腫瘤進階護理之發展及現況

進階護理師之角色於1960發展於美國，目前由進階護理而產生之角色，特別是專科護理師及護理執業師已成為美國及其它許多國家各科醫療照顧之主要提供者。進階護理在1970年開始介入腫瘤護理，不僅因此增加醫療照顧的途徑，達到成本效益的控制，且改善癌症病人生活品質。目前進階護理仍面臨著臨床角色混淆，導致與醫師工作職責界線不明之窘境，教育制度尚未周全完整，各相關法律政策不清以及成果評值項目與方法選擇不當等問題。腫瘤進階護理未來之發展，也因而受到嚴重影響。進階護理在台灣雖仍處萌芽時期，但此角色之發展將是必然。如何經由了解他國之經驗，發展屬於本國專業文化的進階護理，並進而提昇腫瘤護理專業之水準，提供最佳腫瘤護理品質，將是身為腫瘤護理人員需要努力的方向。

關鍵字

進階護理；專科護理師；護理職業師

並列摘要

The movement of advanced nursing practice emerged in the North America in the 1960s. Since then, the concept has been introduced into different countries. The extended roles, particularly both the clinical nurse specialist and nurse practitioner, have gradually become one of the essential members in health care system. The involvement of advanced nursing practice in oncology began in the 1970s and has been found benefit to the accessibility of health care, cost effectiveness, quality of patient care, and patients' quality of life. However, the development of oncology advanced nursing practice has been jeopardized owing to some common problems in the current advanced nursing practice. These include the ambiguity of the definition of their roles, the uncertainty of legislation regarding the job descriptions and scope of practice, the lack of a national standard for education requirement, and the difficulty in the outcome measurement. In Taiwan, although the advanced nursing practice is still at an early stage of development, the growth is expected. The emergency of the new practice will certainly affect the traditional roles of oncology nurses. While we are under the development, it is vital to learn the lessons from the experience of other countries, so that we could tackle the problems listed above and develop the roles of advanced nursing practice consistent with the local needs in Taiwan. Hence, we can achieve the goal of the advanced nursing practice to not only promote oncology nursing profession but also, more importantly, to provide an integrated and comprehensive care to patients with cancer.

並列關鍵字

advanced nursing practice ； clinical nurse specialist ； nurse practitioner

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腫瘤進階護理之發展及現況

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