immediate problem emerges regarding the increased use of empiric antibiotics during the current pandemic, which may lead to the increase of multiple drug resistant organisms. A structural problem underlying this situation is incurred by difficulty associated with the operation of the antimicrobial stewardship program (AMS) in hospitals. For example, AMS personnel have been reassigned to pandemic prevention units, preventing them from maintaining communications with multiple teams. In addition, the pandemic has impeded the basic monitoring of nosocomial infections or multiple drug resistant organisms. Therefore, approaches to addressing the effect of the COVID-19 pandemic on antimicrobial stewardship and preparing for emerging pandemics in the future are critical topics that merit further exploration.
自2019年底，全球遭逢了COVID-19疫情，除了造成全球大量的感染及死亡，医疗机构也面临重大的考验。在病人处置中，传统上于流感之后常见的次发感染为革兰氏阳性菌，例如：肺炎链球菌感染。而在 COVID-19疫情中，自文献发现有相当多的患者接受了经验性抗生素疗法，但实际上续发或共同感染的比率 并没有比在流感疫情中来得高。所以在疫情中，立即可见的问题是经验性抗生素的使用增加，可能的影响 是多重抗药性菌株随之增加，而背后的结构性问题是院内抗生素管理系统(antimicrobial stewardship program, AMS)运作的困难，如：AMS的人力挪为防疫人员，无法维系多团队沟通，或是基本的院内感染与多重感染 性菌株监测无法进行。因此如何面对现在COVID-19对抗生素管理的影响，为未来可能的新兴疫情做准备， 是一个重要的议题。 The COVID-19 pandemic has affected the globe since the late 2019 and caused immense infections and deaths worldwide, thereby posing severe challenges to medical institutions. Regarding patient treatments, a common secondary infection following influenza is associated with symptoms induced by gram-positive bacteria such as streptococcus pneumoniae. A review of relevant literature suggests that the during the COVID-19 pandemic, numerous patients have received empiric antimicrobial therapy. However, the incident rates of secondary diseases or coinfection during the COVID-19 pandemic are not higher than those during influenza epidemics. Consequently, an immediate problem emerges regarding the increased use of empiric antibiotics during the current pandemic, which may lead to the increase of multiple drug resistant organisms. A structural problem underlying this situation is incurred by difficulty associated with the operation of the antimicrobial stewardship program (AMS) in hospitals. For example, AMS personnel have been reassigned to pandemic prevention units, preventing them from maintaining communications with multiple teams. In addition, the pandemic has impeded the basic monitoring of nosocomial infections or multiple drug resistant organisms. Therefore, approaches to addressing the effect of the COVID-19 pandemic on antimicrobial stewardship and preparing for emerging pandemics in the future are critical topics that merit further exploration.
{"title":"在COVID-19 疫情時代的抗生素管理","authors":"盤松青 盤松青","doi":"10.53106/199457952023011701011","DOIUrl":"https://doi.org/10.53106/199457952023011701011","url":null,"abstract":"\u0000 自2019年底，全球遭逢了COVID-19疫情，除了造成全球大量的感染及死亡，醫療機構也面臨重大的考驗。在病人處置中，傳統上於流感之後常見的次發感染為革蘭氏陽性菌，例如：肺炎鏈球菌感染。而在 COVID-19疫情中，自文獻發現有相當多的患者接受了經驗性抗生素療法，但實際上續發或共同感染的比率 並沒有比在流感疫情中來得高。所以在疫情中，立即可見的問題是經驗性抗生素的使用增加，可能的影響 是多重抗藥性菌株隨之增加，而背後的結構性問題是院內抗生素管理系統(antimicrobial stewardship program, AMS)運作的困難，如：AMS的人力挪為防疫人員，無法維繫多團隊溝通，或是基本的院內感染與多重感染 性菌株監測無法進行。因此如何面對現在COVID-19對抗生素管理的影響，為未來可能的新興疫情做準備， 是一個重要的議題。\u0000 The COVID-19 pandemic has affected the globe since the late 2019 and caused immense infections and deaths worldwide, thereby posing severe challenges to medical institutions. Regarding patient treatments, a common secondary infection following influenza is associated with symptoms induced by gram-positive bacteria such as streptococcus pneumoniae. A review of relevant literature suggests that the during the COVID-19 pandemic, numerous patients have received empiric antimicrobial therapy. However, the incident rates of secondary diseases or coinfection during the COVID-19 pandemic are not higher than those during influenza epidemics. Consequently, an immediate problem emerges regarding the increased use of empiric antibiotics during the current pandemic, which may lead to the increase of multiple drug resistant organisms. A structural problem underlying this situation is incurred by difficulty associated with the operation of the antimicrobial stewardship program (AMS) in hospitals. For example, AMS personnel have been reassigned to pandemic prevention units, preventing them from maintaining communications with multiple teams. In addition, the pandemic has impeded the basic monitoring of nosocomial infections or multiple drug resistant organisms. Therefore, approaches to addressing the effect of the COVID-19 pandemic on antimicrobial stewardship and preparing for emerging pandemics in the future are critical topics that merit further exploration.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121737322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-01DOI: 10.53106/199457952022111606003
蔡岡廷 蔡岡廷, 林宏榮 林宏榮
臺灣在高齡化的情況下，多重疾病、衰弱與失能變得普遍，多重用藥與高醫療耗用的問題隨之浮現。照顧高齡衰弱病人，應重視健康促進與功能維持，將目標由治癒轉向照顧，因此需要跨領域團隊合作進行全人照護，並將照護場域由醫療機構延伸至社區居家。這樣的照護就是整合醫學的核心理念，根據本人意願，以價值為導向，提供全人、全程、全家、全團隊、全社區的五全照護模式。 在這背景下，各國的醫療體系開始面臨重整，包括減少治療疾病的急性病床、擴增以功能回復為目標的急性後期或是回復期病床、也提升在宅醫療的量能。疫情導致的就醫障礙，更使遠距與居家醫療的趨勢獲得普遍重視。後疫情時代的醫院整合醫學照護模式，應有專責病房來照顧多重疾病、高醫療耗用、身心失能的病人，並強化社區連結、建立在宅醫療團隊、提升遠距醫療能力，以提供病人從醫院到社區的全程健康照護服務。 In Taiwan, the multimorbidity, frailty, and disability associated with population aging have aggravated the problem of polypharmacy and resulted in high medical resource consumption. The care for patients who are frail and in an advanced age must emphasize health promotion and function maintenance, focusing on the provision of care rather than the curing of a disease. This requires an interdisciplinary team capable of extending the holistic care provided in medical institutions to patients’ homes. This is a type of care that embodies the core concepts of integrative medicine, namely a value-oriented health care that involves the patient, the medical treatment, the patient’s family, the medical team, and the community based on the patient’s own free will.To meet this requirement, medical systems worldwide are in the process of reorganization, and the measures taken include reducing the number of acute care beds, increasing the number of beds for post-acute and rehabilitative care, and enhancing the capacity for home health care. The barriers to medical access, which are induced by the COVID-19 pandemic, have also turned global attention to telemedicine and home health care. To provide patients with a holistic care that extends from hospital to community, post-pandemic medical institutions must apply integrative medicine; establish dedicated wards for patients with polypharmacy, high medical resource consumption, and physical and mental impairment; strength their ties with local communities; create medical teams proficient in home health care; and improve their abilities in telemedicine.
