進階搜尋


 
系統識別號 U0026-0707201803075800
論文名稱(中文) 急性醫療機構護理人員對失智症照護能力現況之探討
論文名稱(英文) Competence in caring for patients with dementia for nurses working in acute care setting
校院名稱 成功大學
系所名稱(中) 護理學系
系所名稱(英) Department of Nursing
學年度 106
學期 2
出版年 107
研究生(中文) 蕭均卉
研究生(英文) Chun-Hui Hsiao
學號 T26034082
學位類別 碩士
語文別 中文
論文頁數 96頁
口試委員 指導教授-王靜枝
口試委員-劉立凡
口試委員-馬淑清
中文關鍵字 失智症  急性醫療機構  護理人員  照護能力 
英文關鍵字 dementia  acute care setting  nurse  Competence 
學科別分類
中文摘要 研究背景
我國已邁向高齡社會,失智症患者急速增加且其因慢性病程常需至急性醫療院所就醫或住院,而住院期間失智病人的問題行為加劇。護理人員面對忙碌的臨床事務與對失智照護知能的缺乏,常需要使用醫師處方藥物或身體約束來處理失智症患者問題行為,使得住院失智症病人接受疾病治療時沒有獲得尊嚴且加劇問題行為,甚至影響照護人員的工作效率與延長住院天數。若能了解急性醫療機構護理人員於照護失智症病人的能力之現況,作為我國急性醫療機構護理人員培訓與教育基準,進而使護理人員實踐有效的失智症照護,提升醫院整體照護品質。
目的
本研究的目的為探討急性醫療機構的護理人員對失智症照護能力的現況,並分析護理人員對失智症照護的知識、態度、照護技巧於人口學特性上的差異,及探討護理人員對失智症照護的知識、態度與照護技巧三者之間的相關性。
方法
採橫斷式、描述性研究,研究對象為南部二所醫學中心內外科成人單位與精神科的護理人員。以結構式問卷收集資料。包含人口學特性、失智症照護的知識與態度、技巧。以描述性統計、變異數分析與皮爾森相關係數來分析各變項間的資料。
結果
本研究結果發現急性醫療機構93.5%護理人員皆有照顧失智症病人的經驗,然曾接受培訓者只有36.7%,培訓時數平均為2小時,主要學習失智症照護來源多為經驗學習。年齡愈大、工作年資愈長、照護失智症年資愈久、曾接受培訓者在失智症照護的知識、態度、技巧得分上愈高;在護理人員對於失智症照護能力的得分上,顯示在失智症照護知識的平均得分13.79(標準差±1.84),照護態度的平均得分42.98(標準差±4.61),照護技巧的平均得分6.86(標準差±1.32)。在護理人員對失智症照護知識、態度、技巧間的相關性中,結果顯示失智症照護知識得分高低與失智症照護的態度無顯著相關,但失智症照護知識得分與失智症照護技巧有顯著相關(p<0.01);而失智症照護的正負向態度也會影響照護技巧的得分(p<0.01)。
結論
研究結果顯示護理人員對於失智症的知識與照護技巧基礎的認識尚佳且多持正向的態度,但對失智症疾病分期的症狀認知、識別失智症與瞻妄及問題行為行為處理的技巧、方法上仍需加強的空間。本研究提供初步台灣醫學中心護理人員對失智症照護能力的現況,建議急性醫療院所應該加強護理人員某些主題的失智症教育訓練,透過多學科合併臨床實作,提升護理人員對失智症照護能力,以改善住院失智症病人的照護品質。
英文摘要 The purpose of this study was to investigate competencies in caring for PwD among nurses in ACFs; to examine the differences in dementia care knowledge, attitudes and skills by demographic characteristics of nurses. A cross-sectional and descriptive research was conducted on nurses from departments of internal medicine and surgery for adults and psychiatry in two medical centers in South Taiwan. Results of this study show that the nurses do have knowledge of dementia care and basics of dementia care skills, but need methodological enhancement in symptom awareness in different stages of dementia, differentiation between dementia and delirium, and skills for dealing with problem behaviors. Most of nurses have positive attitudes towards care for patients with dementia, but should receive further education and training on awareness of dementia and skills for handling problem behaviors to improve quality of care for hospitalized patients with dementia.


