簡易檢索 / 詳目顯示

研究生: 范卉妤
Fan, Hui-Yu
論文名稱: 罕見疾病兒童與青少年之主要照護者資訊行為研究
A Study of Information Behaviors of the Primary Caregivers of Children and Adolescents with Rare Diseases
指導教授: 邱銘心
Chiu, Ming-Hsin
學位類別: 碩士
Master
系所名稱: 圖書資訊學研究所
Graduate Institute of Library and Information Studies
論文出版年: 2016
畢業學年度: 104
語文別: 中文
論文頁數: 106
中文關鍵詞: 罕見疾病罕見疾病兒童罕見疾病青少年主要照護者資訊行為
英文關鍵詞: Rare Diseases, Rare Diseases Children, Rare Diseases Adolescents, Primary Caregivers, Information Behaviors
DOI URL: https://doi.org/10.6345/NTNU202204825
論文種類: 學術論文
相關次數: 點閱:222下載:49
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報
  • 因為美國的冰桶挑戰風潮與罕見疾病相關電影《一首搖滾上月球》,讓罕病家庭備受關注。罕病家庭的照護者所承受的壓力不但高於一般的身障家庭,而且能收集到的醫療照護資訊相當有限,若可以盡早得知有關罕見疾病治療方式的資訊,減緩罕病病友的病情,或許能防止許多憾事發生。
    本研究採用半結構式訪談法,訪問10位罕病兒童與青少年主要照護者為研究對象。研究結果發現,照護者在未得知病友罹患罕病前,照護者平常皆不會注意罕病資訊,診斷與確診初期會想先了解罕見疾病類型的介紹。在治療與復健階段,照護者會產生醫療照護、復健、防止惡化的資訊需求。終身與病為伍階段,照護者會面臨社會福利及病友生涯發展的資訊需求。照護者的資訊需求因教育程度與病友類型有所不同。
    主要照護資訊來源多以醫生與病友協會為主,因照護者年齡與病友的罕病類型讓主要照護來源有所不同。資訊使用行為方面,會利用所獲得的資訊做進一步的運用。以醫療專業權威、多重資訊來源、自行經驗三者擇其一作為辨識資訊正確性的依據,照護者的資訊使用行為會因為病友罕見疾病類型而有所不同。資訊分享行為,發現全部的照護者都非常樂於主動分享相關資訊,但會因為性別和病友的罕病類型讓照護者的資訊分享行為有所不同。
    對主要照護者建議可以將自己的經驗,主動分享於公共場合活動,讓民眾了解罕見疾病,教導民眾如何預防罕見疾病兒童的發生,成為資訊的提供者。對人數眾多之病友協會建議,可申請社群網站成立病友協會粉絲專頁,定期發佈相關疾病之背景知識、舉辦健康資訊講座,透過活動以及贈品吸引民眾參與,增加民眾對罕病病類的認識。未來研究建議能繼續以罕病病友之「就學(教育學習)」、「就業(促進就業)」、「就醫(醫療復健)」、「就養(生活照顧)」四個方向發展,心理層面則可針對病友不同年齡層做比對,罕病家庭的研究,可以往家庭經濟問題、家中其他非罕見病患手足與家屬心理調適問題、家庭工作型態改變問題、夫妻間面臨危機問題,與照護者因應壓力做探討。

    The topic of the research is derived from the Ice Bucket Challenge trend and a movie called, Rock Me To The Moon, which is related to rare diseases. Both the event and the movie inform the public about rare diseases. Rare disease caregivers are under more pressure than caregivers who treat general physically challenged problems. The medical care information caregivers collect is very limited. If they knew how to treat rare diseases earlier, their children’s condition could have been prevented before something regretful happened.
    The study uses a semi-structured interview from the qualitative research method. We interviewed 10 primary caregivers as subjects. These primary caregivers are parents of children with rare diseases. The results of the study indicated that if no one in their family suffers from rare diseases, primary caregivers do not focus on the rare disease information. Primary caregivers want to understand the fundamentals of rare diseases first as a diagnostics incipient step. After a patient’s outbreak of the rare disease, primary caregivers would want to find physiotherapy, to keep their disease at bay. They would want care information, which would help relieve their pain and discomfort of rare diseases. When they discover their child’s disease is incurable, primary caregivers need information about social welfare and their child’s future. Primary caregivers have different information needs because it depends on their education background and patient rare disease type.
    The main source of medical care information is provided by doctors and associations. The different sources of the information depends on primary caregivers’ age and patients’ disease type. In using the information behavior aspect, primary caregivers employ the information which they obtain and they either check the information they obtain with a professional authority, multiple sources, or compare it with patient experience to identify if the information is accurate or not. The information of using behavior is different because of a patient’s rare disease type. In sharing information behavior aspect, primary caregivers are glad to share what they find with other families that have children with a rare disease. The information of sharing behavior is different because it depends on primary caregivers gender.
    The suggestion to primary caregivers is that they can share their own experience with others in public places or during social activities. They should let people know about rare diseases and teach them how to prevent the rare disease from developing in their children. Primary caregivers also become the information provider. The suggestion to associations is that, they can establish Facebook fan pages and post rare disease information regularly or hold healthy information lectures. Social events can increase the number of people that know about rare disease types. Future research can develop through patients’ “education studies”, “employment promoting”, “medical and rehabilitation”, and discussing “life care” issues. Psychological research can help people of different age groups cope with their disease. In the future, people will want to discuss a variety of issues, such as family economic issues, siblings who do not have a rare disease and their mental accommodation issues, life style change issues, crises in married couples, and primary caregivers coping stress issues.