台湾在高龄化的情况下，多重疾病、衰弱与失能变得普遍，多重用药与高医疗耗用的问题随之浮现。照顾高龄衰弱病人，应重视健康促进与功能维持，将目标由治愈转向照顾，因此需要跨领域团队合作进行全人照护，并将照护场域由医疗机构延伸至社区居家。这样的照护就是整合医学的核心理念，根据本人意愿，以价值为导向，提供全人、全程、全家、全团队、全社区的五全照护模式。 在这背景下，各国的医疗体系开始面临重整，包括减少治疗疾病的急性病床、扩增以功能回复为目标的急性后期或是回复期病床、也提升在宅医疗的量能。疫情导致的就医障碍，更使远距与居家医疗的趋势获得普遍重视。后疫情时代的医院整合医学照护模式，应有专责病房来照顾多重疾病、高医疗耗用、身心失能的病人，并强化社区连结、建立在宅医疗团队、提升远距医疗能力，以提供病人从医院到社区的全程健康照护服务。 In Taiwan, the multimorbidity, frailty, and disability associated with population aging have aggravated the problem of polypharmacy and resulted in high medical resource consumption. The care for patients who are frail and in an advanced age must emphasize health promotion and function maintenance, focusing on the provision of care rather than the curing of a disease. This requires an interdisciplinary team capable of extending the holistic care provided in medical institutions to patients’ homes. This is a type of care that embodies the core concepts of integrative medicine, namely a value-oriented health care that involves the patient, the medical treatment, the patient’s family, the medical team, and the community based on the patient’s own free will.To meet this requirement, medical systems worldwide are in the process of reorganization, and the measures taken include reducing the number of acute care beds, increasing the number of beds for post-acute and rehabilitative care, and enhancing the capacity for home health care. The barriers to medical access, which are induced by the COVID-19 pandemic, have also turned global attention to telemedicine and home health care. To provide patients with a holistic care that extends from hospital to community, post-pandemic medical institutions must apply integrative medicine; establish dedicated wards for patients with polypharmacy, high medical resource consumption, and physical and mental impairment; strength their ties with local communities; create medical teams proficient in home health care; and improve their abilities in telemedicine.
{"title":"後疫情時代的醫院醫學照護模式","authors":"蔡岡廷 蔡岡廷, 林宏榮 林宏榮","doi":"10.53106/199457952022111606003","DOIUrl":"https://doi.org/10.53106/199457952022111606003","url":null,"abstract":"臺灣在高齡化的情況下，多重疾病、衰弱與失能變得普遍，多重用藥與高醫療耗用的問題隨之浮現。照顧高齡衰弱病人，應重視健康促進與功能維持，將目標由治癒轉向照顧，因此需要跨領域團隊合作進行全人照護，並將照護場域由醫療機構延伸至社區居家。這樣的照護就是整合醫學的核心理念，根據本人意願，以價值為導向，提供全人、全程、全家、全團隊、全社區的五全照護模式。 在這背景下，各國的醫療體系開始面臨重整，包括減少治療疾病的急性病床、擴增以功能回復為目標的急性後期或是回復期病床、也提升在宅醫療的量能。疫情導致的就醫障礙，更使遠距與居家醫療的趨勢獲得普遍重視。後疫情時代的醫院整合醫學照護模式，應有專責病房來照顧多重疾病、高醫療耗用、身心失能的病人，並強化社區連結、建立在宅醫療團隊、提升遠距醫療能力，以提供病人從醫院到社區的全程健康照護服務。 In Taiwan, the multimorbidity, frailty, and disability associated with population aging have aggravated the problem of polypharmacy and resulted in high medical resource consumption. The care for patients who are frail and in an advanced age must emphasize health promotion and function maintenance, focusing on the provision of care rather than the curing of a disease. This requires an interdisciplinary team capable of extending the holistic care provided in medical institutions to patients’ homes. This is a type of care that embodies the core concepts of integrative medicine, namely a value-oriented health care that involves the patient, the medical treatment, the patient’s family, the medical team, and the community based on the patient’s own free will.To meet this requirement, medical systems worldwide are in the process of reorganization, and the measures taken include reducing the number of acute care beds, increasing the number of beds for post-acute and rehabilitative care, and enhancing the capacity for home health care. The barriers to medical access, which are induced by the COVID-19 pandemic, have also turned global attention to telemedicine and home health care. To provide patients with a holistic care that extends from hospital to community, post-pandemic medical institutions must apply integrative medicine; establish dedicated wards for patients with polypharmacy, high medical resource consumption, and physical and mental impairment; strength their ties with local communities; create medical teams proficient in home health care; and improve their abilities in telemedicine.","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122913121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-01DOI: 10.53106/199457952022111606006
陳信銘 陳信銘
臺灣即將在2025年邁入超高齡社會(Super-Aged Society)，屆時470萬人以上65歲長者口腔照護是一個重要的議題。我國政府自2011年起，在臺灣北、中、南、東區各醫學中心或醫院，共成立7所特殊需求者牙科醫療服務示範中心。本文將就高齡者牙科就醫問題，提出以「特殊需求者口腔醫學科牙醫醫療服務」作為最新的服務模式，並就高齡者常見口腔問題，分享「臺大醫院特殊需求者牙科醫療服務示範中心」基於34年的實務經驗，並提供建議，期能在未來的高齡化社會挑戰中，協助特殊需求者牙科的醫療同業們，一起為高齡長者們提供完善的口腔醫療服務。 By 2025, Taiwan will have a super-aged society comprising approximately 4.7 million older adults. This increase is associated with an increased demand for oral health care. The Taiwanese Government has established a total of seven oral health-care centers for individuals with special needs. The first center was established in 2010; the centers are spread (north, middle, south, and east) across Taiwan. Older adults, particularly those with special needs, often experience several barriers when searching for dental service. Therefore, we developed a new model for providing dental service for these individuals. This article presents our 34-year clinical experience at an oral health-care center (National Taiwan University Hospital) for individuals with special needs. Our findings may help clinicians in the field of special care dentistry develop effective oral health programs for older adults with special needs.