論文目次 第一章 緒論 1
第一節 研究背景與重要性 1
第二節 研究目的 3
第三節 研究問題 3
第二章 文獻查證 4
第一節 失智症照護能力 4
第二節 失智症照護知識 7
第三節 失智症照護態度 12
第四節 失智症照護技巧 14
第五節 臨床上失智症病人行為與精神症狀處置的現況 17
第六節 影響急性醫療機構護理人員對失智症知識、態度、照護技巧之相關因素 18
第七節 急性醫療機構護理人員在照護失智症病人的困難 20
第三章 研究方法 23
第一節 研究設計 23
第二節 研究步驟 23
第三節 研究對象 25
第四節 研究工具 26
第五節 資料統計與分析方法 31
第六節 研究倫理 33
第四章 研究結果 34
第一節 人口學屬性分析 34
第二節 護理人員之失智症照護知識、態度、技巧的現況 37
第三節 護理人員的失智症照護知識、態度、技巧於人口學屬性與專業特性下之差異性 43
第四節 護理人員之失智症照護知識、態度、技巧之相關性為何? 50
第五節 開放式問題 51
第五章 討論 53
第一節 急性醫院護理人員人口學屬性分析 54
第二節 護理人員之失智症照護知識、態度、技巧的現況 56
第三節 護理人員的失智症照護知識、態度、技巧於人口學屬性之差異 61
第四節 護理人員之失智症照護知識、態度、技巧之相關性 63
第六章 結論與建議 65
第一節 結論 65
第二節 研究限制 66
第三節 建議 67
文獻參考 71
中文文獻 71
英文文獻 73
附錄
附錄一 研究問卷……………………………………………………………………84
附錄二 受試者同意書………………………………………………………………92
附錄三 人體試驗委員會審查同意書……………………………………………..95


參考文獻 中文文獻
國際失智症協會(2015).2015年全球失智症報告.取自https://www.alz.co.uk/research/worldalzheimerreport2015-traditionalchinese.pdf
內政部統計處(2018).重要內政統計指標.取自https://www.moi.gov.tw/files/site_node_file/6717/list.PDF
國家發展委員會(2016).中華民國人口推估.取自file:///C:/Users/user/Downloads/105%E7%89%88%E4%BA%BA%E5%8F%A3%E6%8E%A8%E4%BC%B0%E5%A0%B1%E5%91%8A0810final%20(1).pdf
台灣失智症協會(2017).台灣失智症人口推估.取自http://www.tada2002.org.tw/About/IsntDementia
台灣失智症協會(2017).失智症照護技巧.取自http://tada2002.ehosting.com.tw/Support.Tada2002.org.tw/support_care02.html
衛生福利部(2017).呼應WHO全球失智症行動計畫 長照2.0創新設立失智共同照護中心.取自https://www.mohw.gov.tw/cp-3250-29917-1.html
石新添 (2006).高階政風人員核心能力之研究-以北台灣地區簡任政風人員為例.台北:政治大學行政管理碩士學位論文。
江筱璇(2005).公共衛生護理人員對失智症照護的知識、 態度與執行信心.臺灣大學護理學研究所學位論文。
李彩緣、徐慧娟、周怡伶、陳鈺如(2012).中部某醫學中心護理人員對老人態度及照顧意願之探討.護理暨健康照護研究, 8(4),297-305。
李怡萱、陳晶瑩、湯麗玉、梁繼權(2013).失智症行為及精神症狀的非藥物處置.台北市醫師公會會刊, 57(5),33-37。
黃政傑(1985).課程改革.台北:漢文。
黃惠玲、徐亞瑛(2003).照顧者訓練方案對改善失智症照顧者能力之探討.長期照護雜誌,7(2), 121-134。
黃雅祺、雷若莉、許振榮、曾怡樺、葉建鑫(2018).人本環境對失智症住民之精神行為問題之成效-系統性文獻回顧.澄清醫護管理雜誌,14(1),52-60。
傅中玲、陳正生、歐陽文貞、林克能、李光廷、宋惠娟等(2015).失智症的類型、病程與治療.傅中玲,失智症照護(22-39頁).台北市:華都文化。
傅中玲(2008).台灣失智症現況‧台灣老年醫學暨老年學雜誌, 3(3), 169-181。
齊于箴、劉芳、蕭伃伶(2017).照顧服務員的失智症照護知識與態度之探討.長期照護雜誌,21(1),37-52。
歐陽文貞(2011).老人失智症的藥物治療及其重要課題.中南盟研究年刊,4(1),49-71。
謝美芬、顏兆熊(2008).失智症患者之行為精神症狀的處置.基層醫學, 23(7), 203-208。
Carol A. Miller(2013).照護中度失智者.於王靜枝總校閱,失智症臨床照護指引(莊琬筌).台北市:華都文化,96-105。
Carol A. Miller(2013).照護重度失智者.於王靜枝總校閱,失智症臨床照護指引(莊琬筌).台北市:華都文化,108-118。





英文文獻
