星期三, 8月 31, 2005

自評項目，請提供意見

王主任請各位提供「自評項目」之內容，我想：
工作績效
工作態度
協調能力
其它事蹟

請修改，補充！

posted by Ching-Lin @ 星期三, 8月 31, 2005 0 comments

星期三, 8月 24, 2005

病人/家屬及學生之滿意度調查

  • 為掌握病人/家屬/學生之需求，提升服務與教學水準。
  • 擬請吳學長協助調查病人/家屬及學生之滿意度及建議事項。
  • 病人/家屬方面擬訪問病人及家屬對於「治療成效」、「治療器材」、「治療環境」、「治療師專業能力」「治療師之服務態度」、「便利性」等。
  • 學生方面擬訪問同學對於「實習內容」、「作業內容」、「實習環境」、「指導老師」等。
  • 請提供意見，以使調查內容更完整，具有參考價值。

posted by Ching-Lin @ 星期三, 8月 24, 2005 0 comments

職能治療科白皮書檔案

職能治療科白皮書檔案，請下載。

posted by Ching-Lin @ 星期三, 8月 24, 2005 0 comments

吳方南學長可協助之事務

1. 將早療名單會入網頁（網址： ），每週一次，每次約1-2小時。由博彥負責說明與確認。
2. 刪除早療未到之名單（網址： ），每月一次，每次約2小時。由博彥負責說明與確認。
3. 抄寫照會單於病人登錄簿，每天約半小時。小兒由博彥，成人由怡君負責說明與確認。
4. 病歷整理與歸檔，每月一次，每次約2小時。小兒由資皇，成人由怡萱負責說明與確認。
5. 協助領取請領物品（4F圖書室），每月中旬一次，由怡萱負責說明與確認。
6. 協助治療病患，預計9/12開始治療病情穩定之成人病人（如OPD病人）。

其它（尚待確認）：
1. 病人每次來OT 之登錄/記帳流程（含治療人數統計），請小菁與彬心負責彙整意見及規劃後，於下週三之前 post 於部落格，再確認。
2. 統計品質管理照會單，每月一次。

posted by Ching-Lin @ 星期三, 8月 24, 2005 0 comments

星期二, 8月 23, 2005

期刊論文推薦

  • Fritz SL, Light KE, Patterson TS, Behrman AL, Davis SB. Active finger extension predicts outcomes after constraint-induced movement therapy for individuals with hemiparesis after stroke. Stroke. 2005 Jun;36(6):1172-7.
BACKGROUND AND PURPOSE: Constraint-induced movement therapy (CIMT) is a rehabilitative strategy used primarily with the post-stroke population to increase the functional use of the neurologically weaker upper extremity through massed practice while restraining the lesser involved upper extremity. Whereas research evidence supports CIMT, limited evidence exists regarding the characteristics of individuals who benefit most from this intervention. The goal of this study was to investigate the potential of 5 measures to predict functional CIMT outcomes.
CONCLUSIONS: When using finger extension/grasp release as a predictor in the regression equations, one can predict individual's follow-up scores for CIMT. This experiment provides the most comprehensive investigation of predictors of CIMT outcomes to date.

  • Studenski S, Duncan PW, Perera S, Reker D, Lai SM, Richards L. Daily functioning and quality of life in a randomized controlled trial of therapeutic exercise for subacute stroke survivors. Stroke. 2005 Aug;36(8):1764-70.

BACKGROUND AND PURPOSE: The ability of therapeutic exercise after stroke to improve daily functioning and quality of life (QOL) remains controversial. We examined treatment effects on these outcomes in a randomized controlled trial (RCT) of exercise in subacute stroke survivors.

CONCLUSIONS: This rehabilitation exercise program led to more rapid improvement in aspects of physical, social, and role function than usual care in persons with subacute stroke. Adherence interventions to promote continued exercise after treatment might be needed to continue benefit.

posted by Ching-Lin @ 星期二, 8月 23, 2005 0 comments

星期一, 8月 22, 2005

可能遭遇之困難（目前及未來）

1. 治療師幾無晉升管道，向心力不足，已造成士氣低落，人才流失。
2. 本科之發展目標（或特色）亟待凝聚共識，亦需復健部與院方之協助。
3. 本科之研究成果明顯低落，亟待提昇與協助。
4. 復健部對於業績要求過高（或目標不明確），但職能治療師之人力不足，恐影響臨床服務與教學品質。
5. 復健部之發展與本科之發展缺乏充分溝通與共識之建立。
6. 復健部各科室之整合不足，難以提昇服務效率與品質。
7. 本科同仁不解復健部業績/成本/績效獎金發放之計算方式，希望能夠明朗化，以確定努力之目標。

posted by Ching-Lin @ 星期一, 8月 22, 2005 0 comments

星期六, 8月 20, 2005

期刊論文推薦

Computerized Arm Training Improves the Motor Control of the Severely Affected Arm After Stroke. A Single-Blinded Randomized Trial in Two Centers
S. Hesse MD*; C. Werner MA; M. Pohl MD; S. Rueckriem PT; J. Mehrholz PT; and M. L. Lingnau MA
「此文最快將於8/24的 Stroke 雜誌刊登」