台湾即将在2025年迈入超高龄社会(Super-Aged Society)，届时470万人以上65岁长者口腔照护是一个重要的议题。我国政府自2011年起，在台湾北、中、南、东区各医学中心或医院，共成立7所特殊需求者牙科医疗服务示范中心。本文将就高龄者牙科就医问题，提出以「特殊需求者口腔医学科牙医医疗服务」作为最新的服务模式，并就高龄者常见口腔问题，分享「台大医院特殊需求者牙科医疗服务示范中心」基于34年的实务经验，并提供建议，期能在未来的高龄化社会挑战中，协助特殊需求者牙科的医疗同业们，一起为高龄长者们提供完善的口腔医疗服务。 By 2025, Taiwan will have a super-aged society comprising approximately 4.7 million older adults. This increase is associated with an increased demand for oral health care. The Taiwanese Government has established a total of seven oral health-care centers for individuals with special needs. The first center was established in 2010; the centers are spread (north, middle, south, and east) across Taiwan. Older adults, particularly those with special needs, often experience several barriers when searching for dental service. Therefore, we developed a new model for providing dental service for these individuals. This article presents our 34-year clinical experience at an oral health-care center (National Taiwan University Hospital) for individuals with special needs. Our findings may help clinicians in the field of special care dentistry develop effective oral health programs for older adults with special needs.
{"title":"長者看牙不麻煩-特殊需求者牙科醫療服務示範中心分享","authors":"陳信銘 陳信銘","doi":"10.53106/199457952022111606006","DOIUrl":"https://doi.org/10.53106/199457952022111606006","url":null,"abstract":"\u0000 臺灣即將在2025年邁入超高齡社會(Super-Aged Society)，屆時470萬人以上65歲長者口腔照護是一個重要的議題。我國政府自2011年起，在臺灣北、中、南、東區各醫學中心或醫院，共成立7所特殊需求者牙科醫療服務示範中心。本文將就高齡者牙科就醫問題，提出以「特殊需求者口腔醫學科牙醫醫療服務」作為最新的服務模式，並就高齡者常見口腔問題，分享「臺大醫院特殊需求者牙科醫療服務示範中心」基於34年的實務經驗，並提供建議，期能在未來的高齡化社會挑戰中，協助特殊需求者牙科的醫療同業們，一起為高齡長者們提供完善的口腔醫療服務。\u0000 By 2025, Taiwan will have a super-aged society comprising approximately 4.7 million older adults. This increase is associated with an increased demand for oral health care. The Taiwanese Government has established a total of seven oral health-care centers for individuals with special needs. The first center was established in 2010; the centers are spread (north, middle, south, and east) across Taiwan. Older adults, particularly those with special needs, often experience several barriers when searching for dental service. Therefore, we developed a new model for providing dental service for these individuals. This article presents our 34-year clinical experience at an oral health-care center (National Taiwan University Hospital) for individuals with special needs. Our findings may help clinicians in the field of special care dentistry develop effective oral health programs for older adults with special needs.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"175 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123201619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-01DOI: 10.53106/199457952022111606010
楊智傑 楊智傑
精神疾病常被認為僅是心理問題，而忽略了大腦病理機轉的重要影響，造成精神醫學的診斷和評估仍停滯於主觀的症狀學診斷，而未能如內科疾病引入客觀的儀器診斷。近年來，越來越多的證據顯示精神疾病是大腦的問題。對於結構性和功能性磁振造影的解析，使得精神醫學有機會邁入生物標記診斷評估精神疾病的新階段。而機器學習方法的興起，對於大腦結構和功能數據的分析，更是帶來重要突破和深遠的影響。運用人工智慧與腦影像大數據，我們將有機會建立客觀評估精神疾病診斷與症狀嚴重程度的科學方法，除了能有效協助臨床醫師輔助評估精神疾病，提升精神醫療的照護品質，更重要的是能進一步解析大腦結構和功能與精神症狀的病理機轉，促進我們對於大腦此一人體最複雜的器官的理解，加速現代精神醫學的再進化。 Mental illness is occasionally dismissed as merely a psychological problem, with the underlying cause of brain pathology often ignored. This lack of knowledge has hindered the development of psychiatric diagnosis and related pathophysiology research. Psychiatric medicine has also failed to adopt objective diagnostic criteria such as those employed in internal medicine. Accumulating evidence reveals that mental illnesses may have underlying neurological causes. Structural and functional magnetic resonance imaging can enable the investigation of novel biomarkers for assessing psychiatric disorders. Additionally, the emergence of machine learning techniques has resulted in considerable breakthroughs and far-reaching consequences in the analysis of brain structure and functional data. Artificial intelligence and brain imaging big data may also provide an opportunity for the establishment of a scientific method for objectively assessing the diagnosis and severity of mental illness symptoms. This can effectively help clinicians in assessing mental illnesses and improve the quality of mental health care. In particular, brain-based psychiatric diagnosis may further delineate the pathological mechanisms of psychiatric symptoms, promote the understanding of the human brain (the most complex organ of the human body), and accelerate the re-evolution of modern psychiatry
