- 期刊
婦癌病人介入個案管理照護於化學藥物治療完成率之成效
Effect of Case Management Care of Gynecological Cancer Patients on the Rate of Chemotherapy Completion
摘要
腫瘤個案管理已成為台灣癌症照護的主流模式，此模式介入的照護成效可做為臨床個案管理照護策略調整的參考。國內外對運用個案管理照護於婦癌病人化學藥物治療( 化療) 完成率之探討付之闕如，本研究比較介入建構完整的婦癌個案管理模式世代的病人與非介入個案管理模式世代的病人，接受化療首次療程的完成率及其三個年度間的改變情形。採回溯性世代研究法進行兩個世代之比較，共收案563 位婦癌病人，其中非個案管理世代有196 位，個案管理世代有367 位。每個世代皆回溯病人三年化學藥物治療完成率，共追蹤六年。本研究以Excel 統計分析，結果發現個案管理世代病人的化療完成率較非個案管理世代的高且每年維持在90% 以上；經廣義估計方程式比較化療完成率，個案管理世代之化療完成率連續三年均較高，達統計顯著差異(t = 3.624, p = .000)。本研究結果顯示個案管理照護對婦癌病人接受首次化療療程的完成率能逐年穩定成長且有上升之趨勢，透過腫瘤個案管理能提供婦癌病人整合且連續性照護，及早解決病人無法繼續接受化療的問題，可更有效地提升婦癌病人的化療完成率，增進癌症照護品質。
並列摘要
Cancer case management has become the main mode of cancer care in Taiwan. This mode of care and intervention has resulted in better efficiency and monitoring of clinical cases. Few domestic studies have investigated the completion rate of chemotherapy in gynecological cancer patients using case management strategies. This study compared gynecological cancer patients with constructs involving complete case management and noncase management. The rate of completion of the first chemotherapy treatment and the change between 3 years were examined. A retrospective cohort study was performed on all gynecological cancer patients. The study group was divided into before and after case management implementation in patient care, and a 3-year chemotherapy completion rate was calculated for each group. A total of 563 cases of gynecological cancer patients were included in this statistical analysis, of which 196 were cases of nongynecological cancer management, and 367 were cases of female cancer management. Completion rates were backtracked for a total of 6 years. Each generation is back to the patient for 3 years to complete the rate of chemotherapy. Intervention of case managers yielded a higher chemotherapy completion rate (＞ 90%) than nonmanaged cases. Completion rates in case management in gynecologic cancer were higher than for nonmanaged cases, yielding a significant difference (t = 3.624, p = .000). The results of this study demonstrate that case management care for female cancer patients receiving chemotherapy treatment produces completion rates that increase annually, with a stable trend of rising. The results demonstrate improved patient chemotherapy completion rates. Promotion and implementation of cancer case management should allow for improved chemotherapy completion rates. Cancer case management can be used to provide gynecological cancer patients with integrated and continuous care. The problem of patients being unable to continue to receive treatment can be solved early, thereby, improving the rate of chemotherapy of gynecological cancer patients and enhancing the quality of cancer care.