Alfredson, B. B., & Annerstedt, L. (1994). Staff attitudes and job satisfaction in the care of demented elderly people: group living compared with long‐term care institutions. Journal of Advanced Nursing, 20(5), 964-974.
Algase, D. L., Beck, C., Kolanowski, A., Whall, A., Berent, S., Richards, K., & Beattie, E. (1996). Need-driven dementia-compromised behavior: An alternative view of disruptive behavior. American Journal of Alzheimer's Disease, 11(6), 10-19.
Abderhalden, C., Needham, I., Friedli, T. K., Poelmans, J., & Dassen, T. (2002). Perception of aggression among psychiatric nurses in Switzerland. Acta Psychiatrica Scandinavica, 106(s412), 110-117.
Amador, L. F., Reed, D., & Lehman, C. A. (2007). The acute care for elders unit: Taking the rehabilitation model into the hospital setting. Rehabilitation Nursing, 32(3), 126-131.
Alzheimer’s Society (2009). Counting the cost. https://www.alzheimers.org.uk/site/scripts/download_info.php?fileID=787
Alzheimer's Society (2014). Dementia 2014: Opportunity for change.取自https://www.alzheimers.org.uk/sites/default/files/migrate/downloads/dementia_2014_opportunity_for_change.pdf
Alzheimer's Society (2015). Delivering dementia-friendly health and care settings.
https://www.alzheimers.org.uk/sites/default/files/migrate/downloads/dementia_2015_aiming_higher_to_transform_lives.pdf
Bruton, A., Conway, J. H., & Holgate, S. T. (2000). Reliability: what is it, and how is it measured?.Physiotherapy, 86(2), 94-99.

Brodaty, H., Draper, B., & Low, L.F. (2003). Nursing home staff attitudes towards residents with dementia: Strain and satisfaction with work. Journal of Advanced Nursing, 44, 583-590.
Brooker, D. (2003). What is person-centred care in dementia?. Reviews in clinical gerontology, 13(3), 215-222.
Borbasi, S., Jones, J., Lockwood, C., & Emden, C. (2006). Health professionals’ perspectives of providing care to people with dementia in the acute setting: Toward better practice. Geriatric Nursing, 27(5), 300-308.
Banerjee, S. (2009). The use of antipsychotic medication for people with dementia: time for action. Retrieved from http://psychrights.org/research/digest/nlps/banerjeereportongeriatricneurolepticuse.pdf
Bateman, C. (2012). Research Into Practice: Volunteers Improving Person Centred Dementia Care in a Rural Hospital. An Intervention Study.University of Canberra.
