以病人及家庭為中心的成人癌症病人之身心困擾照護模式

Patient- and Family-Centered Physical and Psychological Distress Care Model for Adult Patients With Cancer

孫秀卿(Shiow-Ching SHUN)

《護理雜誌》 69卷4期 (2022/08) Pp. 6-12

https://doi.org/10.6224/JN.202208_69(4).02

摘要

以病人及家庭為中心之照護（patient- and family-centered care, PFCC），在面臨醫療創新與疫情時代的衝擊相形重要，且實證指出家庭介入措施可以達到三方（病人、家屬、醫療人員）共贏的結果。國內十大癌症中，近十年胰臟癌的死亡人數與排名逐漸上升至第七位。由於胰臟癌不易早期發現，常常診斷時多以晚期居多；因此，導致病人與家屬的身心困擾。因此，此篇主旨為說明PFCC及其在成人癌症之實證成效，並以整合實證提出以病人及家庭為中心發展的預防性復健照護包含家庭的參與、正向態度、有效的因應方式、降低不確定感、症狀處理及促進身體活動；以胰臟癌病人與家屬之身心照護為例，期望透過對PFCC的瞭解，運用於不同癌別之發展照護模式，改善癌症病人及其家屬的生活品質。

關鍵字

以家庭為中心 ； 癌症 ； 困擾

並列摘要

Patient- and family-centered care (PFCC) has become more important due to advances in medical treatment and the impact of the COVID-19 pandemic. The evidence in the literature has proven the ability of PFCC to accomplish win-win results for the three principal parties (patients, family, and healthcare providers). In Taiwan, pancreatic cancer has risen to the 7^(th) largest cause of cancer mortality, with increasing numbers of pancreatic-cancer-related deaths over the past ten years. Pancreatic cancer is difficult to diagnose early, and diagnoses are nearly always made during the late stage, resulting in high levels of physical and psychological distress for patients. This article was developed to introduce the core concept of PFCC and its evidence in the context of adult patients with cancer. Furthermore, the rehabilitation care model, based on PFCC, includes the 6 aspects of Family involvement, Optimistic attitude, Coping effectiveness, Uncertainty reduction, Symptom management, and Physical enhancement (FOCUS+P). A PFCC-based example of pancreatic cancer care is proposed that may be expanded to the care of patients with other types of cancer to improve the quality of life of patients and their families.

並列關鍵字

family-centered ； cancer ； distress

參考文獻

Abid, M. H., Abid, M. M., Shahid, R., Al Nofeye, J., & Ratnani, I. (2021). Patient and family engagement during challenging times: What works and what does not? Cureus, 13(5), Article e14814. https://doi.org/10.7759/cureus.14814

Chou, Y.-J., Kuo, H.-J., & Shun, S.-C. (2018). Cancer prehabilitation programs and their effects on quality of life. Oncology Nursing Forum, 45(6), 726–736. https://doi.org/10.1188/18.ONF.726-736

Dockham, B., Schafenacker, A., Yoon, H., Ronis, D. L., Kershaw, T., Titler, M., & Northouse, L. (2016). Implementation of a psychoeducational program for cancer survivors and family caregivers at a cancer support community affiliate: A pilot effectiveness study. Cancer Nursing, 39(3), 169–180. https://doi.org/10.1097/NCC.0000000000000311

Hornbuckle, L. M., Rauer, A., Winters-Stone, K. M., Springer, C., Jones, C. S., & Toth, L. P. (2021). Better together? A pilot study of romantic partner influence on exercise adherence and cardiometabolic risk in African-American couples. Jounal of Racial Ethnic Health Disparities, 8(6), 1492–1504. https://doi.org/10.1007/s40615-020-00912-6

Karagianni, V. T., Papalois, A. E., & Triantafillidis, J. K. (2012). Nutritional status and nutritional support before and after pancreatectomy for pancreatic cancer and chronic pancreatitis. Indian Journal of Surgical Oncology, 3(4), 348–359. https://doi.org/10.1007/s13193-012-0189-4