肝病防治方法之關鍵因素

The Key Factors of Liver Disease Prevention and Treatment Methods

洪憶雯(I-Wen Hung)

指導教授 ： 簡德金

國立虎尾科技大學/管理學院/資訊管理系碩士在職專班/碩士(2016年)

摘要

肝病是國人的健康殺手，尤其是肝癌在台灣近10年仍居癌症死因第二位。對此，雖有學者發展出「肝癌風險預測模式」，來計算罹患肝癌風險，並有學者提出多層面研究，但無法從一般民眾、肝病患者及其家屬、醫療人員等綜合體系角度，來探討不同角色在肝病防治上的方向與作法。本研究目的在提出一系統化綜合體系架構，以呈現肝病防治上之構面、類別與關鍵因素，並透過量化研究成果，來比較不同角色下，應注意事項的重要度差異，進而快速掌握其預防及治療方向與作法。
本研究(1)先藉由文獻回顧，彙整肝病防治方法之關鍵因素與實施業務項目；(2)透過KJ法、焦點團體訪談法與德爾菲法等質性訪談法，來建立「肝病防治架構表」，以具象化肝病防治之構面、分類、實施業務及項目；(3)並透過層級分析法(AHP)，來呈現各構面、分類及實施業務之整體權重值。
本研究結果驗證「預防」勝於「治療」之重要性，衛生機關及醫療人員能針對此關鍵因素來推動肝病健康促進方案；一般民眾及病人皆能掌握肝病防治的有效方法，做到早期診斷、早期治療，以降低罹患肝病及其併發症的發生機會。相對過去單純關鍵因素的陳述，本研究成果不僅更為系統化、具象化，更同時考慮不同角色下各事項之重要度差異，故能有效鏈結學術理論與實務應用上之價值。

關鍵字

肝病 ； 預防 ； 治療 ； 質性訪談法 ； 層級分析法

並列摘要

Liver disease is the health killer in Taiwan, especially hepatic carcinoma (HCC), which is still ranked as second leading cause of death resulting from cancer in the past 10 years. Although scholars developed “Scoring System for Predicting Risk of HCC” to estimate the risk about suffering hepatic carcinoma and proposed multifaceted researches, they couldn’t investigate the directions and methods of prevention and treatment of liver disease in the view of general public, liver disease patients and their families, and medical personnel. This research aims to propose a systematic integrated structure to show the dimensions, categories, and key factors of prevention and treatment of liver disease. Then, using the quantitative research to compare the importance difference of precautions between different identities, and grasping the directions and methods of prevention and treatment.
This research (1) reviews the literatures to integrate the key factors and the implement tasks of prevention and treatment of liver disease; (2) establish “A structure of prevention and treatment of liver disease” to concrete the dimensions, categories, implement tasks of prevention and treatment of liver disease with the Qualitative Interviews methods, like KJ method, Focus Group Interviews, and Delphi method; (3) apply Analytic Hierarchy Process (AHP) to show the overall weights of dimensions, categories, implement tasks.
The research results confirm the importance of “Prevention” is better than “Treatment”, Health authorities and medical personnel can be a key factor for this to promote liver disease romotion programs; the general public and patients have encountered master effective of liver disease of prevention and treatment methods; early diagnosis, early treatment in order to reduce the risk of liver disease and its complications opportunities. Compared to simple description the key factors in the past, this research results are not only systematism and concretization, but also taking consideration of the importance difference of each dimension, category, and factor in different view. As these results, this research can effectively connect the value between academic and practical application.

並列關鍵字

Liver disease ； Prevention and Treatment ； Qualitative Interviews method ； AHP

參考文獻

[72] Huang, C. W., Hsu, P. I., & Chan, H. H. (2013). Acute Pancreatitis and Cholangitis Caused by Hemobilia Secondary to Hepatocellualr Carcinoma: A Case Report. 內科學誌，24(6)，500-504。

[74] Lin, W. C., Wang, T. E., Wang, H. Y., & Shih, S. C. (2015). A Rare Complication Following Transarterial Chemoembolization for Hepatocellular Carcinoma. 台灣癌症醫學雜誌，2(4)，314-318。

[16] 陳思安 (民101)。健康檢查中心流程模擬之效率最佳化探討。中山醫學大學醫療產業科技管理學系碩士班學位論文，未出版，台中市。

[45] 陳姿方 (民99)。醫院特質與醫師特質對於接受積極治療的肝癌病患之照護與結果相關探討。臺灣大學健康政策與管理研究所學位論文，未出版，台北市。

[15] 文萬欣 (民102)。接種B型肝炎疫苗兒童發生B型肝炎病毒感染之研究。國立臺灣大學臨床醫學研究所博士論文，未出版，台北市。