Chinn, S. (1991). Statistics in respiratory medicine. 2. Repeatability and method comparison. Thorax, 46(6), 454.
Cohen-Mansfield, J. (1999). Measurement of inappropriate behavior associated with dementia. Journal of Gerontological Nursing, 25(2), 42-51.
Cohen‐Mansfield, J. (1986). Agitated behaviors in the elderly: II. Preliminary results in the cognitively deteriorated. Journal of the American Geriatrics Society, 34(10), 722-727.
Crabtree, J., & Mack, J. (2009). Designing a training programme to improve staff attitudes towards people with dementia. Nursing times, 106(39), 14-16.

Chenoweth, L., King, M. T., Jeon, Y. H., Brodaty, H., Stein-Parbury, J., Norman, R., ... & Luscombe, G. (2009). Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. The Lancet Neurology, 8(4), 317-325.
Cowdell, F. (2010).The care of older people with dementia in acute hospitals.
International Journal of Older People Nursing, 5(2), 83-92.
Dementia 2014:Opportunity for change.
https://www.alzheimers.org.uk/site/scripts/download_info.php?fileID=2317
Dewing, J., & Dijk, S. (2016). What is the current state of care for older people with dementia in general hospitals? A literature review. Dementia,15(1),106-124.
Digby, R., Lee, S., & Williams, A. (2017). The experience of people with dementia and nurses in hospital: an integrative review. Journal of clinical nursing, 26(9-10), 1152-1171.
Elvish, R., Burrow, S., Cawley, R., Harney, K., Graham, P., Pilling, M., ... & Keady, J. (2014). ‘Getting to Know Me’: the development and evaluation of a training programme for enhancing skills in the care of people with dementia in general hospital settings. Aging & mental health, 18(4), 481-488.
Fossey, J., Ballard, C., Juszczak, E., James, I., Alder, N., Jacoby, R., & Howard, R. (2006). Effect of enhanced psychosocial care on antipsychotic use in nursing home residents with severe dementia: cluster randomised trial. Bmj, 332(7544), 756-761.
Fessey, V. (2007). "Patients who present with dementia: exploring the knowledge of hospital nurses." Nurs Older People 19(10): 29-33.


Fletcher, K. (2008). Dementia. In E. Capezuti, D. Zwicker, M. Mezey, T. Fulmer, D. Gray-Miceli, & M. Kluger, (Eds.), Evidenced based geriatric nursing protocols for best practice (3rd ed.) (pp. 83-109). New York:Springer.
Flagg, B., Cox, L., McDowell, S., Mwose, J. M., & Buelow, J. M. (2010). Nursing identification of delirium. Clinical nurse specialist, 24(5), 260-266.
Fukuda, R., Shimizu, Y., & Seto, N. (2015). Issues experienced while administering care to patients with dementia in acute care hospitals: a study based on focus group interviews. Int J Qual Stud Health Well-being, 10, 25828. doi: 10.3402/qhw.v10.25828
Galvin, J. E., Kuntemeier, B., Al-Hammadi, N., Germino, J., Murphy-White, M., & McGillick, J.(2010). “Dementia-friendly hospitals: Care not crisis” An educational program designed to improve the care of the hospitalized patient with dementia. Alzheimer Disease and Associated Disorders,24(4), 372–379.
Gladman, J., Porock, D., Griffiths, A., Clissett, P., Harwood, R. H., Knight, A., ...& Kearney, F. (2012). Care of older people with cognitive impairment in general hospitals. Final report NIHR Service Delivery and Organisation programme.
Gandesha, A., Souza, R., Chaplin, R., & Hood, C. (2012). Adequacy of training in dementia care for acute hospital staff: AartiGandesha and colleagues present the results of a national audit to assess how hospital staff from different specialties rated their awareness of the needs of patients with dementia. Nursing older people, 24(4), 26-31.