精神疾病常被认为仅是心理问题，而忽略了大脑病理机转的重要影响，造成精神医学的诊断和评估仍停滞于主观的症状学诊断，而未能如内科疾病引入客观的仪器诊断。近年来，越来越多的证据显示精神疾病是大脑的问题。对于结构性和功能性磁振造影的解析，使得精神医学有机会迈入生物标记诊断评估精神疾病的新阶段。而机器学习方法的兴起，对于大脑结构和功能数据的分析，更是带来重要突破和深远的影响。运用人工智慧与脑影像大数据，我们将有机会建立客观评估精神疾病诊断与症状严重程度的科学方法，除了能有效协助临床医师辅助评估精神疾病，提升精神医疗的照护品质，更重要的是能进一步解析大脑结构和功能与精神症状的病理机转，促进我们对于大脑此一人体最复杂的器官的理解，加速现代精神医学的再进化。 Mental illness is occasionally dismissed as merely a psychological problem, with the underlying cause of brain pathology often ignored. This lack of knowledge has hindered the development of psychiatric diagnosis and related pathophysiology research. Psychiatric medicine has also failed to adopt objective diagnostic criteria such as those employed in internal medicine. Accumulating evidence reveals that mental illnesses may have underlying neurological causes. Structural and functional magnetic resonance imaging can enable the investigation of novel biomarkers for assessing psychiatric disorders. Additionally, the emergence of machine learning techniques has resulted in considerable breakthroughs and far-reaching consequences in the analysis of brain structure and functional data. Artificial intelligence and brain imaging big data may also provide an opportunity for the establishment of a scientific method for objectively assessing the diagnosis and severity of mental illness symptoms. This can effectively help clinicians in assessing mental illnesses and improve the quality of mental health care. In particular, brain-based psychiatric diagnosis may further delineate the pathological mechanisms of psychiatric symptoms, promote the understanding of the human brain (the most complex organ of the human body), and accelerate the re-evolution of modern psychiatry
{"title":"精神醫療再進化：結合人工智慧與精神醫學","authors":"楊智傑 楊智傑","doi":"10.53106/199457952022111606010","DOIUrl":"https://doi.org/10.53106/199457952022111606010","url":null,"abstract":"\u0000 精神疾病常被認為僅是心理問題，而忽略了大腦病理機轉的重要影響，造成精神醫學的診斷和評估仍停滯於主觀的症狀學診斷，而未能如內科疾病引入客觀的儀器診斷。近年來，越來越多的證據顯示精神疾病是大腦的問題。對於結構性和功能性磁振造影的解析，使得精神醫學有機會邁入生物標記診斷評估精神疾病的新階段。而機器學習方法的興起，對於大腦結構和功能數據的分析，更是帶來重要突破和深遠的影響。運用人工智慧與腦影像大數據，我們將有機會建立客觀評估精神疾病診斷與症狀嚴重程度的科學方法，除了能有效協助臨床醫師輔助評估精神疾病，提升精神醫療的照護品質，更重要的是能進一步解析大腦結構和功能與精神症狀的病理機轉，促進我們對於大腦此一人體最複雜的器官的理解，加速現代精神醫學的再進化。\u0000 Mental illness is occasionally dismissed as merely a psychological problem, with the underlying cause of brain pathology often ignored. This lack of knowledge has hindered the development of psychiatric diagnosis and related pathophysiology research. Psychiatric medicine has also failed to adopt objective diagnostic criteria such as those employed in internal medicine. Accumulating evidence reveals that mental illnesses may have underlying neurological causes. Structural and functional magnetic resonance imaging can enable the investigation of novel biomarkers for assessing psychiatric disorders. Additionally, the emergence of machine learning techniques has resulted in considerable breakthroughs and far-reaching consequences in the analysis of brain structure and functional data. Artificial intelligence and brain imaging big data may also provide an opportunity for the establishment of a scientific method for objectively assessing the diagnosis and severity of mental illness symptoms. This can effectively help clinicians in assessing mental illnesses and improve the quality of mental health care. In particular, brain-based psychiatric diagnosis may further delineate the pathological mechanisms of psychiatric symptoms, promote the understanding of the human brain (the most complex organ of the human body), and accelerate the re-evolution of modern psychiatry\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124672553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-01DOI: 10.53106/199457952022111606007
蔡哲嘉 蔡哲嘉, 呂佩穎 Jer-Chia Tsai
年齡歧視是對高齡者產生刻板印象、偏見與差別對待之負面認知態度及行為，是全球嚴重議題，本文探討年齡歧視如何影響高齡者健康品質與介入改善策略。年齡歧視造成健康品質負面效應包括：被排除接受醫療服務與治療、缺少工作機會、心智疾病、身體疾病、被排除參與臨床研究、影響生活品質與幸福感等11項健康領域。健康專業人員與高齡者本身對年齡歧視也造成醫療決策與溝通模式負面效應。改善年齡歧視介入策略包括：運用高齡正面教育與接觸體驗模式、同理心擬真訓練與實證研究彌補實務落差。結語：年齡歧視存在於社會、高齡者、健康專業人員與醫療體系，藉由促進世代間相互瞭解，跨專業之教育訓練與研究合作，以改善年齡歧視，提升高齡者健康品質。 Ageism is a critical global problem that is defined as negative attitudes and behaviors toward older individuals, including stereotyping, prejudice, and discrimination. The aim of this review article was to elucidate how ageism affects the health quality of older individuals and the interventional strategies developed to combat ageism. Previous studies have highlighted the adverse effects of ageism on health quality among 11 health domains, including denied access to health care and treatment, lack of employment opportunities, mental illness, physical illness, exclusion from health research, and poor quality of life and well-being. The previous studies revealed that among health professionals and older individuals, ageism was associated with negative effects on medical decision-making and communication. Moreover, interventional strategies developed to combat ageism involved the use of positive education and contact experience models, empathy simulation training, and evidence-based research to bridge gaps in practice. In conclusion, ageism is a common phenomenon in society and health care systems and among older individuals and health care professionals. Ageism problems must be resolved and the health quality of older individuals must be improved through intergenerational understanding and through interprofessional teamwork in educational training and research.
