DSpace community: 醫務管理系(所)

社群媒體演算法控制對健康醫療產業從業人員的微休息經驗、情緒耗竭之影響：自我損耗的觀點

title: 社群媒體演算法控制對健康醫療產業從業人員的微休息經驗、情緒耗竭之影響：自我損耗的觀點 abstract: 背景及目的：目前關於工作間的微休息策略（Micro-breaks）在工作者恢復經驗與恢復效果之間的影響，仍缺乏實證研究。社群媒體參與（臉書、IG、抖音等）作為當前常見的微休息策略，其平台演算法控制機制往往引導著使用者會收到怎樣的訊息參與體驗。因此本研究擬以工作中微休息策略作為場域，探討醫療從業人員社群媒體演算法控制對微休息恢復經驗、自我損耗與情緒耗竭的關連。因此本研究擬以工作中微休息策略作為場域，探討醫療從業工作者平日社群媒體參與行為中，對演算法控制的認知對其工作間微休息的恢復經驗與情緒耗竭之影響，並透過自我損耗觀點解釋其中介。其研究目的旨在透過文獻的回顧，建構醫療從業人員的恢復經驗、微休息策略、自我損耗與復原力的理論模型，並發展結構化量表，進行實證研究以驗證其效果。

瞭解民眾同意個人健保資料再利用的隱私邊界：擴充傳播隱私管理的理論觀點

title: 瞭解民眾同意個人健保資料再利用的隱私邊界：擴充傳播隱私管理的理論觀點 abstract: 1.社會面：藉由本計畫成果可供政府單位從傳播隱私管理觀點，了解民眾對健保資料再利用的隱私邊界考量因素，故本研究成果可提供政府相關單位參考以建立相關法制，以完足憲法第 22 條對人民資訊隱私權之保障。 2.經濟面：健保資料庫是國家最具經濟價值的大數據資料庫，故藉由本研究成果瞭解促進民眾同意健保資料再利用之關鍵因素，可供健保署擬定相關推廣策略，以鼓勵民眾同意健康資料再利用來促進學術研究及智慧醫療技術的發展，進而增進全民健康福祉。。 3. 學術發展面：擴充傳播隱私管理的理論觀點，探討影響民眾同意健保資料再利用之影響因素，可供後續研究針對不同醫療大數據導入做更深入的探究。

Characteristics and outcomes for pulmonary aspergillosis in critically ill patients without influenza: A 3-year retrospective study

title: Characteristics and outcomes for pulmonary aspergillosis in critically ill patients without influenza: A 3-year retrospective study abstract: Background: Previous studies have revealed higher mortality rates in patients of severe influenza coinfected with invasive pulmonary aspergillosis (IPA) than in those without the coinfection; nonetheless, the clinical outcome of IPA in critically ill patients without influenza remains unclear.Patients and methods: This retrospective study was conducted in three institutes. From 2016-2018, all adult patients diagnosed with IPA in the intensive care units (ICUs) were identified. The logistic regression was used to identify the potential risk factors associated with in-hospital mortality in patients with non-influenza IPA. The stratified analysis of IPA patients with and without antifungal therapy was also performed. The final model was established using a forward approach, selecting variables with p-values less than 0.05. Results: Ninety patients were included during the study period, and 63 (70%) were men. The most common comorbidity was diabetes mellitus (n = 24, 27%), followed by solid cancers (n = 22, 24%). Antifungal therapy was administered to 50 (56%) patients, mostly voriconazole (n = 44). The in-hospital mortality rate was 49% (n = 44). Univariate analysis revealed that the risk factors for mortality included daily steroid dose, APACHE II score, SOFA score, C-reactive protein (CRP) level, carbapenem use, antifungal therapy, and caspofungin use. Multiple regression analysis identified four independent risk factors for mortality: age (Odds ratio [OR], 1.052, p = 0.013), daily steroid dose (OR, 1.057, p = 0.002), APACHE II score (OR, 1.094, p = 0.012), and CRP level (OR, 1.007, p = 0.008). Furthermore, the multivariable analysis identified that more physicians would initiate antifungal therapy for patients with prolonged steroid use (p = 0.001), lower white blood cell count (p = 0.021), and higher SOFA score (p = 0.048). Thus, under the selection bias, the independent risk factors for mortality in the antifungal treatment subgroup were daily steroid dose (OR, 1.046, p = 0.001) and CRP (OR, 1.006, p = 0.018), whereas the independent risk factor for mortality in the untreated group became APACHE II score (OR, 1.232, p = 0.007).Conclusions: Patients with IPA had a substantially high mortality. Overall, age, steroid use, APACHE II score, and CRP level were identified as the independent risk factors for mortality in patients in the ICU.(c) 2023 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Comparison of healthcare utilization and life-sustaining interventions between patients with glioblastoma receiving palliative care or not: A population-based study

title: Comparison of healthcare utilization and life-sustaining interventions between patients with glioblastoma receiving palliative care or not: A population-based study abstract: Background: Palliative care has historically been under-utilized in patients with glioblastoma. Furthermore, literature on the utilization of healthcare and life-sustaining interventions during the late-stage of glioblastoma has been limited. Aim: To identify and compare healthcare utilization and life-sustaining interventions between patients with glioblastoma who received palliative care and who did not based on patients identified retrospectively from Taiwan Cancer Registry between January 2007 and December 2017. Design: In this study, palliative care was defined on the basis of claims submitted to the National Health Insurance, which has a specific code for it. Variables included demographic characteristics, the utilization of healthcare services, and invasive life-sustaining interventions. Setting/participants: Of the 1994 patients with glioblastoma identified, 1784 fulfilled the inclusion criteria, 613 (34%) of whom received palliative care. Results: The survival of patients with glioblastoma under palliative care was significantly longer than that of those without palliative care. Those without palliative care had significantly more frequent intensive care unit admissions and a longer cumulative length of intensive care unit stay. Regarding cardiopulmonary or respiratory treatments, patients without palliative care had significantly more invasive interventions than those with palliative care. Patients receiving palliative care had significantly lower odds than those without life-sustaining interventions. Conclusions: Our retrospective analysis reveals that glioblastoma patients without palliative care had greater odds of receiving life-sustaining treatments within 1 year before their death, although no gains in survival as compared to those that received palliative care. These findings highlight the urgent need for palliative care in caring for patients with glioblastoma.