癌症患者放射治療後迴診追蹤中斷的原因及分析

Interruption of Post-Radiotherapy Follow-Up in Cancer Patients

林奎利(Kuei-Li Lin) ； 郭珍妮(Jenny Que) ； 林立青(Lin Li-Ching) ； 林逢嘉(Forn-Chia Lin) ； 蘇玫綺(Mei-Chi Su)

《放射治療與腫瘤學》 11卷3期 (2004/09) Pp. 151-156

https://doi.org/10.6316/TRO/200411(3)151

摘要

目的：隨著癌症治療方式的改善與整合，癌症患者存活率大為提升；然而除了完整治療之外，定期迴診追蹤也是癌症照護的重要一環；本研究藉由分析放射治療後癌症患者迴診中斷的原因，試圖解決及改善，協助患者接受更完整的照護。
材料與方法：奇美醫院放射腫瘤科自從2001年10月27日到2002年10月19日止，針對199 位放射治療後迴診中斷的患者進行中斷原因分析。資料來源乃依據病歷記載及電話會談連繫追蹤資料為準。
結果：199位迴診中斷患者中，有39位（19.6%）因病情變化，包括死亡14.1%及惡化5.5%；68位（34.2%）轉至他科（院）就醫，包含至他科就診26.1%及轉院治療8.1%；41位（20.6%）因外在環境因素，包含家庭因素4%、經濟因素1%及工作太忙15.6%；7位（3.5%）對醫療不滿；因對疾病錯誤認知者有25位（12.6%），包含不知病情1%、自覺無效1.5%及自覺健康良好，不用迴診10.1%；其他19位（9.5%）。
結論：除因病情惡化或死亡，轉至他科(院)就醫是放射治療後患者迴診中斷的最大原因佔34.2%，放射腫瘤科醫師應加強與他科醫師合作，合力照顧患者。部份患者因環境因素造成迴診中斷，故除了醫療外，應提供患者社會經濟等支援及協助，協助患者排除困難。另有患者因未對疾病有正確認知，所以應加強患者教育,俾使其能接受完整追蹤。

關鍵字

放射治療 ； 癌病登記 ； 追蹤中斷

並列摘要

Purpose : The survival of cancer patients improved after the combination of multi-modality treatment and advance in the facility of radiotherapy. Besides, completion of treatment is essential for cancer patients, and regular follow-up is also an important part of cancer cares. The purposes of this study are, first, to explore the causes of interruption of regular follow-up and, second, to assess the role of onphone medical education as the first-line tool for follow-up course.
Materials and Methods : During the period from 2001/10/27 to 2002/10/19, there are 199 patients who did not come back on the day we had dated for follow-up course. The survey from hospital records, telephone were used to analyze the causes why these patients escaped from the regular follow-up course.
Results : A total of 199 patients were eligible for analysis. Among these patients, 39 patients (19.6%) could not return back due to disease progression and 68 patients (34.2%) were transferred to other hospital / department for further management. Forty-one patients (20.6%) escaped from follow-up due to familial or economic problems. Twenty-five patients (12.6%) had psychologically ignorance of the disease. Seven patients were unsatisfied with our medical service. Nineteen patients were with unknown reasons.
Conclusion : In addition to disease progression, transferring and follow-up by other hospital or department are the major reasons causing follow up interruption. The radiation oncologist should cooperate with doctors of other hospital or department to follow up cancer patients. Other causes of follow-up interruption include economic or family problems, social workers maybe can offer some kind of support for these patients. The on-phone medical education is a useful tool in the follow-up of post treatment patients, but its role should be further evaluated.

並列關鍵字

Radiotherapy ； Cancer registry ； Follow-up interrupation