Background and Purpose--To compare a computerized arm trainer (AT), allowing repetitive practice of passive and active bilateral forearm and wrist movement cycle, and electromyography-initiated electrical stimulation (ES) of the paretic wrist extensor in severely affected subacute stroke patients.
Method--A total of 44 patients, 4 to 8 weeks after stroke causing severe arm paresis (Fugl-Meyer Motor Score [FM, 0 to 66] <18), were randomly assigned to either AT or ES. All patients practiced 20 minutes every workday for 6 weeks. AT patients performed 800 repetitions per session with the robot and ES patients performed 60 to 80 wrist extensions per session. The primary outcome measure was the blindly assessed FM (0 to 66), and the secondary measures were the upper limb muscle power (Medical Research Council [MRC] sum, 0 to 45) and muscle tone (Ashworth score sum, 0 to 25), assessed at the beginning and end of treatment and at 3-month follow-up.
Results--The AT group had a higher Barthel Index score at baseline, but the groups were otherwise homogenous. As expected, FM and MRC sum scores improved overtime in both groups but significantly more in the robot AT group. The initial Barthel Index score had no influence. In the robot AT group, FM score was 15 points higher at study end and 13 points higher at 3-month follow-up than the control ES group. MRC sum score was 15 points higher at study end and at 3-month follow-up compared with the control ES group. Muscle tone remained unchanged, and no side effects occurred.
Conclusion--The computerized active arm training produced a superior improvement in upper limb motor control and power compared with ES in severely affected stroke patients. This is probably attributable to the greater number of repetitions and the bilateral approach.

posted by Ching-Lin @ 星期六, 8月 20, 2005 0 comments

星期三, 8月 17, 2005

請提供[吳方南]學長可協助之事項

Please provide suggestions by this Friday.
Please specify job description and time needed everyday (or every week)

posted by Ching-Lin @ 星期三, 8月 17, 2005 1 comments

有關「建立特色，精益求精」之建議

  • 擬於9月底之前凝聚共識，請各治療師務必於九月中旬之前，提出一個擬發展之臨床特色（請參酌目前本科服務病人之診斷種類的人數與特性。若病人數太少＆短期內又無法擴增，並不利於特色之發展。）。
  • 中長期目標：於5-8年內，成人與小兒至少各有一領域，成為國內最佳之治療團隊。

Note: 影響深遠，請務必深思！

posted by Ching-Lin @ 星期三, 8月 17, 2005 0 comments

8-19（週五）之前，待彙整事項

  1. 具體提出目前或未來，自身或單位所遭遇之困難（毋須重複提出）。
  2. 具體提出目前或未來，自身或單位之需求或需協助之處（毋須重複提出）。
  3. 提出欲觀摩之單位（將申請公假公費補助，事後撰寫參觀報告）。

以上，請盡量於此 blog 發表意見，可避免重複。書面亦歡迎於週五下班前繳給本人。

posted by Ching-Lin @ 星期三, 8月 17, 2005 1 comments

星期五, 8月 05, 2005

期待復健部與台大醫院之協助

需復健部協助之處：
1. 公開業績/成本/績效獎金發放之計算方式，並做到公平合理之分配。
2. 爭取約聘同仁升遷為正式職位。
3. 增加公假與公費進修員額，以提昇治療師之實證服務及研究水準
4. 實質鼓勵同仁創新研發、參與研究。

5. 尊重專業/充分授權。

6. 帶領團隊合作/展現領袖風範。



需院方協助之處：
1. 建立職能治療師晉升管道。
2. 輔導職能治療科與其它單位之服務與教學，甚至研究之合作。

3. 輔導職能治療科之長期發展。

posted by Ching-Lin @ 星期五, 8月 05, 2005 0 comments

台大復健部OT願景

建立共識中。。。。

以下是 Ching-Lin 個人的看法，請提供更好的意見：

  • 服務病人，提昇成效（建立臨床卓越之架構）
  • 指導學生，培養專才（建立臨床教學之典範）
  • 建立特色，精益求精（成人與小兒至少選擇各一領域，建立國內最佳之治療團隊）

  • 5-8年後，期待之景像：
  • 病人首選之職能治療機構
  • 職能治療學生首選之實習機構
  • 其它醫院職能治療部門首選之觀摩機構

posted by Ching-Lin @ 星期五, 8月 05, 2005 0 comments