年龄歧视是对高龄者产生刻板印象、偏见与差别对待之负面认知态度及行为，是全球严重议题，本文探讨年龄歧视如何影响高龄者健康品质与介入改善策略。年龄歧视造成健康品质负面效应包括：被排除接受医疗服务与治疗、缺少工作机会、心智疾病、身体疾病、被排除参与临床研究、影响生活品质与幸福感等11项健康领域。健康专业人员与高龄者本身对年龄歧视也造成医疗决策与沟通模式负面效应。改善年龄歧视介入策略包括：运用高龄正面教育与接触体验模式、同理心拟真训练与实证研究弥补实务落差。结语：年龄歧视存在于社会、高龄者、健康专业人员与医疗体系，借由促进世代间相互了解，跨专业之教育训练与研究合作，以改善年龄歧视，提升高龄者健康品质。 Ageism is a critical global problem that is defined as negative attitudes and behaviors toward older individuals, including stereotyping, prejudice, and discrimination. The aim of this review article was to elucidate how ageism affects the health quality of older individuals and the interventional strategies developed to combat ageism. Previous studies have highlighted the adverse effects of ageism on health quality among 11 health domains, including denied access to health care and treatment, lack of employment opportunities, mental illness, physical illness, exclusion from health research, and poor quality of life and well-being. The previous studies revealed that among health professionals and older individuals, ageism was associated with negative effects on medical decision-making and communication. Moreover, interventional strategies developed to combat ageism involved the use of positive education and contact experience models, empathy simulation training, and evidence-based research to bridge gaps in practice. In conclusion, ageism is a common phenomenon in society and health care systems and among older individuals and health care professionals. Ageism problems must be resolved and the health quality of older individuals must be improved through intergenerational understanding and through interprofessional teamwork in educational training and research.
{"title":"年齡歧視如何影響高齡者健康品質與介入改善策略","authors":"蔡哲嘉 蔡哲嘉, 呂佩穎 Jer-Chia Tsai","doi":"10.53106/199457952022111606007","DOIUrl":"https://doi.org/10.53106/199457952022111606007","url":null,"abstract":"\u0000 年齡歧視是對高齡者產生刻板印象、偏見與差別對待之負面認知態度及行為，是全球嚴重議題，本文探討年齡歧視如何影響高齡者健康品質與介入改善策略。年齡歧視造成健康品質負面效應包括：被排除接受醫療服務與治療、缺少工作機會、心智疾病、身體疾病、被排除參與臨床研究、影響生活品質與幸福感等11項健康領域。健康專業人員與高齡者本身對年齡歧視也造成醫療決策與溝通模式負面效應。改善年齡歧視介入策略包括：運用高齡正面教育與接觸體驗模式、同理心擬真訓練與實證研究彌補實務落差。結語：年齡歧視存在於社會、高齡者、健康專業人員與醫療體系，藉由促進世代間相互瞭解，跨專業之教育訓練與研究合作，以改善年齡歧視，提升高齡者健康品質。\u0000 Ageism is a critical global problem that is defined as negative attitudes and behaviors toward older individuals, including stereotyping, prejudice, and discrimination. The aim of this review article was to elucidate how ageism affects the health quality of older individuals and the interventional strategies developed to combat ageism. Previous studies have highlighted the adverse effects of ageism on health quality among 11 health domains, including denied access to health care and treatment, lack of employment opportunities, mental illness, physical illness, exclusion from health research, and poor quality of life and well-being. The previous studies revealed that among health professionals and older individuals, ageism was associated with negative effects on medical decision-making and communication. Moreover, interventional strategies developed to combat ageism involved the use of positive education and contact experience models, empathy simulation training, and evidence-based research to bridge gaps in practice. In conclusion, ageism is a common phenomenon in society and health care systems and among older individuals and health care professionals. Ageism problems must be resolved and the health quality of older individuals must be improved through intergenerational understanding and through interprofessional teamwork in educational training and research. \u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"601 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123172031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-01DOI: 10.53106/199457952022111606009
陳薇婷 陳薇婷, 陳國佑 陳國佑, 李俊憲 李俊憲
目的：本計畫針對健診顧客於放射科檢查之流程進行探討與改善，以提升健診顧客於放射科之顧客滿意度。 材料與方法：問卷製作參考PZB缺口模型理論，並以SERVQUAL量表作為模版，分為5大項，設計共23個題目。依據調查結果以「動線標示或指標清楚」、「檢查動線的流暢度」列為2大改善方向，改善方法利用資訊流如:路線指示影片、QR code、APP等。 結果：「動線標示或指標清楚」滿意度由87.2%提升至90.2% (p值=0.06)；「檢查動線的流暢度」滿意度由87.8%明顯提升至92% (p值=0.02)。再將改善後23個問題的重視度及滿意度結果繪製成IPA (important performance analysis)分析圖，進行結果分析與探討。 結論：滿意度結合重視度一起分析，可以更客觀的瞭解顧客是否感到滿意，進而針對問題改善，可以有效的改善顧客滿意度。 Aim: The accreditation of teaching hospitals encourages medical staff to present research papers. In this study, we sought to assist medical staff in resolving their research-related dilemma and developing their research interest and ability. Methods: The medical staff of XYZ hospital participated in this study. A questionnaire survey was conducted among the participants. The 28-item questionnaire included questions on the participants’ demographics, experiences related to research and journal submission, research needs, and some open‑ended questions. Results: In total, 113 questionnaires were returned. Of the participants, 54.9% had experience in research paper (mostly domestic journal publications and conference proceedings) presentation and 60% were interested in research. The participants regarded the following three tasks as obstacles to conducting research: data analysis, manuscript writing, and manuscript submission and revision. The participants’ ability to draft manuscripts and use statistical software needed improvements. Conclusions: Our findings and the participants’ feedback may serve as a reference for designing in-service courses and relevant policies for medical staff. Teaching hospitals should provide practical assistance to their medical staff for conducting research in addition to clinical practice.
