慢性阻塞性肺疾病病人之安寧療護

Hospice Care in Patients with Chronic Obstructive Pulmonary Disease

周家汶 ； 陳夏蓮 ； 許正園

《安寧療護雜誌》 16卷1期 (2011/03) Pp. 95-104

https://doi.org/10.6537/TJHPC.2011.16(1).8

摘要

根據世界衛生組織統計，全球有2.1 億人口罹患中度至重度的慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)，預估於2030 年將成為全球第三大死因，在國內十大死因中也位居第六位；根據文獻查證發現COPD 病人之疾病軌跡(Illness trajectories)和癌症有極大之差異，但是身體症狀困擾和需求卻和癌症病人相似，在罹病過程中，有許多安寧療護的需求，此需求包含：1.生理需求、2.心理需求、3.社會服務需求、4.疾病資訊需求。因COPD 疾病的發展軌跡不易界定，安寧療護的介入時機也相對模糊，此議題文獻的探討有限。在推展此觀念時，醫護人員有必要了解病人對安寧療護的需求，使醫護人員有足夠的知識及信心和病人談論安寧療護，協助病人緩解症狀困擾並參與醫療決策，提升生活品質。

關鍵字

慢性阻塞性肺疾病 ； 安寧療護 ； 需求

並列摘要

According to the World Health Organization, 2.1 billion people around the world suffer from moderate to severe Chronic Obstructive Lung Disease (COPD). It is estimatesd that this disease will become the third major cause of death in the world by 2030. In Taiwan, COPD ranks sixth among the top ten causes of death. COPD is a disease with continuous and irreversible pathological changes that may result in damage to the lung. On top of that, other serious complications may also develop, affecting bodily functions and daily activities and lowering the quality of life. A literature review has discovered that COPD patients’ illness trajectory is very different from that of cancer patients, but the symptoms and patients’ needs are very similar. Hospice care for patients with COPD is imperative. At the end stage of the illness, the COPD patients may also need the following cares: (1)physical needs; (2) psychological needs; (3) social services needs; (4) information needs about the disease. Because the patients are affected by this disease chronically, symptom management may alleviate their sufferings and enhance their quality of life. COPD patients have a longer disease process and may suffer from symptom distress over time. They may receive treatment over and over again for symptom managements and extend their life. Since the changes of the disease and its prognosis are unpredictable, the patients and their families do not have such many chances to be informed and offered with the hospice care of end life. The health professionals are also less attentive to the patients’ needs. The illness trajectory of the COPD makes it more difficult to define the time point of intervention. There is limited research in the literature regarding to the issue of the hospice care and the patient needs. The medical staffs need to know about the information in order to properly deliver hospice care properly and help the patients relieve symptom distress and make good medical decisions for better quality of life.

並列關鍵字

Chronic Obstructive Pulmonary Disease(COPD) ； Hospice Care ； Needs