Goldberg, L. S., & Altman, K. W. (2014). The role of gastrostomy tube placement in advanced dementia with dysphagia: a critical review. Clinical interventions in aging, 9, 1733.

Haupt, M., Karger, A., & Jänner, M. (2000). Improvement of agitation and anxiety in demented patients after psychoeducative group intervention with their caregivers. International journal of geriatric psychiatry, 15(12), 1125-1129.
Hweidi, I. M., & Al-Obeisat, S. M. (2006). Jordanian nursing students’ attitudes toward the elderly. Nurse education today, 26(1), 23-30.
Handley, M., Bunn, F., & Goodman, C. (2017). Dementia-friendly interventions to improve the care of people living with dementia admitted to hospitals: a realist review. BMJ open, 7(7), e015257.
Healthcare Quality Improvement Partnership(HQIP) (2011) Report of the
National Audit of Dementia Care in General Hospitals. Available at: https://www.rcpsych.ac.uk/pdf/NATIONAL%20REPORT%20-%20Full%20Report%201201122.pdf
Nilsson, A., Lindkvist, M., Rasmussen, B. H., & Edvardsson, D. (2012). Staff attitudes towards older patients with cognitive impairment: need for improvements in acute care. Journal of nursing management, 20(5), 640-647.
Hynninen, N., Saarnio, R., & Isola, A. (2015). The care of older people with dementia in surgical wards from the point of view of the nursing staff and physicians. Journal of clinical nursing, 24(1-2), 192-201.
Moyle, W., Olorenshaw, R., Wallis, M., & Borbasi, S. (2008). Best practice for the management of older people with dementia in the acute care setting: a review of the literature. International Journal of Older People Nursing, 3(2), 121-130.
Maggie Arnold, R. G. N., Dip, N., & Theresa Mitchell, R. G. N. (2008). Nurses' perceptions of care received by older people with mental health issues in an acute hospital environment. Nursing Older People, 20(10), 28.
Mukaetova-Ladinska, E. B., Teodorczuk, A., &Cerejeira, J. M. (2009).Dementia in the acute hospital. The British Journal of Psychiatry, 195(5), 461-462.
Moyle, W., Borbasi, S., Wallis, M., Olorenshaw, R., &Gracia, N. (2011). Acute care management of older people with dementia: a qualitative perspective. Journal of clinical nursing, 20(3‐4), 420-428.
Miyamoto, Y., Tachimori, H., & Ito, H. (2010).Formal caregiver burden in dementia: Impact of behavioral and psychological symptoms of dementia and activities of daily living. Geriatric Nursing, 31, 246-253. doi:10.1016/j.gerinurse.2010.01.002
Marx, K. A., Stanley, I. H., Van Haitsma, K., Moody, J., Alonzi, D., Hansen, B. R., & Gitlin, L. N. (2014). Knowing Versus Doing: Education and Training Needs of Staff in a Chronic Care Hospital Unit for Individuals With Dementia. Journal of gerontological nursing, 40(12), 26-34.
Mullan, M. A., & Sullivan, K. A. (2016). Positive attitudes and person-centred care predict of sense of competence in dementia care staff. Aging & mental health, 20(4), 407-414.
Nakahira, M., Moyle, W., Creedy, D., &Hitomi, H. (2009). Attitudes toward dementia‐related aggression among staff in Japanese aged care settings. Journal of Clinical nursing, 18(6), 807-816.
Leung, D., & Todd, J. (2010).Dementia care in the acute district general hospital. Clinical Medicine, 10(3), 220-222.
Lin, P. C., Hsieh, M. H., & Lin, L. C. (2012). Hospital nurse knowledge of and approach to dementia care. Journal of Nursing Research, 20(3), 197-207.
Leung, J. L. M., Sezto, N. W., Chan, W. C., Cheng, S. P., Tang, S. H., & Lam, L. C. W. (2013). Attitudes and perceived competence of residential care homes staff about dementia care. Asian Journal of Gerontology and Geriatrics,8(1),21-29.