    第一章 緒論 1 第一節 研究背景與動機 1 第二節 研究目的與問題 4 第三節 研究範圍與限制 5 第四節 名詞解釋 6 第二章 文獻探討 8 第一節 資訊行為相關理論 8 第二節 照護者相關理論 19 第三節 罕見疾病家屬資訊行為 27 第三章 研究方法 35 第一節 研究設計 35 第二節 研究方法 37 第三節 研究實施 39 第四節 前導研究 43 第五節 研究倫理 46 第四章 研究結果 48 第一節 受訪家庭背景資料分析 48 第二節 罕病兒童與青少年主要照護者之資訊需求 60 第三節 罕病兒童與青少年之主要照護來源 67 第四節 罕病兒童與青少年主要照護者之資訊使用行為 71 第五節 罕病兒童與青少年主要照護者之資訊分享行為 76 第六節 綜合討論 79 第五章 結論與建議 83 第一節 研究結論 83 第二節 研究建議 88 參考文獻 94 附錄一 訪談同意書 104 附錄二 訪談大綱 105

    American Psychological Association. (2010). Ethical principles of psychologists and code of conduct. Retrieved from http://www.apa.org/ethics/code/principles.pdf

    Barclay, D. A., & Halsted, D. D. (2001). The Medical Library Association consumer health reference service handbook. New York: Neal-Schuman.

    Belkin, N. J. (1978). Information concepts for information science. Journal of Documentation, 34(1), 55-85.

    Bull, R., & Rumsey, N. (1988). The Social Psychology of Facial Disfigurement. The Social Psychology of Facial Appearance, 179-215.

    Case, D. O. (2002). Looking for information: A survey of research on information seeking, needs, and behavior. San Diego, CA: Academic Press.

    Dervin, B. (1992). From the mind’s eye of the user: The sense-making qualitative-quantitative methodology. Qualitative research in information management, 61,84.

    Dodge, J. A., Chigladze, T., Donadieu, J., Grossman, Z., Ramos, F., Serlicorni, A., ...Wierzba, J. (2011). The importance of rare diseases: From the gene to society. Archives of Disease in Childhood, 96(9), 791-792.

    Dunoyer, M. (2011). Accelerating access to treatments for rare diseases. Nature Reviews Drug Discovery, 10(7), 475-476.

    Ekins, S., Williams, A. J., Krasowski, M. D., & Freundlich, J. S. (2011). In silic repositioning of approved drugs for rare and neglected diseases. Drug Discovery Today, 16(7), 298-310.

    Ellis, D. (1989). A behavioural model for information retrieval system design. Journal of Information Science, 15(4-5), 237-247.

    Forman, J., Taruscio, D., Llera, V. A., Barrera, L. A., Coté, T. R., Edfjäll, C., . . . Henter, J. (2012). The need for worldwide policy and action plans for rare diseases. Acta Paediatrica, 101(8), 805-807.

    Fox, S. (2011). The social life of health information 2011. Washington, DC: Pew Internet & American Life Project.

    Fox, S., & Brenner, J. (2012). Family caregivers online. Washington, DC: Pew Internet & American Life Project.

    Fox,S.,& Duggan, M.(2013) Health online 2013. Washington, DC: Pew Internet & American Life Project.

    Gahl, W. A., Markello, T. C., Toro, C., Fajardo, K. F., Sincan, M., Gill, F., . . . Adams, D. (2011). The national institutes of health undiagnosed diseases program: Insights into rare diseases. Genetics in Medicine, 14(1), 51-59.

