安寧共照介入對癌末病人安寧療護、安寧共照知識及接受意願之成效

Effects of Palliative Care Consultation Service on Knowledge of Hospice Care or Combined Hospice Care on Consent for Palliative Care among Terminal Cancer Patients

賴慧文(Hui-Wen Lai) ； 陳玉紛(Yu-Fen Chen) ； 蔡育倫(Yu-Lun Tsai) ； 張慕民(Mu-Ming Chang) ； 潘雪幸(Hsueh-Hsing Pan)

《源遠護理》 10卷2期 (2016/06) Pp. 33-38

https://doi.org/10.6530/YYN/2016.1.3

摘要

背景：安寧共同照護（以下簡稱安寧共照）是透過安寧團隊與原醫療團隊共同照顧末期病人，解決病人及家屬各層面的問題。目的：本研究旨在探討安寧共照介入對癌末病人安寧療護、安寧共照知識及接受意願之成效。方法：採單組前後測設計，研究期間自2010年1月1日至12月31日，以北部某醫學中心住院癌末病人為對象，以方便取樣收集100位安寧共照會診前及安寧共照介入後7天的住院癌末病人，以基本資料、安寧療護、安寧共照知識量表及接受意願進行資料收集。採描述性統計、配對t檢定及卡方檢定進行分析，以p＜.05作為判斷統計意義之標準。結果：住院癌末病人接受安寧共照會診前安寧療護、安寧共照知識平均值分別為0.76分、0.55分，接受安寧共照介入後7天安寧療護、安寧共照知識平均值分別為3.88分（p＜0.001）、2.89分（p＜0.001）。接受安寧共照會診前願意接受安寧共照48人，接受安寧共照介入後願意接受者增加為76人（p＜0.001）。結論／實務應用：透過本研究使癌末病人更加瞭解安寧療護、安寧共照之理念，提升其接受安寧療護之意願，故建議將安寧共照推廣至各病房，讓更多的病人接受安寧療護的服務，提升末期病人的生活品質。

關鍵字

安寧療護 ； 安寧共同照護 ； 知識 ； 意願

並列摘要

Background: Palliative care consultation service (PCCS) was to collaborate between hospice care and original medical care teams in order to provide palliative care and resolve various issues for terminal cancer patients and their families. Purpose: To study the effects of PCCS on knowledge and willingness to receive hospice/combined hospice care among terminal cancer patients. Methods: The study group consisted of a convenience sample of 100 terminal cancer patients between January and December 2010 prior to and 7 days post combined hospice care, whether they received PCCS or not after intervention. Other variables included patients' demographics, knowledge level of hospice and combined hospice care. Descriptive statistics, paired t test, and Chi-square test were used to verify effects of PCCS on knowledge of hospice care or combined hospice care regarding willingness to receive palliative care. A p value ＜0.05 was considered statistically significant. Results: Before and after PCCS intervention, the knowledge level was 0.76 and 3.88 (p＜0.001), 0.55 and 2.89 (p＜0.001) in terminal cancer patients. Patient agreement to receive PCCS increased from 48 to 76 (p＜0.001) after intervention. Conclusions/Implications for practice: The interventions increased the knowledge of hospice care and increased the patients' consent for PCCS. It is suggested that education on hospice care should be advocated to terminal patients and their families to promote palliative care for improvement of the quality of life in terminal patients.

並列關鍵字

hospice care ； palliative care consultation service ； knowledge ； willingness

參考文獻

Bakitas, M. A., Tosteson, T. D., Li, Z., Lyons, K. D., Hull, J. G., Li, Z., ... Ahles, T. A. (2015). Early versus delayed initiation of concurrent palliative oncology care: Patient outcomes in the EN-ABLE III Randomized Controlled Trial. Jour-nal of Clinical Oncology, 33(13), 1438-1445. doi: 10.1200/jco.2014.58.6362

Campbell, M. J., Edwards, M. J., Ward, K. S., & Weatherby, N. (2007). Developing a parsi-monious model for predicting completion of advance directives. Journal of Nursing Schol-arship, 39(2), 165-171. doi: 10.1111/j.1547-5069.2007.00162.x

Carrion, I. V., Cagle, J. G., Van Dussen, D. J., Culler, K. L., & Hong, S. (2015). Knowledge about hospice care and beliefs about pain manage-ment: Exploring differences between Hispanics and Non-Hispanics. The American Journal of Hospice and Palliative Care, 32(6), 647-653. doi: 10.1177/1049909114536023

Ciemins, E. L., Blum, L., Nunley, M., Lasher, A., & Newman, J. M. (2007). The economic and clini-cal impact of an inpatient palliative care consul-tation service: A multifaceted approach. Journal of Palliative Medicine, 10(6), 1347-1355. doi: 10.1089/jpm.2007.0065

Drisdom, S. (2013). Barriers to using palliative care: insight into African American culture. Clinical Journal of Oncology Nursing, 17(4), 376-380. doi: 10.1188/13.cjon.376-380