Liu, Y. E., Norman, I. J., & While, A. E. (2013). Nurses’ attitudes towards older people: A systematic review. International Journal of Nursing Studies, 50(9), 1271-1282.
Lee, J., Hui, E., Kng, C., & Auyeung, T. W. (2013). Attitudes of long-term care staff toward dementia and their related factors. International psychogeriatrics, 25(1), 140-147.
Lin, P. C., Hsieh, M. H., Chen, M. C., Yang, Y. M., & Lin, L. C. (2018). Knowledge gap regarding dementia care among nurses in Taiwanese acute care hospitals: A cross‐sectional study. Geriatrics & gerontology international, 18(2), 276-285.
Kitwood, T. M. (1997). Dementia reconsidered: The person comes first (Vol. 20, pp. 7-8). Buckingham: Open university press.
Kearney, N., Miller, M., Paul, J., & Smith, K. (2000). Oncology healthcare professionals' attitudes toward elderly people. Annals of Oncology, 11(5), 599-601.
Kim, Y. M., June, K. J., & Cho, S. H. (2005). Factors related to nurse staffing levels in tertiary and general hospitals. Journal of Korean Academy of Nursing, 35(8), 1493-1499.
Kovach, C. R., Noonan, P. E., Schlidt, A. M., & Wells, T. (2005). A model of consequences of need‐driven, dementia‐compromised behavior. Journal of Nursing Scholarship, 37(2), 134-140.
Kane, M. N. (2006). Ageism and gender among social work and criminal justice students. Educational Gerontology, 32(10), 859-880. doi:10.1080/03601270600846543

Kada, S., Nygaard, H. A., Mukesh, B. N., & Geitung, J. T. (2009). Staff attitudes towards institutionalised dementia residents. Journal of Clinical Nursing, 18(16), 2383-2392.
Kang, Y., Moyle, W., &Venturato, L. (2011). Korean nurses’ attitudes towards older people with dementia in acute care settings. International journal of older people nursing, 6(2), 143-152.
Pritchard, E. (1999). Dementia. Part 2: Person-centred assessment. Professional nurse (London, England), 14(9), 655-660.
Pretto, M., Spirig, R., Milisen, K., DeGeest, S., Regazzoni, P., & Hasemann, W. (2009). Effects of an interdisciplinary nurse-led Delirium Prevention and Management Program (DPMP) on nursing workload: a pilot study. International journal of nursing studies, 46(6), 804-812.
Page, S., & Hope, K. (2013). Towards new ways of working in dementia: perceptions of specialist dementia care nurses about their own level of knowledge, competence and unmet educational needs. Journal of psychiatric and mental health nursing, 20(6), 549-556.
Palmer, J. L., Lach, H. W., McGillick, J., Murphy-White, M., Carroll, M. B., & Armstrong, J. L. (2014).The Dementia Friendly Hospital Initiative education program for acute care nurses and staff. The Journal of Continuing Education in Nursing, 45(9), 416-424.
Royal College of Psychiatrists, 2011. Report of the National Audit of Dementia Care in General Hospitals. Healthcare Quality Improvement Partnership, London. Retrieved from
https://www.rcpsych.ac.uk/pdf/NATIONAL%20REPORT%20-%20Full%20Report%201201122.pdf
Spencer, L.M and Spencer, S.G (1993). Competence at work: Models for superior
performance. New York: Wiley
Smith, S. (2007). Raising the profile of older people’s care in hospital through training. Nursing older people, 19(3), 27-31.
Sampson, E. L., Candy, B., & Jones, L. (2009). Enteral tube feeding for older people with advanced dementia. Cochrane Database Syst Rev, 2(2), CD007209.
Schepers, A. K., Orrell, M., Shanahan, N., & Spector, A. (2012). Sense of competence in dementia care staff (SCIDS) scale: development, reliability, and validity. International psychogeriatrics, 24(7), 1153-1162.
