應用健康資訊科技於慢性腎臟病持續性照護之契機與反思

Using eHealth in the Continuity Care of Chronic Kidney Disease: Opportunities and Considerations

陳俞琪(Yu-Chi Chen) ； 張博論(Polun Chang)

《護理雜誌》 63卷2期 (2016/04) Pp. 12-18

https://doi.org/10.6224/JN.63.2.12

摘要

腎臟病是中老年慢性病常見的合併症，初期症狀不明顯易被忽視，返診間隔長，照護人力不足，追蹤不易，照護工作無法落實，導致慢性腎臟病之高發生率已成為全球的健康問題，因此整合持續性照護服務是防治的關鍵。但如何有效落實是項挑戰，而透過創新的科技設備環境、網路資訊、雲端平台，讓疾病照護不受時空限制，不但增加病患主動參與及照護團隊之合作，也提升照護服務的連續性、可近性與及時性，增進疾病管理之成效，可以為照護困境帶來改變的契機。然而創新資訊科技帶來照護效益，但也可能帶來健康不均等的隱憂。創新科技引領的健康照護體系中，病患能否勝任使用者的角色，以獲取適當的照護服務，關係著病患的健康行為表現，亦影響著照護品質。以病患為中心照護需兼顧效益與人性化，故提升病患資訊科技化健康識能之能力，將是推動健康服務創新與資訊科技化過程中重要課題。

關鍵字

健康資訊科技 ； 慢性腎臟病 ； 持續性照護 ； 資訊科技化健康識能

並列摘要

Kidney disease is a common complication of chronic diseases among adult and elderly populations. As early-stage chronic kidney disease (CKD) is asymptomatic, CKD patients are frequently unaware of their condition and fail to implement requisite self-care in a timely fashion. Furthermore, the shortage of case-management manpower and difficulties in follow-up have led to high incidence rates for CKD worldwide. Integrative and continuous care is key to preventing CKD. How to implement this care effectively is a challenge. However, innovative technologies, online information, and cloud technology are increasingly providing access to good-quality healthcare beyond the traditional limitations of time and location. This environment is not only increasing the participation of patients in their care and collaboration among healthcare team members but is also improving the continuity, accessibility, and promptness of care service in order to promote the effectiveness of disease management. While the primary aim of innovative technologies is to make healthcare more cost-effective, it is also causing disparities in healthcare. Within the high-tech e-healthcare system, the ability of patients to utilize these new services relates directly to their health behaviors and quality of care. Thus, emergent e-healthcare system services should be made as patient-centered as possible in order to maximize the benefits in terms of both cost and patient care. Furthermore, improving the eHealth literacy of patients is crucial to promoting innovative technology within healthcare services.

並列關鍵字

eHealth ； chronic kidney disease ； continuity care ； eHealth literacy

參考文獻

李孟芬、潘立傑（2012）．淺談行動健康服務的應用．長期照護雜誌，16（3），237–250。[Li, M. F., & Pan, L., C. (2012). Applications on mobile-health. The Journal of Long-Term Care, 16(3), 237–250.]

吳有基、徐偉閎、陳珮芬、胡志煌、張朝旭、游文清（2011）．行動式電子健康管理系統．技術學刊，26（2），133–141。[Wu, Y. C., Hsu, W. H., Chen, P. F., Hu, Z. H., Chang, C. H., & Yu, W. C. (2011). A mobile e-health-management system. Journal of Technology, 26(2), 133–141.]

周春珍、張蓓莉、李冠慧、李亭亭（2009）．科技始於人性—淺談遠距醫療於老人健康照護之應用．護理雜誌，56（6），76–80。[Chou, C. C., Chang, P. L., Lee, K. H., & Lee, T. T. (2009). Technology connecting people: Applying telecare in elderly health care. The Journal of Nursing, 56(6), 76–80.]

Aponte, J., & Nokes, K. M. (2015). Electronic health literacy of older Hispanics with diabetes. Health Promotion International, 1–8.

Beratarrechea, A., Lee, A. G., Willner, J. M., Jahangir, E., Ciapponi, A., & Rubinstein, A. (2014). The impact of mobile health interventions on chronic disease outcomes in developing countries: A systematic review. Telemedicine and e-Health, 20(1), 75–82.