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以生態系統觀點探討區塊鏈技術應用於健康資料治理

為了解決Seeking Alpha login的問題，作者林姿妤 這樣論述：

遵循有效的資料治理架構為機構間協調進行健康資料交換奠定基礎，而區塊鏈技術可解決健康資料互操作性、隱私與安全問題，成為健康資料交換發展的推手，然而，科技典範轉移往往為產業生態帶來變動，有鑑於此，本研究旨在以生態系統觀點、援引資料生態系統理論，並分別由組織治理角度與技術角度，進行以下探討：（1）探討區塊鏈技術應用於健康資料治理之效益、困境與挑戰；（2）探討區塊鏈技術應用於健康資料治理實際產生之影響，並輔以個案分析、專家訪談法，獲得區塊鏈技術應用於健康資料治理，對於不同組織帶來的效益、挑戰與影響之全面性理解，以掌握可能產生之變動並及早擬定策略。研究結果顯示，儘管不同層級組織機構所組成的醫療區塊鏈生

態系統，各有其發展焦點與目標，但透過不同性質參與者的共同努力，可幫助生態系統擴展並創造異質化價值。其次，不同層級組織機構將區塊鏈技術應用於健康資料治理，實際上獲得了不一樣的效益，換言之，也將面臨不同的困境與挑戰，因此，建立不同機構間的共識，才能充分發揮區塊鏈價值。再者，在不改變現有機制的原則之下，區塊鏈技術的導入，將能幫助醫療產業於組織治理方面與醫療科技方面的突破，因此對於區塊鏈技術之採用應建立於現有技術之上，並同時考慮患者、醫療服務提供者、醫療科技公司、研究機構與政府等不同屬性機構對於健康資料與醫療服務需求，以有效帶動醫療區塊鏈生態統的擴展。

Effect of Prenatal Childbirth Program on Maternal Anxiety, Maternal-Fetal Attachment, Childbirth Self-Efficacy, and Marital Satisfaction: A Randomized Controlled Trial Using Roy’s Adaptation Model

為了解決Seeking Alpha login的問題，作者Endang Koni Suryaningsih 這樣論述：

Background: As the multifaceted changes during a women’s life cycle, pregnancy, is the most crucial period that can affect her further life process.Purposes: The aim of this study was to test the effectiveness of childbirth education based on the Roy Adaptation Model through four modes: physiology,

self-concept, role function, and interdependence.Methods: A randomized controlled trial was applied to invite the participant who met the criteria including nullipara pregnant women and their husband, gestational age ranged 24-32 weeks and married. High-risk pregnancy conditions and miscarriage wer

e excluded. The researcher used computer block size to allocate the participants into groups. To measure the potential outcomes of four modes, the following instruments were used: Demographic Data Set, Pregnancy-Related Anxiety Questionnaire-Revised, a short form of the Childbirth Self-Efficacy Inve

ntory, Prenatal Attachment Inventory, and ENRICH Marital Satisfaction Scale. To produce the Indonesian version of each instrument, the researcher conducted translation and back translation following WHO guidelines and measure its reliability using Cronbach’s Alpha. To describe demographic characteri

stics, a descriptive statistic was calculated. To test the efficacy of the program, a general linear model was analyzed.Results: The mean age of the couple was 23.92/ 26.75 (wife/ husband) in the experimental group and 29.14/ 30.86 (wife/ husband, respectively) in the control group. The mean gestati

onal age week was 29.83 in the experimental group and 31.04 in the control group. In both groups, most couples graduated from high school and more than 50% of mothers go to work. We lost more than twenty percent of total participants in our study that may due to the pandemic COVID-19 just ran into I

ndonesia. Consequently, the significant difference between the two groups on demographic data includes couple’s age, gestational week, husband education level, and wife’s occupation were found.After a-four week intervention, the mean score of maternal anxiety was significantly lower, and the mean sc

ore of maternal-fetal attachment, childbirth self-efficacy were significantly higher in the experimental group than that in the control group (p < .001). However, there were no significantly different mean scores of marital satisfaction in the two groups.Conclusion and Implications to Nursing Practi

ce: the implemented program in the current study was potentially effective in promoting maternal-fetal attachment, childbirth self-efficacy, and decreasing maternal anxiety during pregnancy. Therefore, the modified traditional childbirth education program needs to be considered.Recommendations: For

the midwife, the flexible intervention may increase the response rate for couples to join the class. For the next researcher, the culture issue needs to be considered to establish the feasibility of the marital satisfaction tool.