2014-08-012024-05-14https://scholars.lib.ntu.edu.tw/handle/123456789/655764摘要：落實社區生命末期照護於醫療體系，方能實踐「居家安老，在家善終」的目標，本子計劃應用過去系列研究所編製之本土化多媒體輔助教材與 E化學習平台，據以編製客觀結構式臨床評估(OSCE)之教案與情境考題，採個案導向多媒體互動教學法進行 OSCE回饋教學，但在臨床單教導「生命末期臨床技能」的教學經驗，發現「團隊合作(Team-based)」及「悲憫(Compassion)」經常容易被忽略，但它卻是培養護理人員具備社區生命末期照護核心能力且有助病人在家善終的要素。 故本子計畫主要依據整合性研究計畫總目標，採行動研究法，將以三年時間，致力完成下列研究目的：1)透過「末期病情溝通、家庭會議、全人評估、舒適照顧、末期醫療倫理及團隊會議」六個臨床常見之生命末期重要照顧議題，建置以「TC-OSCE（Team-based Compassion OSCE）」為主軸的多元教學策略與學習評量方法，培養或評核護理教師及社區臨床護理師具備社區生命末期護理能力。2) 應用已發展的社區生命末期照護多媒體輔助教材及 E化學習平台，作為社區生命末期護理教育的基礎，以實習護生、臨床護理人員及護理教師為對象，融入護理專業進階課程，使基礎人文關懷「服務學習課程」與護理專業進階課程間進行垂直整合。4）瞭解在地護理人員接受繼續教育之需求，並建立社區跨領域醫療團隊合作之醫療繼續教育模式，以提昇社區護理人員提供居家護理的能力。5）透過社區臨床實作經驗，建立以「病人」為中心以及「家庭」為照護單位，整合「社會文化脈絡與醫療體系」為導向之社區生命末期照護能力。6）評價社區生命末期照護對「護生、護理教師及社區護理人員」的教學成效。進行社區生命末期照護種子教師培訓，建立可推展的「社區生命末期照護模式-護理專業進階課程」之教學方案。7）實施「社區生命末期照護模式-護理專業進階」課程至國內各大醫學院校，進行跨校合作，並與評估推展成效，作為政府推動「居家安老，在家善終」理念的學術研究基礎。8）發展適合推展至東南亞及大陸地區之「在家善終」教學模式的理論架構與國際化方案，並進行「社區生命末期照護教材」國際化之翻譯工作，以推展四全的社區生命末期照顧。預期效益為培訓更多新生代護理人員具備社區生命末期照護技能，並提昇或滿足她們協助病人在家善終的意願。 <br> Abstract: Dying care and good death at home are the important missions of medical care system, which always depend on the quality of nursing education toward the end-of life care. This study will utilize the results of previous studies to develop a new teaching model, which include the platform and curriculum of e-learning for end-of-life care incorporate with humanities and community, and the evaluation tools; Team-based Compassion OSCE (TC-OSCE) . The three-year period study will be aimed to: 1) design better curriculum to the nursing professionals working in the communities with the platform of e-learning and the teaching strategies of clinical competency based on the teaching materials previously established. And modify TC-OSCE for six important issues in end-of-life- care including: Whole person assement and comfort care etc. 2) integrate the humanities, community and medical practice, and combine the previous basic and clinical curriculums to develop a new teaching model of end-of-life care, especially home dying care 3) investigate the current status of student nurses, district nurses and RNs in the opinions of above topics and compare the improvement of competency and the willingness to provide the home dying before and after the new model training, 4) design the workshop for teacher training and spread the teaching materials and evaluation resources to other medical schools or hospitals and their communities.5) assess the educational needs of nursing professionals for providing e home dying care, therefore able to establish the better strategies of training in communities. And further provide the basis to develop the more appropriate model for medical practice on providing home dying care. 6) promote the international cooperation based on the platform established previously. Anticipating results will include: 1) educate more efficiently the student nurses and RNs the competency of patient-centered care and develop a sense of intimacy and manageable personal responsibility for suffering persons, 2) provide the continuous and efficacious learning and evaluation tools, which will promote the quality of teaching and services of end-of-life care, especially home care dying. Eventually, the value of medical education and the goal of good death home can be achieved more comprehensively.末期照護護理教育核心能力社區善終客觀結構式臨床測驗end-of-life carenursing educationcore competencypalliative careObjective Structured Clinical Examination (OSCE)home deathgood death.