    Glenn, A. D. (2015). Using Online Health Communication to Manage Chronic Sorrow:Mothers of Children with Rare Diseases Speak. Journal of Pediatric Nursing, 30(1), 17-24.

    Global genes (2014). Who we are. Retrieved from https://globalgenes.org/who-we-are-2/

    González-Teruel, A., & Abad-García, M. (2007). Information needs and uses: An analysis of the literature published in Spain, 1990–2004. Library & Information Science Research, 29(1), 30-46.

    Horne, D. C. (1999). A Medical Library for the Public: Starting and Running A Consumer Health. North Carolina Libraries, 57(3), 110-113

    Kessel, M., Hannemann-Weber, H., & Kratzer, J. (2012). Innovative work behavior in healthcare: The benefit of operational guidelines in the treatment of rare diseases. Health Policy, 105(2), 146-153.

    Kim, S., Marigowda, G., Oren, E., Israel, E., & Wechsler, M. E. (2010). Mepolizumab as a steroid-sparing treatment option in patients with Churg-Strauss syndrome. Journal of Allergy and Clinical Immunology, 125(6), 1336-1343.

    Kuhlthau, C. C. (1991). Inside the search process: Information seeking from the user's perspective. Journal of the American Society for Information Science, 42(5), 361- 371.

    Lazarus, R. S.&Folkman. S.(1984) Stress, Appraisal, and Coping. New York: Pringer.

    Leonard, H., Slack-Smith, L., Phillips, T., Richardson, S., D'Orsogna, L.,…Mulroy, S. (2004). How can the Internet help parents of children with rare neurologic disorders? Journal of Child Neurology, 19(11), 902-907.

    Lin, B. K., & Fleischman, A. R. (2008). Screening and Caring for Children with Rare Disorders. Hastings Center Report, 38(3), 3-3.

    Mason, J. W. (1971). A re-evaluation of the concept of ‘non-specificity’ in stress theory. Journal of Psychiatric Research, 8(3), 323-333.

    Patrick, K., & Koss, S. (1995). Consumer health information: White paper. Consumer health Information subgroup, Health information and application working group. Committee on applications and technology. Working draft. Washington: Information Infrastructure Task Force.

    Patsos, M. (2001). The Internet and medicine: Building a community for patients with rare diseases. The Journal of the American Medical Association, 285(6), 805-805.

    Phillips, M. I. (2013). Big Pharma's new model in orphan drugs and rare diseases. Expert Opinion on Orphan Drugs, 1(1), 1-3.

    Power, P. W., & Orto, A. E. D. (2004). Families living with chronic illness and disability: Interventions, challenges, and opportunities. New York: Springer Pub.

    Rajendran, P. R. (2001). The Internet: Ushering in a new era of medicine. The Journal of the American Medical Association, 285(6), 804-805.

    Rajmil, L., Perestelo-Pérez, L., & Herdman, M. (2010). Quality of Life and Rare Diseases. Rare Diseases Epidemiology Advances in Experimental Medicine and Biology, 251-272.

    Rosenstiel,A.K.& Keefe,F.J.(1983)The use of coping strategies in chronic low back pain patients:Relationship to patient characteristics and current adjustment.Pain,17(1):33-44.

    Savolainen, R. (1995). Everyday life information seeking: Approaching information seeking in the context of “way of life”. Library & Information Science Research, 17(3), 259-294.

    Selye, H. (1956). The stress of life. New York:McGraw-Hill.
    Tambuyzer, E. (2010). Rare diseases, orphan drugs and their regulation: Questions and misconceptions. Nature Reviews Drug Discovery, 9(12), 921-929.

    Tarby, W., & Hogan, K. (1997). Hospital-based patient information services: A model for collaboration. Bulletin of the Medical Library Association, 85(2), 158.

    Taylor, R. S. (1968). Question-negotiation and information seeking in libraries. College & research libraries, 29(3), 178-194.

    van Teijlingen, E., & Hundley, V. (2001). The importance of pilot studies. Social Research Update, 35, 1-4.

    Walker, K. K. (2013). Rare disease-specific social media sites: An opportunity for collaboration. Journal of Communication in Healthcare, 6(1), 71-76.

    Williams, J. K. (1982). Pediatric nurse practitioners' knowledge of genetic disease. Pediatric Nursing, 9(2),119-121.

    Wilson, T. D. (1981). On user studies and information needs. Journal of Documentation, 37(1), 3-15.