目的：本计划针对健诊顾客于放射科检查之流程进行探讨与改善，以提升健诊顾客于放射科之顾客满意度。 材料与方法：问卷制作参考PZB缺口模型理论，并以SERVQUAL量表作为模版，分为5大项，设计共23个题目。依据调查结果以「动线标示或指标清楚」、「检查动线的流畅度」列为2大改善方向，改善方法利用资讯流如:路线指示影片、QR code、APP等。 结果：「动线标示或指标清楚」满意度由87.2%提升至90.2% (p值=0.06)；「检查动线的流畅度」满意度由87.8%明显提升至92% (p值=0.02)。再将改善后23个问题的重视度及满意度结果绘制成IPA (important performance analysis)分析图，进行结果分析与探讨。 结论：满意度结合重视度一起分析，可以更客观的了解顾客是否感到满意，进而针对问题改善，可以有效的改善顾客满意度。 Aim: The accreditation of teaching hospitals encourages medical staff to present research papers. In this study, we sought to assist medical staff in resolving their research-related dilemma and developing their research interest and ability. Methods: The medical staff of XYZ hospital participated in this study. A questionnaire survey was conducted among the participants. The 28-item questionnaire included questions on the participants’ demographics, experiences related to research and journal submission, research needs, and some open‑ended questions. Results: In total, 113 questionnaires were returned. Of the participants, 54.9% had experience in research paper (mostly domestic journal publications and conference proceedings) presentation and 60% were interested in research. The participants regarded the following three tasks as obstacles to conducting research: data analysis, manuscript writing, and manuscript submission and revision. The participants’ ability to draft manuscripts and use statistical software needed improvements. Conclusions: Our findings and the participants’ feedback may serve as a reference for designing in-service courses and relevant policies for medical staff. Teaching hospitals should provide practical assistance to their medical staff for conducting research in addition to clinical practice.
{"title":"優化健診顧客於放射科受檢流程","authors":"陳薇婷 陳薇婷, 陳國佑 陳國佑, 李俊憲 李俊憲","doi":"10.53106/199457952022111606009","DOIUrl":"https://doi.org/10.53106/199457952022111606009","url":null,"abstract":"\u0000 目的：本計畫針對健診顧客於放射科檢查之流程進行探討與改善，以提升健診顧客於放射科之顧客滿意度。 材料與方法：問卷製作參考PZB缺口模型理論，並以SERVQUAL量表作為模版，分為5大項，設計共23個題目。依據調查結果以「動線標示或指標清楚」、「檢查動線的流暢度」列為2大改善方向，改善方法利用資訊流如:路線指示影片、QR code、APP等。 結果：「動線標示或指標清楚」滿意度由87.2%提升至90.2% (p值=0.06)；「檢查動線的流暢度」滿意度由87.8%明顯提升至92% (p值=0.02)。再將改善後23個問題的重視度及滿意度結果繪製成IPA (important performance analysis)分析圖，進行結果分析與探討。 結論：滿意度結合重視度一起分析，可以更客觀的瞭解顧客是否感到滿意，進而針對問題改善，可以有效的改善顧客滿意度。\u0000 Aim: The accreditation of teaching hospitals encourages medical staff to present research papers. In this study, we sought to assist medical staff in resolving their research-related dilemma and developing their research interest and ability. Methods: The medical staff of XYZ hospital participated in this study. A questionnaire survey was conducted among the participants. The 28-item questionnaire included questions on the participants’ demographics, experiences related to research and journal submission, research needs, and some open‑ended questions. Results: In total, 113 questionnaires were returned. Of the participants, 54.9% had experience in research paper (mostly domestic journal publications and conference proceedings) presentation and 60% were interested in research. The participants regarded the following three tasks as obstacles to conducting research: data analysis, manuscript writing, and manuscript submission and revision. The participants’ ability to draft manuscripts and use statistical software needed improvements. Conclusions: Our findings and the participants’ feedback may serve as a reference for designing in-service courses and relevant policies for medical staff. Teaching hospitals should provide practical assistance to their medical staff for conducting research in addition to clinical practice.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"155 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114017808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-01DOI: 10.53106/199457952022111606004
許甯傑 許甯傑, 范盛程 范盛程, 蔡景耀 蔡景耀
醫院整合醫學從2009年引進台灣之後，從院內科別與團隊整合開始，逐步擴散到院際之間的合作，並於分級醫療的架構下，作上、中下游連續性照護的垂直轉銜，樹立了醫療網的典範，目前全國有二十多所醫院參與衛生福利部的試辦計畫，並發展出在地特色的醫院與社區轉銜模式，本文以臺北市立聯合醫院的整合醫學照護科為例，分享都會區轉銜的經驗與挑戰，期盼不分層級、醫界共好，攜手合作成為民眾健康的守護者。 Hospital medicine was introduced to Taiwan in 2009. Starting with the integration of teams and departments within a hospital, hospital medicine was gradually expanded to inter-hospital collaborations. Under the framework of the hierarchy of medical care, vertical referrals involving continuous care in the upstream, midstream, and downstream were achieved, establishing an example for the medical network. At present, over 20 hospitals in Taiwan participated in the trial project of the Ministry of Health and Welfare, and they developed hospital and community referral models with local features. This study used the Department of Hospital Medicine of Taipei City Hospital as an example to share the experiences of and challenges faced by making referrals in metropolitan areas, hoping that hospitals of every level can co-prosper and collaborate to become the protector of people’s health.
医院整合医学从2009年引进台湾之后，从院内科别与团队整合开始，逐步扩散到院际之间的合作，并于分级医疗的架构下，作上、中下游连续性照护的垂直转衔，树立了医疗网的典范，目前全国有二十多所医院参与卫生福利部的试办计划，并发展出在地特色的医院与社区转衔模式，本文以台北市立联合医院的整合医学照护科为例，分享都会区转衔的经验与挑战，期盼不分层级、医界共好，携手合作成为民众健康的守护者。 Hospital medicine was introduced to Taiwan in 2009. Starting with the integration of teams and departments within a hospital, hospital medicine was gradually expanded to inter-hospital collaborations. Under the framework of the hierarchy of medical care, vertical referrals involving continuous care in the upstream, midstream, and downstream were achieved, establishing an example for the medical network. At present, over 20 hospitals in Taiwan participated in the trial project of the Ministry of Health and Welfare, and they developed hospital and community referral models with local features. This study used the Department of Hospital Medicine of Taipei City Hospital as an example to share the experiences of and challenges faced by making referrals in metropolitan areas, hoping that hospitals of every level can co-prosper and collaborate to become the protector of people’s health.
