本篇論文為「老人整合性門診服務運作之現況調查」,內容主要為調查及分析目前設有老人整合性門診在台灣北部醫院服務現況,從回顧整合性門診設立、經營特色、就診條件及提供服務項目內容與看診方式等進行分析,並透過質性研究調查,以非參與式觀察和深度訪談法,對整合性門診專業團隊成員進行會談,以了解目前在老人整合門診執行上所遇到之困境。並藉由此現況的分析,以瞭解目前老人整合性門診實施現況,及在整合性專業團隊中其推行的可行性。雖然現階段老人整合性門診的運作情況可說是「革命尚未成功,同志仍需努力」,但相信在政府組織、醫療院所、專業的照護團隊成員與民眾等多方面的配合下,可將阻力化為助力,更有助老人整合性門診的推行。根據訪談結果與實際觀察發現,「老人整合性門診」除了可以節省醫療費用、減輕病患往返醫院奔波的時間、增加病患多科看診的方便性、減少與避免重複用藥的危險性,更重要的是老年病患可以由此獲得到跨專業領域團隊的共同服務。不論是老人專業團隊成員或非老人專業團隊成員間,以老年病患的立場為主要考量,彼此藉由溝通、互相鼓勵與正面積極思考的態度來解決問題,更能為長者病患與家屬帶來最大的效益。老年民眾的醫療和照護在現今社會中極為重要,又因老年人需求多元化,亦需發展不同的照護模式,所以在推動上更需要多重專業的密切合作才能永續推動。
This article describes a research in the present situation of integrated geriatric medicine clinics. The contents include the survey and analysis of the present service situation in the north Taiwan hospitals with integrated geriatric medicine clinics. The review of setting procedures, working properties, treating conditions, servicing items and diagnosing ways in the integrated geriatric medicine clinics are for analysis. And the qualitative research is used to understand the difficulty in implementation of integrated geriatric medicine clinics by nonparticipant observation and interviews with interdisciplinary team members. From the present analysis, understanding the situation of integrated geriatric medicine clinics and practicability in the interdisciplinary team. Although the present situation of integrated geriatric medicine clinics could be “A revolution has not succeeded yet and still keeps going today.” We believe the Government, hospitals, team members and people’s cooperation could turn the tables and creat more advantage to help integrated geriatric medicine clinics development. According the result of interviews and observation, integrated geriatric medicine clinics could economize medical expenses, save traffic time to hospital、more convinient for interdisciplinary clinics, erase and avoid the danger of medical repeat, the more important is geiatric patients could get the collective service of interdisciplinary teams. No matter the members is with geriatric team or non- geriatric team,the principal consideration will center around geriatric patients. With communication, help and positive attitude with each other to solve problems, these could bring geriatric patients and families the most benefit. The geriatric medicine and nursing are very important today. For geriatric’s different needs, various nursing models required, more interdisciplinary specialists’ close cooperation will be needed for sustainable development.
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