[[alternative]]The Effectiveness of Back Pain Health Education for Spine Compression Fracture women clients by pain relief and Quality of Life.

[[abstract]]本研究目的為：探討背痛衛教諮詢手冊介入，對脊椎壓迫性骨折婦女背痛及生活品質之成效。採雙盲隨機對照的研究設計，於北區某區域教學醫院門診，依就診順序、隨機對照表，隨機分配個案至實驗組37名，控制組34名脊椎壓迫性骨折合併背痛的個案，實驗組介入背痛衛教諮詢手冊，控制組予常規護理指導。每位個案，以中文版簡易疼痛量表及台灣版SF-36生活品質量表等問卷為研究工具，於前測、後測（衛教後1個月）及後後測（衛教後2個月），收集脊椎壓迫性骨折婦女疼痛程度：疼痛強度及疼痛影響的改變，與生活品質於前測及後後測（衛教後2個月）的變化。研究資料使用SPSS for Windows 14.0套裝軟體英文版進行資料處理與分析，主要使用統計為獨立t檢定（Independent t test ）、配對t 檢定（Pair samples t test）、卡方檢定（Chi-square）及重覆測量（General linear mix effect model）等。研究結果顯示（一）疼痛強度呈組別有顯著差異，並與時間有交互作用；疼痛影響呈組別無顯著差異，但與時間有交互作用。（二）實驗組與控制組整體生活品質差異呈統計顯著意義。衛教介入一個月，疼痛程度（疼痛強度與疼痛影響）即改善並延宕至兩個月；衛教介入二個月，整體生生活品質即見成效。未來可提供病患一個安全且有效的疼痛照顧，並改善生活品質，進而能減少骨折再發生率及縮減醫療社會成本。[[abstract]]The study purpose is to evaluate the effect of using back-pain health education manual for the pain degree and quality of life of the female patients suffering from spine compression fracture. The study is designed under double-blind randomized control trial, conducted in the outpatient service of a local hospital in the north area. By the blocking randomization number of patients, 37 clients having spine compression fracture induced pain are randomly assigned to experiment group and 34 to control group. The back pain health education is used for experiment group and regular nursing instruction for control group. BPI-C and SF-36 measurements are utilized for questionnaire, in the pre-test, post-test (after education one month) and after post-test (after education two months), to collect the conditions of patients’ suffering for each case. The data is processed and analyzed by SPSS for Windows 14.0 software package in English, using Independent T test, Pair Samples T test, Chi-square, and General Linear mix effect model（GLMM）. The study results show:1. There is a significant difference of pain strength between the two groups, but no significant difference of impact of pain between the two groups. Both the strength and impact, however, interact with time.2. The difference of quality of life between experiment group and control group shows statistically significant meaning.One month after implementing health education, the degree of pain was eased and continuous by two months. Two months after implementing health education, the overall life of quality sees improvement. In future, back-pain patients can be provided with a safe and effective health care, with life of quality improved, fracture less recurred and medical social cost saved

輕省科技與數位轉型翻轉長期照護

[[abstract]]本文主要在探討台灣目前長照機構遇到系統設計的問題，如：無法即時掌握照護需求、資訊介面未考量人因設計及無法提供家人科技溝通資訊。並藉由參訪加拿大長照系統標竿學習後，整理具有學習價值的科技設計融入長期照護系統之運用，如UX（user experience）設計思維，回到人的主動式參與的需求，建立更智慧的健康照護模式，提供一站式資訊服務，解決機構整體資料儲存與應用的安全性，發展物聯網設計，把人與人的連結變得簡單快速，崁入照護零距離的概念，提升服務品質與滿意度。這些科技化設計不但可改善工作流程照護模式，也能提供更多臨床決策，另可搭配現代串聯5G的高流量科技，提供更快速即時的資訊傳遞服務、簡化護理工作與提升了護理價值，達到輕省科技目的。本文經整理相關科技發展內容，期能對台灣長照科技發展有所參考與助益

