肺癌之整合性照護：以南部某醫學中心為例

Integrated Care for Lung Cancer at a Medical Center in Southern Taiwan

孫婉娜(Wan-Na Sun) ； 許心恬(Hsin-Tien Hsu)

《領導護理》 18卷3期 (2017/09) Pp. 13-22

https://doi.org/10.29494/LN.201709_18(3).0002

摘要

在民國2001年後，肺癌已蟬聯我國十大惡性腫瘤為第一長達至今，不論是罹癌人數、住院天數、醫療支出上都以倍數增加，現今因醫療科技發達、人口平均老化，間接導致罹患肺癌病人生命存活期延長，以傳統醫療體系為主要的醫療照護模式已不再適用，「整合性照護」是以病人為中心，透過多專科醫療團隊成員提供照護及資源連結，最終讓病人、家屬、急性醫療機構與社區，共同構連成一體系，而個案管理師於各期間擔任統合角色，協助團隊成員各司其職。整合性照護特色在於提供病人水平及垂直的兩種照護概念，水平照護是指在同一時期跨科部的醫療照護資源，如：住院期間跨科部照會，垂直照護則是指橫跨時間及地點的縱貫性照護，如：社區醫療輔具轉介。本文將以南部某醫學中心為例，闡述肺癌整合性照護模式各角色工作核心內容、照護模式運用及其成效，並提供建議與流程圖供讀者參考。

關鍵字

肺癌 ； 整合性照護

並列摘要

Lung cancer has been ranked as the most common type of cancer in Taiwan since 2001, with exponentially growing numbers of cancer patients and length of stays. With the medical expense of hospitals increasing at an alarming rate due to the aging of the patient population and the need for current technology, the traditional health care system is no longer effective. Due to this, integrated care is becoming a crucial part of the health care system. Integrated care is patient-oriented care provided by an interprofessional transdisciplinary team with the goal to unite the patient/family, acute care medical institution and the social community as one unit. Case managers play the leading role of the multidisciplinary team to collaborate with other professionals. There are two types of integrated care: horizontal care which links similar levels of care within a medical facility to incorporate different departments, and vertical care which links different levels of care such as primary, secondary, and tertiary care in multiple facilities. The process and outcomes of integrated care for a lung cancer patient at a medical center in southern Taiwan will be addressed in the following report along with the procedure and flow chart of the integrated care model.

並列關鍵字

lung cancer ； integrated care ； Taiwan

參考文獻

林麗英、黎國洪（2013）建構腫瘤個案管理照護模式實務介紹‧ 榮總護理，30（1）,53 -58。doi:10.6142/vghn.30.1.53

許瀚仁、李怡濃、康云、陳蕙茹、葉春長、 洪東源、高玉玲（2015）外科重症生命末期整合護理照護模式． 源遠護理，9（3） ，20-26。doi: 10.6530/YYN/2015.5.10

陳淑娟、朱栩萱、陳玨伶、陳淑娟、張桂玲、 洪敏瑛（2014）‧無縫接軌的腫瘤個案管理模式－臺大醫院經驗‧源遠護理 ，8（2）, 12-18。 doi:10.6530/yyn.2014.8(2).03

陳惠姿（2007）整合性照護系統． 護理雜誌， 54（5），5-10。doi:10.6224/JN.54.5.5

游千代、馮明珠、柯乃熒（2013）個案管理之概念分析． 護理雜誌，60（4），99-104。 doi:10.6224/jn.60.4.99