114 年 國立臺灣大學職能治療學系研究所《英文文獻閱讀測驗》

請根據下文描述,用中文回答以下問題(配分共15分)

1. 請定義 well being。(5%)
2. 請說明 health promotion。(5%)
3. 請精簡說明 healthy people 2030的5個目標。(5%)

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Definitions

Well-Being

Well-being is the ultimate goal of health promotion. Well-being is an evolving concept that includes "the presence of positive emotions and moods (e.g., contentment, happiness), the absence of negative emotions (e.g., depression, anxiety), satisfaction with life, fulfillment, and positive functioning" (Centers for Disease Control and Prevention, 2018, para. 1). In occupational therapy, well-being also includes satisfaction with participation in occupations and daily activities that enhance quality of life (QoL). Eight dimensions of well-being are identified in the Substance Abuse and Mental Health Services Administration (2016) model: (1) emotional, (2) environmental, (3) financial, (4) intellectual, (5) occupational, (6) physical, (7) social, and (8) spiritual.

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Health Promotion, Health, and Healthy Life

It is important to frame the discussion of occupational therapy's role in health promotion by first defining health promotion and health. According to the Ottawa Charter for Health Promotion,

Health promotion is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental, and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector but goes beyond healthy lifestyles to well-being. (World Health Organization, 1986, para. 2, italics added)

For nearly 40 years, the U.S. Department of Health and Human Services (DHHS) has established health promotion and disease prevention objectives to facilitate and measure improvement in health (DHHS, 1980, 1990, 2000, 2010, 2018a). The vision of Healthy People 2030 is the realization of "a society in which all people achieve their full potential for health and well-being across the lifespan" (DHHS, 2018a, para. 11). Attention to all dimensions in health promotion programming is essential to facilitate overall well-being. Healthy People 2030 has five major goals:

1. Attain healthy, thriving lives and well-being, free of preventable disease, disability, injury, and premature death.
2. Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.
3. Create social, physical, and economic environments that promote attaining full potential for health and well-being for all.
4. Promote healthy development, healthy behaviors, and well-being across all life stages.
5. Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all. (DHHS, 2018a, para. 11)

請用中文寫出此篇研究對復健的含意。(配分共10分)

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DISABILITY AND REHABILITATION
2023, VOL. 45, NO. 14, 2382-2389
https://doi.org/10.1080/09638288.2022.2089737

PERSPECTIVES IN REHABILITATION
Toward a paradigm shift in healthcare: using the International Classification of Functioning, Disability and Health (ICF) and the capability approach (CA) jointly in theory and practice

Sabina van der Veen, Natalie Evans, Martijn Huisman, Patricia Welch Saleeby and Guy Widdershoven

*Department of Ethics, Law and Humanities, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands; Department of Sociology, Criminology and Social Work, Bradley University, Peoria, IL, USA

ABSTRACT
Purpose: Over the past two decades, healthcare systems have shifted to adopt a more holistic, patient-centered care system. However, operationalization in practice remains challenging. Two frameworks have contributed substantially to the transformation toward more holistic and patient-centered care: the International Classification of Functioning, Disability and Health (ICF) and the capability approach (CA). Using these frameworks jointly can contribute to improved patient-centered care in clinical practice.
Methods: This article explores the strengths and weaknesses of the use of the two frameworks. In care and investigates whether using them jointly might contribute to more appropriate and patient-centered care. We will present a practical example of this integration in the form of a novel e-health application.
Results: The exploration indicated that if the frameworks are used jointly, the individual weaknesses can be overcome. The application, used to exemplify the joint use of the frameworks, contains all categories of the ICF. It offers a unique tool that allows a person to self-assess, record, and evaluate their functioning and capabilities and formulate related goals.
Conclusions: Using the ICF jointly with the CA can foster holistic, patient-centered care. The e-health application provides a concrete example of how the frameworks can be used jointly.

➤ IMPLICATIONS FOR REHABILITATION

• Using the International Classification of Functioning, Disability and Health jointly with the capability approach can foster holistic, patient-centered care.
• The joint use of the frameworks is demonstrated by an e-health application which enables users to evaluate their functioning in relation to their own goals, provides them with the opportunity to increase control over their health and have a more active role in their care.
• Tools to record both functioning and goals from a patient's perspective can support professionals in offering patient-centered care in daily practice.
• Individual recording, monitoring and evaluation of functioning, capabilities and goals regarding functioning can provide a basis for research and quality improvement.

Please address the following questions based on the following abstract. (請用中文回答)(配分共15分)

1. What is the aim of the practice guidelines? (5%)
2. How did the authors develop the clinical recommendations? (5%)
3. What is the recommended regimen for enhancing performance of extended daily life activities in individuals with stroke? (5%)

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Occupational Therapy Practice Guidelines for Adults with Stroke
Mary W. Hildebrand, Daniel Geller, Rachel Proffitt

Importance: Stroke is a leading cause of disability. Occupational therapy practitioners ensure maximum participation and performance in valued occupations for stroke survivors and their caregivers.
Objective: These Practice Guidelines are meant to support occupational therapy practitioners' clinical decision making when working with people after stroke and their caregivers.
Method: Clinical recommendations were reviewed from three systematic review questions on interventions to improve performance and participation in daily activities and occupations and from one question on maintaining the caregiving role for caregivers of people after stroke.
Results: The systematic reviews included 168 studies, 24 Level 1a, 90 Level 1b, and 54 Level 2b. These studies were used as the basis for the clinical recommendations in these Practice Guidelines and have strong or moderate supporting evidence.
Conclusions and Recommendations: Interventions with strong strength of evidence for improving performance in activities of daily living and functional mobility include mirror therapy, task-oriented training, mental imagery, balance training, self-management strategies, and a multidisciplinary three-stages-of-care rehabilitation program. Constraint-induced therapy has strong strength of evidence for improving performance of instrumental activities of daily living. Moderate strength of evidence supported cognitive-behavioral therapy (CBT) to address balance self-efficacy, long-term group intervention to improve mobility in the community, and a wearable upper extremity sensory device paired with training games in inpatient rehabilitation to improve social participation. Practitioners should incorporate problem-solving therapy in combination with CBT or with education and a family support organizer program.
What This Article Adds: These Practice Guidelines provide a summary of strong and moderate evidence for effective interventions for people with stroke and for their caregivers.