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本文另有預刊版本,請見:10.6200/TCMJ.202008/PP.0007

摘要


新型冠狀病毒的出現造成社會衝擊層面廣,對於在醫療、公共衛生、藥物化學、生化等領域等的醫療人員及研究工作者,也都需要跳脫過去的思維,重新檢視工作方法以因應公共衛生危機。新型冠狀病毒流行對個人健康帶來的威脅和醫療照護體系的衝擊,引發世界各國對預立醫療照護決定的關注和討論。預立醫療照護諮商(Advance Care Planning,簡稱ACP)已被證實可明顯改善病人和家庭的滿意度和幸福感,然影響個人參與預立醫療決定的因素眾多,在新型冠狀病毒(Coronavirus disease,簡稱COVID-19)之後,我們亦觀察到流行病對ACP的影響。因應新型冠狀病毒的流行,世界各國開始提醒民眾及醫療人員預立醫療照護決定的重要性,希望民眾可以花時間思考當個人罹患新型冠狀病毒時希望得到符合他們個人價值的醫療照護方式。因此,在後新冠時代,我們應善用生活事件來宣導ACP,例如:流行病學,提升民眾死亡識能以增加ACP知識,以及在壓力情境下更應加強以人為本的ACP照護概念。除了積極推動ACP,依照臺灣目前對ACP的規範,我們建議ACP的執行應有更多彈性,包括:多元ACP執行地點,鬆綁執行ACP諮商團隊人力,其次,COVID-19的治療方式及症狀並不符臺灣病人自主權利法(Patient Right to Autonomy Act,簡稱病主法)中啟動預立醫療醫療決定(Advance decision,縮寫AD)的臨床條件,醫療團隊必須要花更多時間去瞭解並協助病人討論他們所期望的醫療照護模式,也為病人、家人和整個醫療體系提供支持。

並列摘要


The spread of the Coronavirus disease (COVID -19) has caused a wide range of social impacts. For workers in the fields of health care settings, it is also necessary to change the way of thinking and reexamine the working methods in response to the public health crisis. The threat of the COVID -19 to personal health and the impact of the medical care system have aroused the attention and discussion of advance care planning in many countries around the world. Advance Care Planning (ACP) has been proven to significantly improve patient and family satisfaction and well-being. However, there are many factors influence individuals to engage in ACP, after COVID -19, we have observed the impact of epidemic on ACP. In response to the prevalent COVID-19, countries around the world have begun to remind the public and medical staff of the importance of ACP, hoping that the public can spend time thinking about the preferences of medical care that individuals would like to receive when they are suffering from COVID-19. ACP During the period of post- COVID-19, we recommend to use life events, such as epidemic to promote actively in community; to enhance people's awareness of death to promote ACP knowledge; and to strengthen the concept of person-centered care specially under the situation of crisis. In addition to promotion of ACP more actively, regarding the regulation of ACP in Taiwan, we also suggest first that the implementation of ACP should be more flexible, including provide variety accessibility of ACP locations, loosen consultation team manpower required by ACP. Second, because the medical treatment and condition in COVID-19 may not be applicable in initiating advance decision (AD) according of Patient Right to Autonomy Act in Taiwan, health care team need more understanding and discussion to assist patients to receive the care they want, and also provide support for patients, family members and the entire medical system.

被引用紀錄


楊惠卿(2022)。後疫情時代探討病人自主權利法對個人與家庭心理的影響輔導季刊58(3),33-42。https://www.airitilibrary.com/Article/Detail?DocID=19966822-202209-202210120013-202210120013-33-42

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