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臨床心理師在周全性老年病人評估之角色

Role of Clinical Psychologist in Comprehensive Geriatric Assessment

摘要


周全性老年評估(Comprehensive Geriatric Assessment,簡稱CGA)針對老年病患的特殊需求,提供適當的因應策略與資源,其中,臨床心理師以獨特的專業知識與背景,提供老年病患、家屬及醫療團隊不同的協助,藉此提升老年病患獨立生活的能力、較佳的生活品質。 筆者以臨床心理師的角度,首先針對老年病患本身的特質,介紹認知與情緒狀態的本質與評估方式,同時討論目前台灣常見的測量工具之優劣,以及測驗結果的解釋與應用;在了解老年病患的認知與情緒狀態後,接下來的重點是設定適當的認知復健訓練與提供情緒支持,在此過程中,臨床心理師考量了階段性目標與認知能力之間的關聯性,以及情緒與外在生活環境的影響,並整合各項可能的影響因素,以便對不同病患訂定獨一無二的治療計畫。另外,針對陪伴的照顧家屬,臨床心理師需澄清症狀與合理病情期待,協助減少照顧時給與受之間的落差,維持病患家庭間的良好溝通與資源調配,並促進醫病之間的良好互動,以利整體醫療品質的良好呈現。在醫療團隊內,臨床心理師除能促進各專業的整合,改善對病患的醫療品質外,更能協助團隊人員釐清在醫療過程中所產生的情緒影響,提升專業效能。

並列摘要


The Comprehensive Geriatric Assessment (CGA) offers practical coping strategies and resources to meet the specific needs of the elderly patients. With the professional knowledge and background, the clinical psychologist in CGA could provide specific assistances to elderly patients, their caregivers and even medical care team members. It is expected that clinical psychologists could help elderly patients to enhance their living abilities and quality of lives. From a clinical psychologist's point of view, the article first introduces the emotion and cognition assessments based on the features of elderly patients. It then further discusses the advantage and disadvantage of scales that are frequently used in Taiwan. Meanwhile, the article also comments on the application and interpretation of these scales. After assessing patients, the clinical psychologist would arrange a reasonable cognitive rehabilitation program and provide adequate emotional support by considering the stepwise goal, the patient's cognitive ability and emotional state, the living environment, and other possible influential factors. In addition, the clinical psychologist could also assist family caregivers to realize the patient's symptoms, and help them to form a rational expectation. The clinical psychologist's coordination would be helpful in minimizing the distinction between caregivers' anticipation and patient's need, as well as in keeping sufficient communication and family resource allocation. Furthermore, in order to improve the quality of medical care, the clinical psychologist endeavors to build up a good relationship among medical staffs and patients. The clinical psychologist would also encourage the integration of professional suggestions in the medical team. More than that, the clinical psychologist could help medical staffs to improve their practices by perceiving their own emotional experiences that are generated during working.

被引用紀錄


林劭(2011)。老人整合性門診服務運作之現況調查〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://doi.org/10.6831/TMU.2011.00037

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