Spencer, K., Foster, P. E., Whittamore, K. H., Goldberg, S. E., & Harwood, R. H. (2014). Staff confidence, morale and attitudes in a specialist unit for general hospital patients with dementia and delirium—a qualitative study. International journal of geriatric psychiatry, 29(12), 1315-1317.
Smythe, A., Bentham, P., Jenkins, C., & Oyebode, J. R. (2015). The experiences of staff in a specialist mental health service in relation to development of skills for the provision of person centred care for people with dementia. Dementia, 14(2), 184-198.
Surr, C. A., Smith, S. J., Crossland, J., & Robins, J. (2016). Impact of a person-centred dementia care training programme on hospital staff attitudes, role efficacy and perceptions of caring for people with dementia: A repeated measures study. International journal of nursing studies, 53, 144-151.
Setters, B. and L. M. Solberg (2017). "Delirium." Prim Care 44(3): 541-559.
Taylor, C. (1995). Rethinking nursing's basic competencies. Journal of Nursing Care Quality, 9(4), 1-9.

Tzeng, H. M., & Ketefian, S. (2003). Demand for nursing competencies: an exploratory study in Taiwan's hospital system. Journal of Clinical Nursing, 12(4), 509-518.
Todd, S. J., & Watts, S. C. (2005). Staff responses to challenging behaviour shown by people with dementia: An application of an attributional-emotional model of helping behaviour. Aging & Mental Health, 9(1), 71-81.
Travers, C. M., Beattie, E., Martin-Khan, M., & Fielding, E. (2013). A survey of the Queensland healthcare workforce: attitudes towards dementia care and training. BMC geriatrics, 13(1), 101.
Turner, A., Eccles, F. J., Elvish, R., Simpson, J., & Keady, J. (2017). The experience of caring for patients with dementia within a general hospital setting: a meta-synthesis of the qualitative literature. Aging & mental health, 21(1), 66-76.
Vazirani, N. (2010). Competencies and competency model-a brief overview of its development and application. SIES Journal of management, 7(1), 121.
Williams, C. L., Hyer, K., Kelly, A., Leger-Krall, S., & Tappen, R. M. (2005). Development of nurse competencies to improve dementia care. Geriatric Nursing, 26(2), 98-105.
Wesson, L., & Chapman, B. (2010). A dementia education scheme: A dynamic, multiagency strategy set up across Cornwall is improving the care of patients with memory and communication difficulties. Laura Wesson and Beverley Chapman explain how. Nursing older people,22(2), 22-25.
Weitzel, T., Robinson, S., Barnes, M. R., Berry, T. A., Holmes, J. M., Mercer, S., ... & Steinkruger, K. (2011). The special needs of the hospitalized patient with dementia. Medsurg Nursing, 20(1), 13.

Waugh, A., Marland, G., Henderson, J., Robertson, J., & Wilson, A. (2011). Improving the care of people with dementia in hospital. Nursing Standard, 25(32), 44-49.
Wimo, A., Jönsson, L., Bond, J., Prince, M., & Winblad, B. (2013). The worldwide economic impact of dementia 2010. Alzheimer's & Dementia, 9(1), 1-11.
Wang, C. J., Pai, M. C., Hsiao, H. S., & Wang, J. J. (2015).The investigation and comparison of the underlying needs of common disruptive behaviours in patients with Alzheimer's disease. Scandinavian journal of caring sciences, 29(4), 769-775.
Zhang, Z. X., Luk, W., Arthur, D., & Wong, T. (2001). Nursing competencies: personal characteristics contributing to effective nursing performance. Journal of advanced nursing, 33(4), 467-474.
論文全文使用權限
  • 同意授權校內瀏覽/列印電子全文服務,於2020-07-10起公開。
  • 同意授權校外瀏覽/列印電子全文服務,於2020-07-10起公開。


  • 如您有疑問,請聯絡圖書館
    聯絡電話:(06)2757575#65773
    聯絡E-mail:etds@email.ncku.edu.tw