{"title":"醫院整合醫學照護與社區轉銜：臺北市立聯合醫院為例","authors":"許甯傑 許甯傑, 范盛程 范盛程, 蔡景耀 蔡景耀","doi":"10.53106/199457952022111606004","DOIUrl":"https://doi.org/10.53106/199457952022111606004","url":null,"abstract":"\u0000 醫院整合醫學從2009年引進台灣之後，從院內科別與團隊整合開始，逐步擴散到院際之間的合作，並於分級醫療的架構下，作上、中下游連續性照護的垂直轉銜，樹立了醫療網的典範，目前全國有二十多所醫院參與衛生福利部的試辦計畫，並發展出在地特色的醫院與社區轉銜模式，本文以臺北市立聯合醫院的整合醫學照護科為例，分享都會區轉銜的經驗與挑戰，期盼不分層級、醫界共好，攜手合作成為民眾健康的守護者。\u0000 Hospital medicine was introduced to Taiwan in 2009. Starting with the integration of teams and departments within a hospital, hospital medicine was gradually expanded to inter-hospital collaborations. Under the framework of the hierarchy of medical care, vertical referrals involving continuous care in the upstream, midstream, and downstream were achieved, establishing an example for the medical network. At present, over 20 hospitals in Taiwan participated in the trial project of the Ministry of Health and Welfare, and they developed hospital and community referral models with local features. This study used the Department of Hospital Medicine of Taipei City Hospital as an example to share the experiences of and challenges faced by making referrals in metropolitan areas, hoping that hospitals of every level can co-prosper and collaborate to become the protector of people’s health. \u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133233250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
疼痛照護，既廣且深。疼痛是就醫病人中，最常見的主訴。幾乎每個單位都有疼痛的病人，涉及層面之廣，需要全院的參與。透過政策面及品質管理面的介入，來提升全院疼痛照護的品質。但慢性疼痛病人的複雜度，又需要跨團隊協力，長期且深度地追蹤治療。 本院藉由疼痛照護品質認證，打造智慧化「疼痛地圖」，發現疼痛「熱區」，進一步介入改善。並藉由個案管理，深度追蹤，以期兼顧疼痛照護的廣度和深度。謹此分享準備認證過程的經驗，以供醫學先進與同道們參考。 Pain is the most common complaint by patients receiving medical care. Nearly all medical units have encountered patients with pain. Because pain management requires deep knowledge of multiple disciplines, it often requires collaboration across an entire medical institution. Policies and quality control are required to ensure the overall quality of pain management at an institution. Chronic pain is particularly complex and requires long-term and in-depth follow-up treatment by multidisciplinary teams. We developed an intelligent pain map to identify hot spots of pain to facilitate further intervention during the preparation of accreditation of disease-specific care certification in pain management. Through case management and in-depth tracking, high-quality pain care on a large scale was expected to implement thoroughly. The certification process is presented in this article, and the experience is shared with all medical professionals and experts.
疼痛照护，既广且深。疼痛是就医病人中，最常见的主诉。几乎每个单位都有疼痛的病人，涉及层面之广，需要全院的参与。透过政策面及品质管理面的介入，来提升全院疼痛照护的品质。但慢性疼痛病人的复杂度，又需要跨团队协力，长期且深度地追踪治疗。 本院借由疼痛照护品质认证，打造智慧化「疼痛地图」，发现疼痛「热区」，进一步介入改善。并借由个案管理，深度追踪，以期兼顾疼痛照护的广度和深度。谨此分享准备认证过程的经验，以供医学先进与同道们参考。 Pain is the most common complaint by patients receiving medical care. Nearly all medical units have encountered patients with pain. Because pain management requires deep knowledge of multiple disciplines, it often requires collaboration across an entire medical institution. Policies and quality control are required to ensure the overall quality of pain management at an institution. Chronic pain is particularly complex and requires long-term and in-depth follow-up treatment by multidisciplinary teams. We developed an intelligent pain map to identify hot spots of pain to facilitate further intervention during the preparation of accreditation of disease-specific care certification in pain management. Through case management and in-depth tracking, high-quality pain care on a large scale was expected to implement thoroughly. The certification process is presented in this article, and the experience is shared with all medical professionals and experts.
{"title":"臺北醫學大學附設醫院參與「疼痛照護品質認證」經驗分享","authors":"劉志中 劉志中, 張淳昭 張淳昭, 李元文 李元文, 施俊明 施俊明, 郭淑柳 郭淑柳, 黃麗宜 黃麗宜","doi":"10.53106/199457952022111606011","DOIUrl":"https://doi.org/10.53106/199457952022111606011","url":null,"abstract":"\u0000 疼痛照護，既廣且深。疼痛是就醫病人中，最常見的主訴。幾乎每個單位都有疼痛的病人，涉及層面之廣，需要全院的參與。透過政策面及品質管理面的介入，來提升全院疼痛照護的品質。但慢性疼痛病人的複雜度，又需要跨團隊協力，長期且深度地追蹤治療。 本院藉由疼痛照護品質認證，打造智慧化「疼痛地圖」，發現疼痛「熱區」，進一步介入改善。並藉由個案管理，深度追蹤，以期兼顧疼痛照護的廣度和深度。謹此分享準備認證過程的經驗，以供醫學先進與同道們參考。\u0000 Pain is the most common complaint by patients receiving medical care. Nearly all medical units have encountered patients with pain. Because pain management requires deep knowledge of multiple disciplines, it often requires collaboration across an entire medical institution. Policies and quality control are required to ensure the overall quality of pain management at an institution. Chronic pain is particularly complex and requires long-term and in-depth follow-up treatment by multidisciplinary teams. We developed an intelligent pain map to identify hot spots of pain to facilitate further intervention during the preparation of accreditation of disease-specific care certification in pain management. Through case management and in-depth tracking, high-quality pain care on a large scale was expected to implement thoroughly. The certification process is presented in this article, and the experience is shared with all medical professionals and experts. \u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"124 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128137665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-01DOI: 10.53106/199457952022111606005
陳博淵 陳博淵
隨著臺灣逐漸步入超高齡社會，重病或行動不便導致就醫不便的民眾正逐漸增加，居家醫療的需求也隨之而起。中醫於2019年納入「全民健康保險居家醫療照護整合計劃」，中醫師加入居家醫療照護及中西醫療整合，共同提升醫療服務與品質。2020年衛生福利部（以下簡稱衛福部）實施「建立中醫社區醫療及長期照顧服務網絡計畫」，從社區醫療、居家個案及長照服務發現需求，提供適切的資源。另由中醫師公會全國聯合會執行來自衛福部長照司核定的「一般及複雜照顧問題生活調養解決方案之專業指導」試辦計畫，透過跨專業之照顧，提高高齡者主動參與日常生活活動能力，解決困難照顧問題。本文將從人口老化與照護負擔至中醫在長照中所扮演的角色，分享中醫參與社區醫療及長照服務之經驗，希冀更多中醫師能夠參與，共創全民健康福祉。 As Taiwan enters the superaged society, the number of people who find it difficult to seek medical care because of severe illness or mobility problems is increasing, leading to a rise in the need for home medical care. In 2019, traditional Chinese medicine (TCM) was incorporated into the National Health Insurance Home Medical Care Integration Program; thus, TCM practitioners joined home medical care, leading to the integration of TCM and Western medicine, improving the quality of medical services. In 2020, the Ministry of Health and Welfare implemented the Program to Establish a TCM Community and Long-term Medical Care Service Network, in which the medical needs of people are identified through community, home, and long-term medical services and appropriate resources are provided accordingly. In addition, the National Union of Chinese Medical Doctor’s Association executed the pilot program Professional Guidance on Solutions for General and Complex Problems in Medical Care by the Ministry of Health and Welfare Department of Long-term Care, in which interdisciplinary care is provided to raise older adults’ capability to autonomously participate in daily life activities, thereby solving the difficulties encountered in medical care. In this study, the experience of TCM practitioners in participating in community and long-term medical care services is presented from the perspectives of population aging, burden of medical care, and the role of TCM practitioners in long-term care, providing incentives to TCM practitioners to participate in community and long-term medical care, thereby enhancing health and welfare across Taiwan.
