脫離準備度之概念分析

所有呼吸器依賴病人進行呼吸器脫離前，建議應評估脫離準備度，以及早啟動呼吸器脫離訓練並進而提高脫離的成效。目前對「脫離準備度」尚無明確的概念分析，本文依據Walker及Avant（1995）所提出的概念分析方法，從實證觀點及病人主觀經驗，進行操作性定義，以確認此概念的鑑定性特徵，包括連續性評估與多面向的評估，並舉出範例輔助說明。期本文經概念分析後，有助於呼吸器脫離之相關語言基本概念的澄清，減少臨床人員在呼吸照護溝通的混淆，並做為臨床制定呼吸器脫離準備度評估表之參考。

關鍵字

呼吸器；脫離準備度

並列摘要

For early initiation of spontaneous breathing trail and to improve the effectiveness of weaning from ventilator, all ventilator-dependent patients should be assessed for weaning readiness prior to weaning. However, the concept of weaning readiness has been unexplored in literature. According to Walker and Avant (1995), the focus that underpins concept analysis is to develop an operational definition of weaning readiness, including continual assessment and multidimensional assessment. Through a list of defining attributes, and model case development, these will clarify the basic concepts in order to reduce confusion in communication among clinical staff. Also guild to formulate the assessment tool of weaning readiness.

並列關鍵字

ventilator ； weaning readiness

參考文獻

Blackwood, B. (2000). The art and science of predicting patient readiness for weaning from mechanical ventilation. International Journal of Nursing Study, 37(2), 145-151. doi:10.1016/S0020-7489(99)00062-0

Burns, S. M., Ryan, B., & Burns, J. E. (2000). The weaning continuum use of acute physiology and chronic health evaluation III, burns wean assessment program, therapeutic intervention scoring system, and wean index scores to establish stages of weaning. Critical Care Medicine, 28(7), 2259-2267. doi:10.1097/00003246- 200007000-00013

Chang, M. Y., Chang, L. Y., Huang, Y. C., Lin, K. M., & Cheng, C. H. (2011). Chair-sitting exercise intervention does not improve respiratory muscle function in mechanically ventilated intensive care unit patients. Respiratory Care, 56(10), 1533-1538. doi: 10.4187/respcare.00938

Hampton, D. C., Griffith, D., & Howard, A. (2005). Evidence-based clinical improvement for mechanically ventilated patients. Rehabilitation Nursing, 30(4), 160-165. doi:10.1002/j.2048-7940.2005. tb00101.x

Lee, P. C. (1996). The meanings of weaning: growth, lactation, and life history. Evolutionary Anthropology: Issues, News, and Reviews, 5(3), 87-96. doi: 10.1002/ (SICI)1520-6505 (1996)5:3<87::AID- EVAN4>3.0.Co;2T

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脫離準備度之概念分析

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