案例討論於社區醫療照護團隊教育成效之初探

Application of A Case Study Teaching Method in Community Hospice Health Care Providers- A Pilot Study

邱世哲(Shih-Che Chiu) ； 杜瀛岳(Ying-Yueh Tu) ； 黃銘源(Ming-Yun Huang) ； 李英芬(In-Fun, Li)

《安寧療護雜誌》 20卷1期 (2015/03) Pp. 13-23

https://doi.org/10.6537/TJHPC.2015.20(1).2

摘要

背景：政府於2014年1月起，新增社區安寧療護服務納入健保給付，鼓勵社區基層醫療院所亦能投入生命末期之照護。雖多數基層醫療人員對安寧療護有所認知，但照護方式及內容較缺少經驗。研究目的：以ADDIE教育模式研擬之案例討論教育課程，提供社區醫療照護人員不同之學習，增加其對末期病人之照護能力。材料與方法：由臨床專家共同擬定包含多種臨床情境之案例，進行分組討論，另有安寧緩和醫療條例臨床運用常見問題及哀傷輔導之講授。評值工具為學員之前後測及課程滿意度。結果與結論：參與課程共78位，護理師51位最多(65.4%)，有22位(28.2%)工作於地區醫院為最多。後測之各題答對率均有提高，整體答對率後測平均為85.6%，較前測平均之74.1%高，且達統計之顯著差異(t= 9.38, p＜ .005)。課程滿意度達4.41分(滿分5分)，自評對未來工作之助益為4.39分(滿分5分)。初步顯示結合臨床情境與學理之案例有別於一般傳統式教學，增加學員學習效果，有效達成教學目標。

關鍵字

案例討論 ； 社區安寧療護 ； 教育模式

並列摘要

Backhground: Since January 2014, the Ministry of Health and Welfare of Taiwan has included community hospice care service into National Health Insurance in order to encourage community health care porviders to participate in this service. Although most of them have some concepts about hospice care service, they are still lack of the practical experience. Purpose: By ADDIE education model, we develop a case-discussion workshop of hospice care to offer basic hospice care abilities for health care porviders. Method: Clinical hospice care experts develop multi-scene cases for group discussion conference in the workshop. Besides, experts will give two topic lectrures of clinical obstacles about Hospice Palliative Care Regulation and bereavement management. The evaluation tools are pre-test, post-test sheet and the satisfication survey. Results：There were 78 paritcipators attended the workshop, with 51 nurses (65.4%) and 22(28.2%) working in the distrinct hospitals. The correct answer rate raised from 74.1% of pre-test to 85.6% of post-test and had statistical differences (t= 9.38, p＜ .005). The satisfication rate of the workshop was 4.41(total score was 5), and the rate of “helpfulness for the future clinical practice” was 4.39(total 5). The pilot results appeared that this multi-scene cases discussion conference workshop combined with topic lectrures (the short class) were effective and helpful for the incumbent health providers.

並列關鍵字

Case study ； Community hospice care ； teaching method

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