随著台湾逐渐步入超高龄社会，重病或行动不便导致就医不便的民众正逐渐增加，居家医疗的需求也随之而起。中医于2019年纳入「全民健康保险居家医疗照护整合计划」，中医师加入居家医疗照护及中西医疗整合，共同提升医疗服务与品质。2020年卫生福利部（以下简称卫福部）实施「建立中医社区医疗及长期照顾服务网络计划」，从社区医疗、居家个案及长照服务发现需求，提供适切的资源。另由中医师公会全国联合会执行来自卫福部长照司核定的「一般及复杂照顾问题生活调养解决方案之专业指导」试办计划，透过跨专业之照顾，提高高龄者主动参与日常生活活动能力，解决困难照顾问题。本文将从人口老化与照护负担至中医在长照中所扮演的角色，分享中医参与社区医疗及长照服务之经验，希冀更多中医师能够参与，共创全民健康福祉。 As Taiwan enters the superaged society, the number of people who find it difficult to seek medical care because of severe illness or mobility problems is increasing, leading to a rise in the need for home medical care. In 2019, traditional Chinese medicine (TCM) was incorporated into the National Health Insurance Home Medical Care Integration Program; thus, TCM practitioners joined home medical care, leading to the integration of TCM and Western medicine, improving the quality of medical services. In 2020, the Ministry of Health and Welfare implemented the Program to Establish a TCM Community and Long-term Medical Care Service Network, in which the medical needs of people are identified through community, home, and long-term medical services and appropriate resources are provided accordingly. In addition, the National Union of Chinese Medical Doctor’s Association executed the pilot program Professional Guidance on Solutions for General and Complex Problems in Medical Care by the Ministry of Health and Welfare Department of Long-term Care, in which interdisciplinary care is provided to raise older adults’ capability to autonomously participate in daily life activities, thereby solving the difficulties encountered in medical care. In this study, the experience of TCM practitioners in participating in community and long-term medical care services is presented from the perspectives of population aging, burden of medical care, and the role of TCM practitioners in long-term care, providing incentives to TCM practitioners to participate in community and long-term medical care, thereby enhancing health and welfare across Taiwan.
{"title":"中醫參與社區醫療及長照服務之經驗分享","authors":"陳博淵 陳博淵","doi":"10.53106/199457952022111606005","DOIUrl":"https://doi.org/10.53106/199457952022111606005","url":null,"abstract":"\u0000 隨著臺灣逐漸步入超高齡社會，重病或行動不便導致就醫不便的民眾正逐漸增加，居家醫療的需求也隨之而起。中醫於2019年納入「全民健康保險居家醫療照護整合計劃」，中醫師加入居家醫療照護及中西醫療整合，共同提升醫療服務與品質。2020年衛生福利部（以下簡稱衛福部）實施「建立中醫社區醫療及長期照顧服務網絡計畫」，從社區醫療、居家個案及長照服務發現需求，提供適切的資源。另由中醫師公會全國聯合會執行來自衛福部長照司核定的「一般及複雜照顧問題生活調養解決方案之專業指導」試辦計畫，透過跨專業之照顧，提高高齡者主動參與日常生活活動能力，解決困難照顧問題。本文將從人口老化與照護負擔至中醫在長照中所扮演的角色，分享中醫參與社區醫療及長照服務之經驗，希冀更多中醫師能夠參與，共創全民健康福祉。\u0000 As Taiwan enters the superaged society, the number of people who find it difficult to seek medical care because of severe illness or mobility problems is increasing, leading to a rise in the need for home medical care. In 2019, traditional Chinese medicine (TCM) was incorporated into the National Health Insurance Home Medical Care Integration Program; thus, TCM practitioners joined home medical care, leading to the integration of TCM and Western medicine, improving the quality of medical services. In 2020, the Ministry of Health and Welfare implemented the Program to Establish a TCM Community and Long-term Medical Care Service Network, in which the medical needs of people are identified through community, home, and long-term medical services and appropriate resources are provided accordingly. In addition, the National Union of Chinese Medical Doctor’s Association executed the pilot program Professional Guidance on Solutions for General and Complex Problems in Medical Care by the Ministry of Health and Welfare Department of Long-term Care, in which interdisciplinary care is provided to raise older adults’ capability to autonomously participate in daily life activities, thereby solving the difficulties encountered in medical care. In this study, the experience of TCM practitioners in participating in community and long-term medical care services is presented from the perspectives of population aging, burden of medical care, and the role of TCM practitioners in long-term care, providing incentives to TCM practitioners to participate in community and long-term medical care, thereby enhancing health and welfare across Taiwan.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122303205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：