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系統識別號 U0026-2301201412122200
論文名稱(中文) 以行動研究建立癌症病童返校照護之永續發展模式
論文名稱(英文) Action research:Building a Sustainable Development Model of School Reentry Care for Children with Cancer
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 102
學期 1
出版年 103
研究生(中文) 呂香瑩
研究生(英文) Hsiang-Ying Lu
電子信箱 lovepurin76@gmail.com
學號 T26994038
學位類別 碩士
語文別 中文
論文頁數 112頁
口試委員 指導教授-黃美智
口試委員-陳建旭
口試委員-葉莉莉
中文關鍵字 癌症兒童  返校照護  行動研究  永續發展模式 
英文關鍵字 Children with cancer  school reentry care  action research  sustainable development model 
學科別分類
中文摘要 台灣醫療進步,癌症病童五年存活率逐漸提升。為使癌症病童順利回歸原有生活,治療期間之正常化返校極為關鍵。返回學校是一種正向的經驗,可協助癌症病童順利適應治療期、發展自主能力、增加自信與同儕支持;然而許多病童因家庭、學校或醫療方面的不確定感與不支持,在返校復學的過程中多面臨障礙。2011年陳文菁學者同南部某醫學中心研發癌症病童返校照護,藉醫療專業團隊人員提供以家庭為中心的照護,協助癌症病童回歸正常化生活。但研究者於該醫學中心工作時觀察到有拓展返校照護模式之需求,及須強化返校後追蹤等議題,引起照護團隊再修正原模式之動機。
本研究延續陳(2010)的行動研究循環,與研究參與者:小兒血液腫瘤醫師、門診護理師、病房護理師、血液腫瘤個案管理師、社工師研擬出建立返校照護永續發展模式之想法,共同執行七項自擬行動研究措施:釐清問題與分析需求、確定團隊成員、設計草案、修正計畫草案、個案試行與臨床觀察、專家諮詢、以及反思與評值。
修正後的返校照護擴展了收案年齡層、新增了門診返校路徑、強化返校照護連續性、建立了定期評值系統。整體模式結構也更加確立,照護流程與各團隊成員職責也重新達成共識。上述的修正行動過後,研究者針對所收集之質量性資料進行內容分析,結果發現返校照護永續發展模式之特質,包含結構與團隊成員兩大類。結構方面包含:人際資源的應用、發展永續指標並定期評值;團隊成員互動方面則發展出五項特質:能力提升,賦予價值;發現價值,連結資源;逐步投入,團隊合一:彈性調整,互相幫忙;自我反省,邁向未來。此行動研究透過修正返校照護模式的互動過程,引發團隊成員改變,激起自我成長之動機,營造團隊凝聚力,建立返校照護之永續發展模式。
英文摘要 This action research building up a sustainable development model of the school re-entry care for cancer children. The healthcare team members of a medical center in south Taiwan were invited to revise the school reentry care model through the second action cycle. The research process consists of seven self-designed steps. Through the process of revising the school reentry care model, the team members have been empowered and making this model been sustainable. Finally, the sustainable development model enhances the care quality of school reentry care through the continual action research cycle.
論文目次 摘要 I
英文延伸摘要 II
致謝 IV
目錄 VI
表目錄 VIII
圖目錄 VIII
第一章、緒論 1
第一節、前言 1
第二節、研究動機與重要性 2
第二章、文獻查證 6
第一節、癌症病童正常化返校 6
第二節、癌症兒童連續性照護 15
第三節、永續發展 17
第四節、行動研究 19
第三章、研究設計 26
第一節、研究方法 26
第二節、研究目的 26
第三節、研究場域 26
第四節、研究者背景 27
第五節、實施程序 27
第六節、研究嚴謹度的考核 33
第七節、倫理考量 34
第四章、研究結果 35
第一節、反思_評值原返校照護模式 35
第二節、計畫_釐清問題與分析需求 39
第三節、計畫_確認行動目標 41
第四節、計畫、行動、觀察_修正計畫草案 42
第五節、反思_返校照護永續發展之特質 58
第五章、討論 69
第一節、探討返校照護模式的發展與改變 69
第二節、返校醫療照護永續發展之延伸問題 71
第三節、納入照護接受者為團隊成員 73
第四節、行動歷程中的省思 74
第六章、結論與建議 76
第一節、結論 76
第二節、研究應用與建議 76
第三節、研究限制 78
參考文獻 79
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