DSpace collection: 期刊論文
https://ir.cnu.edu.tw/handle/310902800/2790
The collection's search engineSearch the Channels
https://ir.cnu.edu.tw//simple-search
Potentially Inappropriate Medication among Older Patients Who Are Frequent Users of Outpatient Services
https://ir.cnu.edu.tw/handle/310902800/34481
title: Potentially Inappropriate Medication among Older Patients Who Are Frequent Users of Outpatient Services abstract: Aging is accompanied by changes in organ degeneration, and susceptibility to multiple diseases, leading to the frequent occurrence of adverse drug reactions resulting from polypharmacy (PP) and potentially inappropriate medications (PIM) in older patients. This study employs a retrospective cohort design and investigates the association of PP with PIM among older patients with high rates of medical utilization. Using records from a national pharmaceutical care database, an experimental group is formed from patients meeting these criteria, who are then offered home pharmaceutical care. Correspondingly, a control group is formed by identifying older patients with regular levels of use of medical services who had been dispensed medications at community pharmacies. Multivariate logistic regression is performed to assess the association between the rate of PIM and variables, including age, gender, and PP. The study finds that experimental PP participants had a higher rate of PIM prescription (odds ratio (OR) = 5.4) than non-PP control participants (all p < 0.001). In clinical practice, additional caution is required to avoid PIMs. Patients engaged in continuously using long-term medication should take precautions in daily life to alleviate related discomforts. Pharmacists should serve as a bridge between patients and physicians to enhance their health and improve their quality of life.
<br>An Integrated View of Information Feedback, Game Quality, and Autonomous Motivation for Evaluating Game-Based Learning Effectiveness
https://ir.cnu.edu.tw/handle/310902800/34071
title: An Integrated View of Information Feedback, Game Quality, and Autonomous Motivation for Evaluating Game-Based Learning Effectiveness abstract: Critical factors that influence the value of digital game-based learning (DGBL) for enhancing learning effectiveness remain debatable. Based on the self-determination theory (SDT), people can be autonomously motivated to adopt DGBL to enhance learning effectiveness if their basic psychological needs are satisfied. Additionally, studies that simultaneously examine the effects of two critical factors of information feedback and game quality on students' autonomous motivation and learning effectiveness in DGBL contexts are missing in the literature. This study integrates information feedback, game quality, and SDT to develop a research model for comprehending the effectiveness of DGBL systems. Data collected from 383 respondents was analyzed to validate our research model. The results showed that information feedback, game quality, and autonomous motivation significantly influenced students' learning effectiveness and their continuance intention to use DGBL systems. Additionally, autonomous motivation indirectly influenced continuance intention via learning effectiveness. Implications for theory and for practice are discussed accordingly.
<br>Effect of Pharmacist Intervention on a Population in Taiwan with High Healthcare Utilization and Excessive Polypharmacy
https://ir.cnu.edu.tw/handle/310902800/32628
title: Effect of Pharmacist Intervention on a Population in Taiwan with High Healthcare Utilization and Excessive Polypharmacy abstract: Patients with high healthcare utilization are at increased risk of polypharmacy and drug interactions. This study investigated the changes in the number of medications, drug interactions and interaction severity in high frequency outpatients with polypharmacy at hospitals and clinics in Taiwan after home pharmaceutical care, to understand the effectiveness of interventions by pharmacists. This was a retrospective observational study. Cases with excessive polypharmacy (10+ drugs) were selected from the Pharmaceutical Care Practice System database of the Taiwan Pharmacist Association in 2017. After the home care intervention, the number of drug types used decreased 1.89-fold (p < 0.001), and the number of medications fell 61.6%. The incidence of drug interaction was 93.82%. In an average case, the incidence of drug interaction after the pharmacist intervention decreased 0.6-fold (p < 0.001). The drug most commonly causing interactions was aspirin, followed by diclofenac; also common were three used in diabetes, two psycholeptics and two beta blockers. Among 22 cases of severe drug interaction, seven resulted in increased risk of extrapyramidal symptoms and neuroleptic malignant syndrome. By analyzing the relationship between the side effects of individual drugs and the pharmacokinetic T-max, a sequential thermal zone model of adverse drug reactions can be established, the value of which could prompt physicians and pharmacists to intervene in order to prevent adverse events. It is concluded that home pharmaceutical care by pharmacists can significantly reduce the number of medications and interactions in patients with excessive polypharmacy and high healthcare utilization.
<br>The Effects of Competitive Gaming Scenarios and Personalized Assistance Strategies on English Vocabulary Learning
https://ir.cnu.edu.tw/handle/310902800/32221
title: The Effects of Competitive Gaming Scenarios and Personalized Assistance Strategies on English Vocabulary Learning abstract: English vocabulary is the foundation of English learning. According to information processing theory, recitation helps learners remember and understand English terminology. However, this type of exercise may lead to boredom, anxiety, difficulty concentrating, and other negative effects. This study proposes the integration of competitive gaming with personalized assistance as a means of reducing anxiety and enhancing the degree of immersion, as well as raising the overall effectiveness of the lesson. The board game Monopoly was used as the basis for the design of a vocabulary-focused competitive game. Personalized assistance was provided to help learners study and review new English vocabulary words in an attempt to improve their memorization. A total of 120 students were recruited to serve as participants in the study. Each was randomly assigned to one of four different groups to take part in select English vocabulary activities. The results show that the integration of a competitive gaming scenario with a personalized assistance strategy helped students improve their vocabulary acquisition.
<br>