癌症患者於放射治療後中斷回診的原因

Reasons for Interruption of Post-radiotherapy Follow-up in Cancer Patients

陳淑茹(Shew-Ju Chen) ； 李晴雯(Ching-Wen Lee) ； 呂志得(Jyh-Der Leu)

《北市醫學雜誌》 4卷9期 (2007/12) Pp. 853-860

https://doi.org/10.6200/TCMJ.2007.4.9.09

摘要

目的：透過此探討以了解癌症病患在放射治療後中斷回診的原因，希望藉此給予更多的支持與幫助，進而提供癌症病患更完整且全人化的總體治療照護，從預防、治療到復健，為民眾的健康把關。方法：取臺北市立聯合醫院仁愛院區放射腫瘤科自94年1月3日起至94年5月31日止，完成放射治療後由放射腫瘤科醫師預約回診的病患共454位，其中有61位未依約回診，以本科癌登資料、病歷記載與門診約診單為基礎，依病患的性別、年齡、職業、教育程度、疾病種類及中斷回診的原因做分析，依據文獻參考及臨床經驗設計17項詢問項目，藉由電話聯繫或親自訪談方式做問卷調查，做個案分析探討。結果：中斷回診的病患中以乳癌患者占44.2%最多，年齡分佈在40-69歲之間，中斷回診的主要原因包括：他科回診22位(36.1%)，其次是工作太忙、沒空13位(21.3%)，病情惡化10位(16.4%)含惡化7位、死亡3位，多科回診9位(14.8%)，自覺健康狀況良好不願回診6位(9.8%)，忘記回診的時間1位(1.6%)。結論：綜合各項中斷回診的原因發現，到他科回診31位(50.8%)，含他科回診22位，多科回診9位，是造成病患於放射治療後中斷回診的最主要因素，解決此狀況的方法除了加強放射腫瘤科醫師與各科醫師的聯繫溝通之外，可成立腫瘤聯合門診，建立互動式癌病資訊網以提供病患更方便的就醫管道；建立系統化的癌病登記定期追蹤。13位(21.3%)病患因工作因素而中斷回診，此狀況可建立以病患為中心的回診方式，給予癌症患者更方便的就醫空間。對於自覺健康狀況良好而不需回診6位(9.8%)，除了定期以其他方式進行衛教宣導聯繫外，應建立病患正確的就醫觀念，適時的給予關懷與鼓勵，進而提供癌症病患完整且全人化的總體治療照護。

關鍵字

放射線治療 ； 中斷回診 ； 癌症 ； 追蹤

並列摘要

Background and Purpose: The purpose of the study is to analyze the reasons for interruption of regular follow-up after radiotherapy. Our aim was to provide cancer patients with better amelioration of symptoms and help. Without treatment, rehabilitation will be unable to provide cancer patients with proper protection. Methods: Between Jan 3, 2005 to May 31, 2005, our hospital records showed that the Radiation Oncology Division of our hospital had 454 patients registered for Outpatient Department follow-up after receiving a completed course of radiotherapy. Of these, 61 patients did not return for this follow-up. These patients were initially analyzed using their registration records and history and sorted on sex, age, occupation and education. Then, the cause of the interruption in follow-up was determined by questionnaire using either the telephone or a personal interview. Results: The reasons for interruption of the regular follow-up after radiotherapy included: 22 patients were doing follow-up at another department (36.1%), 13 patients were too busy (21.3%), 10 patient's disease had worsened, which included the death of 3 patients (16.4%), 9 patients were registered with more than one hospital [R&A1] (14.8%), 6 patients were unwilling to return because they felt healthy (9.8%), and 1 patient had forgot the time of the appointment (1.6%). Conclusions: The main reason for interruption of follow-up was that the patient was involved in a follow-up at another department. In order to solve this problem, there is a need to improve communication between the oncologists and other doctors and clinical treatments needs to be carried out in a unified way with doctors from different departments providing interactive information though an established network. In order to help those who missed their follow-up appointment because they were too busy, a more flexible follow-up system should be considered. Among the patients who did not return to the follow-up because they now felt healthy, there is a need to provide better information on correct health concepts and how care is provided as well as better general health education.

並列關鍵字

radiotherapy ； interruption ； follow-up ； cancer