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摘要


台灣已於2019年4月24日公告修正《兒童及少年福利與權益保障法》,第13條新增「中央衛生主管機關應進行六歲以下兒童死亡原因回溯分析並定期公布分析結果」,讓兒童死亡回顧有法源依據。本文包括三個部分:首先解釋為什麼要進行兒童死亡回顧,接著簡述兒童死亡回顧的發展,最後建議如何進行兒童死亡回顧。兒童死亡回顧的定義:由跨單位跨領域代表組成的小組,分享該單位對於該兒童死亡個案相關記錄,勾勒出導致兒童死亡的較完整脈絡情境,找出可改變的因素,提出具體建議,系統性減少類似死亡事件再發生。本文建議各縣市依照四個步驟來推動兒童死亡回顧:步驟一:由府一層主管擔任兒童死亡回顧小組召集人,邀請核心成員固定參與討論;步驟二:由衛生局擔任資料小組與協作平台,整理死亡兒童基本資料與聯絡開會事宜;步驟三:依照議程進行個案討論;步驟四:撰寫會議記錄與建議報告。中央衛生主管機關應彙集不同縣市建議,擬定適當防治(制)策略,有效降低兒童死亡率。

並列摘要


The Protection of Children and Youth Welfare and Rights Act was amended on April 24, 2019. Article 13 indicates that health authorities must conduct a child death review (CDR) for children who die when aged 6 years and younger and periodically release analysis results. The present article includes three sections. First, we explain why CDR should be implemented. Second, we introduced the development of CDR. Third, we suggest appropriate measures to implement a CDR program. CDR is defined as a collaborative process that brings people together from different sectors and multiple disciplines to share and discuss comprehensive information on circumstances leading to the death of a child. Moreover, notable and potentially remediable factors are identified, and recommendations for system improvements are made to prevent future child deaths. Four steps were recommended to implement a CDR program at the city or county government level. Step 1: a deputy mayor or magistrate of the city or county government is appointed as the convener of the CDR team and invites core members to attend regular meetings. Step 2: the health bureau of the city or county is established as the coordinating center for the collection of basic information regarding deceased children and is responsible for arranging the meetings. Step 3: the CDR meeting agenda is followed. Step 4: meeting minutes and recommendations are recorded. Health authorities in the central government collect recommendations from city or county governments and use them to design relevant prevention and control strategies to effectively reduce child mortality.

參考文獻


呂宗學、蕭安芝、徐俊強、彭花春、陳麗華:死因診斷與死因統計品質。台灣醫學 2013;17:551-7。Lu TH, Hsiao AJ, Hsu CC, Peng HC, Chen LH. Quality of cause of death statements and statistics. Formosan J Med 2013;1 7:551-7. doi:10.6320/FJM.2013.17(5).13. [In Chinese: English abstract]
梁富文、黃雅莉、吳美環、呂鴻基、江東亮、呂宗學:兒童死亡率:台灣與經濟發展合作組織國家比較。台灣衛誌 2016;35:221-33。doi:10.6288/TJPH201635104087。Liang FW, Huang YL, Wu MH, Lue HC, Chiang TL, Lu TH. Child mortality: Taiwan compared with OECD countries. Taiwan J Public Health 2016;35:221-33. doi:10.6288/TJPH201635104087. [In Chinese: English abstract]
Fraser J, Sidebotham P, Frederick J, Covington T, Mitchell EA. Learning from child death review in the USA, England, Australia and New Zealand. Lancet 2014;384:894-903. doi:10.1016/S0140-6736(13)61089-2
Sidebotham P, Fraser J, Ward-Platt M, Hain R. Patterns of child death in England and Wales. Lancet 2014;384:904-14. doi:10.1016/S0140-6736(13)61090-9
Sidebotham P, Fraser J, Covington T, et al. Understanding why children die in high-income countries. Lancet 2014;384:915-27. doi:10.1016/S0140-6736(14)60581-X

被引用紀錄


張弘潔(2023)。第二次《兒童權利公約》國際審查對台灣兒少公共衛生政策之啟示台灣公共衛生雜誌42(3),271-274。https://doi.org/10.6288/TJPH.202306_42(3).111112

延伸閱讀


  • 汪欣怡、黃馨慧(2009)。幼兒死亡概念之探究生死學研究(10),117-158。https://doi.org/10.29844/JLDS.200907.0003
  • 王淑俐(2012)。一個單親家庭孩子之死台灣教育(673),27-29。https://doi.org/10.6395/TER.201202.0027
  • 張馥安、陳玉蓉(2014)。陪孩子走過死亡臺灣教育評論月刊3(7),112-114。https://www.airitilibrary.com/Article/Detail?DocID=P20130114001-201407-201408120025-201408120025-112-114
  • 盧文雄、魏火曜(1966)。兒童企圖自殺之臨床分析Acta Paediatrica Sinica7(3),157-160。https://www.airitilibrary.com/Article/Detail?DocID=00016578-196609-7-3-157-160-a
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