    Wilson, T. D. (1997). Information behaviour: An interdisciplinary perspective.Information processing & management, 33(4), 551-572.

    Wolf, L. F. and Sangl, A. (1996). Role of consumer information in today’s health care system. Health Care Financing Review, 18(1), 1-8.

    World Health Organization. (2003). WHO definition of health. Retrieved from http://www.who.int/about/definition/en/print.html

    Zurynski, Y., Frith, K., Leonard, H., & Elliott, E. (2008). Rare childhood diseases: How should we respond? Archives of Disease in Childhood, 93(12), 1071-1074.

    中央社新聞(2014)。冰桶公益名人急凍影片大集合。檢自:
    http://www.cna.com.tw/news/firstnews/201408185003-1.aspx

    中央健康保險署(2014)。健保30多萬人之愛心,幫助罕見疾病及血友病患者獲得妥適醫療照護。檢自:
    http://www.mohw.gov.tw/cht/Ministry/DM2_P.aspx?f_list_no=7&fod_list_no=4555&docno=44057

    文崇一、楊國樞(2000)。訪問調查法。社會及行為科學研究法下冊。臺北:東華。

    方凱企(2006)。發展遲緩兒童照護者壓力與其對遺傳諮詢資源獲取的需求研究(未出版之碩士論文)。國立臺灣大學分子醫學研究所,臺北市。

    王作仁(1999)。罕見疾病。臺北市:聯合文學。

    田翠琳 (2001)。社會上的弱勢族群?專訪罕見疾病基金會。健康世界,183,56-60。

    余漢儀、周雅容、畢恆達、胡幼慧、嚴祥鸞(1998)。危險與秘密-研究倫理。臺北市:三民書局。

    吳佳穎(2012)。擁抱太陽的月亮-一位罕見疾病患者的敘說研究(未出版之碩士論文)。實踐大學家庭研究與兒童發展學系家庭諮商與輔導研究所,臺北市。

    吳昭新(2000)。台灣網上醫學教育資訊的內容品質-現況與建議。檢自:http://olddoc.tmu.edu.tw/chiaungo/tmw-guide/critic-1.htm

    李佳苓、劉立凡、陳淑馨、林琇君(2014)。探討照顧管理服務成效與主要照顧者照顧負荷之相關性研究。護理雜誌,61(1),64-72。

    李英芬、蔡麗雲、 張澤芸(2008)。末期癌症病人之主要照顧者的負荷相關因素探討。安寧療護雜誌,13(4),394-410。

    李雅琪、劉潔心、王建得(2015)。自學式手冊介入策略對醫師面對罕見疾病急性紫質症之影響。臺灣公共衛生雜誌,34(2),143-155。

    李曜安、陳明終、鍾才元、楊政穎(2014)。社群網路使用者之線上社會支持與線上人際關係。國教新知,61(4),22-27。

    罕見疾病基金會(2008)。罕見疾病資源手冊III心理支持篇。臺北市:罕見疾病基金會。

    罕見疾病基金會(2013)。遺傳檢驗服務。財團法人罕見疾病基金會會訊。53,14-15。

    罕見疾病基金會(2014)。罕病分類與介紹。檢自:http://www.tfrd.org.tw/tfrd/rare_b

    罕見疾病基金會(2014)。建立NPO與政府合作網絡 推動罕病照護政策的經驗。檢自:http://www.irpma.org.tw/20130322/TFRD%20Serena%20Chen.pdf

    罕見遺傳疾病中文資料庫(2014)。罕見!孫小弟罹腎上腺白質退化症 缺醫療費待援。檢自:http://www.genes-at-taiwan.com.tw/genehelp/database/disease/ALD_news2.html

    谷玲玲、張惠蓉(2002)。網路社群的人際互動:以玉山虛擬航空公司為例。新聞學研究,72,55-83。

    卓玉聰、林千鈺(2004)。消費者健康資訊網路資源之探討。圖書資訊學刊,2(2),57-85。

    奇摩電影(2013)。一首搖滾上月球。檢自:
    https://tw.movies.yahoo.com/movieinfo_main.html/id=4887

    岳修平(2008)。Web 2.0影音分享平台之學習應用探討。臺灣圖書館管理季刊,4(3),9-21。

    林志鴻、曾敏傑(2002)。罕見疾病長期照護制度與生活照顧成本費用推估研究。臺北:財團法人罕見疾病基金會。

    林書羽(2009)。晚發型遺傳性神經退化疾病家族的心理調適及決策衝突(未出版之碩士論文)。國立臺灣大學分子醫學研究所,臺北市。

    社團法人中華民國軟骨發育不全症病友關懷協會(2015)。臉書粉絲專頁。檢自:https://www.facebook.com/TLPA2011?ref=br_rs

