身心障礙機構實施癲癇控制分級管理措施實踐經驗之研究-以瑪利亞霧峰教養家園為例

The study of graded management implementation experiences on epilepsy control measures in the disability institution --Example of Maria Educational Homes,Wufeng

蔡春足(Chun-Tsu Tsai)

指導教授 ： 黃源協

國立暨南國際大學/人文學院/公共行政與政策學系/碩士(2014年)

https://doi.org/10.6837/NCNU.2014.00250

摘要

論文名稱：身心障礙機構實施癲癇控制分級管理措施實踐經驗之研究
---以瑪利亞霧峰教養家園為例
校院系：國立暨南國際大學人文學院公共行政與政策學系 頁數：151頁
畢業時間：中華民國103年1月 學位別：碩 士
研究生：蔡春足 指導教授：黃源協博士
論文摘要
本研究針對身心障礙機構實施「癲癇控制分級管理措施」的實踐經驗探討，以了解某全日型生活照顧機構如何實施癲癇控制分級評估管理措施，其中也呈現全日型身心障礙教養機構在面對癲癇問題時所帶來的挑戰。說明此管理措施介入之後的轉變、探討機構的建立分級管理的歷程、如何執行癲癇控制分級評估管理措施，以實施歷程的研究來探討癲癇控制分級評估策略的運作模式。
研究者採用質性研究的方式，且透過「文件分析」及「深度訪談」，呈現癲癇分級評估措施之實踐經驗，以說明一套分級管理措施的實踐歷程，呈現癲癇處理的配套與機構實施此措施的經驗，探討改善癲癇發作的行動，並據以了解我國全日型身心障礙機構在服務癲癇疾患的身心障礙者時所面對的困境。研究結果發現癲癇發作問題的特質：癲癇發作的型態不一、發作時間難以掌握；癲癇重積有生命的危險，機構工作人員在處理上有急迫性；服務對象癲癇發作需要緊急動員人力前來支援處理、處理癲癇發作的技巧需要靠經驗的累積。另一方面，全日型身心障礙機構在面對癲癇發作處理時面臨到：照顧人力比例高、時間長，工作人員在照顧癲癇個案心理壓力大、社區就近的醫院接受癲癇急救處理的意願低、全日型機構家長支持度低且癲癇問題處理的態度與機構不同調、身障者在癲癇的就醫方面則面臨到設施設備與本身認知障礙的困難。
根據研究目的與結論，提出對於我國身心障礙機構實施癲癇控制分級評估措施的反思與具體之建議。

關鍵字

身心障礙機構 ； 癲癇控制 ； 分級管理

並列摘要

Title of Thesis: The Study of Graded Management Implementation Experiences on Epilepsy Control Measures in the Disability Institution -- Example of Maria Educational Homes, Wufeng.
Department:Department of Public Policy and Administration, College of Humanities, National Chi Nan University University page：151
Graduation: January, 2014 Degree: Master
Graduate Student: Chun-Tsu,Tsai Advising Professor: Yuan-Shie ,Huang ph.D.

Abstract

This study explores the implementation experiences of “graded management measures of epilepsy control” in a disability institution in order to understand how management measures of epilepsy control graded assessments are implemented in a 24-hour Life Care Institution; and from which, challenges facing 24-hour disability educational institutions with problems of epilepsy are also presented. The transformation after the introduction of this management measure is illustrated, the processes of institutions establishing this graded management are studied, and how to execute the epilepsy control graded assessment management measures, using studies of the implementing processes to explore the operating model of epilepsy control graded assessment strategy.

Researcher adopts qualitative research method; and through document analysis and in-depth interview, this research demonstrates the implementing experiences of epilepsy control graded assessment management measures. By illustrating the implementing experiences of a set of graded management measures, the supporting measures for epilepsy processing and the experiences gained by the implementing institution are demonstrated, the actions during epilepsy seizures are explored and improved, and based on the above, the difficulties facing the 24-hour disability institution when servicing disabled individual with epilepsy are understood. The research result uncovers the characteristics of epilepsy at the time of seizure: there are different types of epilepsy seizures and the times of attacks are hard to grasp, epilepticus is life-threatening and institution staff should handle it with urgency, emergency support mobilization is required when the subject of service is having a seizure, and the techniques required for dealing with seizures depend on the accumulation of experience. On the other hand, when dealing with seizures, the 24-hr disability institution faces: high percentage of care-taking personnel, long work hours, highly stressed epilepsy subject caretakers, low willingness of nearby community hospitals to accept epilepsy patients, 24-hr institution has minimal support from parents and their attitudes towards how epilepsy is handled are not in tune with the institution, and disable individuals face difficulties in facility and equipment and have cognitive impairment when it comes to epilepsy medical care.

Based on the purpose and conclusion, this study brings forward introspections and specific recommendations for domestic disability institutions implementing the epilepsy control graded assessment management measures.

並列關鍵字

Disability Institution ； Epilepsy Control ； Graded Management

參考文獻

參考文獻：

內政部，2013，《身心障礙福利機構評鑑及獎勵辦法》，台北：內政部。

內政部統計處， 2012，《內政統計通報:101年底列冊身心障礙者人數統計》，內

政部統計處。

內政部統計處，2012，《內政統計通報:101年1-12月身心障礙者福利服務概