纾缓护理及预设医疗指示
我们的研究致力于提升纾缓护理及晚期照护，尤其着重推广预设照顾计划和预设医疗指示，服务对象包括癌症患者、儿童患者、长者以至全港市民。
纾缓护理是指透过及早识别及治疗身体痛症及其他生理、心理、社交或精神方面的问题，帮助危重症患者预防或减轻痛楚，从而改善患者及其家人的生活质素。接受纾缓护理的患者一般饱受精神困扰，或会因而感到人生没有意义，并产生一些负面情绪如恐惧、紧张、焦虑、灰心、自杀倾向、抑郁、绝望等。
有时晚期病人会希望撤去维生治疗，安详而有尊严地离世。但若患者已失去意识、又未有预先表明医疗意愿，该选择何种医疗方式，是医护人员经常面对的困局。预设医疗指示是清晰记载个人对晚期医疗所作选择的书面文件，用来表明将来失去自决能力时所希望接受的医疗护理形式。预设医疗指示的概念建基于知情同意原则，并相信个人有自主权作出医疗护理决定。
相关研究项目
| 项目名称 | 拨款来源 | 首席研究员 | 项目年期 |
|---|---|---|---|
| Research on basic medical insurance payment strategies of advance care planning under value orientation | National Natural Science Foundation of China (NSFC) | CHAN Yue Lai, Helen | 2023–2026 |
| The effectiveness of a multi-media experiential training programme in advance care planning for nurses working in acute care settings | General Research Fund (GRF) | CHAN YIP Wing Han, Carmen | 2023–2024 |
| Effects of a decision support intervention on end-of-life care planning in patients with advanced chronic obstructive pulmonary disease and their family members: A mixed method approach | General Research Fund (GRF) | CHAN Yue Lai, Helen | 2023–2024 |
| Identifying social capital for family caregiving in chronic organ failure: A concept mapping study | Public Policy Research Funding Scheme | NG Shek Nam, Marques | 2021–2022 |
精选学术论文
| Selected Publications |
|---|
| Chan, C. W. H., Choi, K. C., Chan, H. Y. L., Wong M. M. H., Ling, G. C. C., Chow, K. M., Chow, A. Y. M., Lo, R. S. K, & Sham, M. M. K. (2019). Unfolding and displaying the influencing factors of advance directives from the stakeholder’s perspective: A concept mapping approach. Journal of Advance Nursing. https://onlinelibrary.wiley.com/doi/full/10.1111/jan.14017 |
| Chan, C. W. H., Wong, M. M. H., Choi, K. C., Chan, H. Y. L., Chow A. Y. M., Lo, R. S. K., & Sham, M. M. K. (2019). Prevalence, perception and predictors of advance directives among Hong Kong Chinese: A Population-based survey. International Journal of Environmental Research and Public Health, 16(3), 365. https://www.mdpi.com/1660-4601/16/3/365 |
| Chan, C. W. H., Wong, M. M. H., Choi, K. C., Chan, H. Y. L., Chow, A. Y. M., Lo, R. S. K, & Sham, M. M. K. (2019). What patients, families, health professionals and hospital volunteers told us about advance directives. Asia-Pacific Journal of Oncology Nursing, 6(1), 72–77. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6287378/ |
| Chan, Y. L., Lee D. T. F., Chan, C. W. H., & Ko, P. S. (2018). Effects of a nurse-led post-discharge advance care planning programme for community-dwelling patients nearing the end of life and their family members: A randomised controlled trial. International Journal of Nursing Studies. 87, 26–33. https://www.sciencedirect.com/science/article/pii/S002074891830172X |
| Kwan, C. W. M., Ng, M. S. N., & Chan C. W. H. (2017). The use of life review to enhance spiritual wellbeing in patients with terminal illnesses: An integrative review. Journal of Clinical Nursing, 26 (23–24), 4201–4211. https://onlinelibrary.wiley.com/doi/full/10.1111/jocn.13977 |
知识转移活动
报章撰文及传媒专访：
- 陈叶咏娴及谢文琪（2022年7月22日） 。 南亚族裔人医疗自主意向。《信报财经新闻》。
- 陈叶咏娴及黄铭谦（2018年11月2日）。〈保持尊严 安然离世〉。《信报财经新闻》。
- Chan, C.W.H. (2015, February 24). Many Hong Kong citizens still know little about end-of-life care. South China Morning Post.
所制作的健康教育资源：
健康讲座／工作坊／探访：
| 核心研究课题 |
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癌症及纾缓护理 |
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心血管、代谢疾病及中风护理 |
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老年、行为及精神健康 |
| 与我们合作 |
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陈叶咏娴教授
陈裕丽教授