    邱培源(2002)。病患健康資訊需求與尋求行為之研究(未出版之碩士論文)。淡江大學資訊與圖書館學研究所,新北市。

    徐溢謙(譯)。(2005)。照護心理學(原作者:S. Payne; J. Walker)。(原著出版年:2004)

    財團法人罕見疾病基金會、臺大醫院基因醫學部(2009)。認識罕見疾病 I & II。臺北市:罕見疾病基金會。

    陳世娟(2012)。癌症病患家庭照護者之資訊行為研究(未出版之博士論文)。國立臺灣大學圖書資訊所,臺北市。

    陳向明(2002)。社會科學質的研究。臺北市:五南。

    陳志昇(1999)。醫界孤兒-罕見疾病患者權益之探討(未出版之碩士論文)。國立臺灣大學新聞研究所,臺北市。

    陳亭華(2002)。醫療資源分配倫理之探討-罕見疾病患者家庭之困境與權利(未出版之碩士論文)。國立中正大學社會福利研究所,嘉義縣。

    曾紀瑋(2009)。全民健康保險罕見疾病兒童醫療利用分析:2000及2011年為例(未出版之碩士論文)。國立中正大學社會福利學系暨研究所,嘉義縣。

    曾敏傑(2005,12月)。台灣罕見疾病基金會的發展。行政院衛生署國民健康局主辦,優生保健暨罕見疾病防治國際學術研討會,臺北市。

    黃惠屏、吳瓊滿(2004)。協助一位家庭主要照顧者適應照顧壓力過程。護理雜誌,51(1),99-104。

    黃菊珍(2006)。復原力對罕見疾病患者家屬心理調適影響之研究。臺北市:臺北護理學院生死教育與輔導研究所。

    楊明理(2011)。淺談賦能概念在喘息服務之應用。台灣心理諮商季刊,3(1),16-28。

    楊美文、金繼春(2005)。癌症兒童主要照顧者資訊需求量表之發展與測試。醫學科技學刊,7(2),163-174。

    楊茹萍、顏妙芬、張秀蘭(2002)。緩解一位主要照顧者身、心、社會負荷的護理經驗。護理雜誌,49(6),89-94。

    楊智凱(2009)。找尋家庭韌力:以三個罕見疾病兒童家庭為例(未出版之碩士論文)。東吳大學社會工作學研究所,臺北市。

    詹培儀(2014)。螢火蟲之母-罕見疾病患者母親之生命敘說(未出版之碩士論文)。國立臺中教育大學諮商與應用心理學研究所,臺中市。

    廖韋淳、邱立安、岳修平(2012)。鄉村地區老年人健康資訊需求與尋求行為之研究。圖書資訊學刊,10(1),155-204。

    廖學能(2007)。論我國罕見疾病醫療資源分配的制度與法律問題(未出版之碩士論文)。國立清華大學科技法律研究所,新竹市。

    臺大醫院(2015)。遺傳學和疾病的關係。檢自:
    https://www.ntuh.gov.tw/gene/cdisease/second_level_pages/c_genetics/g0002.htm

    潘淑滿(2003)。質性研究:理論與應用。臺北市:心理。

    衛生福利部中央健康保險署(2015)。全民健康保險重大傷病證明有效領證統計表。檢自:www.nhi.gov.tw/Resource/webdata/15049_2_10405重大傷病.pdf

    鄭芬蘭、蔡孟芬、蔡惠玲(2013)。罕見疾患的家庭壓力因應與需求。教育心理學報,44,433-458。

    賴妍妃(2007)。我痛我愛我再生-一位罕見疾病兼智能障礙兒童母親的心路歷程(未出版之碩士論文)。國立臺北教育大學特殊教育學研究所,臺北市。

    賴鼎銘、黃慕萱、吳美美、林珊如(2001)。圖書資訊學概論。臺北縣:國立空中大學。

    羅一中(2002)。華人母親的人際義務-以罕見疾病兒童的家庭為例(未出版之碩士論文)。國立中正大學心理學研究所,嘉義縣。

    關懷雷特氏症Rett-Syndrome寶貝-關懷蕾雷家族(2015)。臉書粉絲專頁。檢自:https://www.facebook.com/rettsyndrome.taiwan?fref=pb&hc_location=profile_browser

    下載圖示
    QR CODE