- 期刊
建立癌症病人口腔照護之臨床照護指引
Developing an Evidence-Based Clinical Guideline to Provide Cancer Patients with Oral Care
摘要
癌症病人接受化學或放射治療可能導致口腔潰瘍、感染、疼痛不適或營養不良等，進而影響住院天數及醫療成本，口腔照護為癌症護理之重要議題。本指引依JBI實證照護架構分三階段進行：第一階段進行2006－2011年完整文獻搜尋，依評析標準納入9篇系統性文獻回顧研究及4篇臨床照護指引，建立35項之指引草案；第二階段依專家焦點團體座談進行指引草案之效度檢定，修正指引為37項；第三階段以問卷調查十一所醫院19位專家及180位臨床人員實施照護指引之可行性，最後形成35項指引內容。本指引含口腔評估與保健12項，口腔黏膜炎、口腔念珠菌、口乾症及單純疱疹預防策略與照護措施23項，其中建議等級GradeA有29項、GradeB有6項。本指引建立可提供臨床實務之應用，在職教育及改善照護流程之依據，藉以增強臨床照護人員口腔護理評估之知能，促進臨床應用，以提供癌症病人優質照護品質。
並列摘要
Treatment for cancer can cause severe oral ulcers or infections in the mouth. This can cause discomfort, pain, poor nutrition, delays in medication administration, and increase hospital stays and costs. Based on JBI framework, a three-phase design was used to develop the clinical guideline. In Phase I, a comprehensive systematic review was conducted. A totally of 13 studies had performed appraisal including 9 systematic reviews and 4 clinical guidelines during 2006-2011. A 35-item guideline was initially aggregated. In phase II, a focus group was conducted to understand their experiences in providing cancer patients oral care at their hospitals. The 37-item guideline was revised. In phase III, a survey was conducted to measure the feasibility of the clinical guideline which was built by the outcomes from phase I and II. In total, 19 clinical experts and 180 clinical nurses staff from 11 hospitals were invited to fill out the questionnaire. Finally, a 35-item clinical guideline was developed including 2 domains: 12 items of oral hygiene and oral assessment, and 23 items of prevention and interventions for treating oral mucositis, oral candidiasis, xerostomia, or herpes simplex virus. In all, 29 Grade A items and 6 Grade B items were recommended. These results might provide administrators with practical recommendations that can be used to ensure cancer patient care safety, and to provide evidence-based information to nursing staff.