後疫情時代大學生的疫情焦慮、壓力來源與因應策略—以修平科技大學 學生為例

[[abstract]]本研究旨在深入瞭解台中市修平科技大學學生的壓力來源、因應策略，以及與疫情相關的焦慮情緒。透過問卷調查，成功收集59份有效問卷，對象為修平科技大學學生。研究時間為8天，包括計劃、文獻探討、問卷編製、實地調查、訪談、資料整理等步驟。 壓力來源分為六構面，包括課業、家庭、朋友、愛情、未來及自身壓力，整體信度良好。壓力因應分為四構面，包括面對問題、面對情緒、逃避問題及逃避情緒，各分量表信度亦良好。疫情焦慮分為七構面，信度良好。 研究顯示學生對未來壓力感受最高（2.34），自身壓力次之（2.19），而愛情和朋友壓力相對較低，整體困擾程度可控。學生以積極態度面對問題居多（最高得分2.48），對壓力的應對較為積極，主要選擇面對問題的策略，為輔導提供參考。 在疫情焦慮方面，學生主要集中在自身健康、疫情距離、後遺症/死亡等方面，總體疫情焦慮程度中等，但不同學生存在差異。這些結果提供了對學生心理狀態的深入了解，為提供支持和輔導方案提供參考。觀察結果顯示學業、生活環境和應對策略對學生壓力及疫情焦慮產生影響

远程心电图监控之远距照护模式的效果

[[abstract]]目的：分析近年来在某医学中心接受远距照护民众的人口学趋势，以期为未来医疗机构发展远距照护提供参考。方法：本研究收集2013年7月至2018年5月某医学中心参与远距照护的1 621例个案，监测相关数据。结果：服务对象以女性（64.7%)居多；平均年龄（71.0±24.7)岁；以小区筛检的单一疗程使用者居多（69.1%），其次为使用<1年者；个案平均管理时间为4.2个月。服务个案过去的疾病诊断分析以心血管疾病诊断（45%）居多，其他为高血压诊断（35%）。心电图量测方面经由医师判读结果发现，诊断正常心律人次占最多（71.5%），心房颤动（7.2%）次之。有异常值电话关怀1 387人次（24.1%）及定期电话关怀3 787人次（65.9%）。结论：远距照护能成功找出偶发型心房颤动病人，对其防治大有进展。电话关怀功能提醒个案回诊，虽增加门诊次数但可降低住院次数与风险，增加经济效益。未来建议能扩大远距照护保险给付，提升连续性照护与照护质量。 Objective: To analyze the demographic trends of receiving remote care for people in a medical center in recent years, as a reference for the future development of medical institutions. As a result, adopting remote care for the prevention and control of cardiovascular diseases has become a trend, and people's need for such healthcare options has increased. Methods: This study collected data from 1 621 remote care cases monitored by a medical center in Taiwan between July 2013 and May 2018. Results: Most of the case patients were female (n=1 019) and had an average age of 71.0±24.7 years. In addition, most were patients who had undergone a single treatment after community-based screening (69.1%), followed by those who had undergone treatment for <1 year. The average duration of case management was 4.2 months. Most patients had received diagnosis for cardiovascular diseases (n=394; 45%), followed by hypertension (n=308; 35%). Physician interpretation of electrocardiogram readings revealed that the conditions of most of the case patients were diagnosed as normal cardiac rhythm (n=1 315; 71.5%), followed by atrial fibrillation (n=133; 7.2%). The medical center made 1 378 reassurance phone calls (24.1%) to the patients with abnormal values detected and 3 787 regular reassurance phone calls (65.9%) to all patients. Conclusions: The study results determined that remote care effectively assist in identifying patients with sporadic atrial fibrillation for early treatment. Moreover, although reassurance phone calls increase the number of clinical visits by patients, they can also reduce the number of hospital admissions as well as hospital admission risks, thereby yielding economic benefits. This study recommends that the scope of health insurance benefits be extended to remote care to enhance the continuity and quality of care