提昇大腸癌篩檢陽性個案追蹤完成率之專案

A Project to Improve the Follow-Up Completion Rate of Colorectal Cancer Screening-Positive Patients

張珮涵(Pei-Han Chang) ； 陳婷婷(Ting-Ting Chen) ； 江美鳳(Mei-Feng Chiang)

《護理雜誌》 60卷6期 (2013/12) Pp. 76-83

https://doi.org/10.6224/JN.60.6.76

摘要

背景：大腸癌若能早期發現，則有極佳的治癒率。國內大腸癌篩檢陽性個案追蹤完成率低的原因為民眾自覺身體無異狀、出血為痔瘡所致、藉口沒時間返診或不知道相關資訊等；本院篩檢陽案追蹤完成率為四大癌症篩檢中最差者，經調查發現由於病人認知不足、無制訂明確篩檢追蹤流程及教育宣導不足所致，故激起成立專案小組來改善，以期提昇追蹤完成率。目的：提昇大腸癌篩檢陽性個案追蹤完成率達65%。解決方案：由明確的策略介入，包含：製作衛教單張及複檢提醒單、增加篩檢推廣講座場次、提供專人專線諮詢管道、訂定大腸癌篩檢陽性個案追蹤流程、舉辦院內在職教育宣導、建立跨單位合作模式及他院標竿學習等方案。結果：大腸癌篩檢陽性個案追蹤完成率由53.63%提昇至66.08%。結論：本專案應用教育推廣及團隊合作加強個案對確診追蹤的認知，確實可有效提昇大腸癌篩檢陽性個案追蹤完成率及醫療服務品質。

關鍵字

追蹤完成率 ； 篩檢 ； 大腸癌 ； 認知

並列摘要

Background: Colorectal cancer is the third leading cause of cancer-related deaths in Taiwan. Patients diagnosed early have excellent cure rates. Mackay Memorial Hospital, working on a Bureau of Health Promotion (BHP) project, found the colorectal cancer screening completion rate for positive patients to be the lowest among four cancer screenings reviewed. We thus formed a project team to improve the follow-up completion rate for colorectal cancer screening-positive patients.Purpose: This project was designed to raise the follow-up completion rate for colorectal cancer screening-positive patients to 65%.Methods: Explicit interventions implemented included making health education leaflets and return visit reminder sheets, holding/organizing screening seminars, opening a consultation helpline, formulating follow-up colorectal cancer screening procedures for screening-positive patients, holding hospital educational training courses, establishing cross-unit collaboration models, and benchmarking other hospitals.Results: The follow-up completion rate increased from 53.63% to 66.08%.Conclusions: Conducting health education programs and strengthening team awareness of follow-up completion rates effectively enhanced the follow-up completion rate for colorectal cancer screening-positive patients and improved medical care quality.

並列關鍵字

completion rate ； screening ； colorectal cancer ； awareness

參考文獻

吳佩樺、林紋麗（2009）．整合資訊作業系統改善癌症個 案篩選模式之專案．護理雜誌，56（6），55－ 62。 doi:10.6224/JN.56.6.55 [Wu, P. H., & Lin, W. L. (2009). Improving the cancer screening model: Experience applying an integrated operating system. The Journal of Nursing, 56(6), 55－ 62.]

武香君、盧柏樑、陳彥旭、潘慧娟、馮明珠（2011）．探 討個別性衛教對結核病患疾病認知、態度及行為意向 之成效．護理雜誌，58（6），43－ 52。doi:10.6224/ JN.58.6.43 [Wu, S. J., Lu, P. L., Chen, Y. H., Pan, H. J., & Feng, M, C. (2011). Tuberculosis patient disease knowledge, attitudes and behavioral intentions: The impact of individualized counseling. The Journal of Nursing, 58(6), 43－ 52.]

邱瀚模（2008）．早期大腸癌的篩檢、診斷與治療早期大腸 癌的篩檢、診斷與治療．中華民國癌症醫學會雜誌， 24（3），148－ 156。[Chiu, H. M. (2008). Screening, diagnosis and treatment of early colorectal cancer. Journal of the Chinese Oncology Society, 24(3), 148－ 156.]

陳怡君、吳坤和、林為森（2010）．高雄地區民眾大腸癌 篩檢行為及其影響因子．嘉南學報，36，291－ 301。 [Chen, Y. C., Wu, K. H., & Lin, W. S. (2010). The behavior of colorectal cancer screening and its affected factors of residents in Kaohsiung area. Chia Nan Annual Bulletin: Humanity, 36, 291－ 301.]

陳美碧、魏雪卿、侯菊鸝（2000）．出院精神病患電話追 蹤服務品質改善方案．榮總護理，17（1），15 － 22。 [Chen, M. B., Wei, H. C., & Hou, J. L. (2000). Evaluating quality improvement of telephone follow-ups for postdischarge psychiatric patients. VGH Nursing, 